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1

Primary sclerosing cholangitis as an intractable disease  

PubMed Central

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

Tamura, Sumihito; Sugawara, Yasuhiko; Kokudo, Norihiro

2012-01-01

2

Necessity of cooperation with government on publication of scientific research results for intractable diseases  

PubMed Central

Summary The features of intractable diseases make it an important public health issue and a challenge to medical care worldwide. Investigation of intractable diseases with the support of government is urgently expected to activate clinical and pharmaceutical research to promote diagnosis and treatment for patients with intractable diseases. Moreover, linkage to the international database for research achievement is also necessary so that both researchers and other general citizens can assess research trends in the field of intractable diseases. In Japan, supportive activities for patients and researchers of intractable diseases have been well developed with the support of the Ministry of Health, Labor and Welfare (MHLW). Furthermore, in April 2013, a specific academic communication platform on intractable diseases — the Intractable and Rare Diseases Research (IRDR) Journal — was approved to join a governmental project and receive support from the Japan Society for the Promotion of Science (JSPS) under the auspices of Ministry of Education, Culture, Sports, Science and Technology (MEXT). Cooperation with the Japanese government starting this year is hoped to promote information-sharing based on an academic communication platform and further activate research on intractable diseases. PMID:25343106

Inagaki, Yoshinori; Song, Peipei

2013-01-01

3

Necessity of cooperation with government on publication of scientific research results for intractable diseases.  

PubMed

The features of intractable diseases make it an important public health issue and a challenge to medical care worldwide. Investigation of intractable diseases with the support of government is urgently expected to activate clinical and pharmaceutical research to promote diagnosis and treatment for patients with intractable diseases. Moreover, linkage to the international database for research achievement is also necessary so that both researchers and other general citizens can assess research trends in the field of intractable diseases. In Japan, supportive activities for patients and researchers of intractable diseases have been well developed with the support of the Ministry of Health, Labor and Welfare (MHLW). Furthermore, in April 2013, a specific academic communication platform on intractable diseases - the Intractable and Rare Diseases Research (IRDR) Journal - was approved to join a governmental project and receive support from the Japan Society for the Promotion of Science (JSPS) under the auspices of Ministry of Education, Culture, Sports, Science and Technology (MEXT). Cooperation with the Japanese government starting this year is hoped to promote information-sharing based on an academic communication platform and further activate research on intractable diseases. PMID:25343106

Inagaki, Yoshinori; Song, Peipei

2013-05-01

4

Revision of measures to combat intractable diseases in Japan: Three pillars will play an even greater role in the future  

PubMed Central

Summary Over the past 40 years, measures to combat intractable diseases in Japan have progressed substantially since the implementation of the “Outline of Measures to Combat Intractable Diseases” in 1972. However, many challenges remain. In order to further promote measures to combat intractable diseases, a “Revision of Measures to Combat Intractable Diseases” was approved by the Japanese Ministry of Health, Labor, and Welfare (MHLW) on January 25, 2013. The revision rests on the three pillars of development of effective strategies to treat intractable diseases and improved care for those affected, creation of fair and consistent mechanisms to reimburse medical expenses, and implementing measures to enhance public understanding and encourage the social participation of those affected. These pillars will play an even greater role in future measures to combat intractable diseases.

Song, Peipei; Kokudo, Norihiro

2013-01-01

5

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

SciTech Connect

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

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

1999-09-15

6

Intractable diseases treated with intra-bone marrow-bone marrow transplantation  

PubMed Central

Bone marrow transplantation (BMT) is used to treat hematological disorders, autoimmune diseases (ADs) and lymphoid cancers. Intra bone marrow-BMT (IBM-BMT) has been proven to be a powerful strategy for allogeneic BMT due to the rapid hematopoietic recovery and the complete restoration of T cell functions. IBM-BMT not only replaces hematopoietic stem cells (HSCs) but also mesenchymal stromal cells (MSCs). MSCs are multi-potent stem cells that can be isolated from bone marrow (BM), umbilical cord blood (UCB), and adipose tissue. MSCs play an important role in the support of hematopoiesis, and modify and influence the innate and adaptive immune systems. MSCs also differentiate into mesodermal, endodermal and ectodermal lineage cells to repair tissues. This review aims to summarize the functions of BM-derived-MSCs, and the treatment of intractable diseases such as rheumatoid arthritis (RA) and malignant tumors with IBM-BMT. PMID:25364755

Li, Ming; Guo, Kuquan; Ikehara, Susumu

2014-01-01

7

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

PubMed Central

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

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

2012-01-01

8

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

PubMed

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

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

2012-01-01

9

Occipital nerve stimulation for intractable chronic cluster headache: new hope for a dreadful disease?  

PubMed

Chronic cluster headache (CCH) is one of the most painful primary headaches. A small percentage of CCH become intractable (iCCH) and is refractory to the majority of preventing drugs. Various invasive and sometimes destructive procedures have been tempted to help these patients, but none gave satisfactory results for the long term. Hypothalamic deep-brain stimulation (hDBS) has recently raised expectations with an average improvement of 50 to 70%, but is not a riskless procedure. Harmless methods were therefore warranted, and in this perspective occipital nerve stimulation (ONS) trials were undertaken. Up to now, nearly 38 iCCH patients benefited from ONS in the available literature and the technique appears to give results similar to hDBS, having the advantage to have much milder side effects. The mechanism by which ONS is efficient in iCCH remains unknown but preliminary results of neurophysiological and imaging studies suggest ONS is just a symptomatic treatment which does not act on the disease generator. We would however advocate ONS as first choice alternative therapy in iCCH. PMID:21510228

Magis, Delphine; Schoenen, Jean

2011-03-01

10

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

PubMed Central

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

Pujar, Thejeswi; Spinello, Irene M

2009-01-01

11

Preclinical and Clinical Studies of Unrelieved Aural Fullness following Intratympanic Gentamicin Injection in Patients with Intractable M?ni?re's Disease  

PubMed Central

Objective To clarify whether gentamicin affects vestibular dark cells in guinea pigs and relieves patients of aural fullness with intractable Ménière’s disease following intratympanic administration. Materials and Methods Purified gentamicin-Texas Red (GTTR) was injected intratympanically in guinea pigs that were sacrificed at 1, 3, 7, 14 and 28 days. GTTR uptake was examined in hair cells, and transitional cells and dark cells in vestibular end-organs were examined. Specific attention was paid to its distribution in dark cells under confocal microscopy, and the ultrastructure of dark cells using electron microscopy, following intratympanic injection. Results Dark cells in the semicircular canals showed weak GTTR uptake at 1, 3, 7, 14 and 28 days after intratympanic injection, with no significant differences at various time points after injection. However, the adjacent transitional cells demonstrated intense GTTR uptake that was retained for at least 28 days. Ultrastructural studies demonstrated negligible characteristics associated with apoptosis or necrosis in these dark cells. The tight junctions between dark cells showed no signs of disruption at 7 or 28 days after injection. Conclusion Intratympanic gentamicin has little direct impact on vestibular dark cells. Clinical Application A modified low-dose titration intratympanic approach was used in 29 patients with intractable vertigo and the clinical outcomes were followed. Aural fullness following intratympanic gentamicin injection was not relieved based on our subjective scales, demonstrated by no statistically significant difference between preinjection (4.16 ± 3.08) and postinjection (3.58 ± 2.93; p > 0.05) aural fullness scores. Vertigo control was achieved in 88% of patients, with hearing deterioration identified in 16% of patients. Intratympanic gentamicin administration might not lead to relief of aural fullness in patients with intractable vertigo, although it can achieve a high vertigo control rate with some cochleotoxicity. PMID:24008307

Zhai, Feng; Zhang, Ru; Zhang, Ting; Steyger, Peter S.; Dai, Chun-Fu

2014-01-01

12

Oral bismuth for chronic intractable diarrheal conditions?  

PubMed Central

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

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

2013-01-01

13

Real time network modulation for intractable epilepsy Behnaam Aazhang  

E-print Network

Real time network modulation for intractable epilepsy Behnaam Aazhang ! Electrical and Computer;Real time network modulation for intractable epilepsy Behnaam Aazhang ! Electrical and Computer;Real time network modulation for intractable epilepsy Behnaam Aazhang ! Electrical and Computer

Aazhang, Behnaam

14

Mining disease state converters for medical intervention of diseases.  

PubMed

In applications such as gene therapy and drug design, a key goal is to convert the disease state of diseased objects from an undesirable state into a desirable one. Such conversions may be achieved by changing the values of some attributes of the objects. For example, in gene therapy one may convert cancerous cells to normal ones by changing some genes' expression level from low to high or from high to low. In this paper, we define the disease state conversion problem as the discovery of disease state converters; a disease state converter is a small set of attribute value changes that may change an object's disease state from undesirable into desirable. We consider two variants of this problem: personalized disease state converter mining mines disease state converters for a given individual patient with a given disease, and universal disease state converter mining mines disease state converters for all samples with a given disease. We propose a DSCMiner algorithm to discover small and highly effective disease state converters. Since real-life medical experiments on living diseased instances are expensive and time consuming, we use classifiers trained from the datasets of given diseases to evaluate the quality of discovered converter sets. The effectiveness of a disease state converter is measured by the percentage of objects that are successfully converted from undesirable state into desirable state as deemed by state-of-the-art classifiers. We use experiments to evaluate the effectiveness of our algorithm and to show its effectiveness. We also discuss possible research directions for extensions and improvements. We note that the disease state conversion problem also has applications in customer retention, criminal rehabilitation, and company turn-around, where the goal is to convert class membership of objects whose class is an undesirable class. PMID:20183875

Dong, Guozhu; Duan, Lei; Tang, Changjie

2010-02-01

15

Gabapentin for intractable hiccups in palliative care.  

PubMed

Intractable hiccups are not common in the general population or in the palliative care population but can adversely impact quality of life and cause other complications such as weight loss and sleep disturbance. Many treatments have been proposed for intractable hiccups, but there is little consensus regarding treatment in the medical literature. This is partly because hiccups are relatively uncommon and many of the proposed treatments are unproven or have long-term side effects. Pharmacologic treatments rather than home remedies or surgical treatments are more appropriate for the palliative care patient. Gabapentin is a promising medication for the treatment of intractable hiccups for its safety, lack of serious side effects, and rapid onset of action. Further research is indicated to determine whether gabapentin is consistently effective. PMID:18292481

Tegeler, Monica L; Baumrucker, Steven J

2008-01-01

16

An Unusual Cause of Intractable Heel Pain  

Microsoft Academic Search

We report a case of severe heel pain that did not respond to noninvasive measures. Magnetic resonance imaging scans revealed a soft tissue mass that after complete surgical excision was found to be an epidermal cyst. The patient experienced full resolution of the symptoms after excision of the epidermal cyst. To our knowledge, intractable heel pain due to an epidermal

Samuel Ghani; Muhammad Ali Fazal

2011-01-01

17

Intractable Pruritus After Traumatic Spinal Cord Injury  

PubMed Central

Background: This report describes a young woman with incomplete traumatic cervical spinal cord injury and intractable pruritus involving her dorsal forearm. Method: Case report. Findings: Anatomic distribution of the pruritus corresponded to the dermatomal distribution of her level of spinal cord injury and vertebral fusion. Symptoms were attributed to the spinal cord injury and possible cervical root injury. Pruritus was refractory to all treatments, including topical lidocaine, gabapentin, transcutaneous electrical nerve stimulation, intravenous Bier block, stellate ganglion block, and acupuncture. Conclusions: Further understanding of neuropathic pruritus is needed. Diagnostic workup of intractable pruritus should include advanced imaging to detect ongoing nerve root compression. If diagnostic studies suggest radiculopathy, epidural steroid injection should be considered. Because the autonomic nervous system may be involved in complex chronic pain or pruritic syndromes, sympatholysis via such techniques as stellate ganglion block might be effective. PMID:19777867

Crane, Deborah A; Jaffee, Kenneth M; Kundu, Anjana

2009-01-01

18

Progesterone therapy in women with intractable catamenial epilepsy  

PubMed Central

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

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

2013-01-01

19

Sacral nerve stimulation for intractable constipation  

Microsoft Academic Search

ObjectiveTraditional surgical procedures for intractable idiopathic constipation are associated with a variable outcome and substantial morbidity. The symptomatic response, physiological effect and effect on quality of life of sacral nerve stimulation (SNS) were evaluated in patients with constipation (slow transit and normal transit with impaired evacuation).MethodsIn a prospective study at five European sites patients who failed conservative treatment underwent 21

Michael A Kamm; Thomas C Dudding; Jarno Melenhorst; Michael Jarrett; Zengri Wang; Steen Buntzen; Claes Johansson; Søren Laurberg; Harald Rosen; Carolynne J Vaizey; Klaus Matzel; Cor Baeten

2010-01-01

20

Peritoneovenous shunting is an effective treatment for intractable ascites  

PubMed Central

Aim and methods: A retrospective review was carried out of children undergoing peritoneovenous shunting for intractable ascites. Results: 11 children, aged 3 months to 12 years (median 31 months) underwent peritoneovenous shunting over the past 17 years. The duration of ascites ranged from one month to 2.5 years (median two months). The primary pathology consisted of previous surgery in eight (three neuroblastoma, one renal carcinoma, one hepatoblastoma, one adrenal teratoma, one renal artery stenosis, and one diaphragmatic hernia), and cytomegalovirus hepatitis, lymphatic hypoplasia, and lymphohistiocytosis in one patient each. All patients had failed to respond to previous treatment including peritoneal drainage in six patients, diuretics in five, and parenteral nutrition in five. There were no intraoperative problems. Postoperative complications included pulmonary oedema in three patients, shunt occlusion in three, infection in two, and wound leakage in one. Ascites resolved after shunting in 10 patients. Five shunts were removed one to three years after insertion without recurrence of ascites. Three others are free of ascites with shunts in place for less than one year postoperatively. Three children died from their underlying disease: two after resolution of ascites (neuroblastoma) and one in whom the ascites failed to resolve (lymphohisticytosis). Conclusions: Peritoneovenous shunting is an effective treatment for symptomatic intractable ascites in children (10 of 11 successful cases in this series). Elective removal of the shunt after one year is recommended. PMID:15811892

Sooriakumaran, P; McAndrew, H; Kiely, E; Spitz, L; Pierro, A

2005-01-01

21

State-level Zoonotic Disease Surveillance in the United States  

PubMed Central

Summary Most emerging infectious diseases are zoonotic, yet recent commissions have highlighted deficiencies in their surveillance. We conducted a survey to understand the needs of state agencies for zoonotic disease surveillance. The findings will hopefully support the development of biomedical informatics applications that can link animal and human data for surveillance. PMID:21824354

Scotch, Matthew; Rabinowitz, Peter; Brandt, Cynthia

2011-01-01

22

Insulinoma Presenting as Medically Intractable Temporal Lobe Epilepsy  

PubMed Central

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

Park, So-Hee; Kim, Dong Wook

2014-01-01

23

Intractable diarrhea of infancy with congenital intestinal mucosa abnormalities: outcome of four cases.  

PubMed

Microvillous inclusion disease (MID) and epithelial dysplasia (ED) or tufting enteropathy are the most frequent causes of intractable diarrhea with persistent villous atrophy and indefinite dependence on total parenteral nutrition (PN) from early infancy. Since these are intractable diseases, they have been proposed to be elective indication for early bowel transplantation in order to avoid complications, such as PN-related liver disease, that would require a combined small bowel-liver transplant. We describe four cases of intractable diarrhea, two with MID and two with ED, seeking to discover whether these diseases are really elective, early indications for bowel transplant. Among our four patients, only one with ED underwent transplantation. The prognosis of small bowel transplant is still poor and worse than that of prolonged HPN. Further study is necessary to achieve a safe HPN program. Referral for transplant (small bowel only or combined with liver) should be considered when there is a venous access reduction and/or severe and irreversible liver disease. PMID:14697977

Gambarara, M; Diamanti, A; Ferretti, F; Papadatou, B; Knafelz, D; Pietrobattista, A; Castro, M

2003-12-01

24

Complications of Invasive Monitoring Used in Intractable Pediatric Epilepsy  

Microsoft Academic Search

Invasive monitoring for intractable epilepsy is useful when the epileptogenic focus is in question even after an extensive noninvasive presurgical evaluation, or when the epileptogenic focus is located in or near eloquent cortex. From June 1989 to June 2001 at the Children’s Hospital of Philadelphia, 64 children with intractable epilepsy underwent 67 invasive monitoring procedures as part of their presurgical

Scott L. Simon; Albert Telfeian; Ann-Christine Duhaime

2003-01-01

25

Benign Lesions Accompanied by Intractable Epilepsy in Children  

Microsoft Academic Search

Epilepsy surgery has been proposed as a safe alternative treatment for intractable epilepsy in children, especially for patients with structural brain abnormalities. We studied 24 consecutive children who underwent surgery for intractable epilepsy. There were 12 males and 12 females. The mean age was 6.5 years. The seizures' duration ranged from 6 months to 2 years. The histopathological examination of

George A. Alexiou; Maria Varela; George Sfakianos; Neofytos Prodromou

2009-01-01

26

Medullary neurosarcoidosis presenting with intractable hiccoughs.  

PubMed

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

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

2012-08-01

27

Sickle cell disease in Orissa State, India.  

PubMed

A study of 131 patients with homozygous sickle cell (SS) disease in Orissa State, India, indicated that, compared with Jamaican patients, Indian patients have higher frequencies of alpha thalassaemia, higher fetal haemoglobin, total haemoglobin, and red cell counts, and lower mean cell volume, mean cell haemoglobin concentration, and reticulocyte counts. Indian patients have a greater frequency and later peak incidence of splenomegaly, and hypersplenism is common. Painful crises and dactylitis are not uncommon in Indian patients but chronic leg ulceration is rare. Homozygous sickle cell disease in Orissa is similar to that in the Eastern Province of Saudi Arabia and is very different from that in populations of West African origin. PMID:2430154

Kar, B C; Satapathy, R K; Kulozik, A E; Kulozik, M; Sirr, S; Serjeant, B E; Serjeant, G R

1986-11-22

28

Prominent emerging diseases within the United States  

USGS Publications Warehouse

This manuscript reviews disease syndromes that have become significant aquatic animal health issues within the United States since 2003. The emergence of Viral Hemorrhagic Septicemia (VHS) disease among wild fish in the Great Lakes is probably the most problematic and political issue. The emergence of this pathogen resulted in the issuance of a 2006 VHSV Federal order that placed restrictions on the movement of certain species of fish in the eight states that border the Great Lakes (New York, Pennsylvania, Ohio, Indiana, Illinois, Michigan, and Wisconsin and Minnesota) as well as the movement of live fish into the United States from the Ontario and Quebec Provinces, Canada. Spring Viremia of Carp (SVC) was identified for the first times in the United States during 2002. It was diagnosed as the source of mortality among koi at a private facility in North Carolina as well as from feral carp in Cedar Lake (WI). In 2004, Koi Herpesvirus (KHV) killed 8,000 adult common carp (Cyprinus carpio) in the Chadakoin River (NY); it reoccurred the next year within Chautauqua Lake (NY), killing an estimated 25,000 carp (20–30 lbs. apiece). During the summers of 2007 and 2008, KHV epizootics also occurred among carp in Ontario (Canada). Finally, outbreaks of epizootic shell disease in American lobster (Homarus americanus) have generated concern along the southern New England coast and eastern Long Island Sound. The prevalence and severity of shell disease have increased within inshore areas of southern New England and resulted in significant decreases in lobster catches and marketability.

Cipriano, R. C.; Bowser, A.; Dove, A.; Goodwin, A.; Puzach, C.

2011-01-01

29

Neuromyelitis Optica: An Often Forgotten Cause of Intractable Nausea and Vomiting  

PubMed Central

Neuromyelitis optica, also known as Devic's disease, is a rare autoimmune disorder in which a patient's immune system affects the optic nerves and the spinal cord, leading to loss of vision and spinal cord dysfunction. We present our experience with a 38-year-old female who presented to our facility with complaints of intractable nausea and vomiting. After extensive evaluation, she was found to have neuromyelitis optica. Her symptoms completely resolved following institution of appropriate therapy. She made a significant recovery and has since been placed on chronic immunosuppressive therapy. Through this article we hope to bring attention to a significant cause of intractable nausea and vomiting that may often be forgotten in general medicine or gastroenterology services. PMID:23904838

Enweluzo, Chijioke; Yarra, Pradeep

2013-01-01

30

Statistical Inference for Models with Intractable Normalizing Constants  

E-print Network

In this dissertation, we have proposed two new algorithms for statistical inference for models with intractable normalizing constants: the Monte Carlo Metropolis-Hastings algorithm and the Bayesian Stochastic Approximation Monte Carlo algorithm...

Jin, Ick Hoon

2011-06-27

31

Norovirus Disease in the United States  

PubMed Central

Although recognized as the leading cause of epidemic acute gastroenteritis across all age groups, norovirus has remained poorly characterized with respect to its endemic disease incidence. Use of different methods, including attributable proportion extrapolation, population-based surveillance, and indirect modeling, in several recent studies has considerably improved norovirus disease incidence estimates for the United States. Norovirus causes an average of 570–800 deaths, 56,000–71,000 hospitalizations, 400,000 emergency department visits, 1.7–1.9 million outpatient visits, and 19–21 million total illnesses per year. Persons >65 years of age are at greatest risk for norovirus-associated death, and children <5 years of age have the highest rates of norovirus-associated medical care visits. Endemic norovirus disease occurs year round but exhibits a pronounced winter peak and increases by ?50% during years in which pandemic strains emerge. These findings support continued development and targeting of appropriate interventions, including vaccines, for norovirus disease. PMID:23876403

Lopman, Ben A.; Payne, Daniel C.; Patel, Manish M.; Gastanaduy, Paul A.; Vinje, Jan; Parashar, Umesh D.

2013-01-01

32

[State of the Art. Diagnostic imaging of paranasal sinus diseases].  

PubMed

The following article describes a diagnostic concept of paranasal sinus imaging, based on more than 10 years close collaboration of the authors. CT and MR are the primary imaging modalities for investigating paranasal sinus lesions. Conventional X-ray images add little information due to insufficient sensitivity. Angiography is restricted to those patients who require preoperative tumor embolization or emergency treatment of intractable epistaxis. After thorough medical treatment of inflammatory paranasal sinus disease, CT becomes the method of choice to clearly depict preoperative osseous anatomy and to distinguish between benign and malignant intraosseous lesions. In cases where trauma is involved, CT easily identifies anterior skull base fractures. Moreover, CT will be the first step to localize early or late CSF rhinorrhea. MR, with its ability to distinguish between different soft tissues, compliments CT. This holds particularly true for inflammatory or neoplastic disease close to the skull base, orbital apex and cavernous sinus. The signal intensity in T(1) and T(2) weighted images provides additional information with respect to cellularity and vascularization of lesions, which has important diagnostic and therapeutic implications. PMID:11914951

Schuknecht, B; Simmen, D

2002-02-01

33

Epigenome Mapping in Normal and Disease States  

PubMed Central

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 in order 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 utilizing 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

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

2010-01-01

34

Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 7: lumbar fusion for intractable low-back pain without stenosis or spondylolisthesis.  

PubMed

Establishing an appropriate treatment strategy for patients presenting with low-back pain, in the absence of stenosis or spondylolisthesis, remains a controversial subject. Inherent to this situation is often an inability to adequately identify the source of low-back pain to justify various treatment recommendations, such as lumbar fusion. The current evidence does not identify a single best treatment alternative for these patients. Based on a number of prospective, randomized trials, comparable outcomes, for patients presenting with 1- or 2-level degenerative disc disease, have been demonstrated following either lumbar fusion or a comprehensive rehabilitation program with a cognitive element. Limited access to such comprehensive rehabilitative programs may prove problematic when pursuing this alternative. For patients whose pain is refractory to conservative care, lumbar fusion is recommended. Limitations of these studies preclude the ability to present the most robust recommendation in support of lumbar fusion. A number of lesser-quality studies, primarily case series, also support the use of lumbar fusion in this patient population. PMID:24980584

Eck, Jason C; Sharan, Alok; Ghogawala, Zoher; Resnick, Daniel K; Watters, William C; Mummaneni, Praveen V; Dailey, Andrew T; Choudhri, Tanvir F; Groff, Michael W; Wang, Jeffrey C; Dhall, Sanjay S; Kaiser, Michael G

2014-07-01

35

Human Prion Diseases in the United States  

Microsoft Academic Search

BackgroundPrion 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 and epidemiology

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; Mick F. Tuite

2010-01-01

36

Intractability of Assembly Sequencing: Unit Disks in the Plane  

E-print Network

of scheduling with and/or precedence constraints. The Disks problem can be formulated as a scheduling problem where the order of removals is to be scheduled. Before scheduling a disk to be removed, a path mustIntractability of Assembly Sequencing: Unit Disks in the Plane Michael Goldwasser ? and Rajeev

Motwani, Rajeev

37

Successful monotherapy of severe and intractable atopic dermatitis by photopheresis  

Microsoft Academic Search

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

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

1998-01-01

38

Vagus Nerve Stimulation for Control of Intractable Seizures in Childhood  

Microsoft Academic Search

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

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

2001-01-01

39

Gastrointestinal adverse effects of antiepileptic drugs in intractable epileptic patients  

Microsoft Academic Search

Gastrointestinal (GI) discomforts are among the most common side effects of antiepileptic drugs (AEDs) that might lead to discontinuation or irregular consumption of the drugs. This study was conducted to evaluate the frequency of GI side effects of different AEDs in intractable epileptic patients treated with single or multiple drugs. GI discomfort of 100 epileptic patients (aged 35–76 years) treated

Soodeh Razeghi Jahromi; Mansoureh Togha; Sohrab Hashemi Fesharaki; Masoumeh Najafi; Nahid Beladi Moghadam; Jalil Arab Kheradmand; Hadi Kazemi; Ali Gorji

2011-01-01

40

Characteristics of Protracted, Intractable Conflict: Toward the Development of a Metaframework–I  

Microsoft Academic Search

Protracted, intractable conflicts mark a new research frontier in the field of conflict studies. These intense, inescapable conflicts over issues such as critical resources, identity, meaning, justice, and power are complex, traumatic, and often resist even the most serious attempts at resolution. But why are they intractable? What characteristics distinguish intractable conflicts from more tractable, resolvable conflicts? Scholars have begun

Peter T. Coleman

2003-01-01

41

The goals of comprehensive and integrated disease state management for diabetic kidney-disease patients.  

PubMed

Diabetes, cardiovascular disease, and chronic kidney disease present many challenges to clinicians as separate disease entities. Management and optimization of care of diabetic kidney-disease patients requires a proactive and integrated approach for all 3 disease states. To optimize the assessment, monitoring, and intervention in this population, comprehensive and integrated disease state management medical care plans must be established. Medical nutrition therapy is another key component that must be coordinated with these disease-state management medical care plans. Coordination of integrated disease-state management and medical nutrition therapy for diabetes, cardiovascular disease, and chronic kidney disease will help to improve patient outcomes and allow for a proactive approach to the identification, prevention, and management of potential disease-state complications. Several programs and guidelines have been established to accomplish these goals: the K/DOQI Clinical Practice Guidelines, the American Diabetes Association Standards of Medical Care for Diabetes (developed by the American Diabetes Association, the National Institute of Diabetes and Digestive Kidney Diseases, and the Centers for Disease Control-Diabetes Foundation), the National Diabetes Education Program, and the National Cholesterol Education Program. The multidisciplinary medical care team assumes an integral role in the success and implementation of this integrated approach as well as the empowerment of the patient in their own care. PMID:15822060

Goeddeke-Merickel, Catherine M

2005-04-01

42

[Basic and clinical approaches for surgical treatment of intractable epilepsies].  

PubMed

Recent reports demonstrated that patients with medically intractable epilepsy were benefited with surgical treatments. Even in pediatric patients, early surgery is effective not only in seizure control but also in verbal, intelligent and social outcomes. In the present study, basic and clinical approaches in the treatment of intractable epilepsies were studied. In chronic cat model of intractable temporal lobe epilepsy induced by a microinjection of kainic acid, temporal cortical excision with amygdala focus resection or focus and hippocampal resections were examined by means of microsurgical technics. The cats with amygdala focus resection demonstrated spontaneous hippocampal seizures while cats with focus and hippocampal resection did not show seizures in the long time course after the surgery. In a cat model of cortical focal seizures, multiple subpial transection(MST) was examined. The cortical seizures, induced by a microinjection of kainic acid into unilateral sensori-motor cortex, were suppressed immediately after the MST. Postoperative course was uneventful and seizure was not recurred. However, pathological study demonstrated subpial scar formation at the site of MST in the sensori-motor cortex. In 38 patients with medically intractable epilepsies, surgical treatments were performed in the Department of Neurosurgery. Asahikawa Medical College. The site of the epileptogenic lesion was studied with Video-EEG longterm monitorings, Neuro-imagings with CT, MRI, interictal SPECT and/or ictal SPECT. At the surgery, intraoperative electrocorticograms(ECoGs) were monitored under light neuroleptanalgesia in order to localize epileptic focus. Seizure free rate with or without postoperative medication was 72%. Remarkable improvement was observed in 7 patients (18%), but, 4 patients (10%) did not show any improvement. PMID:7774122

Tanaka, T; Yonemasu, Y

1994-12-01

43

The amyloid state of proteins in human diseases  

PubMed Central

Amyloid fibers and oligomers are associated with a great variety of human diseases including Alzheimer’s disease and the prion conditions. Here we attempt to connect recent discoveries on the molecular properties of proteins in the amyloid state with observations about pathological tissues and disease states. We summarize studies of structure and nucleation of amyloid and relate these to observations on amyloid polymorphism, prion strains, co-aggregation of pathogenic proteins in tissues, and mechanisms of toxicity and transmissibility. Molecular studies have also led to numerous strategies for biological and chemical interventions against amyloid diseases. PMID:22424229

Eisenberg, David; Jucker, Mathias

2012-01-01

44

OUTBREAKS OF WATERBORNE DISEASE IN THE UNITED STATES, 1978  

EPA Science Inventory

Surveillance of outbreaks of waterborne disease is jointly conducted by the Center for Disease Control (CDC), Atlanta, Ga., and the Environmental Protection Agency (EPA), Cincinnati, Ohio. Waterborne outbreaks are reported to the CDC and EPA by state and local health departments ...

45

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...

46

State-space size considerations for disease-progression models.  

PubMed

Markov models of disease progression are widely used to model transitions in patients' health state over time. Usually, patients' health status may be classified according to a set of ordered health states. Modelers lump together similar health states into a finite and usually small, number of health states that form the basis of a Markov chain disease-progression model. This increases the number of observations used to estimate each parameter in the transition probability matrix. However, lumping together observably distinct health states also obscures distinctions among them and may reduce the predictive power of the model. Moreover, as we demonstrate, precision in estimating the model parameters does not necessarily improve as the number of states in the model declines. This paper explores the tradeoff between lumping error introduced by grouping distinct health states and sampling error that arises when there are insufficient patient data to precisely estimate the transition probability matrix. PMID:23609629

Regnier, Eva D; Shechter, Steven M

2013-09-30

47

Neglected Parasitic Infections in the United States: Chagas Disease  

PubMed Central

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

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

2014-01-01

48

A 9-month-old phosphaturic mesenchymal tumor mimicking the intractable rickets.  

PubMed

Phosphaturic mesenchymal tumor is an extremely rare disease and is frequently associated with oncogenic osteomalacia showing paraneoplastic syndrome, which is characterized by phosphaturia, hypophosphatemia, normocalcemia, and decreased levels of 1,25-dihydroxyvitamin D3 associated with a tumor. A 2-year-old boy, who had a soft tissue tumor on his right thigh and previously diagnosed as myositis ossificans at 9-months-old, was presented with rachitic rosary and mildly enlarged tumor. Biochemical investigations showed hypophosphatemia, hyperphosphaturia, and an increased alkaline phosphatase level of 440 U/l (25-100 U/l), suggesting rickets, which was resistant to vitamin D dietary supplementation. We were certain of intractable rickets because of oncogenic hypophosphatemia and thus decided to excise the soft tissue mass. We observed laboratory improvement of rickets after 2 weeks. On the basis of surgical and histopathological examinations, the tumor was finally diagnosed as the phosphaturic mesenchymal tumor. PMID:19801953

Jung, Gu-Hee; Kim, Jae-Do; Cho, Yool; Chung, So-Hak; Lee, Jung-Hyun; Sohn, Kyung-Rak

2010-01-01

49

Presidential stroke: United States presidents and cerebrovascular disease.  

PubMed

In the United States, more individuals suffer disability from stroke than from any other disease, and as many as 11 of the 43 presidents have been affected. In this article, the authors review the cases of the United States presidents who have had strokes, some of which have occurred while the president was in office, having a direct effect on the country. PMID:16946692

Jones, Jeffrey M; Jones, Joni L

2006-09-01

50

Managing Cushing's disease: the state of the art.  

PubMed

Cushing's disease is a rare chronic disease caused by a pituitary adenoma, which leads to excess secretion of adrenocorticotropic hormone (ACTH). The over-production of ACTH leads to hyperstimulation of the adrenal glands and a chronic excess of cortisol, resulting in the signs and symptoms of a severe clinical state (Cushing's syndrome) that leads to significant morbidity, negative impacts on the patient's quality of life, and, if untreated, increased mortality. The management of patients with Cushing's disease is complicated by the heterogeneity of the condition, with signs and symptoms that overlap with those of other diseases, and high subclinical incidence rates. Controversies surrounding the tests used for screening and identifying patients with Cushing's disease add to the challenge of patient management. Surgical intervention to remove the adenoma is the first-line treatment for patients with Cushing's disease, but medical therapies are useful in patients who relapse or are unsuitable for surgery. The recent introduction of pasireotide, the first pituitary-directed medical therapy, expands the number of treatment options available for patients with Cushing's disease. This state-of-the-art review aims to provide an overview of the most recent scientific research and clinical information regarding Cushing's disease. Continuing research into improving the diagnosis and treatment of Cushing's disease will help to optimize patient management. PMID:24415169

Colao, Annamaria; Boscaro, Marco; Ferone, Diego; Casanueva, Felipe F

2014-09-01

51

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

PubMed

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

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

2014-11-01

52

Gastrointestinal adverse effects of antiepileptic drugs in intractable epileptic patients.  

PubMed

Gastrointestinal (GI) discomforts are among the most common side effects of antiepileptic drugs (AEDs) that might lead to discontinuation or irregular consumption of the drugs. This study was conducted to evaluate the frequency of GI side effects of different AEDs in intractable epileptic patients treated with single or multiple drugs. GI discomfort of 100 epileptic patients (aged 35-76 years) treated with one or multiple AEDs was assessed. Seventy six patients (76%) were treated with two or more AEDs, and 24 (24%) were on monotherapy. The most common prescribed drug for monotherapy was carbamazepine and the most frequent combination was phenytoin and carbamazepine. Patients were suffering from different GI side effects including heartburn (34.6%), nausea (33.7%), constipation (26%), vomiting (22.1%), diarrhea (21.2%) and dysphagia (19.2%). Nausea and vomiting were significantly higher in patients receiving monotherapy with carbamazepine and valproic acid, respectively. When phenytoin, gabapentine, or valproic acid was added to the other AEDs, the risk of the occurrence of diarrhea, dysphagia, or heartburn was significantly increased, respectively. Addition of gabapentine to the other AEDs in multiple drug therapy was accompanied with the highest frequency of GI complications. This study indicated that GI side effects, which can affect drug absorption and utilization, were common in intractable epileptic patients with long-term AEDs treatment. This may influence the efficacy of the therapy with AEDs and enhance the probability of further attacks. PMID:21236703

Jahromi, Soodeh Razeghi; Togha, Mansoureh; Fesharaki, Sohrab Hashemi; Najafi, Masoumeh; Moghadam, Nahid Beladi; Kheradmand, Jalil Arab; Kazemi, Hadi; Gorji, Ali

2011-05-01

53

Laryngotracheal Closure and Cricopharyngeal Myotomy for Intractable Aspiration and Dysphagia Secondary to Cerebrovascular Accident  

Microsoft Academic Search

Objective: To investigate the clinical value, technique, indications and contraindications of laryngotracheal closure (LTC) and cricopharyngeal myotomy (CPM) for intractable aspiration and dysphagia secondary to a cerebrovascular accident (CVA). Materials and Methods: Patients (n = 45) with intractable aspiration and dysphagia secondary to a CVA were treated with LTC and CPM. The LTC was performed by suturing the double cords,

Shen-Hong Qu; Min Li; Jian-Ping Liang; Zheng-Zhong Su; Shi-Qiang Chen; Xiao-Guang He

2009-01-01

54

Neural Synchrony-Monitoring Wireless Brain Implant for Intractable Epilepsy Neuromodulation  

E-print Network

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

Genov, Roman

55

Peace Education in Societies Involved in Intractable Conflicts: Direct and Indirect Models  

ERIC Educational Resources Information Center

The present article deals with the crucial question: Can peace education facilitate change in the sociopsychological infrastructure that feeds continued intractable conflict and then how the change can be carried? Intractable conflicts still rage in various parts of the globe, and they not only cause local misery and suffering but also threaten…

Bar-Tal, Daniel; Rosen, Yigal

2009-01-01

56

Comparison of Serum Zinc and Copper levels in Children and adolescents with Intractable and Controlled Epilepsy  

PubMed Central

Objective Trace elements such as zinc and copper have physiological effects on neuronal excitability that may play a role in the etiology of intractable epilepsy. This topic has been rarely discussed in Iranian epileptic patients. This study with the analysis of serum zinc and copper levels of children and adolescents with intractable and controlled epilepsy may identifies the potential role of these two trace elements in the development of epilepsy and intractability to antiepileptic drug treatment. Materials & Methods Seventy patients between the ages of 6 months to 15 years that referred to Children’s Medical Center with the diagnosis of epilepsy, either controlled or intractable to treatment enrolled in the study. After informed parental consent the levels of serum zinc and copper were measured with atomic absorption spectrophotometer and analyzed with SPSS version 11. Results 35 patients were enrolled in each group of intractable (IE) and controlled epilepsy (CE). 71.45% of the IE and 25.72% of the CE group had zinc deficiency that was statistically significant. 48.58% of the IE and 45.72 of the CE group were copper deficient, which was not statistically significant. Conclusion Our findings showed significant low serum zinc levels of patients with intractable epilepsy in comparison with controlled epilepsy group. We recommend that serum zinc level may play a role in the etiology of epilepsy and intractable epilepsy therefore its measurement and prescription may be regarded in the treatment of intractable epilepsy. PMID:25143774

KHERADMAND, Zeynab; YARALI, Bahram; ZARE, Ahad; POURPAK, Zahra; SHAMS, Sedigheh; ASHRAFI, Mahmoud Reza

2014-01-01

57

Cardiovascular Disease in Asian Indians Living in the United States  

Microsoft Academic Search

Asian Indians (people originating from the Indian subcontinent) are the largest Asian subgroup in the United States and one\\u000a of the fastest growing ethnic groups as well, with the population projected to increase to 41 million by 2050. Prevalence\\u000a of cardiovascular disease is significantly higher in Asian Indians compared to whites living in the United States. Asian Indians\\u000a have a

Jasmine Boparai; Himara Davila; Manisha Chandalia

2011-01-01

58

Total lymphoid irradiation for treatment of intractable cardiac allograft rejection  

SciTech Connect

The ability of postoperative total lymphoid irradiation to reverse otherwise intractable cardiac allograft rejection was examined in a group of 10 patients in whom conventional rejection therapy (including pulsed steroids and monoclonal or polyclonal anti-T-cell antibody therapy) had failed to provide sustained freedom from rejection. Follow-up periods range from 73 to 1119 days since the start of total lymphoid irradiation. No patient died or sustained serious morbidity because of the irradiation. Three patients have had no further rejection (follow-up periods, 105 to 365 days). Two patients died--one in cardiogenic shock during the course of total lymphoid irradiation, the other with recurrent rejection caused by noncompliance with his medical regimen. Total lymphoid irradiation appears to be a safe and a moderately effective immunosuppressive modality for 'salvage' therapy of cardiac allograft rejection unresponsive to conventional therapy.

Hunt, S.A.; Strober, S.; Hoppe, R.T.; Stinson, E.B. (Stanford Univ.Medical Center, CA (USA))

1991-03-01

59

An Acute Postoperative Intractable Hyperventilation after an Endoscopic Third Ventriculostomy  

PubMed Central

This report describes a rare case of postoperative hyperventilation attack after an endoscopic third ventriculostomy in a 46-year-old woman. About 60 min after the termination of the operation, an intractable hyperventilation started with respiratory rate of 65 breaths/min and EtCO2, 16.3 mm Hg. Sedation with benzodiazepine, thiopental sodium, fentanyl, and propofol/remifentanil infusion was tried under a rebreathing mask at a 4 L/min of oxygen. With aggressive sedative challenges, ventilation pattern was gradually returned to normal during the 22 hrs of time after the surgery. A central neurogenic hyperventilation was suspected due to the stimulating central respiratory center by cold acidic irrigation solution during the neuroendoscopic procedure. PMID:22639718

Lee, Hae Mi; Shin, Kyung Bae; Kim, Seong Ho

2012-01-01

60

A Case of Intractable Suspected Perilymph Fistula with Severe Depression  

PubMed Central

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

Oishi, Naoki; Tsutsumi, Tomoko; Ogawa, Kaoru

2014-01-01

61

Surgical outcomes for intractable epilepsy in children with epileptic spasms.  

PubMed

Epileptic spasms, or seizures marked by flexor, extensor, or flexor-extensor spasms, are not always responsive to medical management. The purpose of our study was to evaluate the outcome of epilepsy surgery in children with medically intractable epileptic spasms. We identified 11 children with epileptic spasms who underwent lesionectomy (36%), lobectomy (27%), multi-lobectomy (9%), hemispherectomy (18%), or corpus callosotomy (9%). At the time of surgery, 6 children had developed other concurrent seizure type(s), including simple partial (9%), complex partial (27%), partial undifferentiated (9%), primary generalized tonic clonic (9%), tonic (9%), atonic (27%), and myoclonic (9%) seizures. Six children (55%) were seizure free at last follow-up from initial surgery. Predictors of favorable outcome included lack of focal slowing and the presence of less than 2 interictal epileptiform abnormalities on postoperative electroencephalogram (P = .035 and .035, respectively). Favorable outcome was significantly associated with parent/caregiver report of improved postoperative developmental outcomes (P = .026). PMID:22123426

Moseley, Brian D; Nickels, Katherine; Wirrell, Elaine C

2012-06-01

62

Vector blood meals and Chagas disease transmission potential, United States.  

PubMed

A high proportion of triatomine insects, vectors for Trypanosoma cruzi trypanosomes, collected in Arizona and California and examined using a novel assay had fed on humans. Other triatomine insects were positive for T. cruzi parasite infection, which indicates that the potential exists for vector transmission of Chagas disease in the United States. PMID:22469536

Stevens, Lori; Dorn, Patricia L; Hobson, Julia; de la Rua, Nicholas M; Lucero, David E; Klotz, John H; Schmidt, Justin O; Klotz, Stephen A

2012-04-01

63

New York State Department of Health Meningococcal Disease  

E-print Network

. For some adolescents, such as first-year college students living in dormitories, there is an increased risk the disease. Other persons at increased risk include household contacts of a person known to have had in dormitories. However, the vaccine will benefit all teenagers and young adults in the United States. Also

64

THREE-STATE STUDY OF WATERBORNE DISEASE SURVEILLANCE TECHNIQUES  

EPA Science Inventory

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

65

Vector Blood Meals and Chagas Disease Transmission Potential, United States  

PubMed Central

A high proportion of triatomine insects, vectors for Trypanosoma cruzi trypanosomes, collected in Arizona and California and examined using a novel assay had fed on humans. Other triatomine insects were positive for T. cruzi parasite infection, which indicates that the potential exists for vector transmission of Chagas disease in the United States. PMID:22469536

Dorn, Patricia L.; Hobson, Julia; de la Rua, Nicholas M.; Lucero, David E.; Klotz, John H.; Schmidt, Justin O.; Klotz, Stephen A.

2012-01-01

66

Periodontal Disease and Oral Hygiene Among Children. United States.  

ERIC Educational Resources Information Center

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

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

67

Delayed complications after Gamma Knife surgery for intractable epilepsy.  

PubMed

Despite the controversy concerning the clinical usefulness of Gamma Knife surgery (GKS; Elekta AB, Stockholm, Sweden) for intractable epilepsy, this treatment modality has attracted attention due to its low invasiveness. We report the long-term outcomes of four patients, focusing particularly on the efficacy and complications of GKS. We reviewed the data of four patients with medically intractable epilepsy who underwent GKS between 1998 and 2000 at our hospital. The marginal dose to the 50% isodose line was 24 Gy in one patient and 20Gy in the remaining three patients. Two of the four patients were treated in the right temporal lobe, one was treated in the left parietal lobe, and one was treated in the right frontal lobe. The mean follow-up was 12.5 years (range 12-14 years). One patient was seizure free (Engel class IA) 24 months after GKS, and two patients failed to show any seizure reduction (Engel class IVA). However, a clear aggravation was evident in one patient (Engel class IVC). All four patients underwent resective surgery due to radiation necrosis (RN) 7, 10, 10 and 12 years after GKS. Three patients were seizure free (Engel class IA), and one was considered to have Engel class IB status following the resective surgery. GKS treatment resulted in insufficient seizure control and carried a significant risk of RN after several years. Drawbacks such as a delay in seizure control and the risk of RN should be considered when the clinical application of this treatment is evaluated. PMID:24786716

Chen, Ning; Du, Shou-Qin; Yan, Na; Liu, Chong; Zhang, Jian-Guo; Ge, Yan; Meng, Fan-Gang

2014-09-01

68

Resting state brain networks and their implications in neurodegenerative disease  

NASA Astrophysics Data System (ADS)

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.

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

2012-10-01

69

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

E-print Network

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

Hampton, Robert

70

Identity and psychological ownership in chronic illness and disease state  

PubMed Central

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

Karnilowicz, W

2011-01-01

71

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

PubMed Central

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

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

2013-01-01

72

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.

73

Liver dysfunction in steady state sickle cell disease.  

PubMed

The liver is one of the organs involved in the multiorgan failure that occurs in sickle cell disease, the pathophysiology of liver disease in this condition is complex because of the interrelated multifactorial causes. Liver dysfunction was assessed in both paediatric and adult sickle cell disease patients in the steady state. The transaminases and alkaline phosphatase were analysed by automation while coagulation studies were done manually. The mean (range) of Alanine transaminase (ALT), Aspartate transaminase (AST) and alkaline phosphatase (ALP) were 23.0 (2-77) IU, 48.5 (15-120) IU, 227.5 (37-1200) IU respectively. ALT and AST levels were less than 100 IU in over 95% of the patients. The gender or age of the patients did not significantly affect the level of these three enzymes. There was close association between the liver size and elevation of the liver enzymes except for alkaline phosphatase (ALT=.017, AST=.009, ALP=.056). Twenty-five percent of the patients had normal enzymes while 13% had derangement of the three enzymes, 19%, 50% and 74% had abnormal ALT, AST and ALP respectively. Only 22% and 5% had deranged PT and APTT respectively. In conclusion minimal elevation of the tramsaminases which is not gender or age dependent were observed in steady state sickle cell disease, higher levels of alkaline phosphatase may be due to associated vasoocclussive crises involving the bones rather than a pathology of the liver. PMID:16432491

Kotila, Taiwo; Adedapo, Kayode; Adedapo, Aduragbenro; Oluwasola, Olayiwola; Fakunle, Eyitayo; Brown, Biobele

2005-01-01

74

Treatment of intractable rheumatoid arthritis with total lymphoid irradiation  

SciTech Connect

Eleven patients with intractable rheumatoid arthritis were treated with total lymphoid irradiation (total dose, 2000 rad) in an uncontrolled feasibility study, as an alternative to long-term therapy with cytotoxic drugs such as cyclophosphamide and azathioprine. During a follow-up period of five to 18 months after total lymphoid irradiation, there was a profound and sustained suppression of the absolute lymphocyte count and in vitro lymphocyte function, as well as an increase in the ratio of Leu-2 (suppressor/cytotoxic) to Leu-3 (helper) T cells in the blood. Persistent circulating suppressor cells of the mixed leukocyte response and of pokeweed mitogen-induced immunoglobulin secretion developed in most patients. In nine of the 11 patients, these changes in immune status were associated with relief of joint tenderness and swelling and with improvement in function scores. Maximum improvement occurred approximately six months after irradiation and continued for the remainder of the observation period. Few severe or chronic side effects were associated with the radiotherapy.

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

1981-10-01

75

Treatment of intractable rheumatoid arthritis with total lymphoid irradiation  

SciTech Connect

Eleven patients with intractable rheumatoid arthritis were treated with total lymphoid irradiation (total dose, 2000 rad) in an uncontrolled feasibility study, as an alternative to long-term therapy with cytotoxic drugs such as cyclophosphamide and azathioprine. During a follow-up period of five to 18 months after total lymphoid irradiation, there was a profound and sustained suppression of the absolute lymphocyte count and in vitro lymphocyte function, as well as an increase in the ratio of Leu-2 (suppressor/cytotoxic) to Leu-3 (helper) T cells in the blood. Persistent circulating suppressor cells of the mixed leukocyte response and of pokeweek mitogen-induced immunoglobulin secretion developed in most patients. In nine of the 11 patients, these changes in immune status were associated with relief of joint tenderness and swelling and with improvement in function scores. Maximum improvement occurred approximately six months after irradiation and continued for the remainder of the observation period. Few severe or chronic side effects were associated with the radiotherapy.

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

1981-10-22

76

Electric Impedance Microflow Cytometry for Characterization of Cell Disease States  

PubMed Central

The electrical properties of biological cells have connections to their pathological states. Here we present an electric impedance microflow cytometry (EIMC) platform for the characterization of disease states of single cells. This platform entails a microfluidic device for a label-free and non-invasive cell-counting assay through electric impedance sensing. We identified a dimensionless offset parameter ? obtained as a linear combination of a normalized phase shift and a normalized magnitude shift in electric impedance to differentiate cells on the basis of their pathological states. This paper discusses a representative case study on red blood cells (RBCs) invaded by Plasmodium falciparum malaria parasites. Invasion of P. falciparum induces physical and biochemical changes on the host cells throughout a 48-h multi-stage life cycle within the RBC. As a consequence, it also induces progressive changes in electrical properties of the host cells .We demonstrate that the EIMC system in combination with data analysis involving the new offset parameter allows differentiation of Pf–invaded RBCs from uninfected RBCs as well as among different P. falciparum intraerythrocytic asexual stages including the ring stage. The representative results provided here also point to the potential of the proposed experimental and analysis platform as a valuable tool for non-invasive diagnostics of a wide variety of disease states and for cell separation. PMID:23925122

Diez-Silva, Monica; Dao, Ming; Suresh, Subra; Chandrakasan, Anantha P.

2013-01-01

77

Electric impedance microflow cytometry for characterization of cell disease states.  

PubMed

The electrical properties of biological cells have connections to their pathological states. Here we present an electric impedance microflow cytometry (EIMC) platform for the characterization of disease states of single cells. This platform entails a microfluidic device for a label-free and non-invasive cell-counting assay through electric impedance sensing. We identified a dimensionless offset parameter ? obtained as a linear combination of a normalized phase shift and a normalized magnitude shift in electric impedance to differentiate cells on the basis of their pathological states. This paper discusses a representative case study on red blood cells (RBCs) invaded by the malaria parasite Plasmodium falciparum. Invasion by P. falciparum induces physical and biochemical changes on the host cells throughout a 48-h multi-stage life cycle within the RBC. As a consequence, it also induces progressive changes in electrical properties of the host cells. We demonstrate that the EIMC system in combination with data analysis involving the new offset parameter allows differentiation of P. falciparum infected RBCs from uninfected RBCs as well as among different P. falciparum intraerythrocytic asexual stages including the ring stage. The representative results provided here also point to the potential of the proposed experimental and analysis platform as a valuable tool for non-invasive diagnostics of a wide variety of disease states and for cell separation. PMID:23925122

Du, E; Ha, Sungjae; Diez-Silva, Monica; Dao, Ming; Suresh, Subra; Chandrakasan, Anantha P

2013-10-01

78

Efficacy of intrathecal baclofen therapy in children with intractable spastic cerebral palsy: A randomised controlled trial  

Microsoft Academic Search

BackgroundIntractable spasticity can be treated effectively with continuous infusion of intrathecal baclofen. Because evidence for its use in the treatment of children with spastic cerebral palsy is lacking, we conducted a randomised controlled trial.

Marjanke A. Hoving; Elisabeth P. M. van Raak; Geert H. J. J. Spincemaille; Liesbeth J. Palmans; Jules G. Becher; Johan S. H. Vles

2009-01-01

79

Partial Internal Biliary Diversion: A Solution for Intractable Pruritus in Progressive Familial Intrahepatic Cholestasis Type 1  

PubMed Central

Biliary diversion offers a potential option for intractable pruritus in children with chronic cholestatic disorders. Progressive familial intrahepatic cholestasis (PFIC) is an inherited disorder of impaired bile acid transport and excretion, which presents with jaundice and pruritus in the first few months of life and progresses to cirrhosis by infancy or adolescence. We report a child with PFIC type 1 who underwent internal biliary diversion for intractable pruritus and was relieved of his symptoms. PMID:21546727

Ganesh, Ramaswamy; Suresh, Natarajan; Sathiyasekeran, Malathi; Ramachandran, Priya

2011-01-01

80

Radical Surgical Excision and Use of Lateral Thoracic Flap for Intractable Axillary Hidradenitis Suppurativa  

PubMed Central

Current treatments for hidradenitis suppurativa (HS) include prolonged courses of antibiotics, retinoids, immunosuppressants, and biologics. Severe cases that are resistant to prolonged medical treatment pose a therapeutic challenge. We propose radical excision and lateral thoracic flap reconstruction as a treatment option for such cases. In our experience with two patients, good aesthetic and functional outcomes were achieved, with a high level of patient satisfaction. The availability of suitable flap coverage allows for wide resection of all of the hair-bearing skin, leading to a low incidence of residual disease and subsequent recurrence. Following excision of the affected tissue, the ideal reconstructive method in the axilla provides suitable coverage without unacceptable donor site morbidity and also avoids axillary contractures. A long lateral thoracic flap with delay has excellent coverage with minimal donor tissue sacrifice. With a suitable flap coverage option, the management paradigm of intractable HS should shift from prolonged medical treatment to allow decisive radical excision, which will improve the quality of life for patients. PMID:23233895

Teo, Wan-Lin; Ong, Yee-Siang

2012-01-01

81

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

SciTech Connect

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.

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

82

Acupuncture Modulates Resting State Hippocampal Functional Connectivity in Alzheimer Disease  

PubMed Central

Our objective is to clarify the effects of acupuncture on hippocampal connectivity in patients with Alzheimer disease (AD) using functional magnetic resonance imaging (fMRI). Twenty-eight right-handed subjects (14 AD patients and 14 healthy elders) participated in this study. Clinical and neuropsychological examinations were performed on all subjects. MRI was performed using a SIEMENS verio 3-Tesla scanner. The fMRI study used a single block experimental design. We first acquired baseline resting state data during the initial 3 minutes and then performed acupuncture stimulation on the Tai chong and He gu acupoints for 3 minutes. Last, we acquired fMRI data for another 10 minutes after the needle was withdrawn. The preprocessing and data analysis were performed using statistical parametric mapping (SPM5) software. Two-sample t-tests were performed using data from the two groups in different states. We found that during the resting state, several frontal and temporal regions showed decreased hippocampal connectivity in AD patients relative to control subjects. During the resting state following acupuncture, AD patients showed increased connectivity in most of these hippocampus related regions compared to the first resting state. In conclusion, we investigated the effect of acupuncture on AD patients by combing fMRI and traditional acupuncture. Our fMRI study confirmed that acupuncture at Tai chong and He gu can enhance the hippocampal connectivity in AD patients. PMID:24603951

Wang, Zhiqun; Liang, Peipeng; Zhao, Zhilian; Han, Ying; Song, Haiqing; Xu, Jianyang; Lu, Jie; Li, Kuncheng

2014-01-01

83

Economic consequences of pelvic inflammatory disease in the United States.  

PubMed

Pelvic inflammatory disease is the most common serious complication of sexually transmitted infections caused by Neisseria gonorrhoeae and Chlamydia trachomatis. Initial episodes of sexually transmitted acute PID occur most frequently in the 20 to 24 year age group, while sequelae such as infertility, ectopic pregnancy, and chronic PID are most common among 25- to 34-year-old women. The apparent chronicity of the disease process suggests that the epidemic of sexually transmitted disease, which began in the mid-1960s, could be followed by an epidemic of PID and its sequelae. More than 850,000 episodes of PID occur annually, requiring more than 212,000 hospital admissions, 115,000 surgical procedures, and 2,500,000 physician visits. Ectopic pregnancies in the United States tripled from 1967 to 1977. Direct and indirect costs for PID and PID-associated ectopic pregnancy exceeded $1.25 billion in 1979. If PID and ectopic pregnancy rates continue unabated, by the year 2000 there will have been more than one episode of PID and three related physician visits for every two women who reached reproductive age in 1970. Fifteen percent will require hospitalization, more than 3% will experience an ectopic pregnancy, and more than 10% will involuntarily become sterile because of PID. PMID:7008601

Curran, J W

1980-12-01

84

Expiratory model-based method to monitor ARDS disease state  

PubMed Central

Introduction Model-based methods can be used to characterise patient-specific condition and response to mechanical ventilation (MV) during treatment for acute respiratory distress syndrome (ARDS). Conventional metrics of respiratory mechanics are based on inspiration only, neglecting data from the expiration cycle. However, it is hypothesised that expiratory data can be used to determine an alternative metric, offering another means to track patient condition and guide positive end expiratory pressure (PEEP) selection. Methods Three fully sedated, oleic acid induced ARDS piglets underwent three experimental phases. Phase 1 was a healthy state recruitment manoeuvre. Phase 2 was a progression from a healthy state to an oleic acid induced ARDS state. Phase 3 was an ARDS state recruitment manoeuvre. The expiratory time-constant model parameter was determined for every breathing cycle for each subject. Trends were compared to estimates of lung elastance determined by means of an end-inspiratory pause method and an integral-based method. All experimental procedures, protocols and the use of data in this study were reviewed and approved by the Ethics Committee of the University of Liege Medical Faculty. Results The overall median absolute percentage fitting error for the expiratory time-constant model across all three phases was less than 10 %; for each subject, indicating the capability of the model to capture the mechanics of breathing during expiration. Provided the respiratory resistance was constant, the model was able to adequately identify trends and fundamental changes in respiratory mechanics. Conclusion Overall, this is a proof of concept study that shows the potential of continuous monitoring of respiratory mechanics in clinical practice. Respiratory system mechanics vary with disease state development and in response to MV settings. Therefore, titrating PEEP to minimal elastance theoretically results in optimal PEEP selection. Trends matched clinical expectation demonstrating robustness and potential for guiding MV therapy. However, further research is required to confirm the use of such real-time methods in actual ARDS patients, both sedated and spontaneously breathing. PMID:23802683

2013-01-01

85

Resting State Functional Connectivity in Preclinical Alzheimer's Disease: A Review  

PubMed Central

There has been a dramatic increase in the number of studies using resting state fMRI, a recent addition to imaging analysis techniques. The technique analyzes ongoing low frequency fluctuations in the blood oxygen level dependent (BOLD) signal. Through patterns of spatial coherence, these fluctuations can be used to identify the networks within the brain. Multiple brain networks are present simultaneously and the relationships within and between networks are in constant dynamic flux. Resting state fMRI functional connectivity (rs-fMRI) analysis is increasingly used to detect subtle brain network differences, and in the case of pathophysiology, subtle abnormalities in illnesses such as Alzheimer’s disease (AD). The sequence of events leading up to dementia has been hypothesized to begin many years or decades before any clinical symptoms occur. Here we review the findings across rs-fMRI studies in the spectrum of preclinical AD to clinical AD. In addition, we discuss evidence for underlying preclinical AD mechanisms, including an important relationship between resting state functional connectivity and brain metabolism, and how this results in a distinctive pattern of amyloid plaque deposition in default mode network regions. PMID:23290495

Sheline, Yvette I.; Raichle, Marcus E.

2012-01-01

86

Risk of Importing Zoonotic Diseases through Wildlife Trade, United States  

PubMed Central

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

Schloegel, Lisa M.; Daszak, Peter

2009-01-01

87

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

Microsoft Academic Search

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

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

1997-01-01

88

Vagus nerve stimulation in children with intractable epilepsy: indications, complications and outcome  

Microsoft Academic Search

Purpose  To analyze the indication, complications and outcome of vagus nerve stimulation in intractable childhood epilepsy.\\u000a \\u000a \\u000a \\u000a Materials and methods  We retrospectively reviewed the data of 69 children who had insertion of vagal nerve stimulator (VNS) between June 1995 and\\u000a August 2006 for medically intractable epilepsy. Outcome was based on the Engel's classification. Statistical analysis of the\\u000a data was also done to see

S. M. R. Kabir; C. Rajaraman; C. Rittey; H. S. Zaki; A. A. Kemeny; J. McMullan

2009-01-01

89

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...

90

Modeling the dynamics of disease States in depression.  

PubMed

Major depressive disorder (MDD) is a common and costly disorder associated with considerable morbidity, disability, and risk for suicide. The disorder is clinically and etiologically heterogeneous. Despite intense research efforts, the response rates of antidepressant treatments are relatively low and the etiology and progression of MDD remain poorly understood. Here we use computational modeling to advance our understanding of MDD. First, we propose a systematic and comprehensive definition of disease states, which is based on a type of mathematical model called a finite-state machine. Second, we propose a dynamical systems model for the progression, or dynamics, of MDD. The model is abstract and combines several major factors (mechanisms) that influence the dynamics of MDD. We study under what conditions the model can account for the occurrence and recurrence of depressive episodes and how we can model the effects of antidepressant treatments and cognitive behavioral therapy within the same dynamical systems model through changing a small subset of parameters. Our computational modeling suggests several predictions about MDD. Patients who suffer from depression can be divided into two sub-populations: a high-risk sub-population that has a high risk of developing chronic depression and a low-risk sub-population, in which patients develop depression stochastically with low probability. The success of antidepressant treatment is stochastic, leading to widely different times-to-remission in otherwise identical patients. While the specific details of our model might be subjected to criticism and revisions, our approach shows the potential power of computationally modeling depression and the need for different type of quantitative data for understanding depression. PMID:25330102

Demic, Selver; Cheng, Sen

2014-01-01

91

Modeling the Dynamics of Disease States in Depression  

PubMed Central

Major depressive disorder (MDD) is a common and costly disorder associated with considerable morbidity, disability, and risk for suicide. The disorder is clinically and etiologically heterogeneous. Despite intense research efforts, the response rates of antidepressant treatments are relatively low and the etiology and progression of MDD remain poorly understood. Here we use computational modeling to advance our understanding of MDD. First, we propose a systematic and comprehensive definition of disease states, which is based on a type of mathematical model called a finite-state machine. Second, we propose a dynamical systems model for the progression, or dynamics, of MDD. The model is abstract and combines several major factors (mechanisms) that influence the dynamics of MDD. We study under what conditions the model can account for the occurrence and recurrence of depressive episodes and how we can model the effects of antidepressant treatments and cognitive behavioral therapy within the same dynamical systems model through changing a small subset of parameters. Our computational modeling suggests several predictions about MDD. Patients who suffer from depression can be divided into two sub-populations: a high-risk sub-population that has a high risk of developing chronic depression and a low-risk sub-population, in which patients develop depression stochastically with low probability. The success of antidepressant treatment is stochastic, leading to widely different times-to-remission in otherwise identical patients. While the specific details of our model might be subjected to criticism and revisions, our approach shows the potential power of computationally modeling depression and the need for different type of quantitative data for understanding depression. PMID:25330102

Demic, Selver; Cheng, Sen

2014-01-01

92

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

Microsoft Academic Search

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

Courtney Waite Miller; Michael E. Roloff

2006-01-01

93

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

ERIC Educational Resources Information Center

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

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

2008-01-01

94

Paradigmatic Framing of Protracted, Intractable Conflict: Toward the Development of a Meta-framework-II  

Microsoft Academic Search

Protracted, intractable conflicts are a form of human interaction that may very well determine our capacity to survive as a species. Their high degree of malignancy, complexity, and mercurial natures present severe challenges to our human abilities to perceive, comprehend, and intervene accurately and effectively. The applied literature in this area presents a wide variety of approaches for intervention. Each

Peter T. Coleman

2004-01-01

95

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

SciTech Connect

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

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

2007-04-15

96

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

Microsoft Academic Search

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

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

2006-01-01

97

Intrathecal baclofen therapy in children with intractable spastic cerebral palsy: a cost-effectiveness analysis  

Microsoft Academic Search

In a Dutch national study, we recently established the effectiveness and safety of continuous intrathecal baclofen infusion (CITB) in children with intractable spastic cerebral palsy (CP). Because prospective studies on the cost-effectiveness of CITB in children with spastic CP are lacking, we conducted a cost-effectiveness analysis alongside our prospective national study. We compared the costs and health effects of CITB

M. A. Hoving; S M A A Evers; A J H A Ament; E P M van Raak; J. S. H. Vles; J. G. Becher; R. Vermeulen; O. F. Brouwer; C. G. Maathuis; C. E. Catsman-Berrevoets; J. Gerritsen; M. J. Geerts; P. H. Jongerius; O. F. Nieuwenhuizen; J. J. Rotteveel; L. A. Speth; H. Stroink; E. G. van der Ziel

2008-01-01

98

Neuropathologic findings in cortical resections (including hemispherectomies) performed for the treatment of intractable childhood epilepsy  

Microsoft Academic Search

Despitè the use of hemispherectomy in the treatment of medically refractory seizures since the early 1950's, few studies published have documented neuropathologic findings in the resected specimens. This report describes the neuropathologic findings in 38 children who underwent either hemispherectomy or multilobar cortical resection as treatment for medically intractable epilepsy between 1986 and 1990. Examination of the resected specimens revealed

M. A. Farrell; M. J. DeRosa; J. G. Curran; D. Lenard Secor; M. E. Cornford; Y. G. Comair; W. J. Peacock; W. D. Shields; H. V. Vinters

1992-01-01

99

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

ERIC Educational Resources Information Center

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…

Feinberg, Daniel

100

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

Microsoft Academic Search

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

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

101

Image-Guided, Frameless Stereotactic Sectioning of the Corpus callosum in Children with Intractable Epilepsy  

Microsoft Academic Search

Corpus callosotomy is an effective neurosurgical procedure for children with intractable atonic or drop attack seizures. While this procedure has not changed significantly over the past three decades, some technical issues remain to be resolved. These include the intraoperative determination of the extent of the callosotomy, the need to stage the procedure, as well as side of approach of craniotomy.

Mojgan Hodaie; Awni Musharbash; Hiroshi Otsubo; O. Carter Snead III; Shiro Chitoku; Ayako Ochi; Stephanie Holowka; Harold J. Hoffman; James T. Rutka

2001-01-01

102

Intracoronary Autologous CD34+ Stem Cell Therapy for Intractable Angina  

Microsoft Academic Search

Background\\/Objectives: A large number of patients with coronary artery disease experience angina that is not suitable for revascularization and is refractory to conventional medical therapy. Laboratory and preclinical studies have provided evidence for the safety and potential efficacy of autologous CD34+ stem cell therapies as treatment for angina. Clinical studies investigating intramyocardial transplantation of autologous CD34+ stem cells by catheter

Shihong Wang; Junyu Cui; Wei Peng; Min Lu

2010-01-01

103

[Textual research on 5 words of disease in chu jian (bamboo slips of Chu State) of the Warring States Period].  

PubMed

There are not a few words of disease in the unearthed chu jian (bamboo slips of Chu State) of the Warring States Period. The morphology, pronunciation and meaning among these characters are completed. By collecting the diseases in the equivocally deciphered words, this article comprehensively discusses the words among them. It is claimed that in Geling jian (Geling slips), "Xie" is pronounced as xie, and "Xie disease" refers to the pain below the oxter and above the waist; "Bei", pronounced as jian, and "Bei Pi disease" refers to the pain of the shoulder and back;"Jie" reads as jie and refers to scabies; "Du" pronounced as fu, and "Du disease" refers to distending pain of the skin. In Wangshan jian (Wangshan slips), "Du" is equal to "Du", and is the same as "Du" in baoshan jian (baoshan bamboo slips), pronounced as du, refers to exacerbation of disease. PMID:24135471

Luo, Bao-Zhen

2013-03-01

104

Factors Contributing to Decline in Foodborne Disease Outbreak Reports, United States  

PubMed Central

The number of foodborne disease outbreaks reported in the United States declined substantially in 2009, when the surveillance system transitioned from reporting only foodborne disease outbreaks to reporting all enteric disease outbreaks. A 2013 survey found that some outbreaks that would have been previously reported as foodborne are now reported as having other transmission modes. PMID:25147912

Imanishi, Maho; Murthy, Bhavini P.; Gould, L. Hannah

2014-01-01

105

Prevalence and ethnic differences in gallbladder disease in the United States  

Microsoft Academic Search

Background & Aims: Gallbladder disease is one of the most common conditions in the United States, but its true prevalence is unknown. A national population-based survey was performed to determine the age, sex, and ethnic distribution of gallbladder disease in the United States. Methods: The third National Health and Nutrition Examination Survey (NHANES III) conducted gallbladder ultrasonography among a representative

James E. Everhart; Meena Khare; Michael Hill; Kurt R. Maurer

1999-01-01

106

Diagnosis of Annosus Root Disease in Mixed Conifer Forests in the Northwestern United States1  

E-print Network

Diagnosis of Annosus Root Disease in Mixed Conifer Forests in the Northwestern United States1 Craig States forests is discussed. Field diagnosis can be made by observing characteristic stand patterns to confirm field diagnosis. Annosus root disease, which is caused by Heterobasidion annosum (Fr.) Bref

Standiford, Richard B.

107

Association of heart block with uncommon disease States.  

PubMed

A variety of diseases, other than the common Lev-Lenègre disease, are associated with cardiac conduction system abnormalities. These include acute processes, such as acute rheumatic fever, and other disorders, such as sarcoidosis, connective tissue disorders, neoplasms, and bacterial endocarditis with cardiac abscess formation. The purpose of the study is to raise awareness of these rare conditions. We present 10 adult patients (4 males and 6 females) with a mean age of 47 years (range: 19-69), with various rare diseases associated with heart block, who needed temporary or permanent pacemaker therapy in the past two decades. These conditions included acute rheumatic carditis, Wegener granulomatosis, cardiac involvement of metastatic breast cancer, bacterial endocarditis, sarcoidosis, S/P chest radiotherapy, and quadriplegia with syringomyelia postspinal cord injury, and adult congenital heart block. We conclude that patients with these disorders should be followed periodically, to allow for early detection and treatment of cardiac conduction disturbances, with pacemaker therapy. PMID:24436606

Yahalom, Malka; Roguin, Nathan; Antonelli, Dante; Suleiman, Khaled; Turgeman, Yoav

2013-09-01

108

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

SciTech Connect

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

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

2009-07-15

109

Malignant transformation of a solitary fibrous tumor of the liver and intractable hypoglycemia  

Microsoft Academic Search

Sarcomas of the liver are rare. We report a case of intractable hypoglycemia secondary to a solitary fibrous tumor that underwent\\u000a malignant transformation into a fibrosarcoma. A 70-year-old man presented with a hepatic mass and tumor-associated hypoglycemia\\u000a which was resistant to medical management. Blood tests were remarkable only for elevated serum insulin-like growth factor\\u000a (IGF)-2. The hypoglycemia resolved following resection

Gabriel Chan; Peter J. Horton; Sandra Thyssen; Marie Lamarche; Ayoub Nahal; David J. Hill; Errol B. Marliss; Peter Metrakos

2007-01-01

110

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

PubMed Central

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

2013-01-01

111

Intractable Nausea and Vomiting from Autoantibodies Against a Brain Water Channel  

PubMed Central

Background & Aims Antibodies against the water channel protein aquaporin (AQP)-4 cause a spectrum of inflammatory, demyelinating, central nervous system disorders called neuromyelitis optica spectrum disorders (NMOSDs); these primarily affect the optic nerves and spinal cord, but also the brain. Symptoms of intractable nausea, vomiting and hiccups reflect involvement of AQP4 in the brainstem area postrema and account for gastroenterologic presentations. We investigated the frequency of intractable nausea, vomiting, or hiccups in patients with NMOSD who tested positive for immunoglobulin-G against AQP4 (AQP4-IgG). We also analyzed sera from patients with idiopathic nausea or vomiting for the presence of AQP4-IgG. Methods We reviewed the Mayo Clinic AQP4-IgG positive NMOSD database (n=70) to identify patients who presented with vomiting, focusing on results from gastroenterologic evaluations. We also tested serum samples (from the Gastroparesis Clinical Research Consortium repository) from patients who presented with idiopathic nausea or vomiting for AQP4-IgG (controls n=318 with gastroparesis and 117 without gastroparesis). Results Ten AQP4-IgG-positive patients diagnosed with NMOSD (14% of patients in the database) initially presented with intractable vomiting. Extensive gastroenterological evaluation was non-informative. AQP4-IgG was not detected in any of the controls. Conclusions Though NMOSDs are rare, tests for AQP4-IgG should be considered for patients that present with unexplained, intractable vomiting. Detection of the antibody before the development of optic neuritis or transverse myelitis allows patients to receive immunosuppressive therapy before the development of neurologic disabilities. PMID:23211959

Iorio, Raffaele; Lucchinetti, Claudia F.; Lennon, Vanda A.; Farrugia, Gianrico; Pasricha, Pankaj J.; Weinshenker, Brian G.; Pittock, Sean J.

2013-01-01

112

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

PubMed

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

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

2014-06-01

113

Nebulized lidocaine in the treatment of intractable cough.  

PubMed

Cough is one of the most common symptoms prompting patients to be seen by health care providers in the United States. Persistent cough can disrupt daily activities such as conversation, eating, breathing, and sleeping, and it can become extremely debilitating both physically and mentally. Pharmacological treatments include dextramethorphan, opioid cough suppressants, benzonatate, inhaled ipratropium, and guaifenesin. Successful cough suppression has also been demonstrated in several studies with the use of nebulized lidocaine. Nebulized lidocaine also appears to be well tolerated by patients with minimal side effects including dysphonia, oropharyngeal numbness, and bitter taste. Studies conducted thus far have been small, so larger randomized control trials comparing nebulized lidocaine to placebo need to be conducted in the future. PMID:22964341

Truesdale, Kelly; Jurdi, Adham

2013-09-01

114

Long-Term Outcome in Children With Intractable Epilepsy Showing Bilateral Diffuse Cortical Glucose Hypometabolism Pattern on Positron Emission Tomography  

Microsoft Academic Search

The objective of this study is to determine the long-term outcome of children with intractable epilepsy who have diffuse cortical hypometabolism on 2-deoxy-2-(18F)fluoro-D-glucose positron emission tomography (FDG-PET) scans. Seventeen children with intractable epilepsy showing bilateral, diffuse cortical hypometabolism on FDG-PET were followed up through telephone interview from 1 year 4 months to 11 years 4 months (mean: 5 years 7

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

2012-01-01

115

Intractable Chronic Vulval Ulceration Presenting as Immune Reconstitution Inflammatory Syndrome in a Treatment-Failure Patient: A Case Observation  

PubMed Central

HIV-1 treatment-failure patients are increasingly being initiated on second-line antiretroviral therapy. The case we describe is of a treatment-failure patient who developed intractable chronic vulval ulceration presenting as immune reconstitution inflammatory syndrome (IRIS), following complete viral suppression with second-line highly active antiretroviral treatment (HAART). To the best of our knowledge, this is the first reported case of intractable vulval ulceration IRIS in an HIV-1 treatment-failure patient. PMID:22567519

Katusiime, Christine; Ocama, Ponsiano; Kambugu, Andrew

2011-01-01

116

Electrodiagnostic evidence of subclinical disease states in drug abusers.  

PubMed

One hundred drug abusers, free of clinical signs or symptoms of disease, were examined by electrodiagnostic techniques. Sensory conduction of median, ulnar and sural nerves was evaluated in terms of latency, velocity and amplitude of evoked potential. Motor nerve latencies and conduction velocities of median, ulnar and personeal nerves were determined. Definite changes in the evoked sensory potentials of median and sural nerves of subjects using heroin or LSD were demonstrated. The sensory amplitude changes were suggestive of axonal degreneration because of normal duration. Maximum motor conduction velocity was abnormal in one patient who admitted using a variety of drugs; five heroin and two barbiturate users showed dispersed motor responses suggesting small fiber involvement. No abnormality could be shown in marjuana smokers. Signifcance of these findings is explained, emphasizing important potential for recognition of subclinical abnormalities and the opportunity for disease prevention. PMID:1259544

DiBenedetto, M

1976-02-01

117

Cytokines and coronary artery disease: the state of the art.  

PubMed

Initiation and progression of coronary atherosclerosis has been associated with inflammation and cytokines balance. The objective of this study is to understand the role of cytokines in the pathophysiology and management of coronary artery disease. Coronary artery disease has been revisited with revision of the pertinent published articles in the Medline, Scopus, and EBSCO Host research from 1987 to 2007. The 2 groups of cytokines (proinflammatory and anti-inflammatory) have been detected in human atherosclerotic plaques. The balance between the 2 groups may reflect the intensity of occult plaque inflammation and the vulnerability to rupture. Multiple studies have determined that a diverse set of proinflammatory biomarkers can furnish prognostic information beyond the traditional risk factors. Inflammatory responses after coronary revascularization are known to play key role in vascular lesion formation early in atherosclerosis and restenosis. Clinical utilization of cytokines remains promising yet incompletely explored and need more studies. PMID:18520532

El-Menyar, Ayman A

2008-06-01

118

Burden of Gastrointestinal Disease in the United States: 2012 Update  

PubMed Central

Background & Aims Gastrointestinal (GI) diseases account for substantial morbidity, mortality and cost. Statistical analyses of the most recent data are necessary to guide GI research, education and clinical practice. We estimate the burden of GI disease in the US. Methods We collected information on the epidemiology of GI diseases (including cancers) and symptoms, along with data on resource utilization, quality of life, impairments to work and activity, morbidity, and mortality. These data were obtained from the National Ambulatory Medical Care Survey; National Health and Wellness Survey; Nationwide Inpatient Sample; Surveillance, Epidemiology, and End Results Program; National Vital Statistics System; Thompson Reuters MarketScan®; Medicare; Medicaid; and the Clinical Outcomes Research Initiative’s National Endoscopic Database. We estimated endoscopic use and costs and examined trends in endoscopic procedure. Results Abdominal pain was the most common gastrointestinal symptom that prompted a clinic visit (15.9 million visits). Gastroesophageal reflux was the most common GI diagnosis (8.9 million visits). Hospitalizations and mortality from Clostridium difficile infection have doubled in the last 10 years. Acute pancreatitis was the most common reason for hospitalization (274,119 discharges). Colorectal cancer accounted for more than half of all GI cancers and was the leading cause of GI-related mortality (52,394 deaths). There were 6.9 million upper, 11.5 million lower, and 228,000 biliary endoscopies performed in 2009. The total cost for outpatient gastrointestinal endoscopy examinations was $32.4 billion. Conclusions GI diseases are a source of substantial morbidity, mortality and cost in the US. PMID:22885331

Peery, Anne F.; Dellon, Evan S.; Lund, Jennifer; Crockett, Seth D.; McGowan, Christopher E.; Bulsiewicz, William J; Gangarosa, Lisa M.; Thiny, Michelle T.; Stizenberg, Karyn; Morgan, Douglas R.; Ringel, Yehuda; Kim, Hannah P; DiBonaventura, Marco daCosta; Carroll, Charlotte F.; Allen, Jeffery K.; Cook, Suzanne F.; Sandler, Robert S.; Kappelman, Michael D; Shaheen, Nicholas J.

2012-01-01

119

Crohn’s Disease: an Immune Deficiency State  

Microsoft Academic Search

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

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

2010-01-01

120

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

PubMed Central

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

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

2014-01-01

121

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...

122

Tuberculosis, Sexually Transmitted Diseases, HIV, and Other Infections Among Farmworkers in the Eastern United States  

Microsoft Academic Search

\\u000a Farmworkers in the United States (US) have been disproportionately affected by the intersecting epidemics of tuberculosis\\u000a (TB), sexually transmitted diseases (STDs), and HIV. Furthermore, farmworkers tend to be politically, socially, and economically\\u000a disenfranchised, which contributes to their increased vulnerability to infectious diseases. This chapter examines the epidemiology\\u000a of infectious diseases, specifically TB, STDs, and HIV, among farmworkers; explores the risks

123

Hospitalizations for Valvular Heart Disease in Chronic Dialysis Patients in the United States  

Microsoft Academic Search

Background: Valvular heart disease has not been studied in a national population of end stage renal disease patients. Methods: 327,993 dialysis patients in the United States Renal Data System initiated from 1 January 1992 to 30 June 1997 were analyzed in a historical cohort study of patients hospitalized for valvular heart disease (ICD9 Code 424.x, excluding endocarditis, and 394.x-397.x). Results:

Kevin C. Abbott; Lawrence Y. Agodoa

2002-01-01

124

Metabolic State Determines Sensitivity to Cellular Stress in Huntington Disease: Normalization by Activation of PPAR?  

Microsoft Academic Search

Impairments in mitochondria and transcription are important factors in the pathogenesis of Huntington disease (HD), a neurodegenerative disease caused by a polyglutamine expansion in the huntingtin protein. This study investigated the effect of different metabolic states and peroxisome proliferator-activated receptor ? (PPAR?) activation on sensitivity to cellular stressors such as H2O2 or thapsigargin in HD. Striatal precursor cells expressing wild

Youngnam N. Jin; Woong Y. Hwang; Chulman Jo; Gail V. W. Johnson

2012-01-01

125

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

MedlinePLUS

... Mississippi, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, ... Us: Centers for Disease Control and Prevention 1600 Clifton Rd Atlanta, GA ...

126

Study and analysis of the state of rare disease research in Shandong Province, China  

PubMed Central

Summary As the world's most populous country, China has the world's largest number of rare disease groups in terms of prevalence. However, the country has no system of registering cases of most rare diseases, so there is very little documented information on the epidemiology of those diseases. The purpose of this study was to study the state of rare disease research and survey doctors in Shandong Province regarding their level of awareness of rare diseases. Types of rare diseases and numbers of cases were tallied and their geographical distribution over the decades was analyzed. Eight hundred and twenty-four doctors in tertiary hospitals and maternity and child care hospitals were surveyed by questionnaire. Data were descriptively analyzed and a map of disease distribution was created. Articles about rare diseases were retrieved from the Chinese Biomedical Literature Database to provide pertinent data. This study yielded 5,749 cases of 323 different types of rare diseases. The survey found that doctors lack awareness of research on rare diseases. An authoritative and information-rich platform for rare disease research is urgently needed. Key steps are to study epidemiological and statistical techniques and then obtain available data to provide a basis for the definition and regulation of rare diseases in China.

Zhao, Heng; Cui, Yazhou; Zhou, Xiaoyan; Pang, Jingxiang; Zhang, Xiumei; Xu, Shuangqing; Han, Jinxiang

2012-01-01

127

Altered Resting State Brain Networks in Parkinson's Disease  

PubMed Central

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

Gottlich, Martin; Munte, Thomas F.; Heldmann, Marcus; Kasten, Meike; Hagenah, Johann; Kramer, Ulrike M.

2013-01-01

128

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

PubMed

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

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

129

Lyme disease in the state of Tocantins, Brazil: report of the first cases.  

PubMed

Lyme disease is an underdiagnosed zoonosis in Brazil. There are no cases registered in the state of Tocantins, the newest Brazilian state. The cases of three patients in contact with rural areas in three Tocantins' districts are herein described, and the Brazilian literature is reviewed. PMID:23141972

Carranza-Tamayo, César Omar; Costa, José Nilton Gomes da; Bastos, Whisllay Maciel

2012-01-01

130

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

NSDL National Science Digital Library

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

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

2010-03-23

131

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

PubMed

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

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

2013-02-01

132

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

PubMed Central

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

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

2012-01-01

133

Blood cytokine, chemokine and gene expression in cholestasis patients with intractable pruritus treated with a molecular adsorbent recirculating system: A case series  

PubMed Central

BACKGROUND: The molecular adsorbent recirculating system (MARS) is an albumin-dialysis modality that has been investigated predominantly in patients with acute and acute-on-chronic liver failure. OBJECTIVES: To report the clinical efficacy and safety of MARS therapy for intractable pruritus in cholestasis patients with stable chronic liver disease, characterizing the impact of MARS on cytokine levels and on the transcriptome in the blood compartment. METHODS: MARS therapy was performed on three patients with cholestatic liver disease using 8 h runs for two consecutive days. The expression levels of 65 cytokines/chemokines and 24,000 genes were profiled by Luminex (Luminex Corporation, USA) and microarray, respectively. RESULTS: A quality-of-life assessment demonstrated a marked improvement during therapy, which was sustained in two of three patients. No bleeding or infectious complications were observed. Bile acid levels were markedly reduced following MARS (mean [± SD] pretreatment 478.9±112.2 ?mol/L versus post-treatment 89.7±68.8 ?mol/L). Concordant decreases in cytokine/chemokine levels were noted for interleukin (IL)-1beta, IL-2, IL-6, IL-8, IL-12 (p40), RANTES, tranforming growth factor-alpha, tumour necrosis factor-alpha and thrombopoietin following MARS. On microarray profiling, biologically relevant concordant changes among all patients were evident for 20 different genes (10 upregulated and 10 downregulated). The upregulation of several potentially immune suppressive/regulatory genes (eg, early growth response 3 [EGR-3], ephrin-A2 [EFNA2] and serum amyloid A1 [SAA1]), concurrent with downregulation of genes involved in innate immunity (eg, toll-like receptor 4 interactor with leucine-rich repeats [TRIL]) and inflammation (eg, ephrin receptor B1 [EPHB1]), was observed. CONCLUSIONS: This investigative approach offers new insights into intractable pruritus and suggests future therapeutic targets. The clinical benefit of MARS in cholestasis patients with intractable pruritus may not exclusively result from filtration of pruritogens, but also from systemic changes in cytokine/chemokine levels and changes in gene expression of blood cells. PMID:23166903

Lisboa, Luiz F; Asthana, Sonal; Kremer, Andreas E; Swain, Mark; Bagshaw, Sean M; Gibney, Noel; Karvellas, Constantine J

2012-01-01

134

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

PubMed Central

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

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

2013-01-01

135

Arginine de novo and nitric oxide production in disease states  

PubMed Central

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

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

2012-01-01

136

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

PubMed

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

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

2014-10-14

137

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

PubMed

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

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

2014-01-01

138

Estimates of disease effects on soybean yields in the United States 2003 to 2005.  

PubMed

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

Wrather, J Allen; Koenning, Steve R

2006-06-01

139

The Association of Meningococcal Disease with Influenza in the United States, 1989-2009  

PubMed Central

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

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

2014-01-01

140

Recursive Cluster Elimination Based Support Vector Machine for Disease State Prediction Using Resting State Functional and Effective Brain Connectivity  

PubMed Central

Background Brain state classification has been accomplished using features such as voxel intensities, derived from functional magnetic resonance imaging (fMRI) data, as inputs to efficient classifiers such as support vector machines (SVM) and is based on the spatial localization model of brain function. With the advent of the connectionist model of brain function, features from brain networks may provide increased discriminatory power for brain state classification. Methodology/Principal Findings In this study, we introduce a novel framework where in both functional connectivity (FC) based on instantaneous temporal correlation and effective connectivity (EC) based on causal influence in brain networks are used as features in an SVM classifier. In order to derive those features, we adopt a novel approach recently introduced by us called correlation-purged Granger causality (CPGC) in order to obtain both FC and EC from fMRI data simultaneously without the instantaneous correlation contaminating Granger causality. In addition, statistical learning is accelerated and performance accuracy is enhanced by combining recursive cluster elimination (RCE) algorithm with the SVM classifier. We demonstrate the efficacy of the CPGC-based RCE-SVM approach using a specific instance of brain state classification exemplified by disease state prediction. Accordingly, we show that this approach is capable of predicting with 90.3% accuracy whether any given human subject was prenatally exposed to cocaine or not, even when no significant behavioral differences were found between exposed and healthy subjects. Conclusions/Significance The framework adopted in this work is quite general in nature with prenatal cocaine exposure being only an illustrative example of the power of this approach. In any brain state classification approach using neuroimaging data, including the directional connectivity information may prove to be a performance enhancer. When brain state classification is used for disease state prediction, our approach may aid the clinicians in performing more accurate diagnosis of diseases in situations where in non-neuroimaging biomarkers may be unable to perform differential diagnosis with certainty. PMID:21151556

Deshpande, Gopikrishna; Li, Zhihao; Santhanam, Priya; Coles, Claire D.; Lynch, Mary Ellen; Hamann, Stephan; Hu, Xiaoping

2010-01-01

141

Therapy for Common Parasitic Diseases in Pregnancy in the United States: A Review and a Survey of Obstetrician\\/Gynecologists??? Level of Knowledge About These Diseases  

Microsoft Academic Search

A number of food- and waterborne parasitic diseases that are common in the United States can adversely impact women during pregnancy. Therapeutic considerations during pregnancy for these diseases are reviewed. Also, the level of knowledge of obstetrician-gynecologists about diagnosis and treatment of these diseases (toxoplasmosis, cryptosporidiosis, giardiasis, amebiasis, cyclosporiasis, trichinellosis, ascariasis, and taeniasis) was estimated by means of a questionnaire

Jeffrey L. Jones; Jay Schulkin; James H. Maguire

2005-01-01

142

Chronic Liver Disease in the Hispanic Population of the United States  

PubMed Central

Chronic liver disease is a major cause of morbidity and mortality among Hispanic people living in the United States. Environmental, genetic, and behavioral factors, as well as socioeconomic and health care disparities among this ethnic group have emerged as important public health concerns. We review the epidemiology, natural history, and response to therapy of chronic liver disease in Hispanic patients. The review covers nonalcoholic fatty liver disease, viral hepatitis B and C, coinfection of viral hepatitis with human immunodeficiency virus, alcoholic cirrhosis, hepatocellular carcinoma, autoimmune hepatitis, and primary biliary cirrhosis. For most of these disorders, the Hispanic population has a higher incidence and more aggressive pattern of disease and overall worse treatment outcomes than in the non-Hispanic white population. Clinicians should be aware of these differences in caring for Hispanic patients with chronic liver disease. PMID:21628000

Carrion, Andres F.; Ghanta, Ravi; Carrasquillo, Olveen; Martin, Paul

2014-01-01

143

Endemic, notifiable bioterrorism-related diseases, United States, 1992-1999.  

PubMed

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 to 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

Chang, Man-huei; Glynn, M Kathleen; Groseclose, Samuel L

2003-05-01

144

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

PubMed Central

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

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

2014-01-01

145

Geographical variation of cerebrovascular disease in New York State: the correlation with income  

PubMed Central

Background Income is known to be associated with cerebrovascular disease; however, little is known about the more detailed relationship between cerebrovascular disease and income. We examined the hypothesis that the geographical distribution of cerebrovascular disease in New York State may be predicted by a nonlinear model using income as a surrogate socioeconomic risk factor. Results We used spatial clustering methods to identify areas with high and low prevalence of cerebrovascular disease at the ZIP code level after smoothing rates and correcting for edge effects; geographic locations of high and low clusters of cerebrovascular disease in New York State were identified with and without income adjustment. To examine effects of income, we calculated the excess number of cases using a non-linear regression with cerebrovascular disease rates taken as the dependent variable and income and income squared taken as independent variables. The resulting regression equation was: excess rate = 32.075 - 1.22*10-4(income) + 8.068*10-10(income2), and both income and income squared variables were significant at the 0.01 level. When income was included as a covariate in the non-linear regression, the number and size of clusters of high cerebrovascular disease prevalence decreased. Some 87 ZIP codes exceeded the critical value of the local statistic yielding a relative risk of 1.2. The majority of low cerebrovascular disease prevalence geographic clusters disappeared when the non-linear income effect was included. For linear regression, the excess rate of cerebrovascular disease falls with income; each $10,000 increase in median income of each ZIP code resulted in an average reduction of 3.83 observed cases. The significant nonlinear effect indicates a lessening of this income effect with increasing income. Conclusion Income is a non-linear predictor of excess cerebrovascular disease rates, with both low and high observed cerebrovascular disease rate areas associated with higher income. Income alone explains a significant amount of the geographical variance in cerebrovascular disease across New York State since both high and low clusters of cerebrovascular disease dissipate or disappear with income adjustment. Geographical modeling, including non-linear effects of income, may allow for better identification of other non-traditional risk factors. PMID:16242043

Han, Daikwon; Carrow, Shannon S; Rogerson, Peter A; Munschauer, Frederick E

2005-01-01

146

Pulsed radiofrequency to the great occipital nerve for the treatment of intractable postherpetic itch: a case report  

PubMed Central

A patient with intractable postherpetic itch lasting for 1 year was reported. The itch was mainly from the left vertex, frontal and ophthalmic regions and extended to the left neck area. The patient had negative response to the ophthalmic nerve block. Under the initial positive response to the great occipital nerve block, pulsed radiofrequency (PRF) was performed on the position of the great occipital nerve. After 4 months treatment, the itch was completely vanished. This case study demonstrates the effectiveness of PRF for intractable postherpetic itch originating in the head and neck. However, more samples needed to verify this management.

Ding, De-Fang; Li, Rong-Chun; Xiong, Qiu-Ju; Zhou, Ling; Xiang, Hong-Bing

2014-01-01

147

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

PubMed

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

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

2011-06-01

148

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...

149

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

PubMed Central

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

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

2014-01-01

150

Ebola virus disease cluster in the United States - dallas county, Texas, 2014.  

PubMed

Since March 10, 2014, Guinea, Liberia, and Sierra Leone have experienced the largest known Ebola virus disease (Ebola) epidemic with approximately 13,000 persons infected as of October 28, 2014. Before September 25, 2014, only four patients with Ebola had been treated in the United States; all of these patients had been diagnosed in West Africa and medically evacuated to the United States for care. PMID:25412069

Chevalier, Michelle S; Chung, Wendy; Smith, Jessica; Weil, Lauren M; Hughes, Sonya M; Joyner, Sibeso N; Hall, Emily; Srinath, Divya; Ritch, Julia; Thathiah, Prea; Threadgill, Heidi; Cervantes, Diana; Lakey, David L

2014-11-21

151

Magnetoencephalographic evaluation of resting-state functional connectivity in Alzheimer's disease  

Microsoft Academic Search

Statistical interdependencies between magnetoencephalographic signals recorded over different brain regions may reflect the functional connectivity of the resting-state networks. We investigated topographic characteristics of disturbed resting-state networks in Alzheimer's disease patients in different frequency bands. Whole-head 151-channel MEG was recorded in 18 Alzheimer patients (mean age 72.1 years, SD 5.6; 11 males) and 18 healthy controls (mean age 69.1 years, SD 6.8;

C. J. Stam; B. F. Jones; I. Manshanden; T. Montez; J. P. A. Verbunt; J. C. de Munck; B. W. van Dijk; H. W. Berendse; P. Scheltens

2006-01-01

152

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

Microsoft Academic Search

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

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

2004-01-01

153

An abnormal resting-state functional brain network indicates progression towards Alzheimer's disease.  

PubMed

Brain structure and cognitive function change in the temporal lobe, hippocampus, and prefrontal cortex of patients with mild cognitive impairment and Alzheimer's disease, and brain network-connection strength, network efficiency, and nodal attributes are abnormal. However, existing research has only analyzed the differences between these patients and normal controls. In this study, we constructed brain networks using resting-state functional MRI data that was extracted from four populations (normal controls, patients with early mild cognitive impairment, patients with late mild cognitive impairment, and patients with Alzheimer's disease) using the Alzheimer's Disease Neuroimaging Initiative data set. The aim was to analyze the characteristics of resting-state functional neural networks, and to observe mild cognitive impairment at different stages before the transformation to Alzheimer's disease. Results showed that as cognitive deficits increased across the four groups, the shortest path in the resting-state functional network gradually increased, while clustering coefficients gradually decreased. This evidence indicates that dementia is associated with a decline of brain network efficiency. In addition, the changes in functional networks revealed the progressive deterioration of network function across brain regions from healthy elderly adults to those with mild cognitive impairment and Alzheimer's disease. The alterations of node attributes in brain regions may reflect the cognitive functions in brain regions, and we speculate that early impairments in memory, hearing, and language function can eventually lead to diffuse brain injury and other cognitive impairments. PMID:25206600

Xiang, Jie; Guo, Hao; Cao, Rui; Liang, Hong; Chen, Junjie

2013-10-25

154

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

PubMed Central

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

Zaporowska-Stachowiak, Iwona; Kowalski, Grzegorz; Luczak, Jacek; Kosicka, Katarzyna; Kotlinska-Lemieszek, Aleksandra; Sopata, Maciej; Glowka, Franciszek

2014-01-01

155

Circulating YKL-40 in myelofibrosis a potential novel biomarker of disease activity and the inflammatory state.  

PubMed

Chronic myeloproliferative neoplasms (MPN), encompassing essential thrombocythaemia (ET), polycythaemia vera (PV) and myelofibrosis (PMF), are featured by a chronic inflammatory state which is pronounced in myelofibrosis The value of YKL-40 as a biomarker of disease burden has been demonstrated in several different diseases, including cancer, diabetes mellitus and cardiovascular diseases. A state of chronic inflammation is shared by them all, YKL-40 also being involved in the severity of chronic endothelial inflammation, which today is considered of crucial importance for the development of atherosclerosis. The MPNs being cancers with a heavy burden of cardiovascular diseases we hypothesised that circulating YKL-40 might reflect the inflammatory process and potentially serve as a novel disease marker. Using ELISA, we measured YKL-40 in 15 patients with ET, 16 patients with PV, 17 patients with PMF and 30 healthy controls. YKL-40 was significantly elevated in PMF vs. control subjects, PMF levels median 43 ng/mL vs. controls median 28 ng/mL, P = 0.033. An increase from ET over PV may reflect the integrated impact of disease processes in MPNs. PMID:24689875

Bjørn, Mads Emil; Andersen, Christen Lykkegaard; Jensen, Morten Krogh; Hasselbalch, Hans C

2014-09-01

156

NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Communicable Disease Control  

E-print Network

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

Mahon, Bradford Z.

157

Potato wart disease Synchytrium endobioticum Michigan State University's invasive species factsheets  

E-print Network

Potato wart disease Synchytrium endobioticum Michigan State University's invasive species for confirmation and species identification (USDA 2007). Economic significance to Michigan Since the potato wart factsheets Prepared by T. Noma, M. Colunga-Garcia, M. Brewer, J. Landis, and A. Gooch as a part of Michigan

158

Prevalence of gallbladder disease among persons with hepatitis C virus infection in the United States  

Microsoft Academic Search

Although cirrhosis is a known risk factor for gallstones, little is known about gallbladder disease (GBD) in individuals with hepatitis C virus (HCV) infection. We determined the association between chronic HCV infection and GBD in a representative sample of adults in the United States. Data on HCV infection and GBD were available for 13,465 persons 20 to 74 years of

Edmund J. Bini; John McGready

2005-01-01

159

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...

160

1982 Shellfish-Related Disease Outbreak in New York State: Agency Response and Interaction.  

National Technical Information Service (NTIS)

The shellfish-related disease outbreak of 1982 and initial public and private response to the problem pose important policy issues for the state in inter-agency relationships, enforcement of common properties, and value of public health versus economic he...

M. Becker

1983-01-01

161

3D Mapping of Mini-mental State Examination Performance in Clinical and Preclinical Alzheimer Disease  

Microsoft Academic Search

The Mini-mental State Examination (MMSE) is a brief cognitive screening instrument frequently used to track Alzheimer disease (AD) progression. We investigated the structural neuroimaging correlates of MMSE performance in patients with clinical and preclinical AD. We analyzed structural magnetic resonance imaging data from 29 probable AD and 5 MCI patients who later converted to probable AD using an advanced 3D

Liana G. Apostolova; Po H. Lu; Steve Rogers; Rebecca A. Dutton; Kiralee M. Hayashi; Arthur W. Toga; Jeffrey L. Cummings; Paul M. Thompson

2006-01-01

162

Surveillance for Human West Nile Virus Disease — United States, 1999-2008  

Microsoft Academic Search

Problem\\/Condition: West Nile virus (WNV) is an arthropod-borne virus (arbovirus) in the family Flaviviridae and is the leading cause of arboviral disease in the United States. An estimated 80% of WNV infections are asymptomatic. Most symptomatic persons develop an acute systemic febrile illness that often includes headache, myalgia, arthralgia, rash, or gastrointestinal symptoms. Less than 1% of infected persons develop

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

163

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

E-print Network

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

Ferrara, Katherine W.

164

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...

165

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

PubMed Central

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

2008-01-01

166

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

PubMed

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

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

2011-02-01

167

An evaluation of serum paraoxonase together with arylesterase activities and oxidative stress in children with intractable epilepsy: A cross-sectional study.  

PubMed

Epilepsy is the most common chronic neurological illness in childhood and adolescence. The aim of this study was to investigate paraoxonase and arylesterase activities along with oxidative status parameters in children with intractable epilepsy. The study comprised 42 subjects with intractable epilepsy and a control group of 35 healthy subjects. Serum paraoxonase and arylesterase activities, and lipid hydroperoxide levels were determined. All paraoxonase and arylesterase activities were significantly lower in the intractable epilepsy subjects than in the controls (P<0.001), whereas lipid hydroperoxide levels were significantly higher (P<0.05). In conclusion, paraoxonase and arylesterase activities were decreased and the lipid hydroperoxide level was increased in patients with intractable epilepsy. These results showed that intractable epilepsy subjects may be more prone to the development of atherosclerosis. PMID:25218892

Calik, Mustafa; Oguz, Elif; Sarikaya, Suna; Kocaturk, Ozcan; Koca, Bulent; Gungor, Hatice Eke; Aksoy, Nurten; Yoldas, Tah?r Kurtulus; Iscan, Akin

2014-11-01

168

[Case of intractable hemoptysis controlled by bronchial occlusion with an Endobronchial Watanabe Spigot (EWS)].  

PubMed

A man in his eighties with massive hemoptysis was referred to our hospital in order to control the bleeding. Chest computed tomography (CT) indicated that the hemoptysis originated from the right upper lobe. We performed arterial embolization twice, but failed to stop it. A surgical lobectomy was considered to be very difficult to perform because of his poor general condition and the strong adhesions between the right upper lobe and parietal pleura. We therefore performed fiberoptic bronchoscopy and plugged 4 EWS (Endobronchial Watanabe Spigot) into his right B1b, B1, B2, B3, and this procedure was able to successfully and completely control the hemoptysis. Bronchial occlusion with EWS has been developed in order to treat patients with intractable pneumothorax, pyothorax with bronchial fistula and similar problems. Our findings suggest that this method is also highly effective in controlling hemoptysis in cases in which arterial embolization is unable to stop the bleeding or surgery is difficult to perform. PMID:18517020

Fujii, Akiko; Misumi, Yukihiro; Hiyama, Junichiro; Koshizuka, Hiromasa; Miyakawa, Yosuke; Hayashi, Akihiro

2008-05-01

169

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

NASA Astrophysics Data System (ADS)

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

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

170

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

SciTech Connect

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

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

1988-04-01

171

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

PubMed

A large number of Bhutanese are currently being resettled to the United States. A high prevalence of noninfectious diseases has been noted in some refugee groups, but data on the Bhutanese refugee population are lacking. A retrospective, chart review study was conducted to determine proportion of noninfectious disease among ethnically Nepali Bhutanese refugees (n = 66) seen at the Grady Refugee Clinic (GRC). GRC disease proportions included the following: 52 % of the patients were overweight/obese (n = 34), 23 % were hypertensive (n = 15), 12 % had vitamin B12 deficiency (n = 8), 15 % had depression (n = 10), and 14 % had diabetes (n = 9). Nine (90 %) patients with depression had chronic disease compared to 30 (54 %) of the patients without depression. The study found a substantial burden of chronic disease, micronutrient deficiency, and depression in the GRC. Further research is needed to accurately describe the disease burden in refugee populations and to evaluate pre-resettlement disease prevention strategies to provide a framework for future public health interventions. PMID:23456726

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

2014-10-01

172

People Efficiently Explore the Solution Space of the Computationally Intractable Traveling Salesman Problem to Find Near-Optimal Tours  

PubMed Central

Humans need to solve computationally intractable problems such as visual search, categorization, and simultaneous learning and acting, yet an increasing body of evidence suggests that their solutions to instantiations of these problems are near optimal. Computational complexity advances an explanation to this apparent paradox: (1) only a small portion of instances of such problems are actually hard, and (2) successful heuristics exploit structural properties of the typical instance to selectively improve parts that are likely to be sub-optimal. We hypothesize that these two ideas largely account for the good performance of humans on computationally hard problems. We tested part of this hypothesis by studying the solutions of 28 participants to 28 instances of the Euclidean Traveling Salesman Problem (TSP). Participants were provided feedback on the cost of their solutions and were allowed unlimited solution attempts (trials). We found a significant improvement between the first and last trials and that solutions are significantly different from random tours that follow the convex hull and do not have self-crossings. More importantly, we found that participants modified their current better solutions in such a way that edges belonging to the optimal solution (“good” edges) were significantly more likely to stay than other edges (“bad” edges), a hallmark of structural exploitation. We found, however, that more trials harmed the participants' ability to tell good from bad edges, suggesting that after too many trials the participants “ran out of ideas.” In sum, we provide the first demonstration of significant performance improvement on the TSP under repetition and feedback and evidence that human problem-solving may exploit the structure of hard problems paralleling behavior of state-of-the-art heuristics. PMID:20686597

Acuña, Daniel E.; Parada, Víctor

2010-01-01

173

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

PubMed Central

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

Babel, T; Warnke, P; Ostertag, C

2001-01-01

174

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

PubMed Central

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

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

2014-01-01

175

Treating Intractable Phantom Limb Pain with Ambulatory Continuous Peripheral Nerve Blocks: A Pilot Study  

PubMed Central

Background There is currently no reliable treatment for phantom limb pain (PLP). Chronic PLP and associated cortical abnormalities may be maintained from abnormal peripheral input, raising the possibility that a continuous peripheral nerve block (CPNB) of extended duration may permanently reorganize cortical pain mapping, thus providing lasting relief. Methods Three men with below-the-knee (2) or -elbow (1) amputations and intractable PLP received femoral/sciatic or infraclavicular perineural catheter(s), respectively. Subjects were randomized in a double-masked fashion to receive perineural ropivacaine (0.5%) or normal saline for over 6 days as outpatients using portable electronic infusion. Four months later, subjects returned for repeated perineural catheter insertion (“crossover”), and received an ambulatory infusion with the alternate solution. Subjects were followed for up to one year. Results By chance, all 3 subjects received saline during their initial infusion and reported little change in their PLP. One subject did not receive crossover treatment; but, the remaining 2 subjects reported complete resolution of their PLP during and immediately following treatment with ropivacaine. One subject experienced no PLP recurrence through the 52-week follow-up period; and, the other reported mild PLP occurring once each week of just a small fraction of his original pain (pre-treatment: continuous PLP rated 10/10; post-treatment: no PLP at baseline with average of 1 PLP episode each week rated 2/10) for 12 weeks (lost to follow-up thereafter). Conclusions A prolonged ambulatory CPNB may be a reliable treatment for intractable PLP. The results of this pilot study suggest that a large, randomized clinical trial is warranted. PMID:23489466

Ilfeld, Brian M.; Moeller-Bertram, Tobias; Hanling, Steven R.; Tokarz, Kyle; Mariano, Edward R.; Loland, Vanessa J.; Madison, Sarah J.; Ferguson, Eliza J.; Morgan, Anya C.; Wallace, Mark S.

2013-01-01

176

Intractable Gelastic Seizures During Infancy: Ictal Positron Emission Tomography (PET) Demonstrating Epileptiform Activity Within the Hypothalamic Hamartoma  

Microsoft Academic Search

Gelastic seizures comprise a very rare form of epilepsy. They present with recurrent bursts of laughter voices without mirth and are most commonly associated with the evolution of a hypothalamic hamartoma. The purpose of this article is to describe the second reported ictal fluorodeoxyglucose-positron emission tomography study in a unique case of an infant with intractable gelastic seizures since the

Eli Shahar; Dorit Goldsher; Jacob Genizi; Sarit Ravid; Zohar Keidar

2008-01-01

177

Transcending Intractable Conflict in Health Care: An Exploratory Study of Communication and Conflict Management Among Anesthesia Providers  

Microsoft Academic Search

This paper explores the contrast between the longstanding, intractable conflict between two anesthesia providers and the cooperation of many individual nurse anesthetists and anesthesiologists working side-by-side to provide safe, effective anesthesia. Analysis of interview transcripts reveals that communication among anesthesia nurses and anesthesiologists may enact or transcend the conflict. This article proposes recommendations for improving communication between anesthesiologists and certified

JESSICA KATZ JAMESON

2003-01-01

178

Spatial Clusters of Nontuberculous Mycobacterial Lung Disease in the United States  

PubMed Central

Rationale: Prevalence of pulmonary nontuberculous mycobacterial (PNTM) disease varies by geographic region, yet the factors driving these differences remain largely unknown. Objectives: To identify spatial clusters of PNTM disease at the county level and to describe environmental and sociodemographic factors predictive of disease. Methods: PNTM cases identified from a nationally representative sample of Medicare Part B beneficiaries from 1997 to 2007 were geocoded by county and state of residence. County-level PNTM case counts and Medicare population data were then uploaded into SaTScan to identify significant spatial clusters and low-risk areas of disease. High-risk and low-risk counties were then compared to identify significant sociodemographic and environmental differences. Measurements and Main Results: We identified seven significant (P < 0.05) clusters of PNTM cases. These high-risk areas encompassed 55 counties in 8 states, including parts of California, Florida, Hawaii, Louisiana, New York, Oklahoma, Pennsylvania, and Wisconsin. Five low-risk areas were also identified, which encompassed 746 counties in 23 states, mostly in the Midwest. Counties in high-risk areas were significantly larger, had greater population densities, and higher education and income levels than low-risk counties. High-risk counties also had higher mean daily potential evapotranspiration levels and percentages covered by surface water, and were more likely to have greater copper and sodium levels in the soil, although lower manganese levels. Conclusions: Specific environmental factors related to soil and water exposure appear to increase the risk of PNTM infection. Still, given that environmental sources of NTM are ubiquitous and PNTM disease is rare, both host susceptibility and environmental factors must be considered in explaining disease development. PMID:22773732

Olivier, Kenneth N.; Seitz, Amy E.; Falkinham, Joseph O.; Holland, Steven M.; Prevots, D. Rebecca

2012-01-01

179

The burden of disease and injury in the United States 1996  

PubMed Central

Background Burden of disease studies have been implemented in many countries using the Disability-Adjusted Life Year (DALY) to assess major health problems. Important objectives of the study were to quantify intra-country differentials in health outcomes and to place the United States situation in the international context. Methods We applied methods developed for the Global Burden of Disease (GBD) to data specific to the United States to compute Disability-Adjusted Life Years. Estimates are provided by age and gender for the general population of the United States and for each of the four official race groups: White; Black; American Indian or Alaskan Native; and Asian or Pacific Islander. Several adjustments of GBD methods were made: the inclusion of race; a revised list of causes; and a revised algorithm to allocate cardiovascular disease garbage codes to ischaemic heart disease. We compared the results of this analysis to international estimates published by the World Health Organization for developed and developing regions of the world. Results In the mid-1990s the leading sources of premature death and disability in the United States, as measured by DALYs, were: cardiovascular conditions, breast and lung cancers, depression, osteoarthritis, diabetes mellitus, and alcohol use and abuse. In addition, motor vehicle-related injuries and the HIV epidemic exacted a substantial toll on the health status of the US population, particularly among racial minorities. The major sources of death and disability in these latter populations were more similar to patterns of burden in developing rather than developed countries. Conclusion Estimating DALYs specifically for the United States provides a comprehensive assessment of health problems for this country compared to what is available using mortality data alone. PMID:17049081

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

2006-01-01

180

Postdoctoral Research Fellow: Prion/Chronic Wasting Disease Research The MIP Department at Colorado State University is seeking  

E-print Network

Postdoctoral Research Fellow: Prion/Chronic Wasting Disease Research ­ Open Pool The MIP Department at Colorado State University is seeking postdoctoral fellows to conduct research on the mechanisms of infection and transmission of chronic wasting disease (CWD), a prion disease of deer and elk. Expertise

Stephens, Graeme L.

181

Impact of lifestyle on prevalence of kidney disease in Pima Indians in Mexico and the United States  

Microsoft Academic Search

Impact of lifestyle on prevalence of kidney disease in Pima Indians in Mexico and the United States.Pima Indians in the United States and Mexico share a common genetic background but have very different lifestyles. Comparisons were made of the frequency of obesity, diabetes, hypertension, and kidney disease in these geographically separated but susceptible populations. Mexican Pimas had higher levels of

Mauro E. Valencia; E. Jennifer Weil; Robert G. Nelson; JULIAN ESPARZA; Leslie O. Schulz; ERIC RAVUSSIN; Peter H. Bennett

2005-01-01

182

The development of a mini-array for estimating the disease state of gastric adenocarcinoma by array CGH  

Microsoft Academic Search

BACKGROUND: The treatment strategy usually depends on the disease state in the individual patient. However, it is difficult to estimate the disease state before treatment in many patients. The purpose of this study was to develop a BAC (bacterial artificial chromosome) mini-array allowing for the estimation of node metastasis, liver metastasis, peritoneal dissemination and the depth of tumor invasion in

Tomoko Furuya; Tetsuji Uchiyama; Atsushi Adachi; Takae Okada; Motonao Nakao; Atsunori Oga; Song-Ju Yang; Shigeto Kawauchi; Kohsuke Sasaki

2008-01-01

183

PulseNet: the molecular subtyping network for foodborne bacterial disease surveillance, United States.  

PubMed Central

PulseNet, the national molecular subtyping network for foodborne disease surveillance, was established by the Centers for Disease Control and Prevention and several state health department laboratories to facilitate subtyping bacterial foodborne pathogens for epidemiologic purposes. PulseNet, which began in 1996 with 10 laboratories typing a single pathogen (Escherichia coli O157:H7), now includes 46 state and 2 local public health laboratories and the food safety laboratories of the U.S. Food and Drug Administration and the U.S. Department of Agriculture. Four foodborne pathogens (E. coli O157:H7; nontyphoidal Salmonella serotypes, Listeria monocytogenes and Shigella) are being subtyped, and other bacterial, viral, and parasitic organisms will be added soon. PMID:11384513

Swaminathan, B.; Barrett, T. J.; Hunter, S. B.; Tauxe, R. V.

2001-01-01

184

The importance of waterborne disease outbreak surveillance in the United States.  

PubMed

Analyses of the causes of disease outbreaks associated with contaminated drinking water in the United States have helped inform prevention efforts at the national, state, and local levels. This article describes the changing nature of disease outbreaks in public water systems during 1971-2008 and discusses the importance of a collaborative waterborne outbreak surveillance system established in 1971. Increasing reports of outbreaks throughout the early 1980s emphasized that microbial contaminants remained a health-risk challenge for suppliers of drinking water. Outbreak investigations identified the responsible etiologic agents and deficiencies in the treatment and distribution of drinking water, especially the high risk associated with unfiltered surface water systems. Surveillance information was important in establishing an effective research program that guided government regulations and industry actions to improve drinking water quality. Recent surveillance statistics suggest that prevention efforts based on these research findings have been effective in reducing outbreak risks especially for surface water systems. PMID:23247140

Craun, Gunther Franz

2012-01-01

185

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

Microsoft Academic Search

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

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

2000-01-01

186

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

PubMed Central

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

2011-01-01

187

Prevalence of livestock diseases and their impact on livelihoods in Central Equatoria State, Southern Sudan.  

PubMed

A participatory epidemiological (PE) study was conducted in Kajo Keji and Yei Counties, Central Equatoria State, southern Sudan to assess the impact of livestock diseases on livelihoods. A serological survey of tick-borne diseases was conducted to supplement the PE study. PE data collection tools consisted primarily of focus group interviews and key informant interviews supplemented by observation. Information was collected on the social context, history and species of livestock kept. Constraints in livestock keeping were explored through description and probing. Proportional piling on the importance of different diseases and relative incidence scoring were also conducted. 243 sera were collected from cattle and tested for antibodies to Anaplasma marginale, Babesia bigemina, B. bovis, Theileria mutans and T. parva by ELISA. Additionally, 173 blood samples were collected for a PCR assay of T. parva. Livestock diseases were ranked as the most important constraint to livestock keeping. While East Coast fever was ranked as the most important disease in Kajo Keji, diarrhoea in small ruminants was reported as the most important disease in Yei. Serological analyses of the sera indicated that A. marginale, B. bigemina, T. mutans and T. parva were most prevalent. Prevalence of B. bovis was found to be low (4.0% and 7.4% in Kajo Keji and Yei, respectively). 35% of the samples screened with the T. parva p104 gene nested PCR assay were positive. The study concludes that while ECF is the most important disease in Kajo Keji, it was not the case in Yei. Additional epidemiological studies are proposed before control strategies are recommended. PMID:22244519

Malak, A K; Mpoke, L; Banak, J; Muriuki, S; Skilton, R A; Odongo, D; Sunter, J; Kiara, H

2012-05-01

188

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

PubMed

One of the most daunting challenges for Chagas disease surveillance and control in Mexico is the lack of community level data on vector distributions. Although many states now have assembled representative domestic triatomine collections, only two triatomine specimens had been collected and reported previously from the state of Guanajuato. Field personnel from the state's Secretaría de Salud conducted health promotion activities in 43 of the 46 counties in the state and received donations of a total of 2,522 triatomine specimens between 1998 and 2002. All specimens were identified, and live insects examined for Trypanosoma cruzi. In an effort to develop fine-scale distributional data for Guanajuato, collection localities were georeferenced and ecological niches were modeled for each species by using evolutionary-computing approaches. Five species were collected: Triatoma mexicana (Herrich-Schaeffer), Triatoma longipennis (Usinger), Triatoma pallidipennis (Stål), Triatoma barberi (Usinger), and Triatoma dimidiata (Latreille) from 201 communities located at elevations of 870-2,200 m. Based on collection success, T. mexicana had the broadest dispersion, although niche mapping indicates that T. barberi represents the greatest risk for transmission of Chagas disease in the state. T. dimidiata was represented in collections by a single adult collected from one village outside the predicted area for all species. For humans, an estimated 3,755,380 individuals are at risk for vector transmission in the state, with an incidence of 3,500 new cases per year; overall seroprevalences of 2.6% indicate that 97,640 individuals are infected with T. cruzi at present, including 29,300 chronic cases. PMID:16465750

López-Cárdenas, Jorge; Gonzalez Bravo, Francisco Ernesto; Salazar Schettino, Paz Maria; Gallaga Solorzano, Juan Carlos; Ramírez Barba, Ector; Martinez Mendez, Joel; Sánchez-Cordero, V; Peterson, A Townsend; Ramsey, J M

2005-11-01

189

[Experience of successful treatment for a case of intractable chronic empyema with a bronchopleural fistula].  

PubMed

We report an experience of successful treatment for a case of intractable chronic empyema complicated by bronchopleural fistula (BPF). A 75-year-old woman who had severe diabetes mellitus complained of general fatigue and anorexia. A lung abscess in the right upper lobe was diagnosed and treated with antibiotics. Regrettably, it ruptured into a pyopneumothorax. The BPF was closed primarily and covered with intercostal muscle, but the procedure was not effective. The pyopneumothorax led to the development of chronic empyema with BPF. The patient was admitted to our hospital for treatment and the BPF was managed with a Dumon stent and endobronchial Watanabe spigot (EWS) but failed to heal. Therefore, open drainage was chosen as a 1st stage treatment. After healing the infected space, closure of the BPF and a bronchial embolization by EWS was performed with a closeire of space by pediculed omentum and muscle flap and with a thoracoplasty as a 2nd stage treatment. The postoperative course was uneventful, and the patient was discharged on post-operative day 51. PMID:20214353

Nagata, Toshiyuki; Nakamura, Yoshihiro; Kariatsumari, Kouta; Fukumori, Kazuhiko

2010-03-01

190

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

PubMed

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

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

2013-06-18

191

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

PubMed Central

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

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

2011-01-01

192

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

PubMed Central

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

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

2014-01-01

193

Medical management for intractable pain arising from primary sjögren syndrome involving both brain and spinal cord: a case report.  

PubMed

Primary Sjögren syndrome, which involves lesions in both the brain and spinal cord, is rarely reported. Related symptoms, such as intractable pain due to central nervous system involvement, are very rare. A 73-year-old woman diagnosed with primary Sjögren syndrome manifested with subacute encephalopathy and extensive transverse myelitis. She complained of severe whole body neuropathic pain. Magnetic resonance imaging demonstrated a non-enhancing ill-defined high intensity signal involving the posterior limb of the both internal capsule and right thalamus on a T2 fluid-attenuated inversion recovery image. Additionally, multifocal intramedullary ill-defined contrast-enhancing lesion with cord swelling from the C-spine to L-spine was also visible on the T2-weighted image. Her intractable pain remarkably improved after administration of concomitant oral doses of gabapentin, venlafaxine, and carbamazepine. PMID:25229038

Lee, Kyoung Moo; Han, Kyu Yong; Kwon, Oh Pum

2014-08-01

194

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

PubMed

Fifty-five students with intractable epilepsy and learning difficulties, aged 6.5 to 14.1 years with a mean IQ of 71.25 (SD=13.56), attended a hospital-based classroom of no more than eight students where they received Direct Instruction programming for 3 to 4.5 days a week, typically for up to 16 weeks. Pretest-posttest academic gains were evaluated in comparison to normative test performance. At pretest the students were achieving below test means in reading and mathematics, particularly in calculation. Direct Instruction was associated with significant improvement in all academic areas except word identification in reading. IQ level was related to certain academic gains, but gains were not associated with seizure variables or the number of days students spent in the program. Despite severe learning difficulties, students with intractable epilepsy can make academic gains when taught by highly structured teaching methods such as Direct Instruction. PMID:15820350

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

2005-05-01

195

Vasopressin deficiency and vasodilatory state in end-stage liver disease  

PubMed Central

1. Objectives Relative vasopressin deficiency, a contributor to vasodilatory septic shock may also be a cause of the vasodilatory state in liver disease. This study assesses endogenous vasopressin levels in patients with liver disease and their hemodynamic response to exogenous vasopressin. 2. Design Prospective, observational study 3. Setting Single center, tertiary hospital 4. Participants Human subjects undergoing liver transplantation or major surgery 5. Interventions Vasopressin levels were measured in 28 patients with liver disease undergoing liver transplantation and 7 control patients with normal liver function. Additionally intravenous vasopressin was given to 20 liver transplant recipients and the hemodynamic response was observed. 6. Measurements and Main Results Patients with liver disease had significantly lower baseline vasopressin levels than controls (19.3 +/? 27.1 pg/mL versus 50.9 +/? 36.7 pg/mL, p=0.015). Patients with low vasopressin levels (• 20 pg/mL) were more likely to have low baseline mean blood pressure (• 80 mm Hg) than patients with high vasopressin levels (11 of 16 vs. 0 of 4, p=0.013). Systemic vascular resistance increased by 33% three minutes after intravenous vasopressin. Thirteen of 16 patients with low vasopressin levels compared to one of four patients with high vasopressin levels responded to exogenous vasopressin with an increase of mean blood pressure by more than 20% (p=0.028). 7. Conclusions Patients with liver disease have lower vasopressin levels than controls and respond with a brisk vasoconstrictor response to exogenous vasopressin. Relative endogenous vasopressin deficiency may therefore contribute to vasodilatory shock in liver disease similar to what has been observed in septic shock PMID:21126886

Wagener, Gebhard; Kovalevskaya, Galina; Minhaz, Moury; Mattis, Fallon; Emond, Jean C.; Landry, Donald W.

2010-01-01

196

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

PubMed Central

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

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

2012-01-01

197

Waterborne diseases in the state of Mexico, Mexico (2000-2005).  

PubMed

This paper reports a spatial-temporal examination of waterborne disease data from the State of Mexico, 2000 to 2005, by county as the spatial unit. It was found that the incidence of waterborne disease did not decrease during the period under study. Inequality between metropolitan areas and rural zones was observed. People living in population centres had lower incidence of water-related diseases, possibly due to better access to services. In all cases, children under five years old suffered a much higher relative morbidity than the population in general. Improvement of the water distribution network between 2000 and 2005 could explain the decrease in morbidity from 30% to 15%, for the total population, and from 34% to 18.5%, for children under five years old. Coverage of sewer services over the period was not substantially improved; as a result the coefficient of determination remained nearly constant: 16.5% for the total population and 25% for children under five. Maintenance and operation deficiencies in the water distribution and wastewater sanitation systems play an important role in the incidence of this type of disease. It was found that the institutional division of the territory does not correspond to the actual distribution of the risk areas. PMID:21301127

Jiménez-Moleón, M C; Gómez-Albores, M A

2011-03-01

198

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

PubMed Central

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

Ferrer, Glenio Cesar Nunes; da Silva, Rosemeri Maurici; Ferrer, Kelian Tenfen; Traebert, Jefferson

2014-01-01

199

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

PubMed

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

Onat, Altan; Can, Günay

2014-01-01

200

A spatio-temporal absorbing state model for disease and syndromic surveillance.  

PubMed

Reliable surveillance models are an important tool in public health because they aid in mitigating disease outbreaks, identify where and when disease outbreaks occur, and predict future occurrences. Although many statistical models have been devised for surveillance purposes, none are able to simultaneously achieve the important practical goals of good sensitivity and specificity, proper use of covariate information, inclusion of spatio-temporal dynamics, and transparent support to decision-makers. In an effort to achieve these goals, this paper proposes a spatio-temporal conditional autoregressive hidden Markov model with an absorbing state. The model performs well in both a large simulation study and in an application to influenza/pneumonia fatality data. PMID:22388709

Heaton, Matthew J; Banks, David L; Zou, Jian; Karr, Alan F; Datta, Gauri; Lynch, James; Vera, Francisco

2012-08-30

201

Regional Differences in the Association Between Land Cover and West Nile Virus Disease Incidence in Humans in the United States  

PubMed Central

West Nile virus (WNV) is generally considered to be an urban pathogen in the United States, but studies associating land cover and disease incidence, seroprevalence, or infection rate in humans, birds, domesticated and wild mammals, and mosquitoes report varying and sometimes contradictory results at an array of spatial extents. Human infection can provide insight about basic transmission activity; therefore, we analyzed data on the incidence of WNV disease in humans to obtain a comprehensive picture of how human disease and land cover type are associated across the United States. Human WNV disease incidence in Northeastern regions was positively associated with urban land covers, whereas incidence in the Western United States was positively associated with agricultural land covers. We suggest that these regional associations are explained by the geographic distributions of prominent WNV vectors: Culex pipiens complex (including Cx. pipiens and Cx. quinquefasciatus) in the Northeast and Cx. tarsalis in the Western United States. PMID:21292890

Bowden, Sarah E.; Magori, Krisztian; Drake, John M.

2011-01-01

202

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

E-print Network

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 ...

Dottori, Martin

2014-01-01

203

[Temporal disconnection as an alternative treatment for intractable temporal lobe epilepsy: techniques, complications and results].  

PubMed

Temporal lobe epilepsy (TLE) is the most common form of intractable partial epilepsy in adults. Surgery (lobectomy or amygdalohippocampectomy) is effective in most patients. However, some complications can occur and brain shift, hematoma into the post operative cavity and occulomotor nerve palsy have been reported due to the surgical technic. We report the technique, safety and efficacy of temporal disconnection in nonlesional TLE. Forty-seven patients (18 males, 29 females; handedness: 12 left, 33 right; aged 35 years+/-10; mean duration of epilepsy: 24+/-10 years) underwent temporal disconnection (20 left, 27 right) guided by neuronavigation. Sixteen patients (35 %) underwent additional presurgical evaluation with SEEG. The outcome was assessed using Engel's classification. At the two-year follow-up, 85 % of the patients were seizure-free (Engel I), 26 (58 %) of whom were Ia. Postoperative persistent morbidity included mild hemiparesis (n=1), mild facial paresis (n=1), quadranopsia (n=23) and hemianopia (n=1). Verbal memory worsened in 13 % of cases when the disconnection was performed in the dominant lobe. MRI follow-up showed two cases of nonsymptomatic thalamic or pallidal limited ischemias, two cases of temporal horn-cystic dilatation, one requiring surgical reintervention without sequelae. There was one case of postoperative phlebitis. In the seizure-free patient group, postoperative EEG showed interictal temporal spikes at three months, one year and two years located in the anterior temporal region. Temporal disconnection is effective, prevents the occurrence of subdural cyst and hematomas in the temporal cavity, prevents the occurrence of oculomotor palsy, and limits the occurrence of quadranopsia. However, comparative studies are required to evaluate temporal disconnection as an alternative to lobectomy in nonlesional TLE. PMID:18417163

Chabardès, S; Minotti, L; Hamelin, S; Hoffmann, D; Seigneuret, E; Carron, R; Krainik, A; Grand, S; Kahane, P; Benabid, A-L

2008-05-01

204

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

PubMed Central

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

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

2013-01-01

205

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

PubMed Central

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

Greig, Fiona H.; Nixon, Graeme F.

2014-01-01

206

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

PubMed Central

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

2012-01-01

207

Abnormal resting-state connectivity of motor and cognitive networks in early manifest Huntington's disease.  

PubMed

Background. Functional magnetic resonance imaging (fMRI) of multiple neural networks during the brain's 'resting state' could facilitate biomarker development in patients with Huntington's disease (HD) and may provide new insights into the relationship between neural dysfunction and clinical symptoms. To date, however, very few studies have examined the functional integrity of multiple resting state networks (RSNs) in manifest HD, and even less is known about whether concomitant brain atrophy affects neural activity in patients. Method. Using MRI, we investigated brain structure and RSN function in patients with early HD (n = 20) and healthy controls (n = 20). For resting-state fMRI data a group-independent component analysis identified spatiotemporally distinct patterns of motor and prefrontal RSNs of interest. We used voxel-based morphometry to assess regional brain atrophy, and 'biological parametric mapping' analyses to investigate the impact of atrophy on neural activity. Results. Compared with controls, patients showed connectivity changes within distinct neural systems including lateral prefrontal, supplementary motor, thalamic, cingulate, temporal and parietal regions. In patients, supplementary motor area and cingulate cortex connectivity indices were associated with measures of motor function, whereas lateral prefrontal connectivity was associated with cognition. Conclusions. This study provides evidence for aberrant connectivity of RSNs associated with motor function and cognition in early manifest HD when controlling for brain atrophy. This suggests clinically relevant changes of RSN activity in the presence of HD-associated cortical and subcortical structural abnormalities. PMID:25066491

Wolf, R C; Sambataro, F; Vasic, N; Depping, M S; Thomann, P A; Landwehrmeyer, G B; Süssmuth, S D; Orth, M

2014-11-01

208

Chloroplast phylogenomic analyses resolve deep-level relationships of an intractable bamboo tribe arundinarieae (poaceae).  

PubMed

The temperate woody bamboos constitute a distinct tribe Arundinarieae (Poaceae: Bambusoideae) with high species diversity. Estimating phylogenetic relationships among the 11 major lineages of Arundinarieae has been particularly difficult, owing to a possible rapid radiation and the extremely low rate of sequence divergence. Here, we explore the use of chloroplast genome sequencing for phylogenetic inference. We sampled 25 species (22 temperate bamboos and 3 outgroups) for the complete genome representing eight major lineages of Arundinarieae in an attempt to resolve backbone relationships. Phylogenetic analyses of coding versus noncoding sequences, and of different regions of the genome (large single copy and small single copy, and inverted repeat regions) yielded no well-supported contradicting topologies but potential incongruence was found between the coding and noncoding sequences. The use of various data partitioning schemes in analysis of the complete sequences resulted in nearly identical topologies and node support values, although the partitioning schemes were decisively different from each other as to the fit to the data. Our full genomic data set substantially increased resolution along the backbone and provided strong support for most relationships despite the very short internodes and long branches in the tree. The inferred relationships were also robust to potential confounding factors (e.g., long-branch attraction) and received support from independent indels in the genome. We then added taxa from the three Arundinarieae lineages that were not included in the full-genome data set; each of these were sampled for more than 50% genome sequences. The resulting trees not only corroborated the reconstructed deep-level relationships but also largely resolved the phylogenetic placements of these three additional lineages. Furthermore, adding 129 additional taxa sampled for only eight chloroplast loci to the combined data set yielded almost identical relationships, albeit with low support values. We believe that the inferred phylogeny is robust to taxon sampling. Having resolved the deep-level relationships of Arundinarieae, we illuminate how chloroplast phylogenomics can be used for elucidating difficult phylogeny at low taxonomic levels in intractable plant groups. PMID:25092479

Ma, Peng-Fei; Zhang, Yu-Xiao; Zeng, Chun-Xia; Guo, Zhen-Hua; Li, De-Zhu

2014-11-01

209

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

Code of Federal Regulations, 2013 CFR

...HEALTH 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 §...

2013-01-01

210

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

...HEALTH 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 §...

2014-01-01

211

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

Code of Federal Regulations, 2012 CFR

...HEALTH 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 §...

2012-01-01

212

Relationships between obesity and cardiovascular diseases in four southern states and Colorado.  

PubMed

Obesity is among the leading causes of elevated cardiovascular disease (CVD) mortality and morbidity. In the present study, the associations between the increase in body mass index (BMI) and the increase rates of CVD and high blood pressure (HBP) in the states of Mississippi, Alabama, Louisiana, Tennessee, and Colorado are examined using regression analysis and by means of neural network models for obesity and HBP. Data from Behavioral Risk Factor Surveillance System were obtained and analyzed for obesity rates, percent of myocardial infarction, stroke, and HBP from 2005-2009. Results of this study showed a low association between obesity and myocardial infarction rates (R2=0.067); a moderate association with stroke rates ((R2=0.462); and a strong association with HBP rates ((R2=0.811). The highest rates of obesity, CVD, and HBP were found in Mississippi, while Colorado had the lowest rates. Maintaining healthy weight helps reduce the risks of developing CVD. PMID:22102306

Akil, Luma; Ahmad, H Anwar

2011-01-01

213

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

PubMed Central

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

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

2006-01-01

214

Isolation and transmission of the Lyme disease spirochete from the southeastern United States.  

PubMed

The isolation of the Lyme disease spirochete (Borrelia burgdorferi) from the southeastern United States is reported. Three isolates, two from cotton mice (Peromyscus gossypinus) and one from the black-legged tick (Ixodes scapularis), were recovered from Sapelo Island, Georgia, in July and September 1991. The spirochetes were characterized by indirect fluorescent antibody assay using a battery of five monoclonal antibodies, by sodium dodecyl sulfate/polyacrylamide gel electrophoresis (SDS/PAGE) of whole cell lysates, and by the polymerase chain reaction (PCR) assay using primers for three DNA target sequences found in B. burgdorferi reference strain B-31. Transmission experiments indicate that the three Georgia isolates can infect experimentally inoculated hamsters and mice. Tick transmission of one of the isolates has been attempted so far; I. scapularis transmitted isolate SI-1 from hamsters to mice, but the lone-star tick, Amblyomma americanum, did not. PMID:8346258

Oliver, J H; Chandler, F W; Luttrell, M P; James, A M; Stallknecht, D E; McGuire, B S; Hutcheson, H J; Cummins, G A; Lane, R S

1993-08-01

215

[Study of literature on disease in the Rongchengshi of the Warring States.  

PubMed

Many scholars have studied and disputed over the names of diseases recorded in Rongchengshi, bamboo slips of the Chu kingdon in the Warring States collected in the Shanghai Museum. According to comments of scholars and other literature it could be concluded: JinLong in slip 2 and AnLong in slip 36 means deaf-mutism; MaoFa in slip 2 means blindness; PiBi in slip 2 means lameness; ZhangZhe in slip 2 means persons who are strong and tall; An in slip 3 that it is the variant form of Ying, which means thyroid enlargement; Lou in slip 2 it means kyphosis of the spine; Xia in slip 3 it means pruritus and scabies; ? in slip 36 means blindness; and Shang in slip 37 means bald head. PMID:21569693

Luo, Bao-Zhen

2011-01-01

216

[Epidemiology of sexually transmitted diseases in the mine area of Las Claritas, Bolivar State, Venezuela].  

PubMed

The primordial objective of this study was to carry out an epidemiological analysis of sexually transmitted diseases (STD) in terms of sensed morbidity and real morbidity in the mining region of "Las Claritas", Bolivar State, Venezuela, during the third trimester of 1998. The epidemiological characteristics of time, people and place are interlaced, giving a relationship included within the Epidemiological Triad, that represents this work's conceptual framework; defining both, the determinant and the conditioning factors of the presence of STDs in the zone. The clinical interrogatory was partially steered towards the participant's sensed morbidity. A mostly feminine population is described (65%), with a low scholarly level in the general population and a high index of foreigners among the evaluated patients; with 48.72% of stable unions in the interviewees. From 166 evaluated patients, 27.70% referred to have had some STD episode, being syphilis and blenorrhagia the most frequently reported. In the survey, there was a general hush concerning the presence of STDs; but, key informants such as the medicine retailers, revealed a higher presence of these diseases, which are wrongly treated by automedication. These are important results, since they let opened a space for the epidemiological evaluation in the zone, in the various health, sanitary, environmental and social aspects and mainly, by the individual's quality of life expectations. PMID:10961044

González-O, N; Rodríguez-Acosta, A

2000-06-01

217

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

PubMed Central

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

Sethi, Sanjay; Murphy, Timothy F.

2001-01-01

218

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

PubMed Central

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

Wechalekar, Mihir D; Smith, Malcolm D

2014-01-01

219

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

PubMed Central

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

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

2013-01-01

220

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

PubMed

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

Wechalekar, Mihir D; Smith, Malcolm D

2014-11-18

221

Mortality impact of thoracic aortic disease in S?o Paulo state from 1998 to 2007  

PubMed Central

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

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

2013-01-01

222

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

PubMed Central

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

2013-01-01

223

The role of seafood in foodborne diseases in the United States of America.  

PubMed

In the United States of America, seafood ranked third on the list of products which caused foodborne disease between 1983 and 1992. Outbreaks connected with fish vectors were caused by scombroid, ciguatoxin, bacteria and unknown agents; in shellfish, unknown agents, paralytic shellfish poisoning, Vibrio spp. and other bacteria, followed by hepatitis A virus, were responsible for the outbreaks. At least ten genera of bacterial pathogens have been implicated in seafood-borne diseases. Over the past twenty-five years, bacterial pathogens associated with faecal contamination have represented only 4% of the shellfish-associated outbreaks, while naturally-occurring bacteria accounted for 20% of shellfish-related illnesses and 99% of the deaths. Most of these indigenous bacteria fall into the family Vibrionaceae which includes the genera Vibrio, Aeromonas and Plesiomonas. In general, Vibrio spp. are not associated with faecal contamination and therefore faecal indicators do not correlate with the presence of Vibrio. Viruses are the most significant cause of shellfish-associated disease: in New York State, for example, 33% and 62% of 196 outbreaks between 1981 and 1992 were caused by Norwalk virus and gastrointestinal viruses (small round structured viruses), respectively. In addition, several illnesses are a result of toxic algal blooms, the growth of naturally occurring bacteria and diatoms causing neurotoxic shellfish poisoning, paralytic shellfish poisoning, diarrhoetic shellfish poisoning, amnesic shellfish poisoning and ciguatera. Current estimates place the annual number of ciguatera cases at 20,000 world-wide. Scombroid poisoning is the most significant cause of illness associated with seafood. Scombrotoxin is of bacterial origin and halophilic Vibrio spp. causing high histamine levels are implicated as the source. Scombroid poisoning is geographically diverse and many species have been implicated, namely: tuna, mahi-mahi, bluefish, sardines, mackerel, amberjack and abalone. Temperature abuse has been cited as a major cause of scombroid poisoning. For routine work, the use of faecal indicators to predict the relative level of faecal contamination should not be disposed of. However, the main source of seafood illness is due to species which are not predicted by these organisms. In order to protect public health, routine surveillance using new pathogen-specific techniques such as polymerase chain reaction should be used. This, in combination with risk assessment methods and hazard analysis and critical control points, will begin to address the need for improvement in the safety of seafood. PMID:9501377

Lipp, E K; Rose, J B

1997-08-01

224

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

Microsoft Academic Search

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

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

2008-01-01

225

Major white matter fiber changes in medically intractable neocortical epilepsy in children: a diffusion tensor imaging study.  

PubMed

This study aimed to investigate the extent of microstructural changes in the major white matter fibers and to evaluate whether diffusion tensor imaging (DTI) adds any lateralizing information in children with medically intractable neocortical epilepsy secondary to focal cortical dysplasia. Patient group included twenty-three consecutively enrolled patients with medically intractable focal neocortical epilepsy and focal cortical dysplasia histopathologically confirmed. Thirteen patients (56.5%) had no visible lesion on the conventional magnetic resonance imaging (MRI). Fractional anisotropy (FA) was measured for regions of interest (ROIs) in each major white matter fiber. FA in patients was compared with eighteen age-matched healthy controls. Patient group had lower FA values at corpus callosum, bilateral inferior frontooccipital fasciculus (IFO), bilateral inferior longitudinal fasciculus (ILF) and left superior longitudinal fasciculus (SLF) compared to controls (p<0.05). In the left-side surgery group, the left SLF FA value was lower than controls, while in the right-side surgery group, the right SLF FA values were lower than controls (p<0.05). In the patient group as a whole, ipsilateral SLF FA was significantly lower than the contralateral SLF (p<0.05). Widespread decrease in FA values in the patients compared with the controls suggests that the pathologic changes extend diffusely to most major white matter tracts. In the patient group, the ipsilateral SLF to the seizure focus had greater change compared to the contralateral SLF. These data suggest that the detection of DTI abnormality has an added value to lateralization. PMID:22917916

Kim, H; Harrison, A; Kankirawatana, P; Rozzelle, C; Blount, J; Torgerson, C; Knowlton, R

2013-02-01

226

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

PubMed Central

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

Buhnerkempe, Michael G.; Tildesley, Michael J.; Lindstrom, 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

227

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

E-print Network

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

Keil, David M.

228

Metabolic State Determines Sensitivity to Cellular Stress in Huntington Disease: Normalization by Activation of PPAR?  

PubMed Central

Impairments in mitochondria and transcription are important factors in the pathogenesis of Huntington disease (HD), a neurodegenerative disease caused by a polyglutamine expansion in the huntingtin protein. This study investigated the effect of different metabolic states and peroxisome proliferator-activated receptor ? (PPAR?) activation on sensitivity to cellular stressors such as H2O2 or thapsigargin in HD. Striatal precursor cells expressing wild type (STHdhQ7) or mutant huntingtin (STHdhQ111) were prepared in different metabolic conditions (glucose vs. pyruvate). Due to the fact that STHdhQ111 cells exhibit mitochondrial deficits, we expected that in the pyruvate condition, where ATP is generated primarily by the mitochondria, there would be greater differences in cell death between the two cell types compared to the glucose condition. Intriguingly, it was the glucose condition that gave rise to greater differences in cell death. In the glucose condition, thapsigargin treatment resulted in a more rapid loss of mitochondrial membrane potential (??m), a greater activation of caspases (3, 8, and 9), and a significant increase in superoxide/reactive oxygen species (ROS) in STHdhQ111 compared to STHdhQ7, while both cell types showed similar kinetics of ??m-loss and similar levels of superoxide/ROS in the pyruvate condition. This suggests that bioenergetic deficiencies are not the primary contributor to the enhanced sensitivity of STHdhQ111 cells to stressors compared to the STHdhQ7 cells. PPAR? activation significantly attenuated thapsigargin-induced cell death, concomitant with an inhibition of caspase activation, a delay in ??m loss, and a reduction of superoxide/ROS generation in STHdhQ111 cells. Expression of mutant huntingtin in primary neurons induced superoxide/ROS, an effect that was significantly reduced by constitutively active PPAR?. These results provide significant insight into the bioenergetic disturbances in HD with PPAR? being a potential therapeutic target for HD. PMID:22276192

Jin, Youngnam N.; Hwang, Woong Y.; Jo, Chulman; Johnson, Gail V. W.

2012-01-01

229

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

PubMed Central

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

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

2014-01-01

230

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

Microsoft Academic Search

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

Carla Vande Weerd; Gregory J. Paveza

2006-01-01

231

Dopaminergic modulation of resting-state functional connectivity in de novo patients with Parkinson's disease.  

PubMed

Parkinson's disease (PD) is characterized by degenerative changes of nigral dopamine neurons, resulting in the dopaminergic denervation of the striatum. Resting state networks studies have demonstrated that dopamine modulates distinct network connectivity patterns in both a linear and a nonlinear fashion, but quantitative analyses of dopamine-dependent functional connectivity secondary to PD pathology were less informative. In the present study, we performed a correlation analysis between striatal dopamine levels assessed quantitatively by FP-CIT positron emission tomography imaging and resting-state functional connectivity in 23 drug naïve de novo patients with PD to elucidate dopamine-dependent functional networks. The major finding is that the patterns of dopamine-dependent positive functional connectivity varied depending on the location of striatal seeds. Dopamine-dependent functional connectivity with the caudate predominantly overlay pericentral cortical areas, whereas dopamine-dependent structures functionally connected with the posterior putamen predominantly involved cerebellar areas. The dorsolateral frontal area overlapped as a dopamine-dependent cortical region that was positively connected with the anterior and posterior putamen. On the other hand, cortical areas where functional connectivity from the posterior cingulate was negatively correlated with dopaminergic status in the posterior putamen were localized in the left anterior prefrontal area and the parietal area. Additionally, functional connectivity between the anterior putamen and mesiofrontal areas was negatively coupled with striatal dopamine levels. The present study demonstrated that dopamine-dependent functional network connectivity secondary to PD pathology mainly exhibits a consistent pattern, albeit with some variation. These patterns may reflect the diverse effects of dopaminergic medication on parkinsonian-related motor and cognitive performance. Hum Brain Mapp 35:5431-5441, 2014. © 2014 Wiley Periodicals, Inc. PMID:24938993

Baik, KyoungWon; Cha, Jungho; Ham, Jee Hyun; Baek, Gwang-Min; Sunwoo, Mun Kyung; Hong, Jin Yong; Shin, Na-Young; Kim, Jae Seung; Lee, Jong-Min; Lee, Seung-Koo; Sohn, Young Ho; Lee, Phil Hyu

2014-11-01

232

The prevalence of selected risk factors for chronic disease among American Indians in Washington State.  

PubMed Central

Despite great improvements in recent decades, the health status of American Indians continues to lag behind that of other Americans. Continued health improvement will depend largely on changes in individual behavior. Until recently, however, few data existed on health risk behaviors among American Indians. We conducted personal interviews among the adult population of an Indian Health Service Unit in Washington State to estimate the prevalence of some health risk behaviors. This analysis focuses on three of the many topics covered in the survey: tobacco use, alcohol consumption, and weight. Cigarette smoking was more prevalent among both men and women than it was in the general population in the same area with 43% of men and 54% of women among the American Indians interviewed reported that they currently smoked. However, they tended to smoke much less heavily than smokers in the general population. Smokeless tobacco use was concentrated among young men, with the overall prevalence similar to that found in the general population. Acute heavy drinking was found to be common with 40% of men and 33% of women reporting this behavior for the previous month. The prevalence of substantial overweight was 45% among men and 43% among women, considerably higher than in the general population. Tribal leaders and the Indian Health Service are using the findings to design disease prevention and health promotion activities. In addition to providing valuable information about the surveyed populations, the survey served as a pilot for similar studies of other American Indian groups. PMID:8643820

Kimball, E H; Goldberg, H I; Oberle, M W

1996-01-01

233

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

PubMed Central

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

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

2011-01-01

234

[Description of chagas disease in the Valle de Iguala, Guerrero state, Mexico- Marco].  

PubMed

There are reports regarding the presence of triatomine vectors of Trypanosoma cruzi, the causal agent of Chagas' disease, and infected individuals on the coast and zones south of the State of Guerrero, Mexico. Nonetheless, there are no completed reports in the Valley of Iguala. To know with greater precision endemic zones, seropositive individuals and their health condition, T. cruzi-infected triatomines and characteristics of dwellings were studied. Seroprevalence was 1.8% by indirect ELISA and latex agglutination techniques were carried out in serum of 450 individuals of three municipalities of the Valley of Iguala. We reported presence of triatomine and conditions of dwellings. Of 71 triatomines collected, 38.2% were infected with T. cruzi. Triatoma pallidipennis was the only triatomine species found. No seropositive persons presented intestinal, or cardiac problems. The greatest percentage of infected triatomines was observed in rural zones as compared to urban. Results suggest considerable risk of infection in the Valley of Iguala but studies regarding the infectivity capacity of T. cruzi strains are required. PMID:14723049

Becerril-Flores, Marco Antonio; Valle-De La Cruz, Alfredo

2003-01-01

235

von Willebrand disease in the United States: A Perspective from Wisconsin  

PubMed Central

Von Willebrand disease (VWD) is a common bleeding disorder with prevalence in the United States of 0.01% to 1% and a prevalence in the region around Milwaukee, Wisconsin of at least 0.025%. Care of local patients with VWD primarily occurs through our comprehensive treatment center, although some patients are managed solely by their primary care physician or community hematologist. Type 1 VWD is the most common subtype, with more females carrying this diagnosis than males. Diagnosis and treatment in general follows guidelines outlined by the National Institutes of Health. An ongoing study, the Zimmerman Program for the Molecular and Clinical Biology of VWD, is currently enrolling patients with all VWD subtypes across the US in order to better delineate the extent of VWD and correlate bleeding symptoms with laboratory findings and VWF (von Willebrand factor) sequence variations. Results so far have shown that VWF gene polymorphisms are common, particularly in African Americans, and may affect laboratory assays of VWF function. PMID:22102196

Flood, Veronica H; Gill, Joan Cox; Friedman, Kenneth D; Bellissimo, Daniel B; Haberichter, Sandra L; Montgomery, Robert R

2013-01-01

236

Consensus building and recommendations based on the available epidemiology of meningococcal disease in Gulf Cooperation Council States.  

PubMed

The Gulf Cooperation Council (GCC) States share concerns about meningococcal disease, particularly in association with the Hajj and Umrah pilgrimages, which have been connected with outbreaks within the Kingdom of Saudi Arabia and among contacts of the pilgrims in their countries of origin. Currently, the most prevalent meningococcal serogroup in the GCC States is W-135. Although vaccination with polysaccharide vaccines has protected pilgrims and their close contacts from invasive disease, the potential availability of novel conjugate vaccines, such as the one currently used for vaccination of military personnel in the Kingdom of Saudi Arabia, prompted an evaluation of disease epidemiology in the region. For several countries, published data on recent epidemiology are not available. We report findings from a meeting of the GCC States Meningitis Study Group, which comprised experts from the Kingdom of Saudi Arabia, the Kingdom of Bahrain, Kuwait, Qatar, the Sultanate of Oman, and the United Arab Emirates. These experts provided an update on epidemiology and current vaccination practices in the GCC States, and discussed new approaches to more effective disease prevention. PMID:21345738

Memish, Ziad A; Shibl, Atef M

2011-03-01

237

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

E-print Network

Early Recognition and Disease Prediction in the At-Risk Mental States for Psychosis Using. These patterns may have the potential to substantially improve the early recognition of psychosis. Key words: individualized psychosis prediction/ multivariate analysis/neurocognitive test battery Introduction

Gaser, Christian

238

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...

239

Studies on prolonged acute regional ischemia. IV. Aggressive surgical treatment for intractable ventricular fibrillation after acute myocardial infarction.  

PubMed

Of 21 dogs undergoing ligation of the left anterior descending coronary artery and 50% stenosis of the left circumflex coronary artery, 15 developed intractable ventricular fibrillation and underwent 1 added hour of femoro-femoral bypass. Three hearts were removed after 1 hour on bypass without myocardial reperfusion for biochemical and mitochondrial analysis. After the 1 hour, five underwent unmodified blood reperfusion on bypass; seven underwent 1 hour of aortic clamping on vented bypass to simulate coronary artery bypass grafting with multidose blood cardioplegic reperfusion. Regional systolic shortening was measured with ultrasonic crystals and cardiac output was measured by thermodilution techniques. All six hearts with no ventricular fibrillation or with reversible ventricular fibrillation and hearts that were not reperfused developed cardiogenic shock (40% decrease in stroke work index, p less than 0.05) because of persistent left ventricular dyskinesia (-40% of systolic shortening, p less than 0.05) and progressive circumflex hypocontractility (48% systolic shortening, p less than 0.05) and showed extensive (68%) triphenyltetrazolium chloride nonstaining. Two dogs died of left ventricular power failure (33% mortality rate). In contrast, 11 of 12 dogs that were reperfused could be weaned from bypass (8% mortality rate). The four dogs surviving after unmodified blood reperfusion (20% mortality rate) showed severe residual left ventricular dysfunction (39% of control stroke work index, p less than 0.05), had equivocal recovery of anterior contractility (10% +/- 7% of systolic shortening), had marginal recovery of contractility in the remote myocardium (60% +/- 11% of systolic shortening), and had extensive triphenyltetrazolium chloride nonstaining (58%). Conversely, all seven dogs with intractable ventricular fibrillation undergoing controlled reperfusion after 4 hours of ischemia recovered normal stroke work index (91%), regained 23% of systolic shortening in the region supplied by the left anterior descending coronary artery (p less than 0.05), 125% of systolic shortening in the circumflex region (p less than 0.05), and showed only 25% triphenyltetrazolium chloride nonstaining (p less than 0.05). These results suggest aggressive treatment of intractable ventricular fibrillation after acute myocardial infarction by providing reperfusion on bypass can salvage hearts thought previously to be damaged irreversibly.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2796363

Beyersdorf, F; Acar, C; Buckberg, G D; Partington, M T; Okamoto, F; Allen, B S; Bugyi, H I; Young, H H

1989-10-01

240

A novel cognitive-neurophysiological state biomarker in premanifest Huntington's disease validated on longitudinal data  

PubMed Central

In several neurodegenerative diseases, like Huntington's disease (HD), treatments are still lacking. To determine whether a treatment is effective, sensitive disease progression biomarkers are especially needed for the premanifest phase, since this allows the evaluation of neuroprotective treatments preventing, or delaying disease manifestation. On the basis of a longitudinal study we present a biomarker that was derived by integrating behavioural and neurophysiological data reflecting cognitive processes of action control. The measure identified is sensitive enough to track disease progression over a period of only 6 month. Changes tracked were predictive for a number of clinically relevant parameters and the sensitivity of the measure was higher than that of currently used parameters to track prodromal disease progression. The study provides a biomarker, which could change practice of progression diagnostics in a major basal ganglia disease and which may help to evaluate potential neuroprotective treatments in future clinical trials. PMID:23652721

Beste, Christian; Stock, Ann-Kathrin; Ness, Vanessa; Hoffmann, Rainer; Lukas, Carsten; Saft, Carsten

2013-01-01

241

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

PubMed

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

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

2013-01-01

242

A case of successful management with splenectomy of intractable ascites due to congenital dyserythropoietic anemia type II-induced cirrhosis  

PubMed Central

The congenital dyserythropoietic anemias comprise a group of rare hereditary disorders of erythropoiesis, characterized by ineffective erythropoiesis as the predominant mechanism of anemia and by characteristic morphological aberrations of the majority of erythroblasts in the bone marrow. Congenital dyserythropoietic anemia type II is the most frequent type. All types of congenital dyserythropoietic anemias distinctly share a high incidence of iron loading. Iron accumulation occurs even in untransfused patients and can result in heart failure and liver cirrhosis. We have reported about a patient who presented with liver cirrhosis and intractable ascites caused by congenital dyserythropoietic anemia type II. Her clinical course was further complicated by the development of autoimmune hemolytic anemia. Splenectomy was eventually performed which achieved complete resolution of ascites, increase of hemoglobin concentration and abrogation of transfusion requirements. PMID:16521204

Vassiliadis, Themistoklis; Garipidou, Vassilia; Perifanis, Vassilios; Tziomalos, Konstantinos; Giouleme, Olga; Patsiaoura, Kalliopi; Avramidis, Michalis; Nikolaidis, Nikolaos; Vakalopoulou, Sofia; Tsitouridis, Ioannis; Antoniadis, Antonios; Semertzidis, Panagiotis; Kioumi, Anna; Premetis, Evangelos; Eugenidis, Nikolaos

2006-01-01

243

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

PubMed Central

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

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

2013-01-01

244

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

PubMed Central

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

Monsivais, Diane Burn

2014-01-01

245

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

PubMed Central

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

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

2014-01-01

246

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

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.

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

247

Intractable gelastic seizures during infancy: ictal positron emission tomography (PET) demonstrating epileptiform activity within the hypothalamic hamartoma.  

PubMed

Gelastic seizures comprise a very rare form of epilepsy. They present with recurrent bursts of laughter voices without mirth and are most commonly associated with the evolution of a hypothalamic hamartoma. The purpose of this article is to describe the second reported ictal fluorodeoxyglucose-positron emission tomography study in a unique case of an infant with intractable gelastic seizures since the neonatal period associated with a hypothalamic hamartoma. The patient presented at 4 months old with recurrent, almost persistent, gelastic seizures consisting of laughter bouts without mirth. The seizures were noticeable at the first week of life and increased in frequency to last up to 12 hours, namely status gelasticus. These gelastic fits were accompanied with focal motor seizures, including unilateral right-eye blinking and mouth twitching. Developmental mile-stones were intact for age. Magnetic resonance imaging of the cortex demonstrated a large hypothalamic hamartoma within the third ventricle, hampering cerebrovascular fluid drainage of the lateral ventricles. An electroencephalography was nondiagnostic. Ictal fluorodeoxyglucose-positron emission tomography demonstrated a large circumscribed hypermetabolic region within the location of the hypothalamic hamartoma, representing localized intense epileptiform activity. The infant became instantly free of all seizure types given minute doses of oral benzodiazepine (clonazepam) and remains completely controlled after 12 months. Her overall development remains intact. This ictal fluorodeoxyglucose-positron emission tomography is the second reported study verifying that the main source of the epileptic activity inducing gelastic seizures originates from the hypothalamic hamartoma itself; therefore, a complementary fluorodeoxyglucose-positron emission tomography study should be considered in any patient presenting with intractable gelastic seizures, especially in those associated with hypothalamic hamartoma, in order to localize the region of epileptiform activity amenable to surgical resection if intensive drug therapy fails. PMID:18160558

Shahar, Eli; Goldsher, Dorit; Genizi, Jacob; Ravid, Sarit; Keidar, Zohar

2008-02-01

248

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

SciTech Connect

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

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

2013-12-01

249

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

PubMed Central

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

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

2013-01-01

250

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

PubMed Central

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

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

2013-01-01

251

Detection and molecular characterization of Newcastle disease virus in peafowl (Pavo cristatus) in Haryana State, India.  

PubMed

Present study was undertaken to investigate the cause of deaths of peafowls in Haryana State. In total, 145 birds were sick and 28 birds were reported dead during July to September 2012. Some of the sick birds were showing signs of shaking of heads, torticollis and paresis. Blood and cloacal swab samples from sick birds along with brain and intestinal tissues from dead birds were collected for further investigation. Although post-mortem examination showed no typical lesions of Newcastle disease virus (NDV) yet raised HI tires against NDV in some serum samples and clinical signs indicated the presence of NDV. One of the brain tissues (NDV/IND2012/01) from the field case was processed and adapted to Vero cell line for virus isolation. The fusion (F) gene based nested RT-PCR (RT-nPCR) confirmed the presence of NDV in all field samples and cell culture isolate. Sequencing of the partial F gene amplicons (216 bp) using the PCR primers as sequencing primers confirmed the PCR results. The deduced amino acid sequences of partial F gene were found to have the amino acid motif (111)GRRQKR/F(117) in the fusion protein cleavage site (FPCS). This amino acid motif is indicative of the velogenic nature of these NDVs. Phylogenetic studies have shown that the virus belonged to class II genotype VII very closely related to virus isolates originated from outbreaks in Western Europe, Israel, Indonesia, Taiwan and India. Phylogenetic grouping of the virus and sequence of FPCS is indicative of pathogenic potential of virus strain circulating in peacocks in Haryana. PMID:24426301

Kumar, Aman; Maan, Sushila; Mahajan, Nand Kishore; Rana, Virender Pratap; Jindal, Naresh; Batra, Kanisht; Ghosh, Arnab; Mishra, Shiv Kumar; Kapoor, Sanjay; Maan, Narender Singh

2013-12-01

252

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

PubMed Central

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

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

2014-01-01

253

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

PubMed

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

Ma, Li-Jun; Shea, Terrance; Young, Sarah; Zeng, Qiandong; Kistler, H Corby

2014-01-01

254

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

PubMed

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

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

2013-05-01

255

Defining cut-off values for disease activity states and improvement scores for patient-reported outcomes: the example of the Rheumatoid Arthritis Impact of Disease (RAID)  

PubMed Central

Introduction The Rheumatoid Arthritis Impact of Disease (RAID) is a patient-reported outcome measure evaluating the impact of rheumatoid arthritis (RA) on patient quality of life. It comprises 7 domains that are evaluated as continuous variables from 0 (best) to 10 (worst). The objective was to define and identify cut-off values for disease activity states as well as improvement scores in order to present results at the individual level (for example, patient in acceptable state, improved patient). Methods Patients with definite active RA requiring anti-tumour necrosis factor (anti-TNF) therapy were seen at screening, baseline and after 4 and 12 weeks of etanercept therapy. Answers to "Gold standard" questions on improvement (MCII: Minimum Clinically Important Improvement) and an acceptable status (PASS: Patient Acceptable Symptom State) were collected as well as the RAID score and Disease Activity Score 28- erythrocyte sedimentation rate (DAS28-ESR). Cut-offs were defined by different techniques including empirical, measurement error and gold standard anchors. The external validity of these cut-offs was evaluated using the positive likelihood ratio (LR) based on the patient's perspective (for example, patient's global) and on low disease activity status (such as DAS28-ESR). Results Ninety-seven (97) of the 108 recruited patients (age: 54 ± 13 years old, female gender: 75%, rheumatoid factor positive: 81%, disease duration: 8 ± 7 years, CRP: 18 ± 30 mg/l, DAS28-ESR: 5.4 ± 0.8) completed the 12 weeks of the study. The different techniques suggested thresholds ranging from 0.2 to 3 (absolute change) and from 6 to 50% (relative change) for defining MCII and thresholds from less than 1 to less than 4.2 for defining PASS. The evaluation of external validity (LR+) showed the highest LR+ was obtained with thresholds of 3 for absolute change; 50% for relative change and less than 2 for an acceptable status. Conclusions This study showed that thresholds defined for continuous variables are closely related to the methodological technique, justifying a systematic evaluation of their validity. Our results suggested that a change of at least 3 points (absolute) or 50% (relative) in the RAID score should be used to define a MCII and that a maximal value of 2 defines an acceptable status. Trial Registration Clinicaltrial.gov: NCT004768053 PMID:22647431

2012-01-01

256

The Role of Resting State Networks in Focal Neocortical Seizures  

PubMed Central

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

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

257

Aspirin Use Is Low Among United States Outpatients With Coronary Artery Disease  

Microsoft Academic Search

Background—The goal of the present study was to assess national trends and patterns of aspirin use among outpatients with coronary artery disease. Although there is strong evidence that the use of aspirin reduces the risk of death and recurrent events in patients with coronary artery disease, current national patterns of aspirin use are unknown. Methods and Results—We used data from

Randall S. Stafford

258

Phagocytic Activity and State of Bactericidal Systems in Polymorphonuclear Leukocytes from Patients with Alzheimer's Disease  

Microsoft Academic Search

Phagocytic activity of peripheral blood neutrophils underwent phase changes in patients with Alzheimer's disease. Neutrophils retained the ability to engulf microbes, but their digestive activity decreased at the early stage of Alzheimer's disease. At the late stage we observed a decrease in the count of phagocytizing neutrophils, reduction of myeloperoxidase activity, and increase in the content of cationic proteins.

T. V. Davydova; V. G. Fomina; N. I. Voskresenskaya; O. A. Doronina

2003-01-01

259

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

Microsoft Academic Search

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

HB el-Serag; A Sonnenberg

1997-01-01

260

Enhanced External Counterpulsation in Patients with Coronary Artery Disease-Associated Erectile Dysfunction. Part II: Impact of Disease Duration and Treatment Courses  

Microsoft Academic Search

Introduction. Enhanced external counterpulsation (EECP) is a noninvasive outpatient treatment used for patients with intractable angina refractory to aggressive surgical and medical treatment. Recent results have demonstrated a positive impact of EECP on patients with ischemic heart disease (IHD)-associated erectile dysfunction (ED). Aim. To assess the effect of IHD duration and number of EECP courses on efficacy and satisfaction rate

Ahmed I. El-Sakka; Ayman M. Morsy; Bassam I. Fagih

2007-01-01

261

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

PubMed Central

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

Assari, Shervin

2014-01-01

262

Precipitating antibodies to epizootic hemorrhagic disease and bluetongue viruses in white-tailed deer in the southeastern United States.  

PubMed

From 1981 to 1989, sera were collected from 3,077 white-tailed deer (Odocoileus virginianus) in Georgia and from 1,749 deer from 12 additional states in the southeastern United States. In Georgia, prevalence of precipitating antibodies to epizootic hemorrhagic disease virus (EHDV) and bluetongue virus (BTV), as determined by agar gel immunodiffusion tests, was dependent on physiographic region, age, and year. Overall prevalence of antibodies to EHDV and/or BTV was 11, 33, 48, and 14% for the Mountain, Piedmont, Coastal Plain, and Barrier Island regions, respectively. Results suggested varying patterns of EHDV and BTV activity throughout the state. Serologic results from other southeastern states were consistent with the Georgia sample; prevalence estimates (EHDV and/or BTV) for corresponding physiographic regions deviated by less than 10%. Over this larger geographical area, antibody prevalence in deer appeared to increase with decreasing latitude. PMID:1676762

Stallknecht, D E; Blue, J L; Rollor, E A; Nettles, V F; Davidson, W R; Pearson, J E

1991-04-01

263

Multidrug-resistant nontyphoidal Salmonella in New York state's foodborne diseases active surveillance network counties.  

PubMed

With the emergence of multidrug-resistant nontyphoidal (NT) Salmonella, knowledge of resistance patterns is critical for appropriate presumptive treatment. This report describes the prevalence and trends of NT Salmonella antimicrobial susceptibility within the New York State (NYS) Foodborne Diseases Active Surveillance Network (FoodNet). The NYS Department of Health, Wadsworth Center Public Health Laboratory tested all Salmonella isolates from the NYS FoodNet catchment area between May 2003 and December 2007 for antimicrobial susceptibility to ampicillin, chloramphenicol, streptomycin, sulfisoxazole, tetracycline, nalidixic acid, and ciprofloxacin. Isolate susceptibility results were linked to their corresponding demographic and clinical data and analyzed. Multidrug-resistant isolates were defined as resistant to ampicillin, chloramphenicol, streptomycin, sulfisoxazole, and tetracycline (R-type ACSSuT). Antimicrobial susceptibility for 2189 FoodNet cases (98.5% of total cases) showed 79.6% pansusceptible, 6.9% R-type ACSSuT, and 13.5% resistant to at least one antimicrobial agent but not R-type ACSSuT. Four (0.2%) isolates were resistant to ciprofloxacin. From 2004 to 2007, cases with R-type ACSSuT significantly decreased from 8.7% (37/424) to 4.8% (24/499) (p < 0.01). Serotypes with the highest proportion of R-type ACSSuT included Salmonella Typhimurium 17.9% (79/444), and Salmonella Newport 29.1% (51/175). Among Salmonella Typhimurium isolates, over 40% of the African-American cases (19/46) had R-type ACSSuT isolates, compared with 15.7% of the Caucasian cases (58/369) (p < 0.01). R-type ACSSuT Salmonella Typhimurium cases were hospitalized (41.8%) more frequently than pansusceptible Salmonella Typhimurium cases (24.9%), after controlling for age (p < 0.05). Length of hospitalization was not significantly different. Although R-type ACSSuT NT Salmonella has decreased since 2003 within the NYS FoodNet catchment area, monitoring resistance patterns remains important in identifying emerging resistant strains, vulnerable populations, and determining appropriate presumptive treatment regimens. The higher rate of R-type ACSSuT among the African-American cases requires further study. PMID:19821741

Solghan, Suzanne M; Dumas, Nellie B; Root, Timothy P; Quinlan, Tammy M; Armstrong, Leeanna R; Spina, Nancy L; Zansky, Shelley M

2010-02-01

264

Nontuberculous Mycobacterial Disease Mortality in the United States, 1999-2010: A Population-Based Comparative Study  

PubMed Central

Background Environmental nontuberculous mycobacteria (NTM) are ubiquitous organisms with which humans commonly interact. The epidemiologic characteristics of NTM diseases including mortality rate and its associated factors remain largely unknown. In this study, we explored the geographical area of exposure and mortality and comorbid conditions of affected persons to determine environment, host, and host-pathogen interactive factors. Methods We analyzed mortality related to nontuberculous mycobacterial infections from 1999 through 2010 by examining multiple-cause-of-death data from the National Center for Health Statistics. Among those who died with these diseases, we analyzed age-adjusted mortality rates, trends, associations with demographic variables, and comorbid conditions and correlated this information with similar data for tuberculosis-related mortality during the same time. Measurements and Mean Results From 1999 through 2010, nontuberculous mycobacterial disease was reported as an immediate cause of death in 2,990 people in the United States with a combined overall mean age-adjusted mortality rate of 0.1 per 100,000 person-years. A significant increase in the number of NTM related deaths was seen from 1999 through 2010 (R2?=?0.72, p<0.0001), but it was not significant after adjustment for age. Persons aged 55 years and older, women, those living in Hawaii and Louisiana, and those of non-Hispanic, white ethnicity had higher mortality rates. Compared to tuberculosis-related mortality, chronic obstructive pulmonary disease, bronchiectasis, HIV, interstitial lung diseases, and tobacco use were significantly more common in persons with nontuberculous mycobacteria-related deaths. Conclusions Nontuberculous mycobacteria-related death numbers are rising and are unevenly distributed. The strong association of nontuberculous mycobacterial disease with age suggests that its prevalence will increase as the United States population ages. PMID:24632814

Mirsaeidi, Mehdi; Machado, Roberto F.; Garcia, Joe G. N.; Schraufnagel, Dean E.

2014-01-01

265

The impact of motor and non motor symptoms on health state values in newly diagnosed idiopathic Parkinson’s disease  

Microsoft Academic Search

The aim of the study was to estimate health state utility values in newly diagnosed idiopathic Parkinson’s disease (PD) for\\u000a use in the assessment of health-related quality-of-life (HRQL), and in the estimation of quality-adjusted life-years (QALYs).\\u000a Data from 162 patients enrolled in a community-based incidence study of PD were used to estimate health state utility values.\\u000a Self-report data from the

James Shearer; Colin Green; Carl E. Counsell; John P. Zajicek

266

Medical malpractice involving colon and rectal disease: A 20-year review of United States civil court litigation  

Microsoft Academic Search

To determine objectively the causes of malpractice litigation involving colon and rectal disease, a retrospective review was undertaken of all cases tried in the U.S. federal and state civil court system over a 21-year period from 1971 through 1991. Ninety-eight malpractice cases were identified from a computerized legal data base, involving 103 allegations of negligence. Allegations fell into five major

Kenneth A. Kern

1993-01-01

267

Care of the Adult Congenital Heart Disease Patient in the United States: A Summary of the Current System  

Microsoft Academic Search

With improvements in care, there has been exponential growth in the population of adult congenital heart disease (ACHD) patients.\\u000a We sought to assess the availability of specialized ACHD care in the United States. We analyzed the Adult Congenital Heart\\u000a Association’s ACHD clinic directory for information on patient volume, provider training, and other characteristics. The information\\u000a is self-reported and unverified. The

Manisha S. Patel; Brian E. Kogon

2010-01-01

268

[Prevention of cardiovascular diseases--the most recent recommendations from the United States].  

PubMed

The origins of cardiovascular diseases reside in the childhood. The prevention of these diseases should therefore also start at an early age. The US recommendation for promoting children's cardiac health encourages to pay attention to living habits - non-smoking, healthy eating and adequate physical exercise. The recommendation also proposes the measurement of lipids from all children at the age of about 10 years. This has provoked discussion for and against - what would be the benefits and drawbacks of general screening. PMID:24822327

Pahkala, Katja; Niinikoski, Harri; Raitakari, Olli

2014-01-01

269

Emergency Duties and Deaths from Heart Disease among Firefighters in the United States  

Microsoft Academic Search

Results Deaths from coronary heart disease were associated with suppressing a fire (32.1% of all such deaths), responding to an alarm (13.4%), returning from an alarm (17.4%), engaging in physical training (12.5%), responding to nonfire emergencies (9.4%), and performing nonemergency duties (15.4%). As compared with the odds of death from coronary heart disease during nonemergency duties, the odds were 12.1

Stefanos N. Kales; Elpidoforos S. Soteriades; Costas A. Christophi; David C. Christiani

2007-01-01

270

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

Microsoft Academic Search

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

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

271

Chagas disease: state-of-the-art of diagnosis and management.  

PubMed

Chagas' disease or American trypanosomiasis, is a potentially lethal parasitic zoonosis prevalent and endemic only in Latin America, caused by the flagellate protozoa Trypanosoma cruzi. It has 3 different stages, acute, indeterminate and chronic phase, with the chance of an etiological approach in the first stage and pharmacological and non-pharmacological treatment in the chronic phase. There are five main clinical forms of chronic chagasic cardiomyopathy: indeterminate, arrhythmogenic (predominantly dromotropic and extrasystolic), with ventricular dysfunction, thromboembolic and mixed forms. There are several diagnostic tests at the different stages, however, the ECG is the method of choice in longitudinal population studies in endemic areas because it is simple, with a low cost and a good sensitivity. Microscopic examination or parasitological diagnosis in the acute phase or immunodiagnostic tests are used to confirm the disease. The antiarrhythmic drug amiodarone, the most frequently prescribed agent for symptomatic ventricular arrhythmia treatment of Chagas' disease patients, has also recently been shown to have antifungal activity. Cardiac device implantation is very common, and chronic Chagas disease patients require pacemaker implantation at a younger age in contrast with patients with other cardiac pathologies. In summary, Chagas disease is a social disease, endemic in Latin America and shows different prevalence rates in Latin American countries. PMID:19039752

Dubner, Sérgio; Schapachnik, Edgardo; Riera, Andrés Ricardo Pérez; Valero, Elina

2008-01-01

272

Finding Disease-Related Genomic Experiments Within an International Repository: First Steps in Translational Bioinformatics  

Microsoft Academic Search

The amount of gene expression data in international repositories has grown exponentially. An important first step in translating the results of genomic experiments into medicine is to relate these genomic experiments to the human diseases they have studied. Unfortunately, repositories for expression data store the crucial annotative details only as free-text, making it manually intractable to link these with human

Atul J Butte; Rong Chen

273

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

PubMed

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

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

2013-05-01

274

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

PubMed

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

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

2013-05-01

275

Emergence of salsa and guacamole as frequent vehicles of foodborne disease outbreaks in the United States, 1973-2008.  

PubMed

Fresh salsa and guacamole often contain diced raw produce, are often made in large batches, and are often poorly refrigerated, which may make them prone to contamination that can cause foodborne illness. The safety of salsa and guacamole is increasingly important as these foods gain popularity. Since 1973, local, state, and territorial health departments have voluntarily reported foodborne disease outbreaks to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System (FDOSS) using a standard reporting form. FDOSS used paper-based reporting for 1973-1997 and switched to electronic reporting for 1998-2008. We reviewed all reports of outbreaks during 1973-2008 in which salsa or guacamole was reported as a vehicle. We found 136 outbreaks in which salsa or guacamole was reported as a possible vehicle, which resulted in 5,658 illnesses. Of these 136 salsa- or guacamole-associated (SGA) outbreaks additional possible food vehicles were reported for 33 (24%) outbreaks. There were no SGA outbreaks reported before 1984. Among reported outbreaks, most were caused by norovirus (24%), nontyphoidal Salmonella (19%), and Shigella (7%). Eighty-four percent of outbreaks were caused by foods prepared in restaurants or delis; of these, 19% reported ill foodworkers, and 29% reported improper storage as possible contributing factors. Among all foodborne disease outbreaks with a reported food vehicle during 1984-1997, 26 (0.9%) of 2,966 outbreaks were SGA, and during 1998-2008, 110 (1.4%) of 7,738 outbreaks were SGA. The number of reported foodborne disease outbreaks attributable to salsa or guacamole increased in the United States from 1984 to 2008, especially in later years, and especially in restaurants. Fresh salsa and guacamole require careful preparation and storage. Focused prevention strategies should reduce the risk of illness and ensure that these foods are enjoyed safely. PMID:23461608

Kendall, Magdalena E; Mody, Rajal K; Mahon, Barbara E; Doyle, Michael P; Herman, Karen M; Tauxe, Robert V

2013-04-01

276

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

PubMed

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

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

2014-10-01

277

[The current state of Niemann-Pick disease: evaluation of six cases].  

PubMed

Six pediatric patients with Niemann-Pick disease are reported. They have been studied at Hepatology Unit HI "La Paz" (Madrid) in the period of time between 1975-1988. They are one case of type A, one case of type B and four cases of type C. This group of pediatric patients serve us to make a revision of the disease attending to clinical and biochemical classification aspects, diagnosis and treatment. We insist on two aspects: 1) greater importance of enzymatic diagnose for the "Niemann-Pick complex", in view of the overlapping of clinical symptoms, 2) bone-marrow transplantation as therapeutic alternative and its indications. PMID:2189323

González de Dios, J; Fernández Tejada, E; Díaz Fernández, M C; Ortega Páez, E; Hernández González, J; de la Vega Bueno, A; Hierro Llanillo, L; Larrauri Martínez, J; Jara Vega, P

1990-02-01

278

A case of possible neurosarcoidosis presenting as intractable headache and panhypopituitarism.  

PubMed

Sarcoidosis is a chronic multisystemic inflammatory disease of unknown etiology, which is characterized by noncaseating granulomatous inflammation of the involved organs. It is known that neurosarcoidosis involving the nervous system occurs in about 5% of patients with sarcoidosis. However, neurosarcoidosis without systemic involvement is extremely rare. We present a case of suspicious neurosarcoidosis affecting the pituitary gland, which was manifested as chronic uncontrolled headache, panhypopituitarism, central diabetes insipidus, and hypercalcemia. Though the biopsy at the pituitary lesion was not performed due to the high risk of surgical complication, treatment was needed urgently and we started steroid therapy. After steroid therapy, we observed the immediate symptom relief with improved hypercalcemia. According to the follow-up examination, no recurrent symptom was seen, and resolution of the pituitary lesion with improving panhypopituitarism was noted. PMID:23991342

Hwang, Jin Kyung; Cho, Joo Hee; Park, So Young; Son, Jung Il; Jo, Uk; Chin, Sang Ouk; Lee, Yun Jung; Choi, Moon Chan; Rhee, Sang Youl; Kim, Eui Jong; Chon, Suk

2013-01-01

279

A Case of Possible Neurosarcoidosis Presenting as Intractable Headache and Panhypopituitarism  

PubMed Central

Sarcoidosis is a chronic multisystemic inflammatory disease of unknown etiology, which is characterized by noncaseating granulomatous inflammation of the involved organs. It is known that neurosarcoidosis involving the nervous system occurs in about 5% of patients with sarcoidosis. However, neurosarcoidosis without systemic involvement is extremely rare. We present a case of suspicious neurosarcoidosis affecting the pituitary gland, which was manifested as chronic uncontrolled headache, panhypopituitarism, central diabetes insipidus, and hypercalcemia. Though the biopsy at the pituitary lesion was not performed due to the high risk of surgical complication, treatment was needed urgently and we started steroid therapy. After steroid therapy, we observed the immediate symptom relief with improved hypercalcemia. According to the follow-up examination, no recurrent symptom was seen, and resolution of the pituitary lesion with improving panhypopituitarism was noted. PMID:23991342

Cho, Joo Hee; Park, So Young; Son, Jung Il; Jo, Uk; Chin, Sang Ouk; Lee, Yun Jung; Choi, Moon Chan; Kim, Eui Jong

2013-01-01

280

Maple syrup urine disease-therapeutic use of insulin in catabolic states  

Microsoft Academic Search

High and neurotoxic blood levels of leucine and its ketoanalogue develop in catabolic patients with maple syrup urine disease. The use of relatively high doses of insulin and additional glucose had a more pronounced effect on lowering leucine (and a-ketoisocaproate) blood levels than dietary elimination of leucine alone. This is demonstrated in 2 neonates after blood exchange transfusion and in

U. Wendel; U. Langenbeck; Ingrid Lombeck; H. J. Bremer

1982-01-01

281

Comparison of Selected Methods for Modeling of MultiState Disease Progression Processes: A Simulation Study  

Microsoft Academic Search

Prognostic studies are essential to understand the role of particular prognostic factors and, thus, improve prognosis. In most studies, disease progression trajectories of individual patients may end up with one of mutually exclusive endpoints or can involve a sequence of different events.One challenge in such studies concerns separating the effects of putative prognostic factors on these different endpoints and testing

Ella Huszti; Michal Abrahamowicz; Ahmadou Alioum; Catherine Quantin

2011-01-01

282

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

ERIC Educational Resources Information Center

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…

Esch, Laura; Hendryx, Michael

2011-01-01

283

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...

284

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

Microsoft Academic Search

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%.

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

1998-01-01

285

G protein-coupled receptors: abnormalities in signal transmission, disease states and pharmacotherapy.  

PubMed

The aim of this review is to present the research results and draw new conclusions about the impact of alterations in the signal transmission through the G protein-coupled receptors (GPCRs) on the formation of diseases and drug therapy. GPCR family is the largest and the most diverse group of membrane receptors. They transmit signals into the cell by interaction with different ligands, which include, inter alia, hormones, neurotransmitters, and photons. GPCRs are responsible for the proper conduction of many physiological processes such as vision, intercellular communication, the neuronal transmission, hormonal signaling and are involved in many pathological processes. They are also point on the binding pathway of multiple drugs. They are targets of nearly one third of the drugs at the current pharmaceutical market. The genes encoding GPCRs represent about 4% of the human genome. Mutations that occur in them are associated with a broad spectrum of diseases of diverse etiology. As a mutations result, there is a change in receptor activity (GPCR become inactive, overactive, or constitutively active), in the process of ligand binding and signal transduction. Changes in the GPCRs functioning can cause diseases such as retinitis pigmentosa (rhodopsin mutations), nephrogenic diabetes insipidus (vasopressin receptor mutations), obesity (melanocortin receptor mutations). Many mutational changes in genes encoding GPCR can change drug therapy of already existed diseases: heart failure (adrenergic receptors), asthma (cysteinyl leukotriene receptors). Studies concerning the structure and function of genetically modified GPCRs allow to get know a variety of mechanisms of its action, which in turn can contribute to broaden the knowledge on the etiology and pharmacotherapy of many currently incurable diseases. PMID:25272642

Zalewska, Marta; Siara, Monika; Sajewicz, Waldemar

2014-01-01

286

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

PubMed Central

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

Graham, Garth

2014-01-01

287

Medical Management for Intractable Pain Arising From Primary Sj?gren Syndrome Involving Both Brain and Spinal Cord: A Case Report  

PubMed Central

Primary Sjögren syndrome, which involves lesions in both the brain and spinal cord, is rarely reported. Related symptoms, such as intractable pain due to central nervous system involvement, are very rare. A 73-year-old woman diagnosed with primary Sjögren syndrome manifested with subacute encephalopathy and extensive transverse myelitis. She complained of severe whole body neuropathic pain. Magnetic resonance imaging demonstrated a non-enhancing ill-defined high intensity signal involving the posterior limb of the both internal capsule and right thalamus on a T2 fluid-attenuated inversion recovery image. Additionally, multifocal intramedullary ill-defined contrast-enhancing lesion with cord swelling from the C-spine to L-spine was also visible on the T2-weighted image. Her intractable pain remarkably improved after administration of concomitant oral doses of gabapentin, venlafaxine, and carbamazepine.

Lee, Kyoung Moo; Han, Kyu Yong

2014-01-01

288

Expression and cellular distribution of multidrug transporter proteins in two major causes of medically intractable epilepsy: focal cortical dysplasia and glioneuronal tumors  

Microsoft Academic Search

The cell-specific distribution of multidrug resistance extrusion pumps was studied in developmental glioneuronal lesions, including focal cortical dysplasia (15 cases) and ganglioglioma (15 cases) from patients with medically intractable epilepsy. Lesional, perilesional, as well as normal brain regions were examined for the expression of the multidrug resistance gene 1 encoded P-glycoprotein (P-gp) and the multidrug resistance-associated protein 1 (MRP1) by

E. M. A. Aronica; J. A. Gorter; G. H. Jansen; C. W. M van Veelen; P. C van Rijen; S. Leenstra; M. Ramkema; G. L. Scheffer; R. J. Scheper; D. Troost

2003-01-01

289

[Medical control on the state of pilots' health suffering from urologic diseases].  

PubMed

The complexity of flying work and human factor significance increase the responsibility of aviation physician for health and high working capacity of the flying staff. The early diagnosis of potentially dangerous urological pathology is of particular importance because the renal and urinary tract diseases are revealed unexpectedly among the flying staff. The incidence of surgical pathology including the urologic one takes the third place in the RF Armed Forces. That's why the main directions to improve the urologic care in the Armed Forces medical service are the optimization of urologists' numerical staff, the development of new organizing-and-staff structure and the number of specialized urologic departments (centers, rooms, and wards) on the basis of central, district and garrison hospitals, the increase in urologists' professional training quality, the improvement of treatment-and-prophylactic work. It is necessary to conduct the quarterly, half-yearly and yearly analysis of urological diseases, connected with flying incidents. PMID:17236673

Shelepov, A M; Petrov, S B; Peshkov, V V; Shpilenia, E S; Shestaev, A Iu; Vo?tenko, A M; Iakovlev, A E

2006-10-01

290

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 ...

291

A cross-species analysis method to analyze animal models' similarity to human's disease state  

PubMed Central

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

2012-01-01

292

The income-associated burden of disease in the United States  

Microsoft Academic Search

In this study, we estimate the total burden of disease associated with income in the US. We calculate the relationships between income and life expectancy, health-adjusted life expectancy, annual years of life lost (YLLs), and health adjusted life years (HALYs).We used the 2000 US Medical Expenditure Panel Survey to derive quality of life estimates by income and age, the 1990–1992

Peter Muennig; Peter Franks; Haomiao Jia; Erica Lubetkin; Marthe R Gold

2005-01-01

293

Regulation of Translocator Protein 18 kDa (TSPO) Expression in Health and Disease States  

PubMed Central

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

Batarseh, Amani; Papadopoulos, Vassilios

2010-01-01

294

Periodontal disease and risk of psoriasis among nurses in the United States  

PubMed Central

Objective Periodontal disease has been associated with systemic inflammation and may be a risk factor for autoimmune diseases. We evaluated the association between periodontal disease and the risk of incident psoriasis in a large prospective cohort study. Material and methods Self-reported history of periodontal bone loss, from 1998 to 2008, was evaluated as a risk factor for incident psoriasis among 60,457 women in the Nurses' Health Study. Secondary analyses examined associations between history of tooth loss and number of natural teeth and psoriasis risk. Cox proportional hazards models were used to assess multivariate estimates, adjusting for age, cigarette smoking, body mass index, alcohol intake and physical activity. Results We observed an increased multivariate risk of psoriasis for those with mild periodontal bone loss (RR 1.35, 95% CI: 1.03-1.75) and moderate to severe periodontal bone loss (RR 1.49, 95% CI: 1.08-2.05), as compared to those without periodontal bone loss, after adjusting for age, cigarette smoking, body mass index, alcohol intake, physical activity, and tooth loss. Number of natural teeth and tooth loss were not associated with risk of psoriasis in our study. Conclusion A history of periodontal bone loss may increase risk of subsequent psoriasis. PMID:23374087

Nakib, Sarah; Han, Jiali; Li, Tricia; Joshipura, Kaumudi; Qureshi, Abrar A.

2014-01-01

295

Recurrent tuberculosis: why do patients develop disease again? A United States Public Health Service cooperative survey.  

PubMed Central

In October 1983, a retrospective survey was initiated to determine if patients reported to the Centers for Disease Control as having recurrent tuberculosis truly had recurrent disease and, if so, why they had developed tuberculosis again. Twenty-three health jurisdictions provided information on 800 patients diagnosed as having recurrent tuberculosis during 1981 and 1982. We found that 199 (25 per cent) of the cases did not meet the criteria for recurrent disease. Of the remaining 601 recurrent cases, 20 per cent had no chemotherapy prescribed for their previous episodes of tuberculosis, 20 per cent were prescribed inadequate or inappropriate therapy, and 33 per cent were not compliant with their prescribed therapy regimens. Patients who, during their original episode of tuberculosis, received the major portion of their medical care from physicians in private practice were more compliant than those treated by other health care providers. However, those same patients were more likely to have received inappropriate therapy than patients treated by other providers. Better patient and physician education, closer monitoring, and greater use of preventive therapy and directly observed therapy are necessary to resolve these problems. PMID:2827534

Kopanoff, D E; Snider, D E; Johnson, M

1988-01-01

296

Protein sets define disease states and predict in vivo effects of drug treatment.  

PubMed

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

Meierhofer, David; Weidner, Christopher; Hartmann, Ludger; Mayr, Johannes A; Han, Chung-Ting; Schroeder, Frank C; Sauer, Sascha

2013-07-01

297

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

PubMed Central

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

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

2014-01-01

298

Microvillus inclusion disease as a cause of severe protracted diarrhea in infants.  

PubMed

There are many etiologies responsible for severe intractable diarrhea in infancy, for instance, autoimmune enteropathy, microvillus inclusion disease, tufting enteropathy, food allergy, post-enteritis syndrome, chronic intestinal pseudo-obstruction, Hirschsprung's disease, intestinal lymphangiectasia, congenital sodium or chloride diarrhea, and congenital enzymatic deficiency. This article reports a case of microvillus inclusion disease in a Thai patient. He presented with severe intractable watery diarrhea with persistent metabolic acidosis. After extensive investigation, the diagnosis of microvillus inclusion disease was made, based on the ultrastructural findings of microvillus inclusions in the cytoplasm of the enterocyte on electron microscopic study. Various treatments were introduced to the patient without clinical improvement, including cholestyramine, metronidazole, probiotics, and octreotide. He was dependent on total parenteral nutrition and subsequently died from TPN-related complications. Even though it is a rare disease, it should be considered if an infant has chronic secretory diarrhea. PMID:11800313

Ukarapol, N; Chotinaruemol, S; Lertprasertsuk, N; Wongsawasdi, L

2001-09-01

299

Impaired development of intrinsic connectivity networks in children with medically intractable localization-related epilepsy.  

PubMed

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. Hum Brain Mapp 35:5686-5700, 2014. © 2014 Wiley Periodicals, Inc. PMID:24976288

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; Carter Snead, O

2014-11-01

300

Is Population-Wide Diuretic Use Directly Associated With the Incidence of End-Stage Renal Disease in the United States?  

Microsoft Academic Search

Background: We introduce the hypothesis that population-wide use of diuretics might be associated with acceleration of the incidence of end-stage renal disease (ESRD).Methods: Based on the technique of data fusion, pooled-data trends in disease incidence and antihypertensive medication use were examined to determine whether changes in drug use patterns are predictive of disease emergence in the United States. National databases

Ralph G. Hawkins; Mark C. Houston

2005-01-01

301

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

PubMed

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

Fannon, M R

1996-08-01

302

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

ERIC Educational Resources Information Center

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

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

2009-01-01

303

Distribution of primary renal diseases leading to end-stage renal failure in the United States, Europe, and Australia\\/New Zealand: Results from an international comparative study  

Microsoft Academic Search

This report notes the differences in the classification of the primary renal disease (PRD) used in different renal dialysis and transplant registries worldwide. The heterogeneity of coding systems complicates the comparative analysis of end-stage renal disease from different regions. Using data collected over two decades in the United States, Europe, and Australia\\/New Zealand, we present a method for reorganization of

Patrick Maisonneuve; Lawrence Agodoa; Ryszard Gellert; John H. Stewart; Gherardo Buccianti; Albert B. Lowenfels; Robert A. Wolfe; Elisabeth Jones; Alex P. S. Disney; Douglas Briggs; Margaret McCredie; Peter Boyle

2000-01-01

304

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

PubMed Central

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

2011-01-01

305

NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Communicable Disease Control  

E-print Network

. For some adolescents, such as first year college students living in dormitories, there is an increased risk in dormitories. However, the vaccine will benefit all teenagers and young adults in the United States. Also at increased risk are people with terminal complement deficiencies or asplenia, some laboratory workers

Suzuki, Masatsugu

306

DISEASES DIAGNOSED IN WILD TURKEYS (MELEAGRIS GALLOPAVO) OF THE SOUTHEASTERN UNITED STATES  

Microsoft Academic Search

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

William R. Davidson; Victor F. Nettles; C. Edward Couvillion; Elizabeth W. Howerth

307

Livestock Disease Eradication: Evaluation of the Cooperative State-Federal Bovine Tuberculosis Eradication Program.  

National Technical Information Service (NTIS)

At the request of the U.S. Department of Agriculture (USDA), the Board on Agriculture of the National Research Council (NRC) formed the Committee on Bovine Tuberculosis to undertake a comprehensive review of the Cooperative State-Federal Bovine Turberculo...

J. Overton

1994-01-01

308

Differential Epidemiology: IQ, Neuroticism, and Chronic Disease by the 50 U.S. States  

ERIC Educational Resources Information Center

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…

Pesta, Bryan J.; Bertsch, Sharon; McDaniel, Michael A.; Mahoney, Christine B.; Poznanski, Peter J.

2012-01-01

309

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

PubMed

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

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

2013-10-29

310

Passive case-finding for Alzheimer's disease and related dementias in two United States communities*  

PubMed Central

Passive surveillance for disease is a public health approach that relies on documentation available within existing health records for the region or communities being studied. Its 2 primary advantages over active case-finding are the lower cost of research and the lower burden on the population studied. The effectiveness of passive case-finding depends on the comprehensiveness of the healthcare coverage in a given community and the adequacy of the available medical records. The Rochester Epidemiology Project has permitted dementia case detection for Olmsted County, Minnesota, using a medical records-linkage system. These data were compared with case ascertainment using direct assessment of individuals in an epidemiologic study of the same community. At Group Health Research Institute, investigators compared dementia and Alzheimer’s disease cases detected using an electronic medical record database search with those identified by a parallel active case-finding study. The advantages and disadvantages of passive case-finding are discussed, concluding that the purpose of the study should determine the case-finding approach that is employed. PMID:21255743

Knopman, David S.; Petersen, Ronald C.; Rocca, Walter A.; Larson, Eric B.; Ganguli, Mary

2011-01-01

311

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

PubMed Central

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

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

2012-01-01

312

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

PubMed

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

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

2012-01-01

313

Autosomal recessive diseases among the Athabaskans of the southwestern United States: recent advances and implications for the future.  

PubMed

Genetic and linguistic data suggest that the Na-Dene, of which the Athabaskans are the largest group, are part of a later immigration into the Americas than the first Amerind immigration. Whether a second and third immigration can be separated seems unlikely but continued cross-Bering Strait exchanges may have masked what was a greater separation in the past. The movement of tribes into Siberia appears to have involved a genetic bottleneck leading to at least one disease allele shared by Eskimo/Aleuts and Navajos and a second possibly shared by the Navajo and a Siberian population, but not the same Siberian population that share deep linguistic affinities with the Navajo. A second bottleneck appears to have occurred with the migration of Athabaskans from Northwest North America to the Southwestern United States along the Rocky Mountains. This bottleneck is reflected in several rare recessive diseases shared by the Navajo and Apache. Finally, the Navajo were captured and imprisoned under conditions which led to severe population loss. This, and the "hiding away" of a small number of Navajos in what is now the Western portion of the reservation, led to a Navajo-specific bottleneck(s) resulting in an increased frequency of several rare recessive diseases among the Navajo. Prejudice against human genetic research is high among the Southwestern Athabaskans but attempts to bridge the gap are now occurring. The involvement of Navajo scientists in this process is especially encouraging. PMID:19842189

Erickson, Robert P

2009-11-01

314

Reduced Topological Efficiency in Cortical-Basal Ganglia Motor Network of Parkinson's Disease: A Resting State fMRI Study  

PubMed Central

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

Long, Zhiliang; Wu, Guo-Rong; Hu, Xiaofei; Zhang, Yanling; Wang, Jian

2014-01-01

315

MR-based neurological disease classification methodology: Application to lateralization of seizure focus in temporal lobe epilepsy  

Microsoft Academic Search

Classification approaches for neurological diseases tend to concentrate on specific structures such as the hippocampus (HC). The hypothesis for the novel methodology presented in this work is that pathologies will impact large tissue areas with detectable variations of T1-weighted MR signal intensity and registration metrics. The technique is applied to lateralization of seizure focus in 127 patients with intractable temporal

S. Duchesne; N. Bernasconi; A. Bernasconi; D. L. Collins

2006-01-01

316

Current and Future Disease Progression of the Chronic HCV Population in the United States  

PubMed Central

Chronic hepatitis C virus (HCV) infection can lead to advanced liver disease (AdvLD), including cirrhosis, decompensated cirrhosis, and liver cancer. The aim of this study was to determine recent historical rates of HCV patient progression to AdvLD and to project AdvLD prevalence through 2015. We first determined total 2008 US chronic HCV prevalence from the National Health and Nutrition Evaluation Surveys. Next, we examined disease progression and associated non-pharmacological costs of diagnosed chronic HCV-infected patients between 2007–2009 in the IMS LifeLink and CMS Medicare claims databases. A projection model was developed to estimate AdvLD population growth through 2015 in patients diagnosed and undiagnosed as of 2008, using the 2007–2009 progression rates to generate a “worst case” projection of the HCV-related AdvLD population (i.e., scenario where HCV treatment is the same in the forecasted period as it was before 2009). We found that the total diagnosed chronic HCV population grew from 983,000 to 1.19 million in 2007–2009, with patients born from 1945–1964 accounting for 75.0% of all patients, 83.7% of AdvLD patients, and 79.2% of costs in 2009, indicating that HCV is primarily a disease of the “baby boomer” population. Non-pharmacological costs grew from $7.22 billion to $8.63 billion, with the majority of growth derived from the 60,000 new patients that developed AdvLD in 2007–2009, 91.5% of whom were born between 1945 and 1964. The projection model estimated the total AdvLD population would grow from 195,000 in 2008 to 601,000 in 2015, with 73.5% of new AdvLD cases from patients undiagnosed as of 2008. AdvLD prevalence in patients diagnosed as of 2008 was projected to grow 6.5% annually to 303,000 patients in 2015. These findings suggest that strategies to diagnose and treat HCV-infected patients are urgently needed to increase the likelihood that progression is interrupted, particularly for patients born from 1945–1964. PMID:23704962

Zalesak, Martin; Francis, Kevin; Gedeon, Alex; Gillis, John; Hvidsten, Kyle; Kidder, Phyllis; Li, Hong; Martyn, Derek; Orne, Leslie; Smith, Amanda; Kwong, Ann

2013-01-01

317

Pneumoconiosis and advanced occupational lung disease among surface coal miners--16 states, 2010-2011.  

PubMed

Coal workers' pneumoconiosis (CWP) is a chronic occupational lung disease caused by long-term inhalation of dust, which triggers inflammation of the alveoli, eventually resulting in irreversible lung damage. CWP ranges in severity from simple to advanced; the most severe form is progressive massive fibrosis (PMF). Advanced CWP is debilitating and often fatal. To prevent CWP, the Coal Mine Health and Safety Act of 1969 established the current federal exposure limit for respirable dust in underground and surface coal mines. The Act also established a surveillance system for assessing prevalence of pneumoconiosis among underground coal miners, but this surveillance does not extend to surface coal miners. With enforcement of the exposure limit, the prevalence of CWP among underground coal miners declined from 11.2% during 1970-1974 to 2.0% during 1995-1999, before increasing unexpectedly in the last decade, particularly in Central Appalachia. Exposure to respirable dust is thought to be less in surface than underground coal miners. Although they comprise 48% of the coal mining workforce, surface coal miners have not been studied since 2002. To assess the prevalence, severity, and geographic distribution of pneumoconiosis among current surface coal miners, CDC obtained chest radiographs of 2,328 miners during 2010-2011 through the Coal Workers' Health Surveillance Program of the National Institute for Occupational Safety and Health (NIOSH). Forty-six (2.0%) of 2,257 miners with >1 year of surface mining experience had CWP, including 37 who had never worked underground. Twelve (0.5%) had PMF, including nine who had never worked underground. A high proportion of the radiographs suggested silicosis, a disease caused by inhalation of crystalline silica. Surface coal mine operators should monitor worker exposures closely to ensure that both respirable dust and silica are below recommended levels to prevent CWP. Clinicians should be aware of the risk for advanced pneumoconiosis among surface coal miners, in addition to underground coal miners, to facilitate prompt disease identification and intervention. PMID:22695382

2012-06-15

318

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

PubMed Central

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

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

2014-01-01

319

Regadenoson use in patients with chronic obstructive pulmonary disease: the state of current knowledge.  

PubMed

Stress testing is challenging in patients with chronic obstructive pulmonary disease (COPD). Functional capacity is generally decreased in this patient population, limiting patients' ability to achieve physiologic stress through exercise. Additionally, due to emphysematous changes, COPD patients tend to have poor acoustic windows that impair the quality and therefore diagnostic accuracy of stress echocardiography techniques. Pharmacologic stress myocardial perfusion imaging (MPI) testing is also problematic, particularly due to the concern for adenosine-induced bronchoconstriction with conventional vasodilator stress agents. Regadenoson, a selective A2A adenosine receptor agonist, has gained popularity due to its ease of administration and improved patient experience in the general population. The literature describing the experience with regadenoson in COPD patients, though limited, is rapidly growing and reassuring. This review summarizes the pharmacology and clinical application of this novel stress agent and presents the available data on the safety and tolerability of its use in COPD patients. PMID:24489466

Golzar, Yasmeen; Doukky, Rami

2014-01-01

320

Regadenoson use in patients with chronic obstructive pulmonary disease: the state of current knowledge  

PubMed Central

Stress testing is challenging in patients with chronic obstructive pulmonary disease (COPD). Functional capacity is generally decreased in this patient population, limiting patients’ ability to achieve physiologic stress through exercise. Additionally, due to emphysematous changes, COPD patients tend to have poor acoustic windows that impair the quality and therefore diagnostic accuracy of stress echocardiography techniques. Pharmacologic stress myocardial perfusion imaging (MPI) testing is also problematic, particularly due to the concern for adenosine-induced bronchoconstriction with conventional vasodilator stress agents. Regadenoson, a selective A2A adenosine receptor agonist, has gained popularity due to its ease of administration and improved patient experience in the general population. The literature describing the experience with regadenoson in COPD patients, though limited, is rapidly growing and reassuring. This review summarizes the pharmacology and clinical application of this novel stress agent and presents the available data on the safety and tolerability of its use in COPD patients. PMID:24489466

Golzar, Yasmeen; Doukky, Rami

2014-01-01

321

Regression methods for investigating risk factors of chronic kidney disease outcomes: the state of the art  

PubMed Central

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

2014-01-01

322

Emerging Roles for Retinoids in Regeneration and Differentiation in Normal and Disease States  

PubMed Central

The vitamin A (retinol) metabolite, all-trans retinoic acid (RA), is a signaling molecule that plays key roles in the development of the body plan and induces the differentiation of many types of cells. In this review the physiological and pathophysiological roles of retinoids (retinol and related metabolites) in mature animals are discussed. Both in the developing embryo and in the adult, RA signaling via combinatorial Hox gene expression is important for cell positional memory. The genes that require RA for the maturation/differentiation of T cells are only beginning to be catalogued, but it is clear that retinoids play a major role in expression of key genes in the immune system. An exciting, recent publication in regeneration research shows that ALDH1a2 (RALDH2), which is the rate-limiting enzyme in the production of RA from retinaldehyde, is highly induced shortly after amputation in the regenerating heart, adult fin, and larval fin in zebrafish. Thus, local generation of RA presumably plays a key role in fin formation during both embryogenesis and in fin regeneration. HIV transgenic mice and human patients with HIV-associated kidney disease exhibit a profound reduction in the level of RAR? protein in the glomeruli, and HIV transgenic mice show reduced retinol dehydrogenase levels, concomitant with a greater than 3-fold reduction in endogenous RA levels in the glomeruli. Levels of endogenous retinoids (those synthesized from retinol within cells) are altered in many different diseases in the lung, kidney, and central nervous system, contributing to pathophysiology. PMID:21855651

Gudas, Lorraine J.

2011-01-01

323

Fingolimod for the treatment of neurological diseases--state of play and future perspectives  

PubMed Central

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

Brunkhorst, Robert; Vutukuri, Rajkumar; Pfeilschifter, Waltraud

2014-01-01

324

Quantitative Second Harmonic Generation Imaging of the Diseased State Osteogenesis Imperfecta: Experiment and Simulation  

PubMed Central

We report the integrated use of 3D second harmonic generation (SHG) imaging microscopy and Monte Carlo simulation as a combined metric to quantifiably differentiate normal and diseased tissues based on the physical properties of the respective extracellular matrix. To achieve this, we have identified a set of parameters comprised of the SHG creation attributes and the bulk optical parameters, which are used collectively via comparative analysis. Monte Carlo simulations of the SHG axial directional and attenuation responses allow their decomposition into the underlying factors that are not readily obtainable through experimental techniques. Specifically, this approach allows for estimation of the SHG creation attributes (directionality and relative conversion efficiency) and separation of primary and secondary filter effects, collectively that form the observed SHG contrast. The quantitative metric is shown for the connective tissue disorder Osteogenesis Imperfecta (characterized by abnormal assembly of type I collagen) using a murine model that expresses the disease in the dermis layer of skin. Structural dissimilarities between the osteogenesis imperfecta mouse and wild-type tissues lead to significant differences in the SHG depth-dependent directionality and signal attenuation. The Monte Carlo simulations of these responses using measured bulk optical parameters reproduce the experimental data trends, and the extracted emission directionality and conversion efficiencies are consistent with independent determinations. The simulations also illustrate the dominance of primary filter affects on overall SHG generation and attenuation. Thus, the combined method of 3D SHG imaging and modeling forms an essential foundation for parametric description of the matrix properties that are not distinguishable by sole consideration of either bulk optical parameters or SHG alone. Moreover, due to the quasi-coherence of the SHG process in tissues, we submit that this approach contains unique information not possible by purely scattering based methods and that these methods will be applicable in the general case where the complex fibrillar structure is difficult to fully quantify via morphological analysis. PMID:18281387

LaComb, Ronald; Nadiarnykh, Oleg; Campagnola, Paul J.

2008-01-01

325

Prevalence of coronary heart disease or stroke among workers aged <55 years--United States, 2008-2012.  

PubMed

Cardiovascular disease accounts for one in three deaths in the United States each year, and coronary heart disease and stroke account for most of those deaths. To try to prevent 1 million heart attacks and strokes by 2017, the U.S. Department of Health and Human Services launched the Million Hearts initiative, promoting proven and effective interventions in communities and clinical settings. In workplace settings, cardiovascular disease can be addressed through a Total Worker Health program, which integrates occupational safety and health protection with health promotion. To identify workers likely to benefit from such a program, CDC analyzed data from the National Health Interview Survey (NHIS) for the period 2008-2012 to estimate the prevalence of a history of coronary heart disease or stroke (CHD/stroke) among adults aged <55 years by selected characteristics, employment status, occupation category, and industry of employment. The results of that analysis showed that 1.9% of employed adults aged <55 years reported a history of CHD/stroke, compared with 2.5% of unemployed adults looking for work, and 6.3% of adults not in the labor force (e.g., unemployed adults who stopped looking for work, homemakers, students, retired persons, and disabled persons). Workers employed in service and blue collar occupations were more likely than those in white collar occupations to report a history of CHD/stroke. Two industry groups also had significantly higher adjusted prevalence ratios (aPRs) for CHD/stroke: Administrative and Support and Waste Management and Remediation Services* and Accommodation and Food Service.† Workers in these occupation and industry groups might especially benefit from a Total Worker Health approach to reducing the risk for CHD/stroke. PMID:25078653

Luckhaupt, Sara E; Calvert, Geoffrey M

2014-08-01

326

Early small vessel disease affects frontoparietal and cerebellar hubs in close correlation with clinical symptoms--a resting-state fMRI study.  

PubMed

Cerebral small vessel disease, mainly characterized by white matter lesions and lacunes, has a high clinical impact as it leads to vascular dementia. Recent studies have shown that this disease impairs frontoparietal networks. Here, we apply resting-state magnetic resonance imaging and data-driven whole-brain imaging analysis methods (eigenvector centrality) to investigate changes of the functional connectome in early small vessel disease. We show reduced connectivity in frontoparietal networks, whereas connectivity increases in the cerebellum. These functional changes are closely related to white matter lesions and typical neuropsychological deficits associated with small vessel disease. PMID:24780899

Schaefer, Alexander; Quinque, Eva M; Kipping, Judy A; Arélin, Katrin; Roggenhofer, Elisabeth; Frisch, Stefan; Villringer, Arno; Mueller, Karsten; Schroeter, Matthias L

2014-07-01

327

Abnormal Baseline Brain Activity in Non-Depressed Parkinson's Disease and Depressed Parkinson's Disease: A Resting-State Functional Magnetic Resonance Imaging Study  

PubMed Central

Depression is the most common psychiatric disorder observed in Parkinson’s disease (PD) patients, however the neural contribution to the high rate of depression in the PD group is still unclear. In this study, we used resting-state functional magnetic resonance imaging (fMRI) to investigate the underlying neural mechanisms of depression in PD patients. Twenty-one healthy individuals and thirty-three patients with idiopathic PD, seventeen of whom were diagnosed with major depressive disorder, were recruited. An analysis of amplitude of low-frequency fluctuations (ALFF) was performed on the whole brain of all subjects. Our results showed that depressed PD patients had significantly decreased ALFF in the dorsolateral prefrontal cortex (DLPFC), the ventromedial prefrontal cortex (vMPFC) and the rostral anterior cingulated cortex (rACC) compared with non-depressed PD patients. A significant positive correlation was found between Hamilton Depression Rating Scale (HDRS) and ALFF in the DLPFC. The findings of changed ALFF in these brain regions implied depression in PD patients may be associated with abnormal activities of prefrontal-limbic network. PMID:23717467

Wen, Xuyun; Wu, Xia; Liu, Jiangtao; Li, Ke; Yao, Li

2013-01-01

328

Comparative study of diets and disease prevalence in Greek Chians part II Chian immigrants to Athens and to the United States  

Microsoft Academic Search

The study examined differences in Greek and Greek?American diets and disease patterns related to migration within the Mediterranean and from the Mediterranean to the United States. Data reported here discuss changes in food patterns and health?related characteristics of two populations, both originating from the Greek island of Chios, residing either in Athens, Greece, or urban centers in the United States.

Charles E. Franti; Louis E. Grivetti

1999-01-01

329

A Differential Item Functioning (DIF) Analysis of the Communicative Participation Item Bank (CPIB): Comparing Individuals with Parkinson's Disease from the United States and New Zealand  

ERIC Educational Resources Information Center

Purpose: To examine the cross-cultural applicability of the Communicative Participation Item Bank (CPIB) through a comparison of respondents with Parkinson's disease (PD) from the United States and New Zealand. Method: A total of 428 respondents--218 from the United States and 210 from New Zealand-completed the self-report CPIB and a series…

Baylor, Carolyn; McAuliffe, Megan J.; Hughes, Louise E.; Yorkston, Kathryn; Anderson, Tim; Jiseon, Kim; Amtmann, Dagmar

2014-01-01

330

Evaluation of the current State of Florida West Nile Surveillance Program as a predictor for control and prevention of human West Nile diseases  

Microsoft Academic Search

West Nile is an important novel virus in the United States, having spread rapidly since it was first detected in New York in 1999. The Centers for Disease Control and Prevention as well as many State Health Departments, have mandated programs for surveillance of West Nile Virus activity. These programs incorporate many different aspects including existing arboserology programs with additional

Angela E Butler

2004-01-01

331

Promoting state health department evidence-based cancer and chronic disease prevention: a multi-phase dissemination study with a cluster randomized trial component  

PubMed Central

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

2013-01-01

332

Recognition memory is associated with altered resting-state functional connectivity in people at genetic risk for Alzheimer's disease.  

PubMed

The apolipoprotein E ?4 (ApoE ?4) allele not only represents the strongest single genetic risk factor for sporadic Alzheimer's disease, but also imposes independent effects on brain function in healthy individuals where it has been shown to promote subtle memory deficits and altered intrinsic functional brain network connectivity. Based on previous work showing a potential relevance of the default mode network (DMN) functional connectivity for episodic memory function, we hypothesized that the ApoE ?4 genotype would affect memory performance via modulation of the DMN. We assessed 63 healthy individuals (50-80 years old), of which 20 carried the ?4 allele. All participants underwent resting-state functional magnetic resonance imaging (fMRI), high-resolution 3D anatomical MRI imaging and neuropsychological assessment. Functional connectivity analysis of resting-state activity was performed with a predefined seed region located in the left posterior cingulate cortex (PCC), a core region of the DMN. ApoE ?4 carriers performed significantly poorer than non-carriers in wordlist recognition and cued recall. Furthermore, ?4 carriers showed increased connectivity relative to ?4 non-carriers between the PCC seed region and left-hemispheric middle temporal gyrus (MTG). There was a positive correlation between recognition memory scores and resting-state connectivity in the left MTG in ?4 carriers. These results can be interpreted as compensatory mechanisms strengthening the cross-links between DMN core areas and cortical areas involved in memory processing. PMID:24989884

Matura, Silke; Prvulovic, David; Butz, Marius; Hartmann, Daniel; Sepanski, Beate; Linnemann, Katja; Oertel-Knöchel, Viola; Karakaya, Tarik; Fußer, Fabian; Pantel, Johannes; van de Ven, Vincent

2014-10-01

333

Solid-state laser source of narrowband ultraviolet B light for skin disease care  

NASA Astrophysics Data System (ADS)

We report about the development of all-solid-state laser source of narrowband UV-B light for medical applications. The device is based on a gain-switched Ti: Sapphire laser with volume Bragg grating, pumped at 532 nm and operating at 931.8 nm, followed by a third harmonic generator and a fiber optic beam homogenizer. The maximum available pulse energy exceeded 5 mJ at 310.6 nm, with a pulse repetition rates of 50 Hz. The output characteristics satisfy the medical requirements for psoriasis and vitiligo treatment. A new optical scheme for third harmonic generation enhancement at moderate levels of input intensities is proposed and investigated. As a result, 40% harmonic efficiency was obtained, when input pulse power was only 300 kW.

Tarasov, Aleksandr A.; Chu, Hong

2013-03-01

334

The State of Infectious Diseases Clinical Trials: A Systematic Review of ClinicalTrials.gov  

PubMed Central

Background There is a paucity of clinical trials informing specific questions faced by infectious diseases (ID) specialists. The ClinicalTrials.gov registry offers an opportunity to evaluate the ID clinical trials portfolio. Methods We examined 40,970 interventional trials registered with ClinicalTrials.gov from 2007–2010, focusing on study conditions and interventions to identify ID-related trials. Relevance to ID was manually confirmed for each programmatically identified trial, yielding 3570 ID trials and 37,400 non-ID trials for analysis. Results The number of ID trials was similar to the number of trials identified as belonging to cardiovascular medicine (n?=?3437) or mental health (n?=?3695) specialties. Slightly over half of ID trials were treatment-oriented trials (53%, vs. 77% for non-ID trials) followed by prevention (38%, vs. 8% in non-ID trials). ID trials tended to be larger than those of other specialties, with a median enrollment of 125 subjects (interquartile range [IQR], 45–400) vs. 60 (IQR, 30–160) for non-ID trials. Most ID studies are randomized (73%) but nonblinded (56%). Industry was the funding source in 51% of ID trials vs. 10% that were primarily NIH-funded. HIV-AIDS trials constitute the largest subset of ID trials (n?=?815 [23%]), followed by influenza vaccine (n?=?375 [11%]), and hepatitis C (n?=?339 [9%]) trials. Relative to U.S. and global mortality rates, HIV-AIDS and hepatitis C virus trials are over-represented, whereas lower respiratory tract infection trials are under-represented in this large sample of ID clinical trials. Conclusions This work is the first to characterize ID clinical trials registered in ClinicalTrials.gov, providing a framework to discuss prioritization, methodology, and policy. PMID:24146958

Horton, John R.; Chiswell, Karen; Tasneem, Asba; Tsalik, Ephraim L.

2013-01-01

335

Dietary acid load and chronic kidney disease among adults in the United States  

PubMed Central

Background Diet can markedly affect acid-base status and it significantly influences chronic kidney disease (CKD) and its progression. The relationship of dietary acid load (DAL) and CKD has not been assessed on a population level. We examined the association of estimated net acid excretion (NAEes) with CKD; and socio-demographic and clinical correlates of NAEes. Methods Among 12,293 U.S. adult participants aged >20 years in the National Health and Nutrition Examination Survey 1999–2004, we assessed dietary acid by estimating NAEes from nutrient intake and body surface area; kidney damage by albuminuria; and kidney dysfunction by eGFR < 60 ml/min/1.73m2 using the MDRD equation. We tested the association of NAEes with participant characteristics using median regression; while for albuminuria, eGFR, and stages of CKD we used logistic regression. Results Median regression results (? per quintile) indicated that adults aged 40–60 years (? [95% CI] = 3.1 [0.3–5.8]), poverty (? [95% CI] = 7.1 [4.01–10.22]), black race (? [95% CI] = 13.8 [10.8–16.8]), and male sex (? [95% CI] = 3.0 [0.7- 5.2]) were significantly associated with an increasing level of NAEes. Higher levels of NAEes compared with lower levels were associated with greater odds of albuminuria (OR [95% CI] = 1.57 [1.20–2.05]). We observed a trend toward greater NAEes being associated with higher risk of low eGFR, which persisted after adjustment for confounders. Conclusion Higher NAEes is associated with albuminuria and low eGFR, and socio-demographic risk factors for CKD are associated with higher levels of NAEes. DAL may be an important target for future interventions in populations at high risk for CKD. PMID:25151260

2014-01-01

336

Tickborne Diseases  

MedlinePLUS

... the early 1970s, has since spread to every state except Hawaii. One of the newest tickborne diseases to be identified in the United States is called Southern tick-associated rash illness (STARI). ...

337

"Grutter" Accommodates the Intractable  

ERIC Educational Resources Information Center

Sandra Day O'Connor seems to have given us the next 25 years to reach a resolution to the racial gap in education--a problem on which we've made little headway in the last 25. Nathan Glazer is not sanguine that we'll fnd that answer, but he's prepared to live with the messy but, to him, satisfactory scheme of affirmative action that Justice…

Glazer, Nathan

2003-01-01

338

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

PubMed Central

Background: Neuropsychological deficits predate overt psychosis and overlap with the impairments in the established disease. However, to date, no single neurocognitive measure has shown sufficient power for a prognostic test. Thus, it remains to be determined whether multivariate neurocognitive pattern classification could facilitate the diagnostic identification of different at-risk mental states (ARMS) for psychosis and the individualized prediction of illness transition. Methods: First, classification of 30 healthy controls (HC) vs 48 ARMS individuals subgrouped into 20 “early,” 28 “late” ARMS subjects was performed based on a comprehensive neuropsychological test battery. Second, disease prediction was evaluated by categorizing the neurocognitive baseline data of those ARMS individuals with transition (n = 15) vs non transition (n = 20) vs HC after 4 years of follow-up. Generalizability of classification was estimated by repeated double cross-validation. Results: The 3-group cross-validated classification accuracies in the first analysis were 94.2% (HC vs rest), 85.0% (early at-risk subjects vs rest), and, 91.4% (late at-risk subjects vs rest) and 90.8% (HC vs rest), 90.8% (converters vs rest), and 89.0% (nonconverters vs rest) in the second analysis. Patterns distinguishing the early or late ARMS from HC primarily involved the verbal learning/memory domains, while executive functioning and verbal IQ deficits were particularly characteristic of the late ARMS. Disease transition was mainly predicted by executive and verbal learning impairments. Conclusions: Different ARMS and their clinical outcomes may be reliably identified on an individual basis by evaluating neurocognitive test batteries using multivariate pattern recognition. These patterns may have the potential to substantially improve the early recognition of psychosis. PMID:21576280

Koutsouleris, Nikolaos; Davatzikos, Christos; Bottlender, Ronald; Patschurek-Kliche, Katja; Scheuerecker, Johanna; Decker, Petra; Gaser, Christian; Moller, Hans-Jurgen; Meisenzahl, Eva M.

2012-01-01

339

Molecular epidemiology of infectious bursal disease viruses: distribution and genetic analysis of newly emerging viruses in the United States.  

PubMed

Genetic mutations in the genome of infectious bursal disease virus (IBDV) have resulted in antigenic and pathogenic variants that continue to cause disease in commercially reared chickens. The extent of the genetic diversity among IBDV strains circulating in the United States is unknown. This study was designed to identify newly emerging viruses infecting chickens on poultry farms experiencing immune suppression-related problems. Fifty IBDV-positive samples were identified from 273 bursa samples using a real-time reverse transcription-polymerase chain reaction (RT-PCR) assay. Mutation probes were designed to the hydrophilic B coding region of the VP2 gene. Six mutation probes used in this study were based on the nucleotide sequences of the Del-E, Bursine 2, D-78, STC, G6, and T1 IBDV strains. Following real-time RT-PCR, these mutation probes identified 11 of the 50 viruses in the melting temperature (Tm) analysis. The results indicated that the remaining 39 viruses had one or more nucleotide mutations compared with the six mutation probes in this region of the VP2 gene. Thirty-eight viruses were chosen for nucleotide sequence analysis across the hypervariable region of the VP2 gene. Within this group of 38 viruses, four were identified by the mutation probes and their nucleotide sequences confirmed that real-time RT-PCR data. In the remaining 34 viruses, nucleotide mutations were observed in as many as 8 of 23 nucleotides across the hydrophilic B epitope coding region. Furthermore, every amino acid position except one between 316 and 324 had at least one substitution mutation. Phylogenic analysis placed two of the 38 viruses sequenced on branches with classic viruses and the remaining 36 viruses were placed on four distinct branches. Branches 1 and 2 contained a majority of the viruses, which were distributed across most of the major poultry-producing states in the United States. These branches contained previously characterized variant IBDV strains. Viruses in branches 3 and 4 were confined to three states and did not contain any previously characterized IBDV strains. PMID:16094826

Jackwood, D J; Sommer-Wagner, S E

2005-06-01

340

Cortical sources of resting state EEG rhythms are sensitive to the progression of early stage Alzheimer's disease.  

PubMed

Cortical sources of resting state electroencephalographic (EEG) rhythms are abnormal in subjects with Alzheimer's disease (AD). Here we tested the hypothesis that these sources are also sensitive to the progression of early stage AD over the course of one year. The resting state eyes-closed EEG data were recorded in 88 mild AD patients at baseline (Mini Mental State Evaluation, MMSE I = 21.7 ± 0.2 standard error, SE) and at approximately one-year follow up (13.3 months ± 0.5 SE; MMSE II = 20 ± 0.4 SE). All patients received standard therapy with acetylcholinesterase inhibitors. EEG recordings were also performed in 35 normal elderly (Nold) subjects as controls. EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13 Hz), beta 1 (13-20 Hz), beta 2 (20-30 Hz), and gamma (30-40 Hz). Cortical EEG sources were estimated by low-resolution brain electromagnetic tomography (LORETA). Compared to the Nold subjects, the mild AD patients were characterized by a power increase of widespread delta sources and by a power decrease of posterior alpha sources. In the mild AD patients, the follow-up EEG recordings showed increased power of widespread delta sources as well as decreased power of widespread alpha and posterior beta 1 sources. These results suggest that the resting state EEG sources were sensitive, at least at group level, to the cognitive decline occurring in the mild AD group over a one-year period, and might represent cost-effective and non-invasive markers with which to enrich cohorts of AD patients that decline faster for clinical studies. PMID:23340039

Babiloni, Claudio; Lizio, Roberta; Del Percio, Claudio; Marzano, Nicola; Soricelli, Andrea; Salvatore, Elena; Ferri, Raffaele; Cosentino, Filomena I I; Tedeschi, Gioacchino; Montella, Patrizia; Marino, Silvia; De Salvo, Simona; Rodriguez, Guido; Nobili, Flavio; Vernieri, Fabrizio; Ursini, Francesca; Mundi, Ciro; Richardson, Jill C; Frisoni, Giovanni B; Rossini, Paolo M

2013-01-01

341

Geologic occurrences of erionite in the United States: an emerging national public health concern for respiratory disease.  

PubMed

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. PMID:23315055

Van Gosen, Bradley S; Blitz, Thomas A; Plumlee, Geoffrey S; Meeker, Gregory P; Pierson, M Patrick

2013-08-01

342

Parkinson disease-associated mutation R1441H in LRRK2 prolongs the "active state" of its GTPase domain  

PubMed Central

Mutation in leucine-rich-repeat kinase 2 (LRRK2) is a common cause of Parkinson disease (PD). A disease-causing point mutation R1441H/G/C in the GTPase domain of LRRK2 leads to overactivation of its kinase domain. However, the mechanism by which this mutation alters the normal function of its GTPase domain [Ras of complex proteins (Roc)] remains unclear. Here, we report the effects of R1441H mutation (RocR1441H) on the structure and activity of Roc. We show that Roc forms a stable monomeric conformation in solution that is catalytically active, thus demonstrating that LRRK2 is a bona fide self-contained GTPase. We further show that the R1441H mutation causes a twofold reduction in GTPase activity without affecting the structure, thermal stability, and GDP-binding affinity of Roc. However, the mutation causes a twofold increase in GTP-binding affinity of Roc, thus suggesting that the PD-causing mutation R1441H traps Roc in a more persistently activated state by increasing its affinity for GTP and, at the same time, compromising its GTP hydrolysis. PMID:24591621

Liao, Jingling; Wu, Chun-Xiang; Burlak, Christopher; Zhang, Sheng; Sahm, Heather; Wang, Mu; Zhang, Zhong-Yin; Vogel, Kurt W.; Federici, Mark; Riddle, Steve M.; Nichols, R. Jeremy; Liu, Dali; Cookson, Mark R.; Stone, Todd A.; Hoang, Quyen Q.

2014-01-01

343

Disease Prevalence and Use of Health Care among a National Sample of Black and White Male State Prisoners  

PubMed Central

U.S. prisons have a court-affirmed mandate to provide health care to prisoners. Given this mandate, we sought to determine whether use of prison health care was equitable across race using a nationally-representative sample of Black and White male state prisoners. We first examined the prevalence of health conditions by race. Then, across all health conditions and for each of 15 conditions, we compared the proportion of Black and White male prisoners with the condition who received health care. For most conditions including cancer, heart disease, and liver-related disorders, the age-adjusted prevalence of disease among Blacks was lower than among Whites (p<.05). Blacks were also modestly more likely than Whites to use health care for existing conditions (p<.05), particularly hypertension, cerebral vascular accident/brain injury, cirrhosis, flu-like illness, and injury. The observed racial disparities in health and health care use are different from those among non-incarcerated populations. PMID:22643475

Rosen, David L.; Hammond, Wizdom P.; Wohl, David A.; Golin, Carol E.

2014-01-01

344

Hurling Alone? How Social Capital Failed to Save the Irish From Cardiovascular Disease in the United States  

PubMed Central

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

Kelleher, C. Cecily; Lynch, John; Harper, Sam; Tay, Joseph B.; Nolan, Geraldine

2004-01-01

345

Algal bloom-associated disease outbreaks among users of freshwater lakes--United States, 2009-2010.  

PubMed

Harmful algal blooms (HABs) are excessive accumulations of microscopic photosynthesizing aquatic organisms (phytoplankton) that produce biotoxins or otherwise adversely affect humans, animals, and ecosystems. HABs occur sporadically and often produce a visible algal scum on the water. This report summarizes human health data and water sampling results voluntarily reported to CDC's Waterborne Disease and Outbreak Surveillance System (WBDOSS) via the National Outbreak Reporting System (NORS) and the Harmful Algal Bloom-Related Illness Surveillance System (HABISS)* for the years 2009-2010. For 2009-2010, 11 waterborne disease outbreaks associated with algal blooms were reported; these HABs all occurred in freshwater lakes. The outbreaks occurred in three states and affected at least 61 persons. Health effects included dermatologic, gastrointestinal, respiratory, and neurologic signs and symptoms. These 11 HAB-associated outbreaks represented 46% of the 24 outbreaks associated with untreated recreational water reported for 2009-2010, and 79% of the 14 freshwater HAB-associated outbreaks that have been reported to CDC since 1978. Clinicians should be aware of the potential for HAB-associated illness among patients with a history of exposure to freshwater. PMID:24402467

Hilborn, Elizabeth D; Roberts, Virginia A; Backer, Lorraine; Deconno, Erin; Egan, Jessica S; Hyde, James B; Nicholas, David C; Wiegert, Eric J; Billing, Laurie M; Diorio, Mary; Mohr, Marika C; Hardy, Joan F; Wade, Timothy J; Yoder, Jonathan S; Hlavsa, Michele C

2014-01-10

346

Efficacy of vagus nerve stimulation as a treatment for medically intractable epilepsy in brain tumor patients. A case-controlled study using the VNS therapy Patient Outcome Registry  

PubMed Central

Purpose Vagus nerve stimulation (VNS) therapy is a procedure to control seizure frequency in patients with medically intractable epilepsy. However, there is no data on efficacy in the subset of these patients with brain tumors. The purpose of this study is to evaluate the efficacy of VNS therapy in patients with brain tumor-associated medically intractable epilepsy. Methods Data from the VNS therapy Patient Outcome Registry, maintained by the manufacturer of the device, Cyberonics Inc. (Houston, TX, USA), was queried to characterize the response of patients in whom a brain tumor was listed as the etiology of epilepsy. A case–control analysis was implemented and patient outcome was measured by Engel classification, median seizure response and responder rate (?50% seizure reduction) using t-tests and chi-squared tests. Results In 107 patients with an epilepsy etiology related to a brain tumor, seizure reduction was 45% at 3 months and 79% at 24 months with a responder rate of 48% at 3 months and 79% at 24 months. There was no statistical difference in seizure reduction compared with 326 case–control patients from the registry without brain tumors. There was no significant difference in anti-epileptic drug (AED) usage from baseline to 24 months post implant in either group. Conclusions VNS therapy is equally effective in patients who suffer seizures secondary to brain tumors as in patients without history of a brain tumor. VNS therapy is a viable treatment option for patients with brain tumor associated medically intractable epilepsy, assuming cytoreductive and other adjuvant therapies have been fully explored. PMID:23768541

Patel, Kunal S.; Labar, Douglas R.; Gordon, Charles M.; Hassnain, Kevin H.; Schwartz, Theodore H.

2013-01-01

347

Sexually transmitted diseases in the history of Uganda.  

PubMed Central

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

Lyons, M

1994-01-01

348

Brain natriuretic factor: regional plasma concentrations and correlations with haemodynamic state in cardiac disease.  

PubMed Central

OBJECTIVE--To document regional plasma concentrations of brain natriuretic factor (BNF) and their relations to concurrent concentrations of atrial natriuretic factor, cyclic guanosine monophosphate, and haemodynamic state. DESIGN--Regional blood sampling from a systemic artery and vein, renal vein, and coronary sinus together with concurrent haemodynamic indices in patients coming forward for left and right cardiac catheterisation. SETTING--Tertiary referral centre. PATIENTS--22 consecutive unselected patients coming forward for left and right cardiac catheterisation or electrophysiological studies in the course of standard diagnosis for a range of cardiac disorders. MAIN OUTCOME MEASURES--Significant arteriovenous gradients for plasma BNF concentration were found across the lower limb, the kidney, and the heart. These were less than concurrent arteriovenous gradients in plasma atrial natriuretic factor (ANF). Arterial concentrations of plasma BNF were positively related to concurrent concentrations of ANF (r = 0.72, p < 0.01) and cyclic guanosine monophosphate (r = 0.52, p < 0.05). Arterial plasma concentrations of BNF showed a significant positive correlation with right atrial pressure and pulmonary artery wedge pressure and an inverse relation to cardiac output. CONCLUSIONS--Regional plasma concentrations of BNF indicate cardiac secretion of this peptide and clearance in a number of tissues. Renal clearance is proportionally greater than that found across the limb. Absolute and proportional arteriovenous gradients of this peptide are considerably less than for concomitant concentrations of ANF suggesting slower metabolic clearance of BNF. Plasma BNF concentrations rise with increasing cardiac impairment and are related to indices of cardiac function. These findings are consistent with a role for BNF in the neurohumoral response to cardiac impairment. PMID:8390847

Richards, A M; Crozier, I G; Yandle, T G; Espiner, E A; Ikram, H; Nicholls, M G

1993-01-01

349

Resting state functional MRI in Parkinson's disease: the impact of deep brain stimulation on 'effective' connectivity  

PubMed Central

Depleted of dopamine, the dynamics of the parkinsonian brain impact on both ‘action’ and ‘resting’ motor behaviour. Deep brain stimulation has become an established means of managing these symptoms, although its mechanisms of action remain unclear. Non-invasive characterizations of induced brain responses, and the effective connectivity underlying them, generally appeals to dynamic causal modelling of neuroimaging data. When the brain is at rest, however, this sort of characterization has been limited to correlations (functional connectivity). In this work, we model the ‘effective’ connectivity underlying low frequency blood oxygen level-dependent fluctuations in the resting Parkinsonian motor network—disclosing the distributed effects of deep brain stimulation on cortico-subcortical connections. Specifically, we show that subthalamic nucleus deep brain stimulation modulates all the major components of the motor cortico-striato-thalamo-cortical loop, including the cortico-striatal, thalamo-cortical, direct and indirect basal ganglia pathways, and the hyperdirect subthalamic nucleus projections. The strength of effective subthalamic nucleus afferents and efferents were reduced by stimulation, whereas cortico-striatal, thalamo-cortical and direct pathways were strengthened. Remarkably, regression analysis revealed that the hyperdirect, direct, and basal ganglia afferents to the subthalamic nucleus predicted clinical status and therapeutic response to deep brain stimulation; however, suppression of the sensitivity of the subthalamic nucleus to its hyperdirect afferents by deep brain stimulation may subvert the clinical efficacy of deep brain stimulation. Our findings highlight the distributed effects of stimulation on the resting motor network and provide a framework for analysing effective connectivity in resting state functional MRI with strong a priori hypotheses. PMID:24566670

Kahan, Joshua; Urner, Maren; Moran, Rosalyn; Flandin, Guillaume; Marreiros, Andre; Mancini, Laura; White, Mark; Thornton, John; Yousry, Tarek; Zrinzo, Ludvic; Hariz, Marwan; Limousin, Patricia; Friston, Karl

2014-01-01

350

15 Tackling state space explosion in PEPA models In this lecture note we consider different approaches that are used to try to overcome the  

E-print Network

15 Tackling state space explosion in PEPA models In this lecture note we consider different approaches that are used to try to overcome the state space explosion problem in Markovian based models models are subject to the problem of state space explosion -- the generated models may be intractable

Hillston, Jane

351

Elevated serum uric acid in nondiabetic people mark pro-inflammatory state and HDL dysfunction and independently predicts coronary disease.  

PubMed

We explored the association of serum uric acid (UA) concentrations with pro-inflammatory state and high-density lipoprotein (HDL) dysfunction. UA tertiles in tracked 1,508 nondiabetic participants were analyzed cross-sectionally for associations with inflammation biomarkers and protective proteins over a mean follow-up of 4.9 years for incident coronary heart disease (CHD) using Cox proportional hazards regression. In the absence of metabolic syndrome (MetS), UA tertiles significantly distinguished, in each sex, increasing categories of three MetS components (inflammation/oxidation markers, apolipoprotein (apo)B) and (inversely) current smoking (but not protective proteins such as HDL, apoA-I, and adiponectin). Distinctions attenuated in the presence of MetS. Linear regression model revealed fasting triglycerides (1.86 mg/dl variance), male sex, and gamma-glutamyl transferase and age as covariates of UA levels in women. In Cox analysis, incident CHD (n = 137) was predicted by mid and upper UA tertile in men alone at significant hazard ratios of 2.7, additively to conventional risk factors. Elevated serum UA levels, linked to triglycerides, mark in nondiabetic people pro-inflammatory state, and, notably, HDL dysfunction. CHD risk is independently predicted by elevated UA levels in nondiabetic men and is modulated by MetS and gender. PMID:23934383

Onat, Altan; Can, Günay; Örnek, Ender; Altay, Servet; Yüksel, Murat; Ademo?lu, Evin

2013-12-01

352

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

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

Glen D. Johnson

2008-01-01

353

Complications of Therapy in Parkinson's Disease  

PubMed Central

Despite several more effective combinations, the incidence of disability and intractable complications from levodopa therapy for Parkinson's disease is unchanged. Many of these appear to be related to the development of denervation hypersensitivity as well as to drug tolerance and loss of effect. They include dyskinesia, `wearing off' phenomenon, `on-off' phenomenon, and various psychic changes. More current forms of therapy with bromocriptine and drug holidays are described, emphasizing methods of preventing and controlling the incapacitating complications associated with long term drug therapy. Some future therapeutic considerations are also described. PMID:21286582

Kofman, Oscar S.

1983-01-01

354

[Evaluation of knowledge and practices related to Chagas disease and its vectors among adults and children in an endemic region in Minas Gerais State, Brazil].  

PubMed

Despite the success of the Chagas Disease Control Program (PCCD) in Brazil, some endemic areas have experienced difficulty in maintaining the program's activities, especially after the health system's decentralization, since the sustainability of control measures for Chagas disease and vectors is known to depend on information and community participation. This study aimed to analyze knowledge and practices related to vectors and Chagas disease in Bambuí, Minas Gerais State, Brasil. The population's knowledge was tested with a questionnaire, accompanied by six illustrations of triatomine bugs for identification. Both adults and primary and secondary schoolchildren in rural areas of the county participated in the research. The Bambuí population showed good overall knowledge on triatomines and Chagas disease in both groups (adults and children), although the concepts were limited to preventing the insect vector from invading houses. The results emphasize the importance of educational campaigns in the context of the program as a fundamental component of community participation in Chagas disease vector control. PMID:19649411

Villela, Marcos Marreiro; Pimenta, Denise Nacif; Lamounier, Paulo Acácio; Dias, João Carlos Pinto

2009-08-01

355

Atlanto-axial subluxation syndrome and management of intractable headache, neck pain and shoulder pain with auricular stimulation: a clinical case report.  

PubMed

Atlanto-axial subluxation syndrome is a condition that is easily overlooked, misdiagnosed and mismanaged. Anatomy, neurovascular involvement and description of clinical manifestations are reviewed. Bi-Digital O-Ring Test is employed to establish an accurate diagnosis and its value and accuracy described briefly. Bi-Digital O-Ring Test has been an important diagnosis confirmation method (reconfirmed by CT or MRI in over 95% of more than 850 clinical cases) in this author's practice of spinal disorder and intractable pain management. A newly described device, the KIM-STIM, offers auricular stimulation of multiple points, using electrical microcurrent. Each unit is individually custom-molded to the patient's ear, and fitted with multiple electrodes. It was found to be very effective in managing the majority of intractable pain, especially pain requiring multiple daily treatments in order for the patient to live and function normally. The KIM-STIM device allows the patient to self-manage the pain, by day or night, thus allowing for a reduction or elimination of medication intake and diminishing the necessity for frequent doctor visits. PMID:11841111

Kim, K H

2001-01-01

356

Impact of NO(x) emissions reduction policy on hospitalizations for respiratory disease in New York State.  

PubMed

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

Lin, Shao; Jones, Rena; Pantea, Cristian; Özkaynak, Halûk; Rao, S Trivikrama; Hwang, Syni-An; Garcia, Valerie C

2013-01-01

357

[The influence of carbon dioxide baths differing in the total mineralization levels on the functional state of the cardiovascular system of the patients presenting with hypertensive disease associated with coronary heart disease].  

PubMed

The results of the study on the influence of carbon dioxide baths differing in the total mineralization levels on the clinical course of hypertensive disease associated with coronary heart disease and on various functional systems of the body. The data obtained provide an insight into the role of salt concentrations (10 and 20 g/l) in carbon dioxide bath water (1.2 g/l) applied for the traditional treatment of the patients with hypertensive disease associated with concomitant coronary heart disease and musculoskeletal pathology. Highly mineralized bath water has a greater influence on the functional state of the cardiovascular system by causing a more pronounced decrease in peripheral vascular resistance and hypotensive effect. Baths with a salt concentration of 20 g/l markedly reduced pain and had anti-inflammatory effect in the patients with pathology of support and locomotor organs. PMID:24640650

L'vova, N V; Tupitsyna, Iu Iu; Badalov, N G; Krasnikov, V E; Lebedeva, O D

2013-01-01

358

A Bayesian Simulation Approach to Inference on a MultiState Latent Factor Intensity Model  

Microsoft Academic Search

This paper provides a Bayesian approach to inference on a multi-state latent factor intensity model to manage the problem of highly analytically intractable pdfs. The sampling algorithm used to obtain posterior distributions of the model parameters includes a particle filter step and a Metropolis-Hastings step within a Gibbs sampler. A simulated example is conducted to show the feasibility and accuracy

Chew Lian Chua; G. C. Lim; Penelope Smith

2008-01-01

359

Attitude Toward and Current Practice of Transfer and Transition of Adolescents with Congenital Heart Disease in the United States of America and Europe  

Microsoft Academic Search

The objective of this study was to explore the current practice and attitudes of pediatric cardiologists in the United States\\u000a and Europe on the transfer and transition of children with congenital heart disease (CHD). A survey among pediatric cardiology\\u000a programs in the United States and Europe was undertaken. Sixty-nine centers completed and returned the 61-item questionnaire\\u000a that was specifically devised

Deborah Hilderson; Arwa S. Saidi; Kristien Van Deyk; Amy Verstappen; Adrienne H. Kovacs; Susan M. Fernandes; Mary M. Canobbio; Desiree Fleck; Alison Meadows; Rachel Linstead; Philip Moons

2009-01-01

360

Epidemic of end-stage renal disease in people with diabetes in the United States population: Do we know the cause?  

Microsoft Academic Search

Epidemic of end-stage renal disease in people with diabetes in the United States population: Do we know the cause?BackgroundThe number of individuals initiating renal replacement therapy in the United States population grew exponentially over the past two decades. Cases of end-stage renal diseae (ESRD) attributed to diabetes accounted for most of this increase. In this report we examined factors that

Camille A. Jones; Andrzej S. Krolewski; JOHN ROGUS; Jay L. Xue; ALLAN COLLINS; James H. Warram

2005-01-01

361

Decreased Brain-Derived Neurotrophic Factor Depends on Amyloid Aggregation State in Transgenic Mouse Models of Alzheimer's Disease  

PubMed Central

Downregulation of brain-derived neurotrophic factor (BDNF) in the cortex occurs early in the progression of Alzheimer’s disease (AD). Since BDNF plays a critical role in neuronal survival, synaptic plasticity, and memory, BDNF reduction may contribute to synaptic and cellular loss and memory deficits characteristic of AD. In vitro evidence suggests that amyloid-? (A?) contributes to BDNF downregulation in AD, but the specific A? aggregation state responsible for this downregulation in vivo is unknown. In the present study, we examined cortical levels of BDNF mRNA in three different transgenic AD mouse models harboring mutations in APP resulting in A? overproduction, and in a genetic mouse model of Down syndrome. Two of the three A? transgenic strains (APPNLh and TgCRND8) exhibited significantly decreased cortical BDNF mRNA levels compared with wild-type mice, whereas neither the other strain (APP swe/PS-1) nor the Down syndrome mouse model (Ts65Dn) was affected. Only APPNLh and TgCRND8 mice expressed high A?42/A?40 ratios and larger SDS-stable A? oligomers (~115 kDa). TgCRND8 mice exhibited downregulation of BDNF transcripts III and IV; transcript IV is also downregulated in AD. Furthermore, in all transgenic mouse strains, there was a correlation between levels of large oligomers, A?42/A?40, and severity of BDNF decrease. These data show that the amount and species of A? vary among transgenic mouse models of AD and are negatively correlated with BDNF levels. These findings also suggest that the effect of A? on decreased BDNF expression is specific to the aggregation state of A? and is dependent on large oligomers. PMID:19625522

Peng, Shiyong; Garzon, Diego J.; Marchese, Monica; Klein, William; Ginsberg, Stephen D.; Francis, Beverly M.; Mount, Howard T. J.; Mufson, Elliott J.; Salehi, Ahmad; Fahnestock, Margaret

2012-01-01

362

Decreased brain-derived neurotrophic factor depends on amyloid aggregation state in transgenic mouse models of Alzheimer's disease.  

PubMed

Downregulation of brain-derived neurotrophic factor (BDNF) in the cortex occurs early in the progression of Alzheimer's disease (AD). Since BDNF plays a critical role in neuronal survival, synaptic plasticity, and memory, BDNF reduction may contribute to synaptic and cellular loss and memory deficits characteristic of AD. In vitro evidence suggests that amyloid-beta (A beta) contributes to BDNF downregulation in AD, but the specific A beta aggregation state responsible for this downregulation in vivo is unknown. In the present study, we examined cortical levels of BDNF mRNA in three different transgenic AD mouse models harboring mutations in APP resulting in A beta overproduction, and in a genetic mouse model of Down syndrome. Two of the three A beta transgenic strains (APP(NLh) and TgCRND8) exhibited significantly decreased cortical BDNF mRNA levels compared with wild-type mice, whereas neither the other strain (APP(swe)/PS-1) nor the Down syndrome mouse model (Ts65Dn) was affected. Only APP(NLh) and TgCRND8 mice expressed high A beta(42)/A beta(40) ratios and larger SDS-stable A beta oligomers (approximately 115 kDa). TgCRND8 mice exhibited downregulation of BDNF transcripts III and IV; transcript IV is also downregulated in AD. Furthermore, in all transgenic mouse strains, there was a correlation between levels of large oligomers, A beta(42)/A beta(40), and severity of BDNF decrease. These data show that the amount and species of A beta vary among transgenic mouse models of AD and are negatively correlated with BDNF levels. These findings also suggest that the effect of A beta on decreased BDNF expression is specific to the aggregation state of A beta and is dependent on large oligomers. PMID:19625522

Peng, Shiyong; Garzon, Diego J; Marchese, Monica; Klein, William; Ginsberg, Stephen D; Francis, Beverly M; Mount, Howard T J; Mufson, Elliott J; Salehi, Ahmad; Fahnestock, Margaret

2009-07-22

363

Large-scale resting state network correlates of cognitive impairment in Parkinson's disease and related dopaminergic deficits  

PubMed Central

Cognitive impairment is a common non-motor feature of Parkinson's disease (PD). Understanding the neural mechanisms of this deficit is crucial for the development of efficient methods for treatment monitoring and augmentation of cognitive functions in PD patients. The current study aimed to investigate resting state fMRI correlates of cognitive impairment in PD from a large-scale network perspective, and to assess the impact of dopamine deficiency on these networks. Thirty PD patients with resting state fMRI were included from the Parkinson's Progression Marker Initiative (PPMI) database. Eighteen patients from this sample were also scanned with 123I-FP-CIT SPECT. A standardized neuropsychological battery was administered, evaluating verbal memory, visuospatial, and executive cognitive domains. Image preprocessing was performed using an SPM8-based workflow, obtaining time-series from 90 regions-of-interest (ROIs) defined from the AAL brain atlas. The Brain Connectivity Toolbox (BCT) was used to extract nodal strength from all ROIs, and modularity of the cognitive circuitry determined using the meta-analytical software Neurosynth. Brain-behavior covariance patterns between cognitive functions and nodal strength were estimated using Partial Least Squares. Extracted latent variable (LV) scores were matched with the performances in the three cognitive domains (memory, visuospatial, and executive) and striatal dopamine transporter binding ratios (SBR) using linear modeling. Finally, influence of nigrostriatal dopaminergic deficiency on the modularity of the “cognitive network” was analyzed. For the range of deficits studied, better executive performance was associated with increased dorsal fronto-parietal cortical processing and inhibited subcortical and primary sensory involvement. This profile was also characterized by a relative preservation of nigrostriatal dopaminergic function. The profile associated with better memory performance correlated with increased prefronto-limbic processing, and was not associated with presynaptic striatal dopamine uptake. SBR ratios were negatively correlated with modularity of the “cognitive network,” suggesting integrative effects of the preserved nigrostriatal dopamine system on this circuitry. PMID:24765065

Lebedev, Alexander V.; Westman, Eric; Simmons, Andrew; Lebedeva, Aleksandra; Siepel, Francoise J.; Pereira, Joana B.; Aarsland, Dag

2014-01-01

364

Prothrombotic state in senile patients with acute exacerbations of chronic obstructive pulmonary disease combined with respiratory failure.  

PubMed

The aim of this study was to study the clinical value of prethrombotic state and treatment with low molecular weight heparin (LMWH) in senile patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) combined with respiratory failure. Hemorheological markers (hematocrit, blood viscosity and plasma viscosity), fibrinogen (FIB), D-dimer and gas analysis were evaluated in 30 senile patients with AECOPD combined with respiratory failure and compared with those in 30 cases without respiratory failure. A total of 30 cases with AECOPD combined with respiratory failure were randomly divided into treatment and control groups. The two groups received conventional treatment. The treatment group also received LMWH injections every 12 h for 6 days and the clinical effect was observed. The levels of FIB, D-dimer, hematocrit, blood viscosity and plasma viscosity were significantly higher in the patients with AECOPD combined with respiratory failure compared with those in the patients without respiratory failure. The plasma D-dimer and FIB levels had significantly positive correlations with the partial pressure of CO2 (PaCO2) and negative correlations with the partial pressure of O2 (PaO2) in the patients with AECOPD combined with respiratory failure. The curative effect was improved in the treatment group, compared with that in the control group without side-effects. However, no significant changes in activated partial thromboplastin time (APTT) and international normalized ratio (INR) were observed between the treatment and control groups. The senile patients with AECOPD combined with respiratory failure suffered from hypercoagulation. Early detection and diagnosis of the prethrombotic state and timely treatment with LMWH may benefit these patients without side-effects. PMID:23596488

Song, Ya-Jun; Zhou, Zhe-Hui; Liu, Yao-Kang; Rao, Shi-Ming; Huang, Ying-Jun

2013-04-01

365

Cardiovascular Disease in Blacks with HIV/AIDS in the United States: A Systematic Review of the Literature  

PubMed Central

Objectives: Blacks in the United States bear a disproportionate burden of Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) and cardiovascular disease (CVD). It has been demonstrated that HIV/AIDS itself and HIV/AIDS-related therapies may predispose patients to early onset of CVD. It is also possible that Black patients may be at greater risk for this interaction. Thus, the objective of this literature review was to identify and critically evaluate disparities in CVD between Black and White patients with HIV/AIDS. Design: A MEDLINE search (January 1, 1950 to May 31, 2010) was performed to identify original research articles published in the English language. The search was limited to articles that evaluated race-based disparities for CVD among patients with HIV/AIDS. Results: Of the five publications included in this review, a CVD diagnosis was the primary focus for only three of the studies and was a secondary objective for the remaining two studies. Two studies concluded that Blacks were more likely than Whites to have a CVD diagnosis at time of hospital admission, whereas, the other three studies did not detect any race-based disparities. Conclusions: Few studies have addressed the issue of Black race, HIV/AIDS, and CVD, highlighting the need for future research in this area. PMID:22563364

Oramasionwu, Christine U; Hunter, Jonathan M; Brown, Carolyn M; Morse, Gene D; Lawson, Kenneth A; Koeller, Jim M; Frei, Christopher R

2012-01-01

366

The Importance of Diabetes Mellitus in the Global Epidemic of Cardiovascular Disease: The Case of the State of Qatar  

PubMed Central

As a manifestation of the epidemiologic transition being experienced throughout the developing world, the prevalence of diabetes mellitus (DM) is increasing. However, whether an individual's risk of cardiovascular diseases as a consequence of DM is also higher in these countries is unknown. We conducted a case-control study at the medical center in the state of Qatar comparing the prevalence of DM in 512 patients who were admitted with acute myocardial infarctions (MI) and 262 cases of cerebrovascular accidents (CVA) to 382 hospital and outpatient controls to calculate the odds ratios (OR) associated with DM for MI and CVA. The OR for MI was estimated to be 4.01 compared to 2.92 for other countries in the Middle East and 1.75 for North America. The OR was even higher for Qatari natives. Understanding the reasons for this increase, including genetic differences, lifestyle, and medical management issues, is critical for the design and prioritization of effective interventions. PMID:23303985

Mushlin, Alvin I.; Christos, Paul J.; Abu-Raddad, Laith; Chemaitelly, Hiam; Deleu, Dirk; Gehani, Abdul Razak

2012-01-01

367

Environmental noise and cardiovascular disease in adults: research in Central, Eastern and South-Eastern Europe and Newly Independent States.  

PubMed

The adverse effects of noise on health have been intensely explored in the past 50 years. However, the scope of research conducted in the Central and Eastern Europe, South-East Europe, and Newly Independent States is not well-known. The aim of this review was to present studies on cardiovascular effects of environmental noise in adults published since 1965 and to point out the most important issues that need to be addressed in the future. More than 100 papers on noise and health and about 20 papers on cardiovascular effects of environmental noise in adults were identified by literature search. The authors reviewed scientific international and local journals, conference proceedings, and local reports published in national languages. The major endpoints were high blood pressure, ischemic heart disease, and myocardial infarction. The target populations were adults. Experimental and exposure-assessment studies, field, empirical studies, social surveys, and epidemiological studies are presented. The major sources of environmental noise were road and air traffic. The results were presented in tables and the most relevant articles were briefly discussed. The importance of this review is that it refers to some countries that no longer exist in the same political and governmental systems. The strength of this paper is that it includes publications that were not evaluated in earlier systematic reviews. Strategies for future noise-related research on national and global level are proposed. PMID:23412577

Argalášová-Sobotová, L'ubica; Lekaviciute, Jurgita; Jeram, Sonja; Sevcíková, L'udmila; Jurkovicová, Jana

2013-01-01

368

Mortality Caused by Chronic Liver Disease Among American Indians and Alaska Natives in the United States, 1999-2009  

PubMed Central

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

Suryaprasad, Anil; Byrd, Kathy K.; Redd, John T.; Perdue, David G.; Manos, M. Michele; McMahon, Brian J.

2014-01-01

369

Multilocus sequence typing of Xylella fastidiosa causing Pierce's disease and oleander leaf scorch in the United States.  

PubMed

Using a modified multilocus sequence typing (MLST) scheme for the bacterial plant pathogen Xylella fastidiosa based on the same seven housekeeping genes employed in a previously published MLST, we studied the genetic diversity of two subspecies, X. fastidiosa subsp. fastidiosa and X. fastidiosa subsp. sandyi, which cause Pierce's disease and oleander leaf scorch, respectively. Typing of 85 U.S. isolates (plus one from northern Mexico) of X. fastidiosa subsp. fastidiosa from 15 different plant hosts and 21 isolates of X. fastidiosa subsp. sandyi from 4 different hosts in California and Texas supported their subspecific status. Analysis using the MLST genes plus one cell-surface gene showed no significant genetic differentiation based on geography or host plant within either subspecies. Two cases of homologous recombination (with X. fastidiosa subsp. multiplex, the third U.S. subspecies) were detected in X. fastidiosa subsp. fastidiosa. Excluding recombination, MLST site polymorphism in X. fastidiosa subsp. fastidiosa (0.048%) and X. fastidiosa subsp. sandyi (0.000%) was substantially lower than in X. fastidiosa subsp. multiplex (0.240%), consistent with the hypothesis that X. fastidiosa subspp. fastidiosa and sandyi were introduced into the United States (probably just prior to 1880 and 1980, respectively). Using whole-genome analysis, we showed that MLST is more effective at genetic discrimination at the specific and subspecific level than other typing methods applied to X. fastidiosa. Moreover, MLST is the only technique effective in detecting recombination. PMID:20465416

Yuan, Xiaoli; Morano, Lisa; Bromley, Robin; Spring-Pearson, Senanu; Stouthamer, Richard; Nunney, Leonard

2010-06-01

370

Comparison of Examination-Based and Self-Reported Risk Factors for Cardiovascular Disease, Washington State, 2006-2007  

PubMed Central

Introduction Obesity, hypertension, and high cholesterol are risk factors for cardiovascular disease, which accounts for approximately 20% of deaths in Washington State. For most states, self-reports from the Behavioral Risk Factor Surveillance System (BRFSS) provide the primary source of information on these risk factors. The objective of this study was to compare prevalence estimates of self-reported obesity, hypertension, and high cholesterol with examination-based measures of obesity, hypertension, and high-risk lipid profiles. Methods During 2006–2007, the Washington Adult Health Survey (WAHS) included self-reported and examination-based measures of a random sample of 672 Washington State residents aged 25 years or older. We compared WAHS examination-based measures with self-reported measures from WAHS and the 2007 Washington BRFSS (WA-BRFSS). Results The estimated prevalence of obesity from WA-BRFSS (27.1%; 95% confidence interval [CI], 26.3%–27.8%) was lower than estimates derived from WAHS physical measurements (39.2%; 95% CI, 33.6%–45.1%) (P < .001). Prevalence estimates of hypertension based on self-reports from WA-BRFSS (28.1%; 95% CI, 27.4%–28.8%) and WAHS (33.4%; 95% CI, 29.4%–37.7%) were similar to the examination-based estimate (29.4%; 95% CI, 25.8%–33.4%). Prevalence estimates of high cholesterol based on self-reports from WA-BRFSS (38.3%; 95% CI, 37.5%–39.2%) and WAHS (41.8%; 95% CI, 35.8%–48.1%) were similar; both were lower than the examination-based WAHS estimate of high-risk lipid profiles (59.2%; 95% CI, 54.2%–64.2%) (P < .001). Conclusion Self-reported heights and weights underestimate the prevalence of obesity. The prevalence of self-reported high cholesterol is significantly lower than the prevalence of high-risk lipid profiles. Periodic examination-based measurement provides perspective on routinely collected self-reports. PMID:22721502

Bensley, Lillian; Ossiander, Eric M.; Krueger, Karen

2012-01-01

371

Recognizing waterborne disease and the health effects of water contamination: a review of the challenges facing the medical community in the United States  

Microsoft Academic Search

Preservation of water quality and prevention of waterborne disease is a complicated task requiring a coordinated effort from many diverse disciplines including physicians, healthcare providers, epidemiologists, microbiologists, academic scientists, science researchers, local and national health authorities, public and environmental health specialists, water engineers and water purveyors. Any successful strategy to ensure water quality and safety in the United States must

Patricia L. Meinhardt

2006-01-01

372

Review of Brucellosis Cases from Laboratory Exposures in the United States in 2008 to 2011 and Improved Strategies for Disease Prevention  

PubMed Central

Five laboratory-acquired brucellosis (LAB) cases that occurred in the United States between 2008 and 2011 are presented. The Centers for Disease Control and Prevention (CDC) reviewed the recommendations published in 2008 and the published literature to identify strategies to further prevent LAB. The improved prevention strategies are described. PMID:23824776

Guerra, M. A.; Morrow, M. G.; Haupt, T.; Morrison, J.; Saah, J. R.; Smith, C. G.; Williams, C.; Fleischauer, A. T.; Lee, P. A.; Stanek, D.; Trevino-Garrison, I.; Franklin, P.; Oakes, P.; Hand, S.; Shadomy, S. V.; Blaney, D. D.; Lehman, M. W.; Benoit, T. J.; Stoddard, R. A.; Tiller, R. V.; De, B. K.; Bower, W.; Smith, T. L.

2013-01-01

373

Estimated Effects of Reducing Dietary Saturated Fat Intake on the Incidence and Costs of Coronary Heart Disease in the United States  

Microsoft Academic Search

Objectives To estimate the effects of reducing dietary saturated fat intake on the incidence and economic costs of coronary heart disease (CHD) in the United States.Design Modeling techniques and data from secondary sources, including the Framingham Heart Study and the second and third National Health and Nutrition Examination Surveys, were used to estimate the effects on CHD incidence and associated

GERRY OSTER; DAVID THOMPSON

1996-01-01

374

Budesonide CIR capsules (once or twice daily divided-dose) in active Crohn's disease: a randomized placebo-controlled study in the United States  

Microsoft Academic Search

OBJECTIVES:Budesonide controlled ileal release (CIR) capsules deliver budesonide, a glucocorticosteroid with high topical and low systemic activity, to the distal ileum and the proximal colon. In four previous controlled trials in Crohn's disease, remission rates ranged from 51% to 69%. We sought to evaluate the efficacy and safety of this drug in a population of patients in the United States

William J. Tremaine; Stephen B. Hanauer; Seymour Katz; Barry D. Winston; Jeffrey G. Levine; Tore Persson; Anders Persson

2002-01-01

375

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...

376

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...

377

Incidence of Avian Influenza in Adamawa State, Nigeria: The Epidemiology, Economic Losses and the Possible Role of Wild Birds in the Transmission of the Disease  

Microsoft Academic Search

Reducing the huge economic losses due to diseases in poultry as the second largest industry in Nigeria after oil means improving the protein intake of the majority. Similarly, this will also promotes a steady income for the teeming farmers. This study investigated the incidence of the lethal avian influenza in Adamawa State, Nigeria, with particular emphasis on the socio-economic and

H. G. Balla; A. S. Tahir; C. Haskainu

2008-01-01

378

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

379

Comparing bacterial community composition between healthy and white plague-like disease states in Orbicella annularis using PhyloChip™ G3 microarrays  

USGS Publications Warehouse

Coral disease is a global problem. Diseases are typically named or described based on macroscopic changes, but broad signs of coral distress such as tissue loss or discoloration are unlikely to be specific to a particular pathogen. For example, there appear to be multiple diseases that manifest the rapid tissue loss that characterizes ‘white plague.’ PhyloChip™ G3 microarrays were used to compare the bacterial community composition of both healthy and white plague-like diseased corals. Samples of lobed star coral (Orbicella annularis, formerly of the genus Montastraea [1]) were collected from two geographically distinct areas, Dry Tortugas National Park and Virgin Islands National Park, to determine if there were biogeographic differences between the diseases. In fact, all diseased samples clustered together, however there was no consistent link to Aurantimonas coralicida, which has been described as the causative agent of white plague type II. The microarrays revealed a large amount of bacterial heterogeneity within the healthy corals and less diversity in the diseased corals. Gram-positive bacterial groups (Actinobacteria, Firmicutes) comprised a greater proportion of the operational taxonomic units (OTUs) unique to healthy samples. Diseased samples were enriched in OTUs from the families Corynebacteriaceae, Lachnospiraceae, Rhodobacteraceae, and Streptococcaceae. Much previous coral disease work has used clone libraries, which seem to be methodologically biased toward recovery of Gram-negative bacterial sequences and may therefore have missed the importance of Gram-positive groups. The PhyloChip™data presented here provide a broader characterization of the bacterial community changes that occur within Orbicella annularis during the shift from a healthy to diseased state.

Kellogg, Christina A.; Piceno, Yvette M.; Tom, Lauren M.; DeSantis, Todd Z.; Gray, Michael A.; Zawada, David G.; Andersen, Gary L.

2013-01-01

380

Comparing bacterial community composition between healthy and white plague-like disease states in Orbicella annularis using PhyloChip™ G3 microarrays.  

PubMed

Coral disease is a global problem. Diseases are typically named or described based on macroscopic changes, but broad signs of coral distress such as tissue loss or discoloration are unlikely to be specific to a particular pathogen. For example, there appear to be multiple diseases that manifest the rapid tissue loss that characterizes 'white plague.' PhyloChip™ G3 microarrays were used to compare the bacterial community composition of both healthy and white plague-like diseased corals. Samples of lobed star coral (Orbicella annularis, formerly of the genus Montastraea[1]) were collected from two geographically distinct areas, Dry Tortugas National Park and Virgin Islands National Park, to determine if there were biogeographic differences between the diseases. In fact, all diseased samples clustered together, however there was no consistent link to Aurantimonas coralicida, which has been described as the causative agent of white plague type II. The microarrays revealed a large amount of bacterial heterogeneity within the healthy corals and less diversity in the diseased corals. Gram-positive bacterial groups (Actinobacteria, Firmicutes) comprised a greater proportion of the operational taxonomic units (OTUs) unique to healthy samples. Diseased samples were enriched in OTUs from the families Corynebacteriaceae, Lachnospiraceae, Rhodobacteraceae, and Streptococcaceae. Much previous coral disease work has used clone libraries, which seem to be methodologically biased toward recovery of Gram-negative bacterial sequences and may therefore have missed the importance of Gram-positive groups. The PhyloChip™data presented here provide a broader characterization of the bacterial community changes that occur within Orbicella annularis during the shift from a healthy to diseased state. PMID:24278181

Kellogg, Christina A; Piceno, Yvette M; Tom, Lauren M; DeSantis, Todd Z; Gray, Michael A; Zawada, David G; Andersen, Gary L

2013-01-01

381

Comparing Bacterial Community Composition between Healthy and White Plague-Like Disease States in Orbicella annularis Using PhyloChip(TM) G3 Microarrays  

PubMed Central

Coral disease is a global problem. Diseases are typically named or described based on macroscopic changes, but broad signs of coral distress such as tissue loss or discoloration are unlikely to be specific to a particular pathogen. For example, there appear to be multiple diseases that manifest the rapid tissue loss that characterizes ‘white plague.’ PhyloChip™ G3 microarrays were used to compare the bacterial community composition of both healthy and white plague-like diseased corals. Samples of lobed star coral (Orbicella annularis, formerly of the genus Montastraea [1]) were collected from two geographically distinct areas, Dry Tortugas National Park and Virgin Islands National Park, to determine if there were biogeographic differences between the diseases. In fact, all diseased samples clustered together, however there was no consistent link to Aurantimonas coralicida, which has been described as the causative agent of white plague type II. The microarrays revealed a large amount of bacterial heterogeneity within the healthy corals and less diversity in the diseased corals. Gram-positive bacterial groups (Actinobacteria, Firmicutes) comprised a greater proportion of the operational taxonomic units (OTUs) unique to healthy samples. Diseased samples were enriched in OTUs from the families Corynebacteriaceae, Lachnospiraceae, Rhodobacteraceae, and Streptococcaceae. Much previous coral disease work has used clone libraries, which seem to be methodologically biased toward recovery of Gram-negative bacterial sequences and may therefore have missed the importance of Gram-positive groups. The PhyloChip™data presented here provide a broader characterization of the bacterial community changes that occur within Orbicella annularis during the shift from a healthy to diseased state. PMID:24278181

Kellogg, Christina A.; Piceno, Yvette M.; Tom, Lauren M.; DeSantis, Todd Z.; Gray, Michael A.; Zawada, David G.; Andersen, Gary L.

2013-01-01

382

Of mice and men: solving the molecular mysteries of Huntington's disease  

PubMed Central

Recent advances in the manipulation of mouse embryos provide opportunities for the disciplines of neuroscience and molecular genetics to join forces and tackle some previously intractable questions in this area of research. Even Huntington's disease has started to yield clues to its complex pathophysiology as a result of the recent application of transgenic technologies. This short review, while necessarily providing some background clinical information on Huntington's disease, will focus on how modifications of the mouse genome have contributed, and are continuing to contribute, to our understanding of the complex disease process. Such new insights may well turn the hope of developing the first effective treatment for this devastating disease into reality. PMID:10923992

SHELBOURNE, P. F.

2000-01-01

383

Decentralization of Care for Adults with Congenital Heart Disease in the United States: A Geographic Analysis of Outpatient Surgery  

PubMed Central

Background Guidelines recommend that adults with congenital heart disease (CHD) undergo noncardiac surgery in regionalized centers of expertise, but no studies have assessed whether this occurs in the United States. We hypothesized that adults with CHD are less likely than children to receive care at specialized CHD centers. Methods Using a comprehensive state ambulatory surgical registry (California Ambulatory Surgery Database, 2005–2011), we calculated the proportion of adult and pediatric patients with CHD who had surgery at a CHD center, distance to the nearest CHD center, and distance to the facility where surgery was performed. Results Patients with CHD accounted for a larger proportion of the pediatric population (n?=?11,254, 1.0%) than the adult population (n?=?10,547, 0.07%). Only 2,741 (26.0%) adults with CHD had surgery in a CHD center compared to 6,403 (56.9%) children (p<0.0001). Adult CHD patients who had surgery at a non-specialty center (11.9±15.4 miles away) lived farther from the nearest CHD center (37.9±43.0 miles) than adult CHD patients who had surgery at a CHD center (23.2±28.4 miles; p<0.0001). Pediatric CHD patients who had surgery at a non-specialty center (18.0±20.7 miles away) lived farther from the nearest CHD center (35.7±45.2 miles) than pediatric CHD patients who had surgery at a CHD center (22.4±26.0 miles; p<0.0001). Conclusions Unlike children with CHD, most adults with CHD (74%) do not have outpatient surgery at a CHD center. For both adults and children with CHD, greater distance from a CHD center is associated with having surgery at a non-specialty center. These results have significant public health implications in that they suggest a failing to achieve adequate regional access to specialized ACHD care. Further studies will be required to evaluate potential strategies to more reliably direct this vulnerable population to centers of expertise. PMID:25247694

Maxwell, Bryan G.; Maxwell, Thane G.; Wong, Jim K.

2014-01-01

384

Regional Homogeneity Changes in Hemodialysis Patients with End Stage Renal Disease: In Vivo Resting-State Functional MRI Study  

PubMed Central

Objective To prospectively investigate and detect early cerebral regional homogeneity (ReHo) changes in neurologically asymptomatic patients with end stage renal disease (ESRD) using in vivo resting-state functional MR imaging (Rs-fMRI). Methods We enrolled 20 patients (15 men, 5 women; meanage, 37.1 years; range, 19–49 years) with ESRD and 20 healthy controls (15 men, 5 women; mean age, 38.3 years; range, 28–49 years). The mean duration of hemodialysis for the patient group was 10.7±6.4 monthes. There was no significant sex or age difference between the ESRD and control groups. Rs-fMRI was performed using a gradient-echo echo-planar imaging sequence. ReHo was calculated using software (DPARSF). Voxel-based analysis of the ReHo maps between ESRD and control groups was performed with a two-samples t test. Statistical maps were set at P value less than 0.05 and were corrected for multiple comparisons. The Mini-Mental State Examination (MMSE) was administered to all participants at imaging. Results ReHo values were increased in the bilateral superior temporal gyrus and left medial frontal gyrus in the ERSD group compared with controls, but a significantly decreased ReHo value was found in the right middle temporal gyrus. There was no significant correlation between ReHo values and the duration of hemodialysis in the ESRD group. Both the patients and control subjects had normal MMSE scores (?28). Conclusions Our finding revealed that abnormal brain activity was distributed mainly in the memory and cognition related cotices in patients with ESRD. The abnormal spontaneous neuronal activity in those areas provide information on the neural mechanisms underlying cognitive impairment in patients with ESRD, and demonstrate that Rs-fMRI with ReHo analysis is a useful non-invasive imaging tool for the detection of early cerebral ReHo changes in hemodialysis patients with ESRD. PMID:24516545

Qiu, Ying-Wei; Lv, Xiao-Fei; Shen, Sheng; Zhan, Wen-Feng; Tian, Jun-Zhang; Jiang, Gui-Hua

2014-01-01

385

Climate variability and change in the United States: potential impacts on water- and foodborne diseases caused by microbiologic agents.  

PubMed Central

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

Rose, J B; Epstein, P R; Lipp, E K; Sherman, B H; Bernard, S M; Patz, J A

2001-01-01

386

Climate variability and change in the United States: potential impacts on water- and foodborne diseases caused by microbiologic agents.  

PubMed

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

Rose, J B; Epstein, P R; Lipp, E K; Sherman, B H; Bernard, S M; Patz, J A

2001-05-01

387

A Case of Foreign-Body Granuloma of the Glabella due to Polyacrylamide Filler and an Intractable Ulcer after Skin Biopsy: An Immunohistochemical Evaluation of Inflammatory Changes  

PubMed Central

Introduction Polyacrylamide hydrogel has been considered a safe and biocompatible soft tissue filler, and it has been widely used in cosmetic procedures. However, recent studies have revealed some complications with polyacrylamide filler injections. Case Report We present the case of foreign-body granulomas of the glabella, which subsequently formed an infectious ulcer 3 years after a polyacrylamide injection. An immunohistochemical evaluation of the foreign-body granulomas was performed in order to study the relationship between foreign-body granulomas and immune response. Conclusion We believe that our analysis of foreign-body granulomas 1 and 3 years after a filler injection may contribute to revealing the mechanism of chronic and intractable infections after filler injections. PMID:23874295

Park, Kio; Nishiwaki, Fuyuko; Kabashima, Kenji; Miyachi, Yoshiki

2013-01-01

388

Molecular surveillance for lymphoproliferative disease virus in hunter-killed wild turkeys (Meleagris gallopavo) from the eastern United States.  

E-print Network

??Three avian retroviruses can cause lymphoid tumors in galliforms, including avian leukosis virus, reticuloendotheliosis virus, and lymphoproliferative disease virus (LPDV). Historically, LPDV was considered a… (more)

Thomas, Jesse Michael

2013-01-01

389

The use of the United States FDA programs as a strategy to advance the development of drug products for neglected tropical diseases.  

PubMed

Abstract 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

Sachs-Barrable, Kristina; Conway, Jocelyn; Gershkovich, Pavel; Ibrahim, Fady; Wasan, Kishor M

2014-11-01

390

Analysis of attitudes toward the source of progenitor cells in tissue-engineered products for use in burns compared with other disease states.  

PubMed

The first trials using progenitor cells to improve burn wound healing are beginning. However, there remains a paucity of data on patients' opinions of the source of stem cells. In this study, 279 patients attending plastic surgery/burns outpatient and medical outpatient clinics were questioned to assess willingness to accept a tissue-engineered skin product derived from a variety of sources. Levels of acceptance for the use of progenitor cells derived from these sources for treatment across a range of disease states (burns, Parkinson's disease, diabetes, and for cosmetic use) were also assessed. Overall, 80% of those questioned would accept a tissue-engineered product. Autologous cells were the preferred choice of cells (acute burns 94%, diabetes 95%, Parkinson's 93.9%). Allogeneic cells were still widely accepted (acute burns 67%, diabetes 66.7%, Parkinson's 69.2%). There was no difference observed between plastic surgical patients and medical patients in acceptance of cell therapy for burns, Parkinson's disease, or diabetes. There is good potential acceptance for the use of both autologous and allogeneic cells for the treatment of acute burns and burns' scarring as well as in diabetes and Parkinson's disease. Disease state does not appear to influence overall acceptability and choice of cells. PMID:22564226

Clover, Anthony J P; O'Neill, Billy Lane; Kumar, Arun H S

2012-01-01

391

Improvement of Freezing of Gait in Patients with Parkinson's Disease by Imagining Bicycling  

PubMed Central

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

Kikuchi, Akio; Baba, Toru; Hasegawa, Takafumi; Sugeno, Naoto; Konno, Masatoshi; Miura, Emiko; Oshima, Ryuji; Aoki, Masashi; Takeda, Atsushi

2014-01-01

392

Correcting human heart 31P NMR spectra for partial saturation. Evidence that saturation factors for PCr/ATP are homogeneous in normal and disease states  

NASA Astrophysics Data System (ADS)

Heart PCr/ATP ratios measured from spatially localized 31P NMR spectra can be corrected for partial saturation effects using saturation factors derived from unlocalized chest surface-coil spectra acquired at the heart rate and approximate Ernst angle for phosphor creatine (PCr) and again under fully relaxed conditions during each 31P exam. To validate this approach in studies of normal and disease states where the possibility of heterogeneity in metabolite T1 values between both chest muscle and heart and normal and disease states exists, the properties of saturation factors for metabolite ratios were investigated theoretically under conditions applicable in typical cardiac spectroscopy exams and empirically using data from 82 cardiac 31P exams in six study groups comprising normal controls ( n = 19) and patients with dilated ( n = 20) and hypertrophic ( n = 5) cardiomyopathy, coronary artery disease ( n = 16), heart transplants ( n = 19), and valvular heart disease ( n = 3). When TR ? T1,(PCr), with T1(PCr) ? T1(ATP), the saturation factor for PCr/ATP lies in the range 1.5 ± 0.5, regardless of the T1 values. The precise value depends on the ratio of metabolite T1 values rather than their absolute values and is insensitive to modest changes in TR. Published data suggest that the metabolite T1 ratio is the same in heart and muscle. Our empirical data reveal that the saturation factors do not vary significantly with disease state, nor with the relative fractions of muscle and heart contributing to the chest surface-coil spectra. Also, the corrected myocardial PCr/ATP ratios in each normal or disease state bear no correlation with the corresponding saturation factors nor the fraction of muscle in the unlocalized chest spectra. However, application of the saturation correction (mean value, 1.36 ± 0.03 SE) significantly reduced scatter in myocardial PCr/ATP data by 14 ± 11% (SD) ( p ? 0.05). The findings suggest that the relative T1 values of PCr and ATP are substantially the same in chest and heart muscle and are unchanged in these disease states. The mean value for T1 (PCr)/ T1(ATP) is 2.16 ± 0.29 SE.

Bottomley, Paul A.; Hardy, Christopher J.; Weiss, Robert G.

393

Modeling the risk for a new invasive forest disease in the United States: An evaluation of five environmental niche models  

Microsoft Academic Search

Efforts to model the potential habitat and risk for spread of invasive diseases such as Sudden Oak Death (SOD) are important for disease regulation and management. However, spatially referenced risk models using identical data can have differing results, making decision-making based on the mapped results problematic. We examined the results from five spatial risk models generated from common input parameters,

Maggi Kelly; Qinghua Guo; Desheng Liu; David Shaari

2007-01-01

394

Early-Life Origins of Adult Disease: National Longitudinal Population-Based Study of the United States  

PubMed Central

Objectives. We examined the relation between low birth weight and childhood family and neighborhood socioeconomic disadvantage and disease onset in adulthood. Methods. Using US nationally representative longitudinal data, we estimated hazard models of the onset of asthma, hypertension, diabetes, and stroke, heart attack, or heart disease. The sample contained 4387 children who were members of the Panel Study of Income Dynamics in 1968; they were followed up to 2007, when they were aged 39 to 56 years. Our research design included sibling comparisons of disease onset among siblings with different birth weights. Results. The odds ratios of having asthma, hypertension, diabetes, and stroke, heart attack, or heart disease by age 50 years for low–birth weight babies vs others were 1.64 (P < .01), 1.51 (P < .01), 2.09 (P < .01), and 2.16 (P < .01), respectively. Adult disease prevalence differed substantially by childhood socioeconomic status (SES). After accounting for childhood socioeconomic factors, we found a substantial hazard ratio of disease onset associated with low birth weight, which persisted for sibling comparisons. Conclusions. Childhood SES is strongly associated with the onset of chronic disease in adulthood. Low birth weight plays an important role in disease onset; this relation persists after an array of childhood socioeconomic factors is accounted for. PMID:22021306

Schoeni, Robert F.

2011-01-01

395

Chagas disease  

MedlinePLUS

... immigration, the disease also affects people in the United States. Risk factors for Chagas disease include: Living in a hut where reduvid bugs live in the walls Living in Central or South America Poverty Receiving a blood transfusion from a person who ...

396

Six Pillars of Effective Dropout Prevention and Recovery: An Assessment of Current State Policy and How to Improve It  

ERIC Educational Resources Information Center

Solving America's dropout crisis requires immediate, drastic action. Intractable as the dropout problem may seem, recognition of its magnitude has created an environment ripe for action. Most notably, federal regulations adopted in 2008 require states to use more accurate ways of counting dropouts and holding districts and schools more accountable…

Almeida, Cheryl; Steinberg, Adria; Santos, Janet; Le, Cecilia

2010-01-01

397

Alzheimer disease is substantially preventable in the United States -- review of risk factors, therapy, and the prospects for an expert software system.  

PubMed

Epidemiology studies, including both regional incidence and the analysis of specific risk factors for Alzheimer's disease indicate that substantial prevention of the disease, in the 50-70 percent range, is a practical possibility for the United States. Epidemiology has identified a rich diversity of specific prevention strategies relating to nutrition, dietary supplements, lifestyle, food and environmental toxins, and in some cases medication, many of which have a capacity to reduce Alzheimer's risk by 50 percent or more. The interaction of these risk factors with brain biology is increasingly understood. In contrast, therapeutic strategies for un-prevented Alzheimer's generally prove incapable of delaying disease progression by more than 3-11 months, because extensive brain cell death occurs even in preclinical or mild cases. A public health program aimed at prevention can be fashioned with expert software packages, based on already identified risk factors. Such statistical analysis should allow the prediction of individual and group Alzheimer's risks of sufficient power to instruct the formulation of lifestyle, nutritional and environmental programs to substantially reduce disease incidence. A less satisfactory but complementary alternative is very early disease detection with therapeutic strategies focused on retardation of brain cell death, so that the person dies of another cause before the disease is clinically manifested. PMID:15780492

Jansson, Erik T

2005-01-01

398

The tools of the trade: a state of the art "How to Assess Cognition" in the patient with Parkinson's disease.  

PubMed

Cognitive impairment in Parkinson's disease is heterogeneous both in severity and pattern and subject to influences both integral to and external to the disease. Diagnostic Criteria have been developed by the Movement Disorders Society that help to guide clinicians and researchers to an accurate diagnosis of Parkinson's disease - mild cognitive impairment or Parkinson's disease dementia. To operationalize these criteria, and to assess the pattern and severity of cognitive dysfunction we need: (1) Valid measures of cognitive abilities covering the major domains of cognition, (2) amethod to determine whether or not the performance represents a decline from a person's previous level of functioning, and (3) an assessment of how the individual's cognitive abilities enable (or disable) function in day to day activities. This paper will discuss the methods of assessment and the measures that can be used to make a comprehensive assessment of cognition in Parkinson's disease. PMID:24757108

Marras, Connie; Tröster, Alexander I; Kulisevsky, Jaime; Stebbins, Glenn T

2014-04-15

399

Heart Disease in Women  

MedlinePLUS

... page from the NHLBI on Twitter. How Does Heart Disease Affect Women? In the United States, 1 ... about coronary MVD and broken heart syndrome. Coronary Heart Disease CHD is a disease in which plaque ( ...

400

[A study of the overall burden of oral disease in the state of Minas Gerais, Brazil: 2004-2006].  

PubMed

Oral disease is a major public health problem due to its prevalence in practically all age groups. This is a study of the overall burden of dental caries, edentulism and periodontal disease. The Disability-Adjusted Life Year (DALY) indicator was used as it simultaneously measures the impact of mortality and of health problems that affect the quality of life. The overall burden of oral diseases was analyzed in absolute terms and in rates per 1000 inhabitants. The number of Years Lived with Disability (YLD) due to dental caries was 4,489. An estimated 33,888 YLD were lost due to edentulism, with a rate of 1.8/1000 (2.2/1000 among women). An estimated 3217 YLD were lost due to periodontal disease, with a rate of 0.2/1000 for both sexes. Edentulism was the condition that contributed most to the overall burden of oral diseases and is more frequent among women. Higher rates of edentulism and periodontal disease were found in persons aged 45-69 years, while dental caries was more frequent from 15-49 years. The overall burden of oral disease studies represent an important aspect of health diagnosis, integrating both fatal and non-fatal outcomes. Furthermore, these studies provide highly relevant information for preventive and therapeutic policy making. PMID:25014296

da Mota, Jurema Corrêa; Valente, Joaquim Gonçalves; Schramm, Joyce Mendes de Andrade; Leite, Iuri da Costa

2014-07-01

401

Evaluation of plasma proteomic data for Alzheimer disease state classification and for the prediction of progression from mild cognitive impairment to Alzheimer disease.  

PubMed

Previous studies that have examined the potential for plasma markers to serve as biomarkers for Alzheimer disease (AD) have studied single analytes and focused on the amyloid-? and ? isoforms and have failed to yield conclusive results. In this study, we performed a multivariate analysis of 146 plasma analytes (the Human DiscoveryMAP v 1.0 from Rules-Based Medicine) in 527 subjects with AD, mild cognitive impairment (MCI), or cognitively normal elderly subjects from the Alzheimer's Disease Neuroimaging Initiative database. We identified 4 different proteomic signatures, each using 5 to 14 analytes, that differentiate AD from control patients with sensitivity and specificity ranging from 74% to 85%. Five analytes were common to all 4 signatures: apolipoprotein A-II, apolipoprotein E, serum glutamic oxaloacetic transaminase, ?-1-microglobulin, and brain natriuretic peptide. None of the signatures adequately predicted progression from MCI to AD over a 12- and 24-month period. A new panel of analytes, optimized to predict MCI to AD conversion, was able to provide 55% to 60% predictive accuracy. These data suggest that a simple panel of plasma analytes may provide an adjunctive tool to differentiate AD from controls, may provide mechanistic insights to the etiology of AD, but cannot adequately predict MCI to AD conversion. PMID:23023094

Llano, Daniel A; Devanarayan, Viswanath; Simon, Adam J

2013-01-01

402

Integrated Mapping of Neglected Tropical Diseases: Epidemiological Findings and Control Implications for Northern Bahr-el-Ghazal State, Southern Sudan  

PubMed Central

Background There are few detailed data on the geographic distribution of most neglected tropical diseases (NTDs) in post-conflict Southern Sudan. To guide intervention by the recently established national programme for integrated NTD control, we conducted an integrated prevalence survey for schistosomiasis, soil-transmitted helminth (STH) infection, lymphatic filariasis (LF), and loiasis in Northern Bahr-el-Ghazal State. Our aim was to establish which communities require mass drug administration (MDA) with preventive chemotherapy (PCT), rather than to provide precise estimates of infection prevalence. Methods and Findings The integrated survey design used anecdotal reports of LF and proximity to water bodies (for schistosomiasis) to guide selection of survey sites. In total, 86 communities were surveyed for schistosomiasis and STH; 43 of these were also surveyed for LF and loiasis. From these, 4834 urine samples were tested for blood in urine using Hemastix reagent strips, 4438 stool samples were analyzed using the Kato-Katz technique, and 5254 blood samples were tested for circulating Wuchereria bancrofti antigen using immunochromatographic card tests (ICT). 4461 individuals were interviewed regarding a history of ‘eye worm’ (a proxy measure for loiasis) and 31 village chiefs were interviewed regarding the presence of clinical manifestations of LF in their community. At the village level, prevalence of Schistosoma haematobium and S. mansoni ranged from 0 to 65.6% and from 0 to 9.3%, respectively. The main STH species was hookworm, ranging from 0 to 70% by village. Infection with LF and loiasis was extremely rare, with only four individuals testing positive or reporting symptoms, respectively. Questionnaire data on clinical signs of LF did not provide a reliable indication of endemicity. MDA intervention thresholds recommended by the World Health Organization were only exceeded for urinary schistosomiasis and hookworm in a few, yet distinct, communities. Conclusion This was the first attempt to use an integrated survey design for this group of infections and to generate detailed results to guide their control over a large area of Southern Sudan. The approach proved practical, but could be further simplified to reduce field work and costs. The results show that only a few areas need to be targeted with MDA of PCT, thus confirming the importance of detailed mapping for cost-effective control. PMID:19859537

Sturrock, Hugh J. W.; Picon, Diana; Sabasio, Anthony; Oguttu, David; Robinson, Emily; Lado, Mounir; Rumunu, John; Brooker, Simon; Kolaczinski, Jan H.

2009-01-01

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