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1

Travellers with pre-existing medical conditions  

Microsoft Academic Search

Medical conditions that influence travel include those that compromise the immunity of the traveller and chronic underlying diseases or infirmities. The former includes HIV, transplantation, malignancy and its treatment, IgA deficiency, asplenia and use of immunocompromising drugs like corticosteroids. Chronic conditions include diabetes mellitus, end stage renal disease, diseases associated with compromised cardiac or pulmonary function and certain gastrointestinal diseases

Charles D. Ericsson

2003-01-01

2

78 FR 30218 - Pre-Existing Condition Insurance Plan Program  

Federal Register 2010, 2011, 2012, 2013

...dialysis and durable medical equipment benefits...dialysis and durable medical equipment benefits because...provisions related to anti-dumping and fraud, waste, and abuse. This interim...dialysis and durable medical equipment benefits...

2013-05-22

3

Pre-existing condition insurance plan program. Amendment to interim final rule with request for comments.  

PubMed

This document contains an amendment regarding program eligibility to the interim final regulation implementing the Pre-Existing Condition Plan program under provisions of the Patient Protection and Affordable Care Act. In light of a new process recently announced by the Department of Homeland Security, eligibility for the program is being amended so that the program does not inadvertently expand the scope of that process. PMID:22934326

2012-08-30

4

5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?  

Code of Federal Regulations, 2010 CFR

... If I have a pre-existing dental or vision condition, may I join FEDVIP? 894...CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and... If I have a pre-existing dental or vision condition, may I join FEDVIP?...

2010-01-01

5

5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?  

Code of Federal Regulations, 2010 CFR

... If I have a pre-existing dental or vision condition, may I join FEDVIP? 894...CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and... If I have a pre-existing dental or vision condition, may I join FEDVIP?...

2009-01-01

6

5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?  

Code of Federal Regulations, 2013 CFR

...2013-01-01 false If I have a pre-existing dental or vision condition, may I join FEDVIP...REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration...894.102 If I have a pre-existing dental or vision condition, may I join...

2013-01-01

7

Early implementation of pre-existing condition insurance plans: providing an interim safety net for the uninsurable.  

PubMed

The Pre-Existing Condition Insurance Plan (PCIP) is a temporary program implemented under the Patient Protection and Affordable Care Act to make health insurance coverage available to uninsured individuals with preexisting conditions until 2014, when exchange-based health insurance becomes available to all. The PCIP program began enrolling applicants in July 2010. This issue brief examines enrollment trends, early changes to plan structures and premiums, and estimates of out-of-pocket costs by utilization pattern and type of plan. It also provides information about the age and medical conditions of early PCIP enrollees. Although PCIP enrollment has been lower than expected due to affordability issues, a lack of public awareness, and the requirement that applicants be uninsured for six months, the plans are nonetheless playing an important role in making coverage available to otherwise uninsurable Americans with preexisting conditions. PMID:21678623

Hall, Jean P; Moore, Janice

2011-06-01

8

Misclassification of incident conditions using claims data: impact of varying the period used to exclude pre-existing disease  

PubMed Central

Background Estimating the incidence of medical conditions using claims data often requires constructing a prevalence period that predates an event of interest, for instance the diagnosis of cancer, to exclude those with pre-existing conditions from the incidence risk set. Those conditions missed during the prevalence period may be misclassified as incident conditions (false positives) after the event of interest. Using Medicare claims, we examined the impact of selecting shorter versus longer prevalence periods on the incidence and misclassification of 12 relatively common conditions in older persons. Methods The source of data for this study was the National Cancer Institute’s Surveillance, Epidemiology, and End Results cancer registry linked to Medicare claims. Two cohorts of women were included: 33,731 diagnosed with breast cancer between 2000 and 2002, who had???36 months of Medicare eligibility prior to cancer, the event of interest; and 101,649 without cancer meeting the same Medicare eligibility criterion. Cancer patients were followed from 36 months before cancer diagnosis (prevalence period) up to 3 months after diagnosis (incidence period). Non-cancer patients were followed for up to 39 months after the beginning of Medicare eligibility. A sham date was inserted after 36 months to separate the prevalence and incidence periods. Using 36 months as the gold standard, the prevalence period was then shortened in 6-month increments to examine the impact on the number of conditions first detected during the incidence period. Results In the breast cancer cohort, shortening the prevalence period from 36 to 6 months increased the incidence rates (per 1,000 patients) of all conditions; for example: hypertension 196 to 243; diabetes 34 to 76; chronic obstructive pulmonary disease 29 to 46; osteoarthritis 27 to 36; congestive heart failure 20 to 36; osteoporosis 22 to 29; and cerebrovascular disease 13 to 21. Shortening the prevalence period has less impact on those without cancer. Conclusions Selecting a short prevalence period to rule out pre-existing conditions can, through misclassification, substantially inflate estimates of incident conditions. In incidence studies based on Medicare claims, selecting a prevalence period of ?24 months balances the need to exclude pre-existing conditions with retaining the largest possible cohort.

2013-01-01

9

Psychiatric comorbidity in medication overuse headache patients with pre-existing headache type of episodic tension-type headache  

Microsoft Academic Search

Background:Medication overuse headache (MOH) mostly evolves from migraine and episodic tension-type headache (ETTH). Chronic tension-type headache (CTTH) is another headache type that evolves over time from ETTH. It is well known that psychiatric comorbidity is high in MOH patients.

Huseyin Tugrul Atasoy; Nuray Atasoy; Aysun Eroglu Unal; Ufuk Emre; Murat Sumer

2005-01-01

10

[Pre-existing diabetes and pregnancy].  

PubMed

The prevalence of pre-existing diabetes associated with pregnancy is 0.5 to 1%. A third are type 1 diabetes, two-thirds are type 2 diabetes, whose prevalence is increasing due to rising obesity. The improved prognosis of pregnancies in women with pre-existing diabetes relies on preconception programming (therefore an effective contraception), multidisciplinary collaboration and appropriate management of these pregnancies. PMID:23236859

Lepercq, Jacques

2012-09-01

11

HPV Vaccine Not Effective for Treating Pre-Existing Infections  

Cancer.gov

A vaccine developed to prevent infection with human papillomaviruses (HPV), the cause of cervical cancer, was found to be ineffective for treating women with pre-existing HPV infections, according to a study published in the August 15, 2007, Journal of the American Medical Association.

12

Postpneumonectomy syndrome and pre-existing thoracic scoliosis  

Microsoft Academic Search

We report a case of postpneumonectomy syndrome in a 75-year-old man operated on for right lung cancer 18 months previously. The patient had a pre-existing severe thoracic scoliosis. Treatment involved positioning of an expandable silastic prosthesis in the postpneumonectomy cavity. A favorable outcome was observed. We think that a pre-existing scoliosis could be considered as a potentially predisposing factor to

Antonio Bobbio; Marco Alifano; Pierre Magdeleinat; Jean-François Regnard

2002-01-01

13

Postpneumonectomy syndrome and pre-existing thoracic scoliosis  

Microsoft Academic Search

We report a case of postpneumonectomy syndrome in a 75-year-old man operated on for right lung cancer 18 months previously. The patient had a pre-existing severe thoracic scoliosis. Treatment involved positioning of an expandable silastic prosthesis in the postpneumo- nectomy cavity. A favorable outcome was observed. We think that a pre-existing scoliosis could be considered as a potentially predisposing factor

Antonio Bobbio; Marco Alifano; Pierre Magdeleinat; Jean-Francois Regnard

2010-01-01

14

Pre-Existing Condition Insurance Plan (Affordable Care Act)  

MedlinePLUS

... more about coverage in California. PCIP Coverage In Colorado PCIP covers a broad range of health benefits, ... received a notice that your PCIP coverage in Colorado is ending in June, you can continue your ...

15

75 FR 45013 - Pre-Existing Condition Insurance Plan Program  

Federal Register 2010, 2011, 2012, 2013

...High-Risk Pool,'' National Institute for Health Care Reform, Center for Studying Health System Change (2010...High-Risk Pool,'' National Institute for Health Care Reform, Center for Studying Health System...

2010-07-30

16

Alcohol intake and cardiovascular disease and mortality: the role of pre-existing disease  

PubMed Central

Objectives Pre?existing conditions have been postulated as possible causes of the J?shaped relationship between alcohol intake and cardiovascular disease. Two research questions have been addressed in this paper. First, whether never drinkers and former drinkers differ from moderate drinkers in terms of health, and if so, which health problems contribute to this difference. Second, whether the U?shaped relationship between current alcohol intake and cardiovascular disease or all?cause mortality could in part be explained by difference in pre?existing disease burden. Design, setting and participants A prospective case?cohort, the Lifestyle and Health Study, consisting of 16?210 men and women aged between 45 and 70?years. Alcohol intake and risk factors were assessed at baseline with a self?administered questionnaire. Medical information was obtained from general practitioners. Cardiovascular events and mortality were followed for a period of 5?years (1996–2001). Main results Never drinkers and former drinkers were less healthy than moderate drinkers. They rated their health more often as poor, and often had more diseases, such as cardiovascular disease, diabetes, and also alcohol?related diseases. The difference in disease burden did not change the observed relationship between alcohol intake and cardiovascular events, and only partially changed the U?shaped relationship between alcohol intake and all?cause mortality. Conclusions The found difference in health between never drinkers and former drinkers compared with moderate drinkers appeared to be only a partial explanation of the observed relationships between alcohol intake and cardiovascular disease, and between alcohol intake and all?cause mortality.

Friesema, I H M; Zwietering, P J; Veenstra, M Y; Knottnerus, J A; Garretsen, H F L; Lemmens, P H H M

2007-01-01

17

Adventitious Citrus Juice Vesicles from Pre-Existing Juice Vesicles.  

National Technical Information Service (NTIS)

The invention comprises adventitious citrus juice vesicles having the unique characteristic that they branch out of pre-existing citrus juice vesicles. This is in contrast to tree-produced citrus juice vesicles which arise from the endocarp of the citrus ...

B. Tisserat

1989-01-01

18

Pre-existent expectancy effects in the relationship between caffeine and performance  

Microsoft Academic Search

The present study investigated the impact of pre-existent expectancy regarding the effects of the caffeine load of a drink and the perception of the caffeine content on subjective mood and vigilance performance. Caffeine deprived participants (N=25) were tested in four conditions (within subjects design), using a 2×2 design, with caffeine load and information regarding the caffeine content of the drink.

Nicola A. Elliman; Jennifer Ash; Michael W. Green

2010-01-01

19

Associated medical conditions in children  

Microsoft Academic Search

Each year, many children with associated medical conditions, present for surgery. A structured approach to the anaesthetic management of these children reduces the likelihood of an adverse event. Practical advice regarding the management of these conditions, together with some guidelines, is provided in this article. Common conditions, such as upper respiratory tract infection, asthma, epilepsy, autism, diabetes mellitus and obesity,

Andy Tatman

2006-01-01

20

Complication Related to Medical Conditions  

Microsoft Academic Search

\\u000a In this chapter, we discuss the medical conditions that can complicate the perioperative period and postoperative outcome\\u000a of cervical spine surgery. In particular, we discuss about comorbidities determining an increased risk of perioperative complications\\u000a and cardiac events, and about medical conditions associated with postoperative spinal infections, failure of spinal fusion,\\u000a and poor neurologic recovery after surgery. When the published studies

Umberto Vespasiani Gentilucci; Antonio Picardi

21

Sodium valproate induced gingival enlargement with pre-existing chronic periodontitis  

PubMed Central

Gingival enlargement is a common clinical feature of gingival and periodontal diseases. Currently, more than 20 prescription medications are associated with gingival enlargement. Although the mechanisms of action may be different, the clinical and microscopic appearance of drug-induced gingival enlargement is similar with any drug. Gingival enlargement produces esthetic changes, and clinical symptoms including pain, tenderness, bleeding, speech disturbances, abnormal tooth movement, dental occlusion problems, enhancement of caries development and periodontal disorders. Sodium valproate is considered to produce gingival enlargement, but very rarely. This case report features sodium valproate induced gingival enlargement in a patient with pre-existing chronic periodontitis, who came to the Dental Department, Chinmaya Mission Hospital, Bangalore. The case is special as the patient did not develop the enlargement in spite of taking phenytoin for 1 year and developed enlargement with sodium valproate within 6 months.

Joshipura, Vaibhavi

2012-01-01

22

Is pre-existing dementia an independent predictor of outcome after stroke? A propensity score-matched analysis.  

PubMed

With an aging population, patients are increasingly likely to present with stroke and pre-existing dementia, which may lead to greater death and disability. The aim of this work was to assess the risk of all-cause mortality and poor functional outcomes after ischemic stroke in patients with and without pre-existing dementia. We conducted a multicenter cohort study of all patients presenting to 12 tertiary care institutions participating in the Registry of the Canadian Stroke Network (RCSN) with a first ischemic stroke between 2003 and 2008. Individuals with pre-existing dementia were matched using propensity-score methods with patients without dementia during their index hospitalization based on the following characteristics: age (within 3 years), sex, stroke severity, stroke subtype (lacunar vs. non-lacunar), level of consciousness, vascular risk factors, dysphagia, glucose and creatinine on admission, Charlson index, residence prior to hospitalization (home vs. other), pre-admission dependency, hospital arrival via ambulance, admission to stroke unit, thrombolysis, and palliative care. A propensity score for all-cause mortality and clinical outcomes was developed. Registry of the Canadian Stroke Network (RCSN) and Registered Persons Database (RPDB). The primary outcome was all-cause mortality at 30 days. Secondary outcomes included mortality at discharge and at 1 year, disability at discharge (modified Rankin scale ? 3), medical complications (pneumonia), and discharge disposition. A subgroup analysis assessing the risk of intracerebral hemorrhage among those receiving thrombolysis was also conducted. We matched 877 patients with an acute ischemic stroke and pre-existing dementia to 877 stroke patients without dementia. Patients were well matched. The mean age was 82 years and 58 % were women. Mortality at discharge, 30 days, and 1 year after stroke was similar in patients with and without dementia [for mortality at discharge RR 0.88 [95 % confidence interval (CI) 0.74-1.05]; mortality at 30-days: RR 0.88 (95 % CI 0.75-1.03) and mortality at 1 year: RR 1.01 (95 % CI 0.92-1.11). Patients with pre-existing dementia had similar disability at discharge and home disposition. In the subgroup of patients who received thrombolysis, there were no differences between those with and without dementia in the risk of intracerebral hemorrhage (RR 1.27; 95 % CI 0.69-2.35) and no differences in mortality or disability at discharge. Pre-existing dementia is not independently associated with mortality, disability, or institutionalization after ischemic stroke. Pre-existing dementia may not necessarily preclude access to thrombolytic therapy and specialized stroke care. PMID:22532173

Saposnik, Gustavo; Kapral, Moira K; Cote, Robert; Rochon, Paula A; Wang, Julie; Raptis, Stavroula; Mamdani, Muhammad; Black, Sandra E

2012-04-25

23

When People with Pre-Existing Disabilities Age in Place: Implications for Social Work Practice.  

ERIC Educational Resources Information Center

|Focuses on a population of disabled people who are aging with pre-existing physical disabilities. Distinguishes between those who experience prolonged aging and those who experience accelerated aging. Provides four case examples to illustrate the practice implications faced by social workers in partnering with people with pre-existing

Gilson, Stephen French; Netting, F. Ellen

1997-01-01

24

Pre-existing liver disease and DILI: Putting it all together  

Center for Drug Evaluation (CDER)

Text Version... Page 2. Pre-existing liver disease and DILI: Putting it all together Robert J. Fontana, MD ... Page 3. Prior liver disease & DILI • Susceptibility ... More results from www.fda.gov/downloads/drugs/scienceresearch

25

Pre-existent expectancy effects in the relationship between caffeine and performance.  

PubMed

The present study investigated the impact of pre-existent expectancy regarding the effects of the caffeine load of a drink and the perception of the caffeine content on subjective mood and vigilance performance. Caffeine deprived participants (N=25) were tested in four conditions (within subjects design), using a 2×2 design, with caffeine load and information regarding the caffeine content of the drink. In two sessions, they were given caffeinated coffee and in two were given decaffeinated coffee. Within these two conditions, on one occasion they were given accurate information about the drink and on the other they were given inaccurate information about the drink. Mood and vigilance performance were assessed post ingestion. Caffeine was found to enhance performance, but only when participants were accurately told they were receiving it. When decaffeinated coffee was given, performance was poorer, irrespective of expectancy. However, when caffeine was given, but participants were told it was decaffeinated coffee, performance was as poor as when no caffeine had been administered. There were no easily interpretable effects on mood. The pharmacological effects of caffeine appear to act synergistically with expectancy. PMID:20382192

Elliman, Nicola A; Ash, Jennifer; Green, Michael W

2010-04-09

26

Dietary supplement use and medical conditions  

Microsoft Academic Search

BackgroundOver half of U.S. adults use vitamin or mineral supplements, and some are likely using supplements to treat chronic diseases or risk factors for disease. Information on the relationship between supplement use and medical conditions is useful to health professionals to understand the self-medication behavior of their patients, and important for researchers because medical conditions may be potential confounding factors

Jessie Satia-Abouta; Alan R Kristal; Ruth E Patterson; Alyson J Littman; Kayla L Stratton; Emily White

2003-01-01

27

Mining FDA drug labels for medical conditions  

PubMed Central

Background Cincinnati Children’s Hospital Medical Center (CCHMC) has built the initial Natural Language Processing (NLP) component to extract medications with their corresponding medical conditions (Indications, Contraindications, Overdosage, and Adverse Reactions) as triples of medication-related information ([(1) drug name]-[(2) medical condition]-[(3) LOINC section header]) for an intelligent database system, in order to improve patient safety and the quality of health care. The Food and Drug Administration’s (FDA) drug labels are used to demonstrate the feasibility of building the triples as an intelligent database system task. Methods This paper discusses a hybrid NLP system, called AutoMCExtractor, to collect medical conditions (including disease/disorder and sign/symptom) from drug labels published by the FDA. Altogether, 6,611 medical conditions in a manually-annotated gold standard were used for the system evaluation. The pre-processing step extracted the plain text from XML file and detected eight related LOINC sections (e.g. Adverse Reactions, Warnings and Precautions) for medical condition extraction. Conditional Random Fields (CRF) classifiers, trained on token, linguistic, and semantic features, were then used for medical condition extraction. Lastly, dictionary-based post-processing corrected boundary-detection errors of the CRF step. We evaluated the AutoMCExtractor on manually-annotated FDA drug labels and report the results on both token and span levels. Results Precision, recall, and F-measure were 0.90, 0.81, and 0.85, respectively, for the span level exact match; for the token-level evaluation, precision, recall, and F-measure were 0.92, 0.73, and 0.82, respectively. Conclusions The results demonstrate that (1) medical conditions can be extracted from FDA drug labels with high performance; and (2) it is feasible to develop a framework for an intelligent database system.

2013-01-01

28

Medical Conditions of Nursing Home Admissions  

Microsoft Academic Search

BACKGROUND: As long-term nursing home care is likely to increase with the aging of the population, identifying chronic medical conditions is of particular interest. Although need factors have a strong impact on nursing home (NH) admission, the diseases causing these functional disabilities are lacking or unclear in the residents' file. We investigated the medical reason (primary diagnosis) of a nursing

Gilberte Van Rensbergen; Tim Nawrot

2010-01-01

29

Does pre-existing diabetes affect prostate cancer prognosis? A systematic review  

Microsoft Academic Search

To summarize the influence of pre-existing diabetes on mortality and morbidity in men with prostate cancer. We searched MEDLINE and EMBASE from inception through 1 October 2008. Search terms were related to diabetes, cancer and prognosis. Studies were included if they reported an original data analysis of prostate cancer prognosis, compared outcomes between men with and without diabetes and were

C F Snyder; K B Stein; B B Barone; K S Peairs; H-C Yeh; R L Derr; A C Wolff; M A Carducci; F L Brancati

2010-01-01

30

Environmental and Economic Comparison of Hollow Fill and Pre-Existing Bench Storage of Excess Spoil.  

National Technical Information Service (NTIS)

Environmental impact and economic parameters were evaluated and compared for excess spoil disposal at a pre-existing bench and a hypothetical hollow fill. Data from a cross-ridge mountaintop removal operation generating 1.5 million cubic yards of excess s...

D. I. Carey R. E. Nickel

1982-01-01

31

Model of pre-existing traps for electrons in polar glasses  

Microsoft Academic Search

A model of pre-existing traps for electrons in polar glasses is presented. It is assumed that the condensed medium consists of a large number of cells and that each cell is composed of a certain number of molecular dipoles. Two specific cases are investigated. In one case each cell consists of four tetrahedrally located dipoles. In the other it consists

M. Tachiya; A. Mozumder

1974-01-01

32

Are There Pre-Existing Neural, Cognitive, or Motoric Markers for Musical Ability?  

ERIC Educational Resources Information Center

|Adult musician's brains show structural enlargements, but it is not known whether these are inborn or a consequence of long-term training. In addition, music training in childhood has been shown to have positive effects on visual-spatial and verbal outcomes. However, it is not known whether pre-existing advantages in these skills are found in…

Norton, Andrea; Winner, Ellen; Cronin, Karl; Overy, Katie; Lee, Dennis J.; Schlaug, Gottfried

2005-01-01

33

Using an Electronic Highlighter to Eliminate the Negative Effects of Pre-Existing, Inappropriate Highlighting  

ERIC Educational Resources Information Center

The purpose of the present experiment was to determine whether using an active learning technique, electronic highlighting, can eliminate the negative effects of pre-existing, poor highlighting on reading comprehension. Participants read passages containing no highlighting, appropriate highlighting, or inappropriate highlighting. We hypothesized…

Gier, Vicki; Kreiner, David; Hudnell, Jason; Montoya, Jodi; Herring, Daniel

2011-01-01

34

The Real Importance of Pre-Existing Comorbidities on Long-Term Mortality after Acute Kidney Injury  

PubMed Central

Background The causes of death on long-term mortality after acute kidney injury (AKI) have not been well studied. The purpose of the study was to evaluate the role of comorbidities and the causes of death on the long-term mortality after AKI. Methodology/Principal Findings We retrospectively studied 507 patients who experienced AKI in 2005–2006 and were discharged free from dialysis. In June 2008 (median: 21 months after AKI), we found that 193 (38%) patients had died. This mortality is much higher than the mortality of the population of São Paulo City, even after adjustment for age. A multiple survival analysis was performed using Cox proportional hazards regression model and showed that death was associated with Khan’s index indicating high risk [adjusted hazard ratio 2.54 (1.38–4.66)], chronic liver disease [1.93 (1.15–3.22)], admission to non-surgical ward [1.85 (1.30–2.61)] and a second AKI episode during the same hospitalization [1.74 (1.12–2.71)]. The AKI severity evaluated either by the worst stage reached during AKI (P?=?0.20) or by the need for dialysis (P?=?0.12) was not associated with death. The causes of death were identified by a death certificate in 85% of the non-survivors. Among those who died from circulatory system diseases (the main cause of death), 59% had already suffered from hypertension, 34% from diabetes, 47% from heart failure, 38% from coronary disease, and 66% had a glomerular filtration rate <60 previous to the AKI episode. Among those who died from neoplasms, 79% already had the disease previously. Conclusions Among AKI survivors who were discharged free from dialysis the increased long-term mortality was associated with their pre-existing chronic conditions and not with the severity of the AKI episode. These findings suggest that these survivors should have a medical follow-up after hospital discharge and that all efforts should be made to control their comorbidities.

Pereira, Mariana B.; Zanetta, Dirce M. T.; Abdulkader, Regina C. R. M.

2012-01-01

35

Pre-existing immunity against vaccine vectors--friend or foe?  

PubMed

Over the last century, the successful attenuation of multiple bacterial and viral pathogens has led to an effective, robust and safe form of vaccination. Recently, these vaccines have been evaluated as delivery vectors for heterologous antigens, as a means of simultaneous vaccination against two pathogens. The general consensus from published studies is that these vaccine vectors have the potential to be both safe and efficacious. However, some of the commonly employed vectors, for example Salmonella and adenovirus, often have pre-existing immune responses in the host and this has the potential to modify the subsequent immune response to a vectored antigen. This review examines the literature on this topic, and concludes that for bacterial vectors there can in fact, in some cases, be an enhancement in immunogenicity, typically humoral, while for viral vectors pre-existing immunity is a hindrance for subsequent induction of cell-mediated responses. PMID:23175507

Saxena, Manvendra; Van, Thi Thu Hao; Baird, Fiona J; Coloe, Peter J; Smooker, Peter M

2012-11-22

36

Trust formation in Korean new product alliances: How important are pre-existing social ties?  

Microsoft Academic Search

The focus of this study is on the nature and influence of social connections versus other relational mechanisms on trust formation\\u000a in an emerging Asian economy. We examine the role of communication quality, perceived fairness, and pre-existing social relationships\\u000a for the formation of trust in 47 vertical new product development alliances in South Korea. The empirical results indicate\\u000a a relatively

Ludwig Bstieler; Martin Hemmert

2010-01-01

37

Pre-existing histological type and developmental mechanism of mucinous noncystic carcinoma of pancreas  

Microsoft Academic Search

Eleven cases with mucinous noncystic carcinoma (MC) of the pancreas were studied by histology and mucin immunohistochemistry,\\u000a to elucidate the mechanism, or route of development, and pre-existing histological type of MC of the pancreas. These MCs were\\u000a observed in close approximation to, or surrounding, intraductal papillary-mucinous carcinomas (IPMCs), and were centrally\\u000a situated among ductal adenocarcinomas (DAs). Hence, the 11 cases

Koichi Suda; Bunsei Nobukawa; Shigetaka Yamasaki; Fujihiko Suzuki; Hideo Shimizu; Masaru Takase

2000-01-01

38

A further examination of a pre-existing bias favouring a sword in the genus Xiphophorus  

Microsoft Academic Search

Models of sexual selection have recently been broadened to include the pre-existing bias model. This model suggests that female preferences that result in the evolution of male traits can be established prior to the appearance of a male trait. Previous work suggests that in the genusXiphophorus, which consists of swordless platyfish and sworded swordtails, female southern platyfish,X.maculatus, prefer conspecific males

ALEXANDRA L. BASOLO

1995-01-01

39

Are there pre-existing neural, cognitive, or motoric markers for musical ability?  

Microsoft Academic Search

Adult musician’s brains show structural enlargements, but it is not known whether these are inborn or a consequence of long-term training. In addition, music training in childhood has been shown to have positive effects on visual–spatial and verbal outcomes. However, it is not known whether pre-existing advantages in these skills are found in children who choose to study a musical

Andrea Norton; Ellen Winner; Karl Cronin; Katie Overy; Dennis J. Lee; Gottfried Schlaug

2005-01-01

40

Are there pre-existing neural, cognitive, or motoric markers for musical ability?  

PubMed

Adult musician's brains show structural enlargements, but it is not known whether these are inborn or a consequence of long-term training. In addition, music training in childhood has been shown to have positive effects on visual-spatial and verbal outcomes. However, it is not known whether pre-existing advantages in these skills are found in children who choose to study a musical instrument nor is it known whether there are pre-existing associations between music and any of these outcome measures that could help explain the training effects. To answer these questions, we compared 5- to 7-year-olds beginning piano or string lessons (n=39) with 5- to 7-year-olds not beginning instrumental training (n=31). All children received a series of tests (visual-spatial, non-verbal reasoning, verbal, motor, and musical) and underwent magnetic resonance imaging. We found no pre-existing neural, cognitive, motor, or musical differences between groups and no correlations (after correction for multiple analyses) between music perceptual skills and any brain or visual-spatial measures. However, correlations were found between music perceptual skills and both non-verbal reasoning and phonemic awareness. Such pre-existing correlations suggest similarities in auditory and visual pattern recognition as well a sharing of the neural substrates for language and music processing, most likely due to innate abilities or implicit learning during early development. This baseline study lays the groundwork for an ongoing longitudinal study addressing the effects of intensive musical training on brain and cognitive development, and making it possible to look retroactively at the brain and cognitive development of those children who emerge showing exceptional musical talent. PMID:16054741

Norton, Andrea; Winner, Ellen; Cronin, Karl; Overy, Katie; Lee, Dennis J; Schlaug, Gottfried

2005-07-28

41

Total knee arthroplasty in patients with pre-existing fracture deformity.  

PubMed

Pre-existing femoral or tibial extra-articular fracture deformity may adversely affect the results of total knee arthroplasty (TKA). This deformity can be addressed with asymmetrical intra-articular resection or with correctional osteotomy performed prior to or at the time of primary TKA. Careful preoperative planning obviates many potential problems that can occur at the time of surgery with correction of many complex deformities. PMID:17539209

Papagelopoulos, Panayiotis J; Karachalios, Theophilos; Themistocleous, George S; Papadopoulos, Elias Ch; Savvidou, Olga D; Rand, James A

2007-05-01

42

Pre-existent vertebral rotation in the human spine is influenced by body position  

Microsoft Academic Search

Both the humans as well as the quadrupedal spine have been shown to exhibit a pattern of pre-existent rotation that is similar\\u000a in direction to what is found in the most common types of idiopathic scoliosis. It has been postulated that human bipedalism\\u000a introduces forces to the spine that increase a tendency of the vertebrae to rotate. The objective of

Michiel M. A. Janssen; Koen L. Vincken; Bastiaan Kemp; Marina Obradov; Marinus de Kleuver; Max A. Viergever; René M. Castelein; Lambertus W. Bartels

2010-01-01

43

Inheritance of pre-existing weakness in continental breakup: 3D numerical modeling  

NASA Astrophysics Data System (ADS)

The whole process of continental rifting to seafloor spreading is one of the most important plate tectonics on the earth. There are many questions remained related to this process, most of which are poorly understood, such as how continental rifting transformed into seafloor spreading? How the curved oceanic ridge developed from a single straight continental rift? How the pre-existing weakness in either crust or lithospheric mantle individually influences the continental rifting and oceanic spreading? By employing the state-of-the-art three-dimensional thermomechanical-coupled numerical code (using Eulerian-Lagrangian finite-difference method and marker-in-cell technic) (Gerya and Yuen, 2007), which can model long-term plate extension and large strains, we studied the whole process of continental rifting to seafloor spreading based on the following question: How the pre-existing lithospheric weak zone influences the continental breakup? Continental rifts do not occur randomly, but like to follow the pre-existing weakness (such as fault zones, suture zones, failed rifts, and other tectonic boundaries) in the lithosphere, for instance, the western branch of East African Rift formed in the relatively weak mobile belts along the curved western border of Tanzanian craton (Corti et al., 2007; Nyblade and Brazier, 2002), the Main Ethiopian Rift developed within the Proterozoic mobile belt which is believed to represent a continental collision zone (Keranen and Klemperer, 2008),the Baikal rift formed along the suture between Siberian craton and Sayan-Baikal folded belt (Chemenda et al., 2002). The early stage formed rift can be a template for the future rift development and continental breakup (Keranen and Klemperer, 2008). Lithospheric weakness can either reduce the crustal strength or mantle strength, and leads to the crustal or mantle necking (Dunbar and Sawyer, 1988), which plays an important role on controlling the continental breakup patterns, such as controlling the breakup order of crust and mantle (Huismans and Beaumont, 2011). However, the inheritance of pre-existing lithospheric weakness in the evolution of continental rifts and oceanic ridge is not well studied. We use 3D numerical modeling to study this problem, by changing the weak zone position and geometry, and the rheological structure of the model. In our study, we find that: 1).3D continental breakup and seafloor spreading patterns are controlled by (a) crust-mantle rheological coupling and (b) geometry and position of the pre-existing weak zones. 2).Three spreading patterns are obtained: (a) straight ridges, (b) curved ridges and (c) overlapping ridges. 3).When crust and mantle are decoupled, abandoned rift structures often form.

Liao, Jie; Gerya, Taras

2013-04-01

44

Psychological factors affecting a medical condition  

Microsoft Academic Search

The criteria for scientific validation of the entities currently subsumed under the DSM-IV category of “Psychological Factors Affecting a Medical Condition” have never been clearly enumerated. Historically, its precursor category (“Psychophysiological Disorder”) was rarely used, and predicated upon clinical observation of personality styles among patients with specific physical illnesses, or clinical observations relating psychosocial events and symptom exacerbation. Because of

Mark W Ketterer; Gregory Mahr; A. David Goldberg

2000-01-01

45

Menstrual cycle effects on common medical conditions  

Microsoft Academic Search

Menstrual cycle-related exacerbation of common medical conditions such as migraine, epilepsy, asthma, irritable bowel syndrome,\\u000a and diabetes, is a well-recognized phenomenon. Accurate documentation of symptoms on a menstrual calendar allows identification\\u000a of women with cyclic alterations in disease activity.

Allison M. Case; Robert L. Reid

2001-01-01

46

Asperger Syndrome: Associated Psychiatric and Medical Conditions.  

ERIC Educational Resources Information Center

|This article explores the association of medical and psychiatric conditions with Asperger syndrome, based mainly on publications from the last two decades. It examines comorbidity of Asperger syndrome with mood disorders, schizophrenia, obsessive-compulsive disorder, attention deficit/hyperactivity disorder, tic disorders, violence and…

Ghaziuddin, Mohammad

2002-01-01

47

Chronic Medical Conditions Among Jail Detainees in Residential Psychiatric Treatment  

Microsoft Academic Search

Research suggests incarcerate populations have high rates of chronic medical conditions. Because of the association of having a mental illness (MI) with a variety of medical conditions, incarcerates in psychiatric treatment may have an even higher rate of co-occurring chronic medical conditions. In this study, multivariate logistic regression models compared the odds of having any of 15 chronic medical conditions

James A. Swartz; Carl J. Alaimo; Jean E. Kiriazes

2011-01-01

48

Enhancing the Clinical Potential of AAV Vectors by Capsid Engineering to Evade Pre-Existing Immunity.  

PubMed

Vectors based on adeno-associated viruses (AAV) have shown considerable promise in both preclinical models and increasingly in clinical trials. However, one formidable challenge is pre-existing immunity due to widespread exposure to numerous AAV variants and serotypes within the human population, which affect efficacy of clinical trials due to the accompanying high levels of anti-capsid neutralizing antibodies. Transient immunosuppression has promise in mitigating cellular and humoral responses induced by vector application in naïve hosts, but cannot overcome the problem that pre-existing neutralizing antibodies pose toward the goal of safe and efficient gene delivery. Shielding of AAV from antibodies, however, may be possible by covalent attachment of polymers to the viral capsid or by encapsulation of vectors inside biomaterials. In addition, there has been considerable progress in using rational mutagenesis, combinatorial libraries, and directed evolution approaches to engineer capsid variants that are not recognized by anti-AAV antibodies generally present in the human population. While additional progress must be made, such strategies, alone or in combination with immunosuppression to avoid de novo induction of antibodies, have strong potential to significantly enhance the clinical efficacy of AAV vectors. PMID:22065962

Bartel, Melissa; Schaffer, David; Büning, Hildegard

2011-10-04

49

Deterioration of pre-existing hemiparesis due to injury of the ipsilateral anterior corticospinal tract  

PubMed Central

Background The anterior corticospinal tract (CST) has been suggested as one of the ipsilateral motor pathways, which contribute to motor recovery following stroke. In this study, we report on a patient who showed deterioration of pre-existing hemiparesis due to an injury of the ipsilateral anterior CST following a pontine infarct, as evaluated by diffusion tensor tractography (DTT). Case presentation A 55-year-old male patient showed quadriparesis after the onset of an infarct in the right pontine basis. He had history of an infarct in the left middle cerebral artery territory 7 years ago. Consequently, he showed right hemiparesis before onset of the right pontine infarct. Following this, his right hemiparesis deteriorated whereas his left hemiparesis newly developed. The DTTs for whole CST of the right hemisphere in the patient and both hemispheres in control subjects descended through the known CST pathway. By contrast, the DTT for the left whole CST of the patient showed a complete injury finding. The DTTs for the anterior CST of control subjects passed through the known pathway of the CST from cerebral cortex to medulla and terminated in the anterior funiculus of the upper cervical cord. However, the DTT for right anterior CST in the patient showed discontinuation below the right pontine infarct. Conclusion It appeared that the deterioration of the pre-existing right hemiparesis was ascribed to an injury of the right anterior CST due to the right pontine infarct.

2013-01-01

50

Pre-existing sensory biases in the spectral domain in frogs: empirical results and methodological considerations.  

PubMed

In many species of anurans, advertisement calls excite only one of the two inner-ear organs. One prediction of the pre-existing bias hypothesis is that signal innovations that additionally excite the "untapped" organ will be more behaviorally effective than normal calls. However, recent studies have shown that females of three species with single-peaked calls that stimulate only the basilar papilla (BP) preferred single-peaked synthetic calls with a frequency typical of conspecific calls to two-peaked calls that also stimulated the amphibian papilla (AP). We report that in spring peepers (Pseudacris crucifer) that also produce single-peaked calls, females did not show a preference in choices between single-peaked and two-peaked synthetic calls. Thus, the addition of energy exciting the AP had a neutral effect on signal attractiveness. Together, these results are unsupportive of the pre-existing bias hypothesis. An alternative hypothesis is that positive fitness consequences of responding to sounds providing extraordinary spectral stimulation are required for a novel call to become established as a mate-attracting signal. Testing these ideas requires a taxonomically broader examination of responses to sounds with novel spectral complexity, and attention to some methodological details will improve the comparability of such studies. PMID:23160797

Gerhardt, H C; Humfeld, Sarah C

2012-11-18

51

Chronic Medical Conditions and Risk of Sepsis  

PubMed Central

Background We sought to determine the associations between baseline chronic medical conditions and future risk of sepsis. Methods Longitudinal cohort study using the 30,239 community-dwelling participants of the REGARDS cohort. We determined associations between baseline chronic medical conditions and incident sepsis episodes, defined as hospitalization for an infection with the presence of infection plus two or more systemic inflammatory response syndrome criteria. Results Over the mean observation time of 4.6 years (February 5, 2003 through October 14, 2011), there were 975 incident cases of sepsis. Incident sepsis episodes were associated with older age (p<0.001), white race (HR 1.39; 95% CI: 1.22–1.59), lower education (p<0.001) and income (p<0.001), tobacco use (p<0.001), and alcohol use (p?=?0.02). Incident sepsis episodes were associated with baseline chronic lung disease (adjusted HR 2.43; 95% CI: 2.05–2.86), peripheral artery disease (2.16; 1.58–2.95), chronic kidney disease (1.99; 1.73–2.29), myocardial infarction 1.79 (1.49–2.15), diabetes 1.78 (1.53–2.07), stroke 1.67 (1.34–2.07), deep vein thrombosis 1.63 (1.29–2.06), coronary artery disease 1.61 (1.38–1.87), hypertension 1.49 (1.29–1.74), atrial fibrillation 1.48 (1.21–1.81) and dyslipidemia 1.16 (1.01–1.34). Sepsis risk increased with the number of chronic medical conditions (p<0.001). Conclusions Individuals with chronic medical conditions are at increased risk of future sepsis events.

Wang, Henry E.; Shapiro, Nathan I.; Griffin, Russell; Safford, Monika M.; Judd, Suzanne; Howard, George

2012-01-01

52

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 false Condition: Medical records. 494.170 Section...STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE FOR END-STAGE RENAL DISEASE FACILITIES Administration § 494.170 Condition: Medical records. The...

2010-10-01

53

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2010 CFR

...2009-10-01 false Condition: Medical records. 494.170 Section...STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE FOR END-STAGE RENAL DISEASE FACILITIES Administration § 494.170 Condition: Medical records. The...

2009-10-01

54

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2012 CFR

...2012-10-01 false Condition: Medical records. 494.170 Section...STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE FOR END-STAGE RENAL DISEASE FACILITIES Administration § 494.170 Condition: Medical records. The...

2012-10-01

55

Effect of pregnancy on pre-existing liver disease: chronic viral hepatitis.  

PubMed

Women with viral chronic hepatitis generally do quite well during pregnancy, providing that they have not progressed to decompensated cirrhosis. As a general rule, a stable liver equals a safe pregnancy. However, concern is about how pre-existing chronic liver disease may affect the pregnancy and the unborn baby. This review plans to answer some key questions regarding this issue in order to provide to healthcare professionals updated information of the current knowledge in this field. Besides, a synopsis of the following subject matters are reviewed, for instance, the main risk factors associated with vertical transmission of HBV and HCV in pregnant women chronically infected, the influence of pregnancy on HBV and HCV viral load and the effect of pregnancy on the clinical course of chronic hepatitis. Lastly, it is included a list of recommendations to decrease vertical transmission rates of chronic viral hepatitis as well as some information for the reproduction team. PMID:17060881

Sookoian, Silvia

56

Misfit dislocation formation via pre-existing threading dislocation glide in (1122) semipolar heteroepitaxy  

NASA Astrophysics Data System (ADS)

Cathodoluminescence (CL) was used to study the onset of mechanical stress relaxation in low indium composition semipolar (1122) InxGa1-xN lattice-mismatched layers grown on bulk GaN substrates. Monochromatic CL of short interfacial misfit dislocation (MD) segments showed a single threading dislocation (TD) associated with each MD segment--demonstrating that the initial stage of MD formation in semipolar III-nitride heterostructures proceeded by the bending and glide of pre-existing TDs on the (0001) slip plane. The state of coherency as determined by panchromatic CL is also compared to that determined by x-ray diffraction analysis based on crystallographic epilayer tilt and Matthew-Blakeslee's critical thickness calculations.

Hsu, Po Shan; Young, Erin C.; Romanov, Alexey E.; Fujito, Kenji; Denbaars, Steven P.; Nakamura, Shuji; Speck, James S.

2011-08-01

57

Relevance of a pre-existing measles immunity prior immunization with a recombinant measles virus vector.  

PubMed

Measles virus (MV) vectors are promising candidates for designing new recombinant vaccines since the parental live vaccines have a well-known safety and efficacy record. Like all viral vectors, the MV vector efficacy in inducing a protecting immune answer could be affected by the pre-existing immunity among the human population. In order to determine the optimal immunization route and regimen, we mimicked a MV pre-immunity by passively administrating MV neutralizing antibodies (MV-nAb) prior intramuscular (i.m.) and/or intranasal (i.n.) immunization with recombinant MV expressing the SIV-gag antigen (rMV-SIVgag). Our results revealed that 500 mIU of MV-nAb allowed the induction of a humoral and cellular immune response against the vector and the transgene, while higher titers of the MV-nAb were significantly inhibitory. In a prime-boost regimen, in the presence of MV-nAb, the intranasal-intramuscular (i.n.-i.m.) or intramuscular-intramuscular (i.m.-i.m.) routes induced higher humoral immune responses against the vector and the transgene (SIV-gag). In naive animals, cellular immune response was significantly higher by i.m. immunization; however, MV pre-immunity did not seem to affect the cellular immune response after an i.n. immunization.   In summary, we show that a pre-existing immunity of up to 500 mIU anti-MV neutralizing antibodies had little effect on the replication of rMV and did not inhibit the induction of significant humoral and cellular immune responses in immune-competent mice. PMID:23324399

Knuchel, Marlyse C; Marty, René R; Morin, Teldja Neige Azzouz; Ilter, Orhan; Zuniga, Armando; Naim, Hussein Y

2013-01-16

58

Plaque rupture with severe pre-existing stenosis precipitating coronary thrombosis. Characteristics of coronary atherosclerotic plaques underlying fatal occlusive thrombi  

Microsoft Academic Search

Ruptured atheromatous plaques were identified by step-sectioning technique as responsible for 40 of 51 recent coronary artery thrombi and 63 larger intimal haemorrhages. The degree of pre-existing luminal narrowing at the site of rupture was decisive for whether plaque rupture caused occlusive thrombosis or just intimal haemorrhage. If the pre-existing stenosis was greater than 90% (histologically determined) then plaque rupture

E Falk

1983-01-01

59

Discrepancies between home medications listed at hospital admission and reported medical conditions  

Microsoft Academic Search

Background: One of the Joint Commission on Accreditation of Healthcare Organization's National Patient Safety Goals is for hospitals to accurately and completely reconcile patients' medications. Unfortunately, medication histories in charts might bc inaccurate and incomplete. In a thorough medication history, each medication should match a particular reported medical condition. The use of medications without a clear reported indication is of

Douglas Slain; Scott E. Kincaid; Teresa S. Dunsworth

2008-01-01

60

Exact solutions for shells collapsing towards a pre-existing black hole  

NASA Astrophysics Data System (ADS)

The gravitational collapse of a star is an important issue both for general relativity and astrophysics, which is related to the well-known “frozen star” paradox. This paradox has been discussed intensively and seems to have been solved in the comoving-like coordinates. However, to a real astrophysical observer within a finite time, this problem should be discussed in the point of view of the distant rest-observer, which is the main purpose of this Letter. Following the seminal work of Oppenheimer and Snyder (1939), we present the exact solution for one or two dust shells collapsing towards a pre-existing black hole. We find that the metric of the inner region of the shell is time-dependent and the clock inside the shell becomes slower as the shell collapses towards the pre-existing black hole. This means the inner region of the shell is influenced by the property of the shell, which is contrary to the result in Newtonian theory. It does not contradict the Birkhoff's theorem, since in our case we cannot arbitrarily select the clock inside the shell in order to ensure the continuity of the metric. This result in principle may be tested experimentally if a beam of light travels across the shell, which will take a longer time than without the shell. It can be considered as the generalized Shapiro effect, because this effect is due to the mass outside, but not inside as the case of the standard Shapiro effect. We also found that in real astrophysical settings matter can indeed cross a black hole's horizon according to the clock of an external observer and will not accumulate around the event horizon of a black hole, i.e., no “frozen star” is formed for an external observer as matter falls towards a black hole. Therefore, we predict that only gravitational wave radiation can be produced in the final stage of the merging process of two coalescing black holes. Our results also indicate that for the clock of an external observer, matter, after crossing the event horizon, will never arrive at the “singularity” (i.e. the exact center of the black hole), i.e., for all black holes with finite lifetimes their masses are distributed within their event horizons, rather than concentrated at their centers. We also present a worked-out example of the Hawking's area theorem.

Liu, Yuan; Zhang, Shuang Nan

2009-08-01

61

Pre-Existing Diseases of Patients Increase Susceptibility to Hypoxemia during Gastrointestinal Endoscopy  

PubMed Central

Hypoxemia is the most common adverse event that happened during gastrointestinal endoscopy. To estimate risk of hypoxemia prior to endoscopy, American Society of Anesthesiology (ASA) classification scores were used as a major predictive factor. But the accuracy of ASA scores for predicting hypoxemia incidence was doubted here, considering that the classification system ignores much information about general health status and fitness of patient that may contribute to hypoxemia. In this retrospective review of clinical data collected prospectively, the data on 4904 procedures were analyzed. The Pearson’s chi-square test or the Fisher exact test was employed to analyze variance of categorical factors. Continuous variables were statistically evaluated using t-tests or Analysis of variance (ANOVA). As a result, only 245 (5.0%) of the enrolled 4904 patients were found to present hypoxemia during endoscopy. Multivariable logistic regressions revealed that independent risk factors for hypoxemia include high BMI (BMI 30 versus 20, Odd ratio: 1.52, 95% CI: 1.13–2.05; P?=?0.0098), hypertension (Odd ratio: 2.28, 95% CI: 1.44–3.60; P?=?0.0004), diabetes (Odd ratio: 2.37, 95% CI: 1.30–4.34; P?=?0.005), gastrointestinal diseases (Odd ratio: 1.77, 95% CI: 1.21–2.60; P?=?0.0033), heart diseases (Odd ratio: 1.97, 95% CI: 1.06–3.68; P?=?0.0325) and the procedures that combined esophagogastroduodenoscopy (EGD) and colonoscopy (Odd ratio: 4.84, 95% CI: 1.61–15.51; P?=?0.0292; EGD as reference). It is noteworthy that ASA classification scores were not included as an independent predictive factor, and susceptibility of youth to hypoxemia during endoscopy was as high as old subjects. In conclusion, some certain pre-existing diseases of patients were newly identified as independent risk factors for hypoxemia during GI endoscopy. High ASA scores are a confounding predictive factor of pre-existing diseases. We thus recommend that youth (?18 yrs), obese patients and those patients with hypertension, diabetes, heart diseases, or GI diseases should be monitored closely during sedation endoscopy.

Yu, Changhong; Tian, Xia; Yang, Yi-Ran; Wang, Cheng; Pan, Yajuan

2012-01-01

62

Contribution of Medical Conditions to Passenger Vehicle Crashes.  

National Technical Information Service (NTIS)

There is a growing concern about risks associated with driving for people with known medical conditions. However, the association between having a chronic medical condition and being involved in a motor vehicle crash remains controversial. This analysis a...

R. Hanna

2009-01-01

63

Pre-existing brain function predicts subsequent practice of mindfulness and compassion meditation.  

PubMed

While a variety of meditation techniques are increasingly employed as health interventions, the fact that meditation requires a significant commitment of time and effort may limit its potential widespread utility. In the current study, we ask whether baseline subjective reports or brain activity in response to a "Pain for Self and Others" paradigm predicts subsequent engagement in mindfulness and compassion meditation. The study also investigated whether compassion training would impact neural responses when compared to an active health education control group. Prior to training, activation of the left and right anterior insula, an area thought to be important for empathy, in response to the Other pain task was positively related to engagement with compassion meditation as measured by practice time (n=13). On the other hand, activity in the left amygdala during the Self pain task was negatively correlated with mindfulness practice time. Following the study intervention, there was no difference between the compassion group (n=13), and the control group (n=8), in brain responses to either the Self or Other task. These results are the first to indicate that baseline neural responses may predict engagement with meditation training and suggest that pre-existing neurobiological profiles differentially predispose individuals to engage with disparate meditation techniques. PMID:23266748

Mascaro, Jennifer S; Rilling, James K; Negi, Lobsang Tenzin; Raison, Charles L

2012-12-22

64

EVIDENCE FOR PRE-EXISTING DUST IN THE BRIGHT TYPE IIn SN 2010jl  

SciTech Connect

SN 2010jl was an extremely bright, Type IIn supernova (SN) which showed a significant infrared (IR) excess no later than 90 days after explosion. We have obtained Spitzer 3.6 and 4.5 {mu}m and JHK observations of SN 2010jl {approx}90 days post-explosion. Little to no reddening in the host galaxy indicated that the circumstellar material lost from the progenitor must lie in a torus inclined out of the plane of the sky. The likely cause of the high mid-IR flux is the reprocessing of the initial flash of the SN by pre-existing circumstellar dust. Using a three-dimensional Monte Carlo radiative-transfer code, we have estimated that between 0.03 and 0.35 M{sub sun} of dust exists in a circumstellar torus around the SN located 6 x 10{sup 17} cm away from the SN and inclined between 60 deg. and 80 deg. to the plane of the sky. On day 90, we are only seeing the illumination of approximately 5% of this torus, and expect to see an elevated IR flux from this material up until day {approx} 450. It is likely this dust was created in a luminous blue variable (LBV) like mass-loss event of more than 3 M{sub sun}, which is large but consistent with other LBV progenitors such as {eta} Carinae.

Andrews, J. E.; Clayton, Geoffrey C.; Clem, J.; Landolt, A., E-mail: jandrews@phys.lsu.edu, E-mail: landolt@phys.lsu.edu, E-mail: gclayton@fenway.phys.lsu.edu, E-mail: jclem@phys.lsu.edu [Department of Physics and Astronomy, Louisiana State University, 202 Nicholson Hall, Baton Rouge, LA 70803 (United States)

2011-08-15

65

Pre-existent vertebral rotation in the human spine is influenced by body position.  

PubMed

Both the humans as well as the quadrupedal spine have been shown to exhibit a pattern of pre-existent rotation that is similar in direction to what is found in the most common types of idiopathic scoliosis. It has been postulated that human bipedalism introduces forces to the spine that increase a tendency of the vertebrae to rotate. The objective of this study was to examine the effect of body position on vertebral rotation in vivo. Thirty asymptomatic volunteers underwent magnetic resonance imaging scanning of the spine (T2-L5) in three different body positions; upright, quadrupedal-like (on hands-and-knees) and supine. Vertebral rotation in the local transverse plane was measured according to a pre-established method and compared at different spinal levels between the three body positions. It was shown that in all three positions the mid- and lower thoracic vertebrae were predominantly rotated to the right. However, vertebral rotation was significantly less in the quadrupedal position than in both the standing upright and supine positions. PMID:20405300

Janssen, Michiel M A; Vincken, Koen L; Kemp, Bastiaan; Obradov, Marina; de Kleuver, Marinus; Viergever, Max A; Castelein, René M; Bartels, Lambertus W

2010-04-20

66

Experimental study on crack coalescence mechanisms of pre-existing flaws under blast loading  

NASA Astrophysics Data System (ADS)

The PMMA model transmission-type experiment of dynamic caustics was carried out to simulate the fracture blasting process of material containing pre-existing flaws using the dynamic caustic-test system. The mechanism of the fracture coalescence among four prefabricated flaws with echelon geometry distribution was studied under blast loading. The experiment results show that two wing cracks respectively coalescing with the flaw F2 and flaw F3 appear at both tips of the flaw F1 closest to the blasthole. Whereas the flaw F4 doesn't produce wing cracks, the flaw F2 and flaw F3 also respectively generate two wing cracks which don't link up the flaw F4. Crack propagation is greatly affected by preexisting flaws. During the whole fracture process, the wing crack velocity oscillates with the increase of crack propagating time. The value of dynamic stress intensity factor reaches the maximum in a moment and then gradually decreases. The changes of dynamic stress intensity factor also oscillate in the whole time. Furthermore, the value of dynamic stress intensity factor KdII is smaller than that of dynamic stress intensity factor KdI. The results of the present research can provide the theoretical basis for the study on blasting of rock containing flaws.

Yue, Zhong-Wen; Yang, Ren-Shu; Ma, Xin-Min; Guo, Dong-Ming

2008-11-01

67

Holistic approach of pre-existing flaws on the decay of two limestones.  

PubMed

This study aims to understand the influence of the microfacies and the determination of pre-existing flaws on the weathering behavior of two types of limestones. Therefore, both Lede and Noyant limestones were independently weathered by strong acid tests and freeze-thaw cycles. In order to characterize the weathering patterns inside the stones, a combination of high resolution X-ray CT, SEM-EDS and thin section microscopy was used. The advantage of high resolution X-ray CT is its non-destructive character and the obtained 3D structural information. By using this technique, a time-lapse sequence of the weathering patterns was obtained for both gypsum crust formation as well as crack formation due to freezing and thawing. This way, a clear link could be made with the initial non-weathered state. Thin section microscopy and SEM-EDS provided additional chemical information. The focus of this study lies in the processes that occur in the bioclast fragments in the stone and the influence of the surrounding cement or matrix. The results show that weathering patterns vary for both limestones although the causes of weathering were similar. In case of the Noyant stone, the weathering by crystallizing gypsum was mainly restricted to the microporous matrix of the stone, while in case of the Lede stone, several foraminifera and shell fragments were preferentially recrystallized. In general, the underlying microstructure determines the weathering pattern of the stone. PMID:23410862

Dewanckele, J; Boone, M A; De Kock, T; De Boever, W; Brabant, L; Boone, M N; Fronteau, G; Dils, J; Van Hoorebeke, L; Jacobs, P; Cnudde, V

2013-02-11

68

Medical Conditions of Nursing Home Admissions  

PubMed Central

Background As long-term nursing home care is likely to increase with the aging of the population, identifying chronic medical conditions is of particular interest. Although need factors have a strong impact on nursing home (NH) admission, the diseases causing these functional disabilities are lacking or unclear in the residents' file. We investigated the medical reason (primary diagnosis) of a nursing home admission with respect to the underlying disease. Methods This study is based on two independent, descriptive and comparative studies in Belgium and was conducted at two time points (1993 and 2005) to explore the evolution over twelve years. Data from the subjects were extracted from the resident's file; additional information was requested from the general practitioner, nursing home physician or the head nurse in a face-to-face interview. In 1993 we examined 1332 residents from 19 institutions, and in 2005 691 residents from 7 institutions. The diseases at the time of admission were mapped by means of the International Classification of Diseases - 9th edition (ICD-9). Longitudinal changes were assessed and compared by a chi-square test. Results The main chronic medical conditions associated with NH admission were dementia and stroke. Mental disorders represent 48% of all admissions, somatic disorders 43% and social/emotional problems 8%. Of the somatic disorders most frequently are mentioned diseases of the circulatory system (35%) [2/3 sequels of stroke and 1/5 heart failure], followed by diseases of the nervous system (15%) [mainly Parkinson's disease] and the musculoskeletal system (14%) [mainly osteoarthritis]. The most striking evolution from 1993 to 2005 consisted in complicated diabetes mellitus (from 4.3 to 11.4%; p < 0.0001) especially with amputations and blindness. Symptoms (functional limitations without specific disease) like dizziness, impaired vision and frailty are of relevance as an indicator of admission. Conclusion Diseases like stroke, diabetes and mobility problems are only important for institutionalisation if they cause functional disability. Diabetes related complications as cause of admission increased almost three-fold between 1993 and 2005.

2010-01-01

69

Interactions between X-ray induced transient defects and pre-existing damage precursors in DKDP crystals  

SciTech Connect

Large-aperture laser systems, currently designed to achieve high energy densities at the target location (exceeding {approx} 10{sup 11} J/m{sup 3}), will enable studies of the physics of matter and radiation under extreme conditions. As a result, their optical components, such as the frequency conversion crystals (KDP/DKDP), may be exposed to X-rays and other ionizing radiation. This in turn may lead to a change in the damage performance of these materials as they may be affected by radiation-induced effects by either forming new damage initiation centers or interacting with the pre-existing damage initiating defects (so-called damage precursors). We present an experimental study on the laser-induced bulk damage performance at 355-nm of DKDP crystals following X-ray irradiation at room temperature. Results indicate that the damage performance of the material is affected by exposure to X-rays. We attribute this behavior to a change in the physical properties of the precursors which, in turn, affect their individual damage threshold.

Negres, R A; Saw, C K; Demos, S G

2008-10-24

70

Detection and Management of Pre-Existing Cognitive Impairment and Associated Behavioral Symptoms in the Intensive Care Unit  

PubMed Central

Recent increase in both the elderly population and associated incidence of dementia are of critical importance to patient care in intensive care units (ICU) in the United States. Identification of pre-existing cognitive impairment such as mild cognitive impairment and dementia could prevent delirium and associated morbidity and mortality in ICU. Additionally, non-cognitive behavioral symptoms such as depression, psychosis, agitation, and catastrophic reactions are common in patients with pre-existing cognitive impairment. Detection and management of non-cognitive behavioral symptoms associated with demented elderly patients in ICU leads to improved delivery of life-saving critical care.

Lee, Hochang B.; DeLoatch, Candyce J.; Cho, SeongJin; Rosenberg, Paul; Mears, Simon C.; Sieber, Frederick E.

2008-01-01

71

42 CFR 418.102 - Condition of participation: Medical director.  

Code of Federal Regulations, 2012 CFR

...this determination: (1) The primary terminal condition; (2) Related diagnosis(es), if any; (3) Current subjective and objective medical findings; (4) Current medication and treatment orders; and (5) Information about the...

2012-10-01

72

Medication errors in the homes of children with chronic conditions  

Microsoft Academic Search

BackgroundChildren with chronic conditions often have complex medication regimens, usually administered at home by their parents.ObjectiveTo describe the types of medication errors in the homes of children with chronic conditions.MethodsOur home visit methods include direct observation of administration, medication review and prescription dose checking. Parents of children with sickle cell disease and seizure disorders taking daily medications were recruited from

Kathleen E Walsh; Kathleen M Mazor; Christopher J Stille; Irma Torres; Joann L Wagner; Juliet Moretti; Kevin Chysna; Christy D Stine; G Naheed Usmani; Jerry H Gurwitz

2011-01-01

73

Evaluation of a pre-existing, 3-year household water treatment and handwashing intervention in rural Guatemala  

PubMed Central

Background The promotion of household water treatment and handwashing with soap has led to large reductions in child diarrhoea in randomized efficacy trials. Currently, we know little about the health effectiveness of behaviour-based water and hygiene interventions after the conclusion of intervention activities. Methods We present an extension of previously published design (propensity score matching) and analysis (targeted maximum likelihood estimation) methods to evaluate the behavioural and health impacts of a pre-existing but non-randomized intervention (a 3-year, combined household water treatment and handwashing campaign in rural Guatemala). Six months after the intervention, we conducted a cross-sectional cohort study in 30 villages (15 intervention and 15 control) that included 600 households, and 929 children <5 years of age. Results The study design created a sample of intervention and control villages that were comparable across more than 30 potentially confounding characteristics. The intervention led to modest gains in confirmed water treatment behaviour [risk difference = 0.05, 95% confidence interval (CI) 0.02–0.09]. We found, however, no difference between the intervention and control villages in self-reported handwashing behaviour, spot-check hygiene conditions, or the prevalence of child diarrhoea, clinical acute lower respiratory infections or child growth. Conclusions To our knowledge this is the first post-intervention follow-up study of a combined household water treatment and handwashing behaviour change intervention, and the first post-intervention follow-up of either intervention type to include child health measurement. The lack of child health impacts is consistent with unsustained behaviour adoption. Our findings highlight the difficulty of implementing behaviour-based household water treatment and handwashing outside of intensive efficacy trials.

Arnold, Benjamin; Arana, Byron; Mausezahl, Daniel; Hubbard, Alan; Colford, John M

2009-01-01

74

Incarnation at the Crossroad: The Doctrine of the Pre-existence of Jesus Christ in Dialogue with Judaism and Islam  

Microsoft Academic Search

Renewed study of the doctrine of the pre-existence of Jesus Christ can advance mutual understanding between Christianity and the two other great monotheistic religions, Judaism and Islam, and at the same time contribute to the development of a comparative systematic theology. Christian and Jewish traditions offer remarkable ways of conceiving God's relationship to the world that seem to move in

Paolo Gamberini

2008-01-01

75

Psoriasis Increases Risk for Some Medical Conditions  

MedlinePLUS

... medical tests: Blood pressure check Cholesterol test Electrocardiogram Multiple sclerosis (MS) Risk: Studies suggest that having psoriasis may ... National Library of Medicine National Institutes of Health. “Multiple Sclerosis.” Available at www.nlm.nih.gov/medlineplus/multiplesclerosis. ...

76

Medical Conditions and Medication Use in Adults with Down Syndrome: A Descriptive Analysis  

ERIC Educational Resources Information Center

|Background: We examined the presence of medical conditions and medication use within a sample of adults with Down syndrome. Methods: Retrospective chart review using a sample of 141 adults with Down syndrome and age range of 30 to 65 years. Results: We identify 23 categories of commonly occurring medical conditions and 24 categories of…

Kerins, Gerard; Petrovic, Kimberly; Bruder, Mary Beth; Gruman, Cynthia

2008-01-01

77

Leukemia, lymphoma, and multiple myeloma following selected medical conditions  

Microsoft Academic Search

The role of selected prior medical conditions in the etiology of hematopoietic malignancies was examined in a case-control study of members of two regional branches of the Kaiser Permanente Medical Care Program (USA). Past history of chronic infectious, autoimmune, allergic, and musculoskeletal disorders was abstracted from medical records for leukemia (n = 299), non-Hodgkin's lymphoma (NHL, n = 100), and

Michele Morin Doody; Martha S. Linet; Andrew G. Glass; Gary D. Friedman; Linda M. Pottern; John D. Boice; Joseph F. Fraumeni

1992-01-01

78

Sexual dysfunction among Ghanaian men presenting with various medical conditions  

Microsoft Academic Search

BACKGROUND: Several medical conditions can affect and disrupt human sexuality. The alteration of sexuality in these medical conditions often hinder effective communication and empathy between the patients and their sexual partners because of cultural attitudes, social norms and negative feelings such as anxiety and guilt. Validated and standardized sexual inventories might therefore help resolve this problem. The objective of this

Nafiu Amidu; William KBA Owiredu; Eric Woode; Roselyn Appiah; Lawrence Quaye; Christian K Gyasi-Sarpong

2010-01-01

79

42 CFR 418.106 - Condition of participation: Drugs and biologicals, medical supplies, and durable medical equipment.  

Code of Federal Regulations, 2012 CFR

...Condition of participation: Drugs and biologicals, medical supplies, and durable medical equipment. 418.106 Section 418.106 ...Condition of participation: Drugs and biologicals, medical supplies, and durable medical equipment....

2012-10-01

80

Dissolution of Pre-Existing Platelet Thrombus by Synergistic Administration of Low Concentrations of Bifunctional Antibodies against ?3 Integrin  

Microsoft Academic Search

Most antithrombotic approaches target prevention rather than the more clinically relevant issue of resolution of an existing thrombus. In this study, we describe a novel and effective therapeutic strategy for ex vivo clearance of pre-existing platelet thrombus by the combination of two bifunctional platelet GPIIIa49-66 ligands that target different parts of the arterial thrombus. We produced an additional GPIIIa49-66 agent

Suying Dang; Tao Hong; Thomas Wisniewski; Wei Zhang

2011-01-01

81

Psoriasis, Other Medical Conditions May Be Linked, Study Says  

MedlinePLUS

... sharing features on this page, please enable JavaScript. Psoriasis, Other Medical Conditions May Be Linked, Study Says ... Preidt Wednesday, August 7, 2013 Related MedlinePlus Page Psoriasis WEDNESDAY, Aug. 7 (HealthDay News) -- People with the ...

82

Decreased prevalence of sepsis but not mild or severe P. falciparum malaria is associated with pre-existing filarial infection  

PubMed Central

Background Enhanced inflammatory host responses have been attributed as the cellular basis for development of severe malaria as well as sepsis. In contrast to this, filarial infections have been consistently reported to be associated with an immunological hypo-responsive phenotype. This suggests that successful control of filariasis by employing mass drug administration, could potentially contribute to an increase in incidence of sepsis and cerebral malaria in human communities. A case control study was undertaken to address this critical and urgent issue. Methods Eighty-nine patients with sepsis and one hundred and ninety-six patients with P. falciparum malaria all originating from Odisha, were tested for prevalence of circulating filarial antigens - a quantitative marker of active filarial infection. Antibodies to four stage specific malarial recombinant proteins were measured by solid phase immunoassays and circulating CD4+CD25high T-cells were quantified by flow cytometry with an objective to study if pre-existing filarial infections influence antibody responses to malarial antigens or the levels of circulating T-regulatory cells in P. falciparum infected patients. Results Prevalence of filarial antigenemia was significantly less in sepsis patients as compared to controls suggesting that pre-existing filariasis could influence development of sepsis. On the other hand, levels of circulating filarial antigen were comparable in severe malaria cases and healthy controls suggesting that development of severe malaria is independent of pre-existing W. bancrofti infections. Plasma TNF-a, RANTES and antibodies to recombinant malarial proteins as well as levels of circulating CD4+ CD25high cells were comparable in malaria patients with or without filarial infections. Conclusions These observations imply that successful control of filariasis could have adverse consequences on public health by increasing the incidence of sepsis, while the incidence of severe malaria may not adversely increase as a consequence of elimination of filariasis.

2013-01-01

83

Lentivirus-mediated platelet gene therapy of murine hemophilia A with pre-existing anti-FVIII immunity  

PubMed Central

Summary Background The development of inhibitory antibodies, referred to as inhibitors, against exogenous FVIII in a significant subset of patients with hemophilia A remains a persistent challenge to the efficacy of protein replacement therapy. Our previous studies using the transgenic approach provided proof-of-principle that platelet-specific expression could be successful for treating hemophilia A in the presence of inhibitory antibodies. Objective To investigate a clinically translatable approach for platelet gene therapy of hemophilia A with pre-existing inhibitors. Methods Platelet-FVIII expression in pre-immunized FVIIInull mice was introduced by transplantation of lentivirus-transduced bone marrow or enriched hematopoietic stem cells. FVIII expression was determined by a chromogenic assay. The transgene copy number per cell was quantitated by real time PCR. Inhibitor titer was measured by Bethesda assay. Phenotypic correction was assessed by the tail clipping assay and an electrolytic-induced venous injury model. Integration sites were analyzed by LAM-PCR. Results Therapeutic levels of platelet-FVIII expression were sustained long-term without evoking an anti-FVIII memory response in the transduced pre-immunized recipients. The tail clip survival test and the electrolytic injury model confirmed that hemostasis was improved in the treated animals. Sequential bone marrow transplants showed sustained platelet-FVIII expression resulting in phenotypic correction in pre-immunized secondary and tertiary recipients. Conclusions Lentivirus-mediated platelet-specific gene transfer improves hemostasis in hemophilic A mice with pre-existing inhibitors, indicating that this approach may be a promising strategy for gene therapy of hemophilia A even in the high-risk setting of pre-existing inhibitory antibodies.

Kuether, E. L.; Schroeder, J. A.; Fahs, S. A.; Cooley, B. C.; Chen, Y.; Montgomery, R. R.; Wilcox, D. A.; Shi, Q.

2012-01-01

84

Immunogenicity of recombinant adenovirus serotype 35 vaccine in the presence of pre-existing anti-Ad5 immunity.  

PubMed

The high prevalence of pre-existing immunity to adenovirus serotype 5 (Ad5) in human populations may substantially limit the immunogenicity and clinical utility of recombinant Ad5 vector-based vaccines for HIV-1 and other pathogens. A potential solution to this problem is to use vaccine vectors derived from adenovirus (Ad) serotypes that are rare in humans, such as Ad35. However, cross-reactive immune responses between heterologous Ad serotypes have been described and could prove a major limitation of this strategy. In particular, the extent of immunologic cross-reactivity between Ad5 and Ad35 has not previously been determined. In this study we investigate the impact of pre-existing anti-Ad5 immunity on the immunogenicity of candidate rAd5 and rAd35 vaccines expressing SIV Gag in mice. Anti-Ad5 immunity at levels typically found in humans dramatically blunted the immunogenicity of rAd5-Gag. In contrast, even high levels of anti-Ad5 immunity did not substantially suppress Gag-specific cellular immune responses elicited by rAd35-Gag. Low levels of cross-reactive Ad5/Ad35-specific CD4(+) T lymphocyte responses were observed, but were insufficient to suppress vaccine immunogenicity. These data demonstrate the potential utility of Ad35 as a candidate vaccine vector that is minimally suppressed by anti-Ad5 immunity. Moreover, these studies suggest that using Ad vectors derived from immunologically distinct serotypes may be an effective and general strategy to overcome the suppressive effects of pre-existing anti-Ad immunity. PMID:15128818

Barouch, Dan H; Pau, Maria G; Custers, Jerome H H V; Koudstaal, Wouter; Kostense, Stefan; Havenga, Menzo J E; Truitt, Diana M; Sumida, Shawn M; Kishko, Michael G; Arthur, Janelle C; Korioth-Schmitz, Birgit; Newberg, Michael H; Gorgone, Darci A; Lifton, Michelle A; Panicali, Dennis L; Nabel, Gary J; Letvin, Norman L; Goudsmit, Jaap

2004-05-15

85

Persistent paranoid delusions following the September 11 terrorist attacks in a man with no pre-existing mental illness.  

PubMed

The effects of modern day terrorism on mental health are not well understood. Described here is a 51-year-old male with no pre-existing mental illness who developed paranoid delusions related to the September 11, 2001, terrorist attacks shortly after they occurred. After about two years of treatment with quetiapine the patient was no longer delusional about terrorism but experienced extensive paranoid delusions about commonly encountered persons, requiring treatment which continues to the current time. Clinicians should be aware of the possible impact of terrorist activities on the mental health of vulnerable individuals. PMID:16553109

Reeves, Roy R; Beddingfield, John J

2006-03-01

86

Survival Patterns in Patients With Hodgkin's Lymphoma With a Pre-Existing Hospital Discharge Diagnosis of Autoimmune Disease  

PubMed Central

Purpose Autoimmune diseases (AIs) are associated with elevated risk for Hodgkin's lymphoma (HL); however, information on the interplay of AIs and HL on survival is sparse. Patients and Methods We evaluated survival patterns for 7,414 patients with HL in relation to a pre-existing hospital discharge diagnosis of an AI. We also assessed survival patterns in relation to a prior AI diagnosis among 29,240 population-based matched controls. Results Among female patients with HL with (v those without) a pre-existing AI, the 5-year and 10-year overall survival was 46.0% (63.3%) and 41.0% (51.9%); for males, the corresponding numbers were 48.5% (59.2%) and 43.6% (51.5%), respectively (P < .001). Among female controls with (v those without) a pre-existing AI, the 5-year and 10-year overall survival was 79.1% (90.2%) and 67.2% (83.3%); for males, the corresponding numbers were 82.5% (90.3%) and 68.6% (81.6%), respectively (P < .001). Female patients with HL with (v those without) a pre-existing AI had a 1.8-fold (range, 1.3- to 2.4-fold) increased relative risk of dying at 5 years of follow-up; for males, the corresponding excess relative risk of dying was 1.7-fold (range, 1.3- to 2.2-fold). Conclusion Patients with HL have an overall excellent outcome from treatment but also pose some of the most complex challenges of cancer survivorship due to many late effects (eg, second malignancies, thyroid disease, cardiovascular disease, and altered reproductive and sexual function). Our finding that patients with HL with a hospital discharge diagnosis of an AI have a substantially higher risk of dying, emphasizes that underlying chronic diseases, such as AIs, should be high of the list of survivorship concerns for clinicians that treat HL.

Landgren, Ola; Pfeiffer, Ruth M.; Kristinsson, Sigurdur Y.; Bjorkholm, Magnus

2010-01-01

87

Individual differences in reading comprehension gains from assisted reading practice: pre existing conditions, vocabulary acquisition, and amounts of practice  

Microsoft Academic Search

We conducted a study of the effects of assisted reading practice (Shany & Biemiller, 1995). In this paper we examined the original data to find factors affecting gains in reading comprehension. We contrasted 14\\u000a children who had below median gains in reading comprehension and 15 who had above median gains. There were no significant\\u000a correlations between pre-program language and reading

Michal Shany; Andrew Biemiller

2010-01-01

88

Pre-Existing T- and B-Cell Defects in One Progressive Multifocal Leukoencephalopathy Patient  

PubMed Central

Progressive multifocal leukoencephalopathy (PML) usually occurs in patients with severe immunosuppression, hematological malignancies, chronic inflammatory conditions or receiving organ transplant. Recently, PML has also been observed in patients treated with monoclonal antibodies. By taking advantage of the availability of samples from a multiple sclerosis (MS) patient treated with natalizumab, the antibody anti-?4 integrin, who developed PML and was monitored starting before therapy initiation, we investigated the fate of T and B lymphocytes in the onset of PML. Real-time PCR was used to measure new T- and B-cell production by means of T-cell receptor excision circle (TREC) and K-deleting recombination excision circle (KREC) analysis and to quantify transcripts for CD34, terminal-deoxynucleotidyltransferase, and V pre-B lymphocyte gene 1. T- and B-cell subsets and T-cell heterogeneity were measured by flow cytometry and spectratyping. The data were compared to those of untreated and natalizumab-treated MS patients and healthy donors. Before therapy, a patient who developed PML had a low TREC and KREC number; TRECs remained low, while KRECs and pre-B lymphocyte gene 1 transcripts peaked at 6 months of therapy and then decreased at PML diagnosis. Flow cytometry confirmed the deficient number of newly produced T lymphocytes, counterbalanced by an increase in TEMRA cells. The percentage of naive B cells increased by approximately 70% after 6 months of therapy, but B lymphocyte number remained low for the entire treatment period. T-cell heterogeneity and immunoglobulins were reduced. Although performed in a single patient, all results showed that an immune deficit, together with an increase in newly produced B cells a few months after therapy initiation, may predispose the patient to PML. These findings indicate the TREC/KREC assay is a potential tool to identify patients at risk of developing PML and may provide insights into the immunological involvement of monoclonal antibody-associated therapies.

Sottini, Alessandra; Capra, Ruggero; Zanotti, Cinzia; Chiarini, Marco; Serana, Federico; Ricotta, Doris; Caimi, Luigi; Imberti, Luisa

2012-01-01

89

Development of the Eastern California Shear Zone — Walker Lane belt: The effects of microplate motion and pre-existing weakness in the Basin and Range  

NASA Astrophysics Data System (ADS)

The role that the motion of microplates has played in the development of the Eastern California Shear Zone in western North America is unclear. It was previously proposed that shear related to Baja California motion has propagated from the Gulf of California northward into Nevada. However, there is evidence that the formation of the Eastern California Shear Zone predates the inception of Baja California motion. Thus, either Baja California began to move northwestward prior to 6 Ma, or the Eastern California Shear Zone formed by shear strain resulting from different microplate motion than Baja California. The role of Sierra Nevada motion on the development of an adjacent shear zone remains untested. We present a numerical modeling study that examines the deformational response of western North America to Baja California and/or Sierra Nevada microplate motion. In particular we study if, and under what condition of microplate motion, shear strain can localize in the northern and southern part of the Eastern California Shear Zone (separated by the Garlock fault). We find that given the pre-existing weakness from Miocene Basin and Range extension (a lithospheric strength contrast or normal faults) shear strain from either the Baja California or Sierra Nevada microplates can lead to the formation of the Eastern California Shear Zone. Furthermore, the presence of a pre-existing weakness explains the earlier initiation of strike-slip faulting north of the Garlock fault. Our models suggest that today, Baja California microplate motion is the major player for present-day deformation rates along the Eastern California Shear Zone and was in the past 6 Myrs also a major driver of strain localization in southern Eastern California Shear Zone within the Mojave block.

Plattner, C.; Malservisi, R.; Furlong, K. P.; Govers, R.

2010-04-01

90

Health Conditions Among Aging Narcotics Addicts: Medical Examination Results  

Microsoft Academic Search

The study examined health conditions among an aging cohort of male narcotics addicts. This prospective cohort study (1964–1998) included interviews and medical testing for 108 surviving subjects who had been admitted to the California Civil Addict Program during the years 1962 through 1964. Medical testing results were: 51.9% had high blood pressure, 22.4% showed hyperlipidemia, 13.3% had elevated levels of

Yih-Ing Hser; Lillian Gelberg; Valerie Hoffman; Christine E. Grella; William McCarthy; M. Douglas Anglin

2004-01-01

91

Attention to medical conditions during mental health clinic visits.  

PubMed

With increased attention being devoted to the metabolic effects of antipsychotic medications, it becomes apparent that efforts need to be made to ensure that patients receiving treatment for a mental illness receive appropriate evaluation and treatment of their medical conditions as well. The individual provider may assist by offering relevant screenings, helping patients take responsibility for their own health, decreasing barriers to treatment, enlisting the assistance of support staff, making appropriate referrals, and collaborating with other providers. PMID:23367501

Miller, Marilyn J

2013-10-01

92

Resolving Treatment Complications Associated with Comorbid Medical Conditions  

Microsoft Academic Search

\\u000a In this chapter, we discuss various treatment complications clinicians encounter in cognitive-behavioral therapy (CBT) with\\u000a patients who have anxiety disorders and comorbid medical conditions. Specifically, we first provide an overview of the diagnostic\\u000a and therapeutic challenges as well as introduce a treatment algorithm to assist clinical decision-making for medically complex\\u000a patients with impairing anxiety. To illustrate the types of difficulties

Joseph Greer; Jessica Graham; Steven Safren

93

Risk of endometrial cancer in relation to medical conditions and medication use  

PubMed Central

We studied the relation of medical conditions related to obesity and medications used for these conditions with endometrial cancer. We also investigated the association of other medical conditions and medications with risk. This US population-based case-control study included 469 endometrial cancer cases and 467 controls. Information on putative risk factors for endometrial cancer was collected through personal interviews. We asked women about their medical history and medications used for six months or longer and the number of years each medication was taken. Risk was strongly associated with increasing obesity (p for trend <0.001). Among conditions related to obesity, and after adjustment for age, body mass index (BMI), and other risk factors and conditions, uterine fibroids were independently related to an increased cancer risk (adjusted OR= 1.8, 95%CI= 1.2–2.5). Although hypertension was not significantly related to endometrial cancer after adjustment for age and BMI, use of thiazide diuretics was independently associated with an increased risk (OR= 1.8, 95%CI= 1.1–3.0). Anemia was associated with decreased risk (OR= 0.6, 95%CI= 0.5–0.9). Use of non-steroidal anti-inflammatory drugs was related to a decreased risk (OR= 0.7, 95%CI= 0.5–0.97). To our knowledge, the observation about thiazide diuretics is novel and requires confirmation in other studies and populations.

Fortuny, Joan; Sima, Camelia; Bayuga, Sharon; Wilcox, Homer; Pulick, Katherine; Faulkner, Shameka; Zauber, Ann G.; Olson, Sara H.

2009-01-01

94

The challenges and future considerations regarding pregnancy-related outcomes in women with pre-existing diabetes.  

PubMed

Ineffective management of blood glucose levels during preconception and pregnancy has been associated with severe maternal and fetal complications in women with pre-existing diabetes. Studies have demonstrated that preconception counseling and pre-pregnancy care can dramatically reduce these risks. However, pregnancy-related outcomes in women with diabetes continue to be less than ideal. This review highlights and discusses a variety of patient, provider, and organizational factors that can contribute to these suboptimal outcomes. Based on the findings of studies reviewed and authors' clinical and research experiences, recommendations have been proposed focusing on various aspects of care provided, including improved accessibility to effective preconception and pregnancy-related care and better organized clinic consultations that are sensitive to women's diabetes and pregnancy needs. PMID:24013963

Singh, Harsimran; Murphy, Helen R; Hendrieckx, Christel; Ritterband, Lee; Speight, Jane

2013-12-01

95

Omentin-1 Is Decreased in Maternal Plasma, Placenta and Adipose Tissue of Women with Pre-Existing Obesity  

PubMed Central

Objective The aim of this study was to determine (i) the effect of maternal obesity and gestational diabetes mellitus (GDM) on (i) the circulating levels of omentin-1 in cord and maternal plasma, and (ii) gene expression and release of omentin-1 from human placenta and adipose tissue. The effect of pregnancy on circulating omentin-1 levels was also determined. Design Omentin-1 levels were measured in maternal and cord plasma from obese and non-obese normal glucose tolerant women (NGT; n?=?44) and women with GDM (n?=?39) at the time of term elective Caesarean section. Placenta and adipose tissue expression and release of omentin-1 was measured from 22 NGT and 22 GDM women collected at the time of term elective Caesarean section. Omentin-1 levels were also measured in maternal plasma from 13 NGT women at 11 and 28 weeks gestation and 7 weeks postpartum. Results Maternal obesity was associated with significantly lower omentin-1 levels in maternal plasma; however, there was no effect of maternal obesity on cord omentin levels. Omentin-1 gene expression was lower in placenta and adipose tissue obtained from women with pre-existing obesity. In addition to this, adipose tissue release of omentin-1 was significantly lower from obese pregnant women. Omentin-1 levels were significantly lower in non-obese GDM compared to non-obese NGT women. However, there was no difference in omentin-1 levels between obese NGT and obese GDM women. There was no effect of GDM on cord omentin levels, and placental and adipose tissue omentin-1 expression. Maternal omentin-1 levels were negatively correlated with fetal birthweight and fetal ponderal index. Conclusions The data presented in this study demonstrate that pre-existing maternal obesity is associated with lower omentin-1 expression in placenta, adipose tissue and maternal plasma. Alteration in omentin-1 in pregnancy may influence the development of metabolic disorders in offspring later in life.

Barker, Gillian; Lim, Ratana; Georgiou, Harry M.; Lappas, Martha

2012-01-01

96

Dementia and serious coexisting medical conditions: a double whammy.  

PubMed

Research-based information about the prevalence of other serious medical conditions in people with dementia has become available only recently, and the true prevalence is not known, primarily because many people with dementia do not have a diagnosis. The existing information is sufficient, however, to show that these other conditions are common in people with dementia. It is also clear that coexisting medical conditions increase the use and cost of health care services for people with dementia, and conversely, dementia increases the use and cost of health care services for people with other serious medical conditions. Nurses and other healthcare professionals should expect to see these relationships in their elderly patients. They should know how to recognize possible dementia and assess, or obtain an assessment of, the patient's cognitive status. They should expect the worsening of cognitive and related symptoms in acutely ill people with dementia and try to eliminate factors that cause this worsening, to the extent possible, while assuring the family that the symptoms are likely to improve once the acute phase of illness or treatment is over. Families, nurses, and other health care professionals are challenged by the complex issues involved in caring for a person with both dementia and other serious medical conditions. Greater attention to these issues by informed and thoughtful clinicians will improve outcomes for the people and their family and professional caregivers. PMID:15331302

Maslow, Katie

2004-09-01

97

Medical conditions underlying recurrence of retinal vein occlusion  

Microsoft Academic Search

Seventeen patients with recurrent retinal vein occlusion were investigated for underlying medical conditions and compared with 61 patients with single retinal vein occlusion (26 with central, 35 with branch vein occlusion). The two study groups were comparable for age, sex, and weight. Patients with recurrence had a significantly increased prevalence rate of hypertension (88% versus 48%: p less than 0.01),

P M Dodson; A J Kubicki; K G Taylor; E E Kritzinger

1985-01-01

98

The role of illness perceptions in patients with medical conditions  

Microsoft Academic Search

Purpose of review In this article we summarize recent investigations into the influence of illness perceptions on outcomes in patients with medical conditions. Recent findings Developments in assessment include the publishing of a new brief scale to assess illness perceptions and the examination of the relationship between patient drawings of their illness and outcomes. Recent studies in primary care highlight

Keith J. Petrie; Lana A. Jago; Daniel A. Devcich

2007-01-01

99

Selected medical conditions and risk of breast cancer  

Microsoft Academic Search

Several diseases are known or suspected to be associated with altered levels of hormones and growth factors that may influence breast cancer risk. To elucidate this possibility, we studied the relationship between 23 medical conditions or procedures and breast cancer risk by means of data from a multicentric case-control study conducted between 1991 and 1994 in six Italian areas. The

R Talamini; S Franceschi; A Favero; E Negri; F Parazzini; C La Vecchia

1997-01-01

100

Just Another Sign of Aging, or an Underlying Medical Condition?  

MedlinePLUS

... or an Underlying Medical Condition? Some signs of aging that appear on the skin indicate more than advancing years; they warn of ... then re-appears Circulatory problem Diabetes Skin Cancer Skin lesion with any of the following characteristics: Dry, scaly, rough-textured patches ranging in color ...

101

Medical conditions and risk of adult myeloid leukemia  

PubMed Central

Purpose Although a few previous studies have reported positive associations between adult myeloid leukemia and a history of certain medical conditions, the etiology of most cases remains largely unknown. Our purpose was to examine associations between certain medical conditions and adult myeloid leukemia. Methods Using logistic regression, we evaluated associations between 16 self-reported medical conditions and myeloid leukemia in a case–control study of 670 cases [including 420 acute myeloid leukemia (AML) and 186 chronic myelogenous leukemia (CML)] and 701 population-based controls. Results We observed significant positive associations between AML and ulcerative colitis (odds ratio (OR) = 3.8; 95 % confidence interval (CI), 1.1–13) and between CML and peptic ulcer (OR = 2.0; 95% CI, 1.1–3.8). A personal cancer history increased both AML (OR = 2.6; 95% CI, 1.7–3.9) and CML (OR = 3.5; 95% CI, 2.0–5.8) risk even after excluding individuals who reported prior radiation and/or chemotherapy treatment. Conclusion Certain inflammatory medical conditions and a personal history of cancer, independent from therapy, are associated with an increased risk of myeloid leukemia.

Johnson, Kimberly J.; Blair, Cindy M.; Fink, James M.; Cerhan, James R.; Roesler, Michelle A.; Hirsch, Betsy A.; Nguyen, Phuong L.; Ross, Julie A.

2013-01-01

102

Bovine Adenoviral Vector–based H5N1 Influenza Vaccine Overcomes Exceptionally High Levels of Pre-existing Immunity Against Human Adenovirus  

Microsoft Academic Search

Because of the high prevalence of adenovirus (Ad) infections in humans, it is believed that pre-existing Ad-neutralizing antibodies (vector immunity) may negatively impact the immune response to vaccine antigens when delivered by human Ad (HAd) vectors. In order to evaluate whether bovine Ad subtype 3 (BAd3), a non-HAd vector, can effectively elude high levels of pre-existing vector immunity, naïve and

Neetu Singh; Aseem Pandey; Lakshmi Jayashankar; Suresh K Mittal

2008-01-01

103

On the spatio-temporal distribution of acoustic emissions in two granitic rocks under triaxial compression: the role of pre-existing cracks  

Microsoft Academic Search

We used a new rapid data acquisition system to examine the role of pre-existing crack density in determining the mechanical properties of crystalline rock. Two similar coarse-grained samples. Tsukuba granite (TG) and granitic porphyry (GP), were used in triaxial compression tests. The main difference between the two rocks is that TG contains main large pre-existing cracks, whereas GP is almost

X.-L. Lei; K. Kusunose; O. Nishizawa; A. Cho; T. Satoh

2000-01-01

104

Relations among Chronic Medical Conditions, Medications, and Automobile Crashes in the Elderly: A Population-based Case-Control Study  

Microsoft Academic Search

Older drivers have elevated crash rates and are more likely to be injured or die if they have a crash. Medical conditions and medications have been hypothesized as determinants of crash involvement. This population- based case-control study sought to identify medical conditions and medications associated with risk of at-fault crashes among older drivers. A total of 901 drivers aged 65

Gerald McGwin; Richard V. Sims; Jeffrey M. Roseman

105

Medical and Orthopaedic Conditions in Special Olympics Athletes  

PubMed Central

Objective: Many Special Olympics athletes experience hypokinetic diseases and comorbid conditions that may predispose them to serious injuries during physical activity. A clear understanding of these conditions and diseases may assist health care professionals in preventing further distress and managing the injuries sustained by these athletes. Such diseases and conditions include overweight and obesity, diabetes, vision problems, seizure disorders, and Down syndrome, which is often associated with atlantoaxial instability. Data Sources: MEDLINE, SPORT Discus, and Special Olympics information sources for the years 1990–2000 using the key terms Special Olympics, mental retardation, comorbidity, Down syndrome, hypokinetic diseases, and physical activity were searched. Data Synthesis: A basic review of hypokinetic diseases and comorbid conditions prepares health care professionals for working with people with mental retardation. Conclusions and Recommendations: Health care volunteers at Special Olympics events treat athletes with mental retardation who may also have some of the comorbid conditions and hypokinetic diseases observed commonly in this population. Moreover, many of these conditions and diseases are typical in athletes without mental retardation. Athletic trainers should be familiar with these conditions and diseases but should review the unique conditions and prescription medications commonly found in the Special Olympics population before providing medical services for these athletes.

2001-01-01

106

Pre-existing bacterial infections, not stress fever, influenced previous studies which labeled Gerrhosaurus major an afebrile lizard species.  

PubMed

Early studies indicated that the Sudan plated lizard, Gerrhosaurus major, did not exhibit a febrile response when challenged with bacterial pyrogen. More recent results indicated that a 14-day antibiotic treatment regime produced a significant decrease (0.5 +/- 0.1 degree C) in the mean selected body temperature (MSBT) for this species (31.3 +/- 0.2-30.8 +/- 0.2 degrees C). The antibiotic treatment results suggested that G. major already had a fever caused by a pre-existing bacterial infection. The current study was designed first to determine if a sub-population of G. major, with a higher mean pre-antibiotic treatment MSBT would exhibit a greater decrease in MSBT after antibiotic treatment. A 14-day antibiotic treatment regime for G. major (N = 7) with MSBTs > or = 31.9 degrees C (mean 32.4 +/- 0.2 degrees C) produced a significant decrease of 1.7 +/- 0.4 degrees C in MSBT to 30.7 +/- 0.3 degrees C. Analysis of the combined antibiotic treatment MSBT data from [13] and the current study demonstrated that the magnitude of the change in MSBT after antibiotic treatment was dependent upon the pre-antibiotic treatment MSBT. These data imply that animals with a greater pre-treatment MSBT and greater MSBT change had a greater magnitude fever. In the second portion of this study the MSBT for individual lizards was measured during separate experiments using both indwelling cloacal thermocouples taped to the tail of the lizard and telemeters implanted into the peritoneal cavity of the lizard. This second study was designed to determine if measurement of Tb using thermocouples induced a stress fever which may have masked a portion of the pyrogen-induced fever. The MSBT measured using indwelling cloacal thermocouples (30.5 +/- 0.3 degrees C) was not significantly greater (T > 0.05) than the MSBT increased using telemeters (31.0 +/- 0.2 degrees C). The results of the experiments from this study demonstrate that the previously reported afebrile state for G. major was the result of animals having pre-existing bacterial infections. G. major does exhibit a febrile response similar to other lizard species. PMID:10665384

Muchlinski, A E; Gramajo, R; Garcia, C

1999-11-01

107

Transforming Growth Factor ? Neutralization Ameliorates Pre-Existing Hepatic Fibrosis and Reduces Cholangiocarcinoma in Thioacetamide-Treated Rats  

PubMed Central

Considerable evidence has demonstrated that transforming growth factor ? (TGF-?) plays a key role in hepatic fibrosis, the final common pathway for a variety of chronic liver diseases leading to liver insufficiency. Although a few studies have reported that blocking TGF-? with soluble receptors or siRNA can prevent the progression of hepatic fibrosis, as yet no evidence has been provided that TGF-? antagonism can improve pre-existing hepatic fibrosis. The aim of this study was to examine the effects of a murine neutralizing TGF-? monoclonal antibody (1D11), in a rat model of thioacetamide (TAA)-induced hepatic fibrosis. TAA administration for 8 weeks induced extensive hepatic fibrosis, whereupon 1D11 dosing was initiated and maintained for 8 additional weeks. Comparing the extent of fibrosis at two time points, pre- and post-1D11 dosing, we observed a profound regression of tissue injury and fibrosis upon treatment, as reflected by a reduction of collagen deposition to a level significantly less than that observed before 1D11 dosing. Hepatic TGF-?1 mRNA, tissue hydroxyproline, and plasminogen activator inhibitor 1 (PAI-1) levels were significantly elevated at the end of the 8 week TAA treatment. Vehicle and antibody control groups demonstrated progressive injury through 16 weeks, whereas those animals treated for 8 weeks with 1D11 showed striking improvement in histologic and molecular endpoints. During the course of tissue injury, TAA also induced cholangiocarcinomas. At the end of study, the number and area of cholangiocarcinomas were significantly diminished in rats receiving 1D11 as compared to control groups, presumably by the marked reduction of supporting fibrosis/stroma. The present study demonstrates that 1D11 can reverse pre-existing hepatic fibrosis induced by extended dosing of TAA. The regression of fibrosis was accompanied by a marked reduction in concomitantly developed cholangiocarcinomas. These data provide evidence that therapeutic dosing of a TGF-? antagonist can diminish and potentially reverse hepatic fibrosis and also reduce the number and size of attendant cholangiocarcinomas.

Ling, Hong; Roux, Eric; Hempel, Donna; Tao, Jingzang; Smith, Mandy; Lonning, Scott; Zuk, Anna; Arbeeny, Cynthia; Ledbetter, Steve

2013-01-01

108

42 CFR 494.150 - Condition: Responsibilities of the medical director.  

Code of Federal Regulations, 2012 CFR

...false Condition: Responsibilities of the medical director. 494.150 Section 494.150...150 Condition: Responsibilities of the medical director. The dialysis facility must have a medical director who meets the qualifications...

2012-10-01

109

42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.  

Code of Federal Regulations, 2010 CFR

...Conditions for payment: Medically directed anesthesia services. 415.110 Section 415...Conditions for payment: Medically directed anesthesia services. (a) General payment rule...the physician's medical direction of anesthesia services for one service or two...

2009-10-01

110

42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.  

Code of Federal Regulations, 2010 CFR

...Conditions for payment: Medically directed anesthesia services. 415.110 Section 415...Conditions for payment: Medically directed anesthesia services. (a) General payment rule...the physician's medical direction of anesthesia services for one service or two...

2010-10-01

111

The Role of Pre-Existing Disturbances in the Effect of Marine Reserves on Coastal Ecosystems: A Modelling Approach  

PubMed Central

We have used an end-to-end ecosystem model to explore responses over 30 years to coastal no-take reserves covering up to 6% of the fifty thousand square kilometres of continental shelf and slope off the coast of New South Wales (Australia). The model is based on the Atlantis framework, which includes a deterministic, spatially resolved three-dimensional biophysical model that tracks nutrient flows through key biological groups, as well as extraction by a range of fisheries. The model results support previous empirical studies in finding clear benefits of reserves to top predators such as sharks and rays throughout the region, while also showing how many of their major prey groups (including commercial species) experienced significant declines. It was found that the net impact of marine reserves was dependent on the pre-existing levels of disturbance (i.e. fishing pressure), and to a lesser extent on the size of the marine reserves. The high fishing scenario resulted in a strongly perturbed system, where the introduction of marine reserves had clear and mostly direct effects on biomass and functional biodiversity. However, under the lower fishing pressure scenario, the introduction of marine reserves caused both direct positive effects, mainly on shark groups, and indirect negative effects through trophic cascades. Our study illustrates the need to carefully align the design and implementation of marine reserves with policy and management objectives. Trade-offs may exist not only between fisheries and conservation objectives, but also among conservation objectives.

Savina, Marie; Condie, Scott A.; Fulton, Elizabeth A.

2013-01-01

112

The role of pre-existing disturbances in the effect of marine reserves on coastal ecosystems: a modelling approach.  

PubMed

We have used an end-to-end ecosystem model to explore responses over 30 years to coastal no-take reserves covering up to 6% of the fifty thousand square kilometres of continental shelf and slope off the coast of New South Wales (Australia). The model is based on the Atlantis framework, which includes a deterministic, spatially resolved three-dimensional biophysical model that tracks nutrient flows through key biological groups, as well as extraction by a range of fisheries. The model results support previous empirical studies in finding clear benefits of reserves to top predators such as sharks and rays throughout the region, while also showing how many of their major prey groups (including commercial species) experienced significant declines. It was found that the net impact of marine reserves was dependent on the pre-existing levels of disturbance (i.e. fishing pressure), and to a lesser extent on the size of the marine reserves. The high fishing scenario resulted in a strongly perturbed system, where the introduction of marine reserves had clear and mostly direct effects on biomass and functional biodiversity. However, under the lower fishing pressure scenario, the introduction of marine reserves caused both direct positive effects, mainly on shark groups, and indirect negative effects through trophic cascades. Our study illustrates the need to carefully align the design and implementation of marine reserves with policy and management objectives. Trade-offs may exist not only between fisheries and conservation objectives, but also among conservation objectives. PMID:23593432

Savina, Marie; Condie, Scott A; Fulton, Elizabeth A

2013-04-12

113

The impact of pre-existing memory on differentiation of newly recruited na?ve CD8 T cells1  

PubMed Central

One goal of immunization is to generate memory CD8 T cells of sufficient quality and quantity to confer protection against infection. It has been shown that memory CD8 T cell differentiation in vivo is controlled, at least in part, by the amount and duration of infection, antigen and inflammatory cytokines present early after the initiation of the response. Here, using models of anti-vectorial immunity we investigated the impact of pre-existing immunity on development and differentiation of vector-induced primary CD8 T cell responses. We show that existing CD8 T cell memory influences the magnitude of naïve CD8 T cell responses. However, the differentiation of newly recruited (either T-cell receptor transgenic or endogenous) primary CD8 T cells into populations with the phenotype (CD62Lhi, CD27hi, KLRG-1low) and function (tissue distribution, Ag-driven proliferation, cytokine production) of long-term memory was facilitated when they were primed in the presence of vector-specific memory CD8 T cells of the same or unrelated specificity. Therefore, these data suggest that the presence of anti-vectorial immunity impacts the rate of differentiation of vector-induced naïve CD8 T cells, a notion with important implications for the design of future vaccination strategies.

Martin, Matthew D.; Wirth, Thomas C.; Lauer, Peter; Harty, John T.; Badovinac, Vladimir P.

2011-01-01

114

Evaluation of accelerated stability test conditions for medicated chewing gums.  

PubMed

The overall stability of medicated chewing gums is investigated under different storage conditions. Active substances with different chemical stabilities in solid state are chosen as model drugs. The dosage form is a three layer tablet obtained by direct compression. The gum core contains the active ingredient while the external layers are formulated to prevent gum adhesion to the punches of the tableting machine. Two accelerated test conditions (40°C/75% RH and 30°C/65% RH) are performed for 6 months. Furthermore, a long-term stability test at room conditions is conducted to verify the predictability of the results obtained from the stress tests. Some drugs are stable in all the conditions tested, but other drugs, generally considered stable in solid dosage forms, have shown relevant stability problems particularly when stress test conditions are applied to this particular semi-solid dosage forms. For less stable drugs, the stress conditions of 40°C/75% RH are not always predictable of chewing gum stability at room temperature and may produce false negative; intermediate conditions, 30°C/65% RH, are more predictive for this purpose, the results of drug content found after 6 months at intermediate stress conditions and 12 months at room conditions are generally comparable. But the results obtained show that only long-term conditions stability tests gave consistent results. During aging, the semi solid nature of the gum base itself, may also influence the drug delivery rate during chewing and great attention should be given also to the dissolution stability. PMID:22794248

Maggi, Lauretta; Conte, Ubaldo; Nhamias, Alain; Grenier, Pascal; Vergnault, Guy

2012-07-16

115

Sleep and Culture in Children with Medical Conditions  

PubMed Central

Objectives?To provide an integrative review of the existing literature on the interrelationships among sleep, culture, and medical conditions in children.?Methods?A comprehensive literature search was conducted using PubMed, Medline, and PsychINFO computerized databases and bibliographies of relevant articles.?Results?Children with chronic illnesses experience more sleep problems than healthy children. Cultural beliefs and practices are likely to impact the sleep of children with chronic illnesses. Few studies have examined cultural factors affecting the relationship between sleep and illness, but existing evidence suggests the relationship between sleep and illness is exacerbated for diverse groups.?Conclusions?Sleep is of critical importance to children with chronic illnesses. Cultural factors can predispose children both to sleep problems and to certain medical conditions. Additional research is needed to address the limitations of the existing literature, and to develop culturally sensitive interventions to treat sleep problems in children with chronic illnesses.

Koinis-Mitchell, Daphne

2010-01-01

116

Sleep Problems in Children and Adolescents with Common Medical Conditions  

PubMed Central

Synopsis Sleep is critically important to children’s health and well-being. Untreated sleep disturbances and sleep disorders pose significant adverse daytime consequences and place children at considerable risk for poor health outcomes. Sleep disturbances occur at a greater frequency in children with acute and chronic medical conditions compared to otherwise healthy peers. Sleep disturbances in medically ill children can be associated with sleep disorders (e.g., sleep disordered breathing, restless leg syndrome), co-morbid with acute and chronic conditions (e.g., asthma, arthritis, cancer), or secondary to underlying disease-related mechanisms (e.g. airway restriction, inflammation) treatment regimens, or hospitalization. Clinical management should include a multidisciplinary approach with particular emphasis on routine, regular sleep assessments and prevention of daytime consequences and promotion of healthy sleep habits and health outcomes.

Lewandowski, Amy S.; Ward, Teresa M.; Palermo, Tonya M.

2011-01-01

117

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

ERIC Educational Resources Information Center

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

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

1998-01-01

118

Do patient age and medical condition influence medical advice to stop smoking?  

Microsoft Academic Search

Objective: to determine whether the age and medical condition of a patient influences hospital-based doctors' decision making when advising patients to stop smoking cigarettes. Methods: we presented 142 doctors from four grades (consultant, registrar, senior house officer and house officer) and four specialities (medicine, surgery, psychiatry and anaesthetics), based in a Dublin teaching hospital, with 20 clinical vignettes. Each vignette

CONOR P. M AGUIRE; J AMES RYAN; A LAN KELLY; D ESMOND; D AVIS COAKLEY; J. B ERNARD WALSH

2000-01-01

119

The effect of pre-existing affect on the sexual responses of women with and without a history of childhood sexual abuse.  

PubMed

Women with a history of childhood sexual abuse (CSA) are at greater risk for experiencing sexual problems in their adult lives. Yet, little is known about the possible role of cognitive and affective mechanisms in the development of sexual arousal difficulties in this population. This study investigated the role of pre-existing affect (affect prior to exposure to sexual stimuli) on genital responses, subjective sexual arousal, and affect elicited during the presentation of erotic film excerpts in a community sample of 25 women with and 25 women without a history of CSA. The CSA group showed greater pre-existing negative affect and smaller genital responses to the erotic film stimuli compared to the NSA group. Findings support a moderating effect of CSA, in that pre-existing negative affect was associated with strength of genital responses in the NSA but not in the CSA group. The results did not support a mediation model of pre-existing negative affect as an explanation for smaller physiological sexual responses in the CSA group. Taken together, the findings suggest that pre-existing affect may be more relevant for women with no history of CSA and call for more research on factors implicated in impaired sexual responses in women with a history of CSA. PMID:21667233

Rellini, Alessandra H; Elinson, Samantha; Janssen, Erick; Meston, Cindy M

2011-06-11

120

Pre-existing anticardiolipin antibodies and development of restenosis after coronary balloon angioplasty: predictive value for a complicated course?  

PubMed

Immune mechanisms play a critical role in cardiovascular disease. Cardiolipins are candidate autoantigens with a prothrombotic activity of their corresponding antibodies. We investigated the influence of pre-existing immunoglobulin (Ig)M and IgG anticardiolipin (aCL) antibodies on restenosis after coronary balloon angioplasty and their interaction with tissue plasminogen activator, plasminogen activator inhibitor type-1, von Willebrand factor and lipoprotein (a) in 132 patients with stable angina pectoris using immunoassays. Thirty percent of patients developed angiographically proven restenosis estimated by three independent experienced angiographers; 12% of all patients developed recurrent restenoses at the same site during a follow-up period of 2 years. Circulating IgM aCL antibodies categorized by quartiles predicted recurrent restenoses (logistic regression, for trend P < 0.04) with an increase of relative risk (RR) per quartile of 2.09. The predictive value of IgM aCL antibodies was unchanged adjusting for established cardiovascular risk factors (P = 0.028, RR = 2.69), extent of coronary artery disease (P = 0.014, RR = 2.73) and inflammatory parameters (P = 0.025, RR = 2.79), but lost significance adjusting for other prothrombotic parameters (P = 0.24, RR = 1.76). IgM aCL antibodies positively correlated with lipoprotein (a) (r = 0.23, P = 0.04). However, there was no significant interaction between their influences on recurrent restenoses. The other prothrombotic parameters did not predict single or recurrent restenoses. In conclusion, IgM aCL antibodies may help to identify a group of patients at high risk for recurrent restenoses after coronary balloon angioplasty. PMID:15166916

Niessner, Alexander; Hornykewycz, Stephan; Graf, Senta; Nikfardjam, Mariam; Speidl, Walter S; Probst, Peter; Zorn, Gerlinde; Maurer, Gerald; Wojta, Johann; Huber, Kurt

2004-06-01

121

Modification of Ad5 Hexon Hypervariable Regions Circumvents Pre-Existing Ad5 Neutralizing Antibodies and Induces Protective Immune Responses  

PubMed Central

The development of an effective malaria vaccine is a high global health priority. Vaccine vectors based on adenovirus type 5 are capable of generating robust and protective T cell and antibody responses in animal models and are currently being evaluated in clinical trials for HIV and malaria. They appear to be more effective in terms of inducing antigen-specific immune responses as compared with non-Ad5 serotype vectors. However, the high prevalence of neutralizing antibodies to Ad5 in the human population, particularly in the developing world, has the potential to limit the effectiveness of Ad5-based vaccines. We have generated novel Ad5-based vectors that precisely replace the hexon hypervariable regions with those derived from Ad43, a subgroup D serotype with low prevalence of neutralizing antibody in humans. We have demonstrated that these hexon-modified adenovectors are not neutralized efficiently by Ad5 neutralizing antibodies in vitro using sera from mice, rabbits and human volunteers. We have also generated hexon-modified adenovectors that express a rodent malaria parasite antigen, PyCSP, and demonstrated that they are as immunogenic as an unmodified vector. Furthermore, in contrast to the unmodified vector, the hexon-modified adenovectors induced robust T cell responses in mice with high levels of Ad5 neutralizing antibody. We also show that the hexon-modified vector can be combined with unmodified Ad5 vector in prime-boost regimens to induce protective responses in mice. Our data establish that these hexon-modified vectors are highly immunogenic even in the presence of pre-existing anti-adenovirus antibodies. These hexon-modified adenovectors may have advantages in sub-Saharan Africa where there is a high prevalence of Ad5 neutralizing antibody in the population.

Bruder, Joseph T.; Semenova, Elena; Chen, Ping; Limbach, Keith; Patterson, Noelle B.; Stefaniak, Maureen E.; Konovalova, Svetlana; Thomas, Charlie; Hamilton, Melissa; King, C. Richter; Richie, Thomas L.; Doolan, Denise L.

2012-01-01

122

Modification of Ad5 hexon hypervariable regions circumvents pre-existing Ad5 neutralizing antibodies and induces protective immune responses.  

PubMed

The development of an effective malaria vaccine is a high global health priority. Vaccine vectors based on adenovirus type 5 are capable of generating robust and protective T cell and antibody responses in animal models and are currently being evaluated in clinical trials for HIV and malaria. They appear to be more effective in terms of inducing antigen-specific immune responses as compared with non-Ad5 serotype vectors. However, the high prevalence of neutralizing antibodies to Ad5 in the human population, particularly in the developing world, has the potential to limit the effectiveness of Ad5-based vaccines. We have generated novel Ad5-based vectors that precisely replace the hexon hypervariable regions with those derived from Ad43, a subgroup D serotype with low prevalence of neutralizing antibody in humans. We have demonstrated that these hexon-modified adenovectors are not neutralized efficiently by Ad5 neutralizing antibodies in vitro using sera from mice, rabbits and human volunteers. We have also generated hexon-modified adenovectors that express a rodent malaria parasite antigen, PyCSP, and demonstrated that they are as immunogenic as an unmodified vector. Furthermore, in contrast to the unmodified vector, the hexon-modified adenovectors induced robust T cell responses in mice with high levels of Ad5 neutralizing antibody. We also show that the hexon-modified vector can be combined with unmodified Ad5 vector in prime-boost regimens to induce protective responses in mice. Our data establish that these hexon-modified vectors are highly immunogenic even in the presence of pre-existing anti-adenovirus antibodies. These hexon-modified adenovectors may have advantages in sub-Saharan Africa where there is a high prevalence of Ad5 neutralizing antibody in the population. PMID:22496772

Bruder, Joseph T; Semenova, Elena; Chen, Ping; Limbach, Keith; Patterson, Noelle B; Stefaniak, Maureen E; Konovalova, Svetlana; Thomas, Charlie; Hamilton, Melissa; King, C Richter; Richie, Thomas L; Doolan, Denise L

2012-04-05

123

42 CFR 494.150 - Condition: Responsibilities of the medical director.  

Code of Federal Regulations, 2010 CFR

...2009-10-01 false Condition: Responsibilities of the medical director...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...AND CERTIFICATION CONDITIONS FOR COVERAGE FOR...Administration § 494.150 Condition: Responsibilities of the medical...

2009-10-01

124

42 CFR 494.150 - Condition: Responsibilities of the medical director.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 false Condition: Responsibilities of the medical director...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...AND CERTIFICATION CONDITIONS FOR COVERAGE FOR...Administration § 494.150 Condition: Responsibilities of the medical...

2010-10-01

125

Variation in fracture patterns in damage zones related to strike-slip faults interfering with pre-existing fractures in sandstone (Calcione area, southern Tuscany, Italy)  

NASA Astrophysics Data System (ADS)

This paper deals with the effects of pre-existing fractures on the development of damage zones related to meter and decameter strike-slip faults, which affected Late Oligocene-Early Miocene sandstone in the Calcione area, southern Tuscany (Italy). Strike-slip faults dissected rock masses locally affected by pervasive, pre-existing fractures related to previous deformational events. Two different domains were identified: rock masses affected and unaffected (or relatively unaffected) by pre-existing fractures. Strike-slip faults affecting the two domains made it possible to compare the different configurations of fracture patterns related to isolated or interacting fault segments. New data is provided on scaling relations between: i) fault length and the length of related fractures; ii) mean step length and width for overstepping fault segments; iii) angular values at the intersection of the fault plane and related fractures. Scaling relations obeyed a positive power law for faults dissecting sandstone unaffected by pre-existing fractures. On the contrary, no scaling relations were recognized for faults dissecting sandstone affected by pre-existing fractures. The development of strike-slip faults on rock masses affected by pre-existing fractures can simulate splays apparently related to faulting. Three main points were categorized for detecting deceptive cases. There is a real chance of a deceptive fracture pattern if: i) the angular values at the intersection of the fault and its fractures (mode I opening fracture) exceed 50° in the wall damage zone; ii) the scaling relation between fault length and maximum fracture length does not fit a power law; iii) fractures acted as shear fractures. The resulting framework provides additional data for understanding the development and architecture of strike-slip faults.

Brogi, Andrea

2011-04-01

126

Prior Medical Conditions and Medication use and Risk of non-Hodgkin lymphoma in Connecticut United States Women  

Microsoft Academic Search

Objective: To further investigate the role of prior medical conditions and medication use in the etiology of non-Hodgkin lymphoma (NHL), we analyzed the data from a population-based case–control study of NHL in Connecticut women.

Yawei Zhang; Theodore R. Holford; Brian Leaderer; Shelia Hoar Zahm; Peter Boyle; Lindsay McOmber Morton; Bing Zhang; Kaiyong Zou; Stuart Flynn; Giovanni Tallini; Patricia H. Owens; Tongzhang Zheng

2004-01-01

127

Medical Conditions, Medication Use And Their Relationship With Subsequent Motor Vehicle Injuries: Examination Of The Canadian National Population Health Survey  

Microsoft Academic Search

Purpose: To examine the effects of various medical conditions and medications on subsequent motor vehicle injuries (MVIs).Method: The National Population Health Survey, a large, nationally representative, longitudinal study of Canadians, included self-reported medical conditions of asthma, arthritis\\/rheumatism, back problems excluding arthritis, high blood pressure, migraine headaches, diabetes, heart disease and distress and medication use during the past month for asthma,

Evelyn Vingilis; Piotr Wilk

2012-01-01

128

Medical Conditions, Medication Use, and Their Relationship With Subsequent Motor Vehicle Injuries: Examination of the Canadian National Population Health Survey  

Microsoft Academic Search

Purpose: To examine the effects of various medical conditions and medications on subsequent motor vehicle injuries (MVIs).Method: The National Population Health Survey, a large, nationally representative, longitudinal study of Canadians, included self-reported medical conditions of asthma, arthritis\\/rheumatism, back problems excluding arthritis, high blood pressure, migraine headaches, diabetes, heart disease and distress, and medication use during the past month for asthma,

Evelyn Vingilis; Piotr Wilk

2012-01-01

129

42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.  

Code of Federal Regulations, 2012 CFR

...2 2012-10-01 2012-10-01 false Medical and other health services: Basic conditions...HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.12...

2012-10-01

130

Pre-existing disease: the most important factor for health related quality of life long-term after critical illness: a prospective, longitudinal, multicentre trial  

Microsoft Academic Search

INTRODUCTION: The aim of the present multicenter study was to assess long term (36 months) health related quality of life in patients after critical illness, compare ICU survivors health related quality of life to that of the general population and examine the impact of pre-existing disease and factors related to ICU care on health related quality of life. METHODS: Prospective,

Lotti Orwelius; Anders Nordlund; Peter Nordlund; Eva Simonsson; Carl Bäckman; Anders Samuelsson; Folke Sjöberg

2010-01-01

131

National electricity planning in settings with low pre-existing grid coverage: Development of a spatial model and case study of Kenya  

Microsoft Academic Search

We develop a spatial electricity planning model to guide grid expansion in countries with low pre-existing electricity coverage. The model can be used to rapidly estimate connection costs and compare different regions and communities. Inputs that are modeled include electricity demand, costs, and geographic characteristics. The spatial nature of the model permits accurate representation of the existing electricity network and

Lily Parshall; Dana Pillai; Shashank Mohan; Aly Sanoh; Vijay Modi

2009-01-01

132

Framework for preventing accidental falls in hospitals - management plan for ADL, medication and medical conditions.  

PubMed

Prevention and reduction of medical accidents is essential. Among medical accidents, accidental falls remain a serious problem. While "assessment score sheets" have already been used in hospitals to prevent accidental falls, satisfactory results have not actually been achieved. In this study, we aim to establish a methodology for preventing accidental falls. We consider that the 'management plan' for each patient includes three factors. A plan of instructions for patients on actions they can take for safety in their ADL (Activities of Daily Living) is essential as a base. Second, a plan to keep up with any short term change in a patient's state is needed, because the state of a hospitalized patient will usually be temporarily affected by medication and changing medical conditions. We develop a model for preventing accidental falls, which enable us to design appropriate management plan for each patient. Then, we develop a prototype system based on the designed model. Finally, we address the result of verification of the model, by applying the prototype system into actual cases in hospitals. PMID:19592884

Kato, Shogo; Tsuru, Satoko; Iizuka, Yoshinori

2009-01-01

133

Lateral propagation of active normal faults throughout pre-existing fault zones: an example from the Southern Apennines, Italy  

NASA Astrophysics Data System (ADS)

The main active structures in the Southern Apennines are represented by a set of NW-trending normal faults, which are mainly located in the axial sector of the chain. Evidences arising from neotectonics and seismology show activity of a composite seismic source, the Irpinia - Agri Valley, located across the Campania-Basilicata border. This seismic source is made up of two right-stepping, individual seismic sources forming a relay ramp. Each individual seismic source consists of a series of nearly parallel normal fault segments. The relay ramp area, located around the Vietri di Potenza town, is bounded by two seismic segments, the San Gregorio Magno Fault, to the NW, and the Pergola-Melandro Fault, to the SE. The possible interaction between the two right-stepping fault segments has not been proven yet, since the fault system of the area has never been analyzed in detail. This work is aimed at assessing the geometry of such fault system, inferring the relative age of the different fault sets by studying the crosscutting relationships, characterizing the micromechanics of fault rocks associated to the various fault sets, and understanding the modalities of lateral propagation of the two bounding fault segments. Crosscutting relationships are recognized by combining classical geological mapping with morphotectonic methods. This latter approach, which include the analysis of aerial photographs and field inspection of quaternary slope deposits, is used to identify the most recent structures among those cropping out in the field area. In the relay ramp area, normal faults crosscut different tectonic units of the Apennine chain piled up, essentially, during the Middle to Late Miocene. The topmost unit (only few tens of meter-thick) consists of a mélange containing blocks of different lithologies in a clayish matrix. The intermediate thrust sheet consists of 1-1.5 km-thick platform carbonates of late Triassic-Jurassic age, with dolomites at the base and limestones at the top, unconformably covered by Miocene clastic deposits. The lower thrust sheet is made up of deep-sea deposits of late Triassic to Eocene age, which include pelagic limestones, radiolarites, marls and turbiditic calcarenites. The relay ramp area is comprised of two main fault sets, which are NW-trending (N120-140E) and NE-trending (N60-70E). Minor E-trending (N90-100E) and NNW-trending (N160-170E) faults are also present. Maximum throws of the most developed faults, which are also characterized by the longest traces, are in the order of 300-400 m. Crosscutting relationships and morphotectonic analyses generally show that the NW-trending faults are the most recent, as also shown by the involvement of Quaternary breccias and near surface fault rocks. Our data indicate that propagation of NW-trending normal faults in the relay ramp area took place thanks to the breaking of a pre-existing structural grain made up, mainly, of NE-trending normal faults. This process determined the different multi-scale properties to the two fault sets, and somehow inhibited the lateral growth of the NW-trending normal faults.

Agosta, Fabrizio; Prosser, Giacomo; Ivo Giano, Salvatore

2013-04-01

134

Multiple Chronic Medical Conditions and Associated Driving Risk: A Systematic Review  

Microsoft Academic Search

Background: Numerous medical conditions can affect one's ability to operate a motor vehicle. The likelihood of having multiple medical conditions increases with advancing age; however, the interplay of the associated impairments has not been previously addressed in the literature.Objective: To identify the incremental risks for the effects of multiple chronic medical conditions on driving ability and crash risk.Methods: A comprehensive

Shawn C. Marshall; Malcolm Man-Son-Hing

2011-01-01

135

Medical Conditions Associated with Out-of-Hospital Endotracheal Intubation  

PubMed Central

OBJECTIVE While prior studies describe the clinical presentation of patients requiring paramedic out-of-hospital endotracheal intubation (ETI), limited data characterize the underlying medical conditions or comorbidities. We sought to characterize the medical conditions and comorbidities of patients receiving successful paramedic out-of-hospital ETI. METHODS We used Pennsylvania statewide EMS clinical data, including all successful ETIs performed during 2003–2005. Using multiple imputation triple-match algorithms, we probabilistically linked EMS ETI to statewide death and hospital admission data. Each hospitalization record contained one primary and up to eight secondary diagnoses, classified according to the International Classification of Diseases, Clinical Modification, ninth edition (ICD-9-CM). We determined the proportion of patients in each major ICD-9-CM diagnostic group and subgroup. We calculated the Charlson Comorbidity Index for each patient. Using binomial proportions with confidence intervals, we analyzed the data and combined imputed results using Rubin's method. RESULTS Across the imputed sets, we linked 25,733 (77.7% linkage) successful ETI to death or hospital records; 56.3% died before and 43.7% survived to hospital admission. Of the 14,479 deaths before hospital admission, most (92.7%, 95% CI: 92.5–93.3%) presented to EMS in cardiac arrest. Of the 11,255 hospitalized patents, the leading primary diagnoses were circulatory diseases (32.0%, 30.2–33.7%), respiratory diseases (22.8%, 21.9–23.7%), and injury or poisoning (25.2%; 22.7–27.8%). Prominent primary diagnosis subgroups included: asphyxia and respiratory failure (15.2%), traumatic brain injury and skull fractures (11.3%), acute myocardial infarction and ischemic heart disease (10.9%), poisoning, drug and alcohol disorders (6.7%), dysrhythmias (6.7%), hemorrhagic and non-hemorrhagic stroke (5.9%), acute heart failure and cardiomyopathies (5.6%), pneumonia and aspiration (4.9%), and sepsis, septicemia and septic shock (3.2%). Most of the admitted ETI patients had a secondary circulatory (70.8%), respiratory (61.4%), or endocrine, nutritional or metabolic secondary diagnosis (51.4%). The mean Charlson Index score was 1.6 (95% CI: 1.5–1.7). CONCLUSIONS The majority of successful paramedic ETI occur on patients with cardiac arrest, circulatory and respiratory conditions. Injury, poisoning and other conditions compromise smaller but important portions. ETI patients have multiple comorbidities. These findings may guide the systemic planning of paramedic airway management care and education.

Wang, Henry E.; Balasubramani, G. K.; Cook, Lawrence J.; Yealy, Donald M.; Lave, Judith R.

2011-01-01

136

Medical Conditions in Patients with Pancreatic and Biliary Diseases (Validity and Agreement Between Data from Questionnaires and Medical Records)  

Microsoft Academic Search

The aims of the study were to assess theagreement between data from personal interviews andmedical records on selected medical conditions, toevaluate the validity of each source of information, andto estimate the prevalence of these conditions inpancreatobiliary pathology. Between 1992 and 1995, 602patients with pancreatobiliary diseases were included inthe PANKRAS II Study. Information from interview and medical records was available in

M. Soler; N. Malats; M. Porta; E. Fernandez; L. Guarner; A. Maguire; J. L. Pinol; J. Rifa; A. Carrato

1999-01-01

137

The Role of Pre-Existing Diabetes Mellitus on Hepatocellular Carcinoma Occurrence and Prognosis: A Meta-Analysis of Prospective Cohort Studies  

PubMed Central

Background The impact of pre-existing diabetes mellitus (DM) on hepatocellular carcinoma (HCC) occurrence and prognosis is complex and unclear. The aim of this meta-analysis is to evaluate the association between pre-existing diabetes mellitus and hepatocellular carcinoma occurrence and prognosis. Methods We searched PubMed, Embase and the Cochrane Library from their inception to January, 2011 for prospective epidemiological studies assessing the effect of pre-existing diabetes mellitus on hepatocellular carcinoma occurrence, mortality outcomes, cancer recurrence, and treatment-related complications. Study-specific risk estimates were combined by using fixed effect or random effect models. Results The database search generated a total of 28 prospective studies that met the inclusion criteria. Among these studies, 14 reported the risk of HCC incidence and 6 studies reported risk of HCC specific mortality. Six studies provided a total of 8 results for all-cause mortality in HCC patients. Four studies documented HCC recurrence risks and 2 studies reported risks for hepatic decomposition occurrence in HCC patients. Meta-analysis indicated that pre-existing diabetes mellitus (DM) was significantly associated with increased risk of HCC incidence [meta-relative risk (RR)?=?1.87, 95% confidence interval (CI): 1.15–2.27] and HCC-specific mortality (meta-RR?=?1.88, 95%CI: 1.39–2.55) compared with their non-DM counterparts. HCC patients with pre-existing DM had a 38% increased (95% CI: 1.13–1.48) risk of death from all-causes and 91% increased (95%CI: 1.41–2.57) risk of hepatic decomposition occurrence compared to those without DM. In DM patients, the meta-RR for HCC recurrence-free survival was 1.93(95%CI: 1.12–3.33) compared with non-diabetic patients. Conclusion The findings from the current meta-analysis suggest that DM may be both associated with elevated risks of both HCC incidence and mortality. Furthermore, HCC patients with pre-existing diabetes have a poorer prognosis relative to their non-diabetic counterparts.

Bray, Freddie; Gao, Shan; Gao, Jing; Li, Hong-Lan; Xiang, Yong-Bing

2011-01-01

138

28 CFR 79.26 - Proof of medical condition.  

Code of Federal Regulations, 2010 CFR

...or consultation report; or (E) Radiotherapy summary or consultation report; ...(C) Operative report; (D) Radiotherapy report; or (E) Medical oncology... (C) Operative report; (D) Radiotherapy report; or (E) Medical...

2010-07-01

139

28 CFR 79.26 - Proof of medical condition.  

Code of Federal Regulations, 2010 CFR

...or consultation report; or (E) Radiotherapy summary or consultation report; ...(C) Operative report; (D) Radiotherapy report; or (E) Medical oncology... (C) Operative report; (D) Radiotherapy report; or (E) Medical...

2009-07-01

140

14 CFR 67.313 - General medical condition.  

Code of Federal Regulations, 2013 CFR

...standards for a third-class airman medical certificate are: (a) No established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or...

2013-01-01

141

14 CFR 67.113 - General medical condition.  

Code of Federal Regulations, 2013 CFR

...standards for a first-class airman medical certificate are: (a) No established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or...

2013-01-01

142

14 CFR 67.213 - General medical condition.  

Code of Federal Regulations, 2013 CFR

...standards for a second-class airman medical certificate are: (a) No established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or...

2013-01-01

143

[Features of a cerebral hemodynamics at military men with initial exhibitings of cerebral circulation insufficiency of the pre-existing initial manifestations].  

PubMed

During the epidemiological survey of the military men of the Republic of Karelia with the pre-existing initial manifestations of cerebral circulation insufficiency were established it's main etiological reasons (somatoform autonomic dysfunction--35.2%, cervical osteochondrosis--34.3%) and risk factors (hereditary tainted cardiovascular event, north climate, stress, social habits, peculiarities of military service). Clinical characteristic of labile cerebrastenic syndrome and its peculiarities in compliance with etiological reasons of disease in the presence of autonomic disorders of suprasegmentary character and absence of significant nidal marks in neurological status was given. Complex program for expert diagnosis of the pre-existing initial manifestations of cerebral circulation insufficiency and methods of its propaganda (school, questionary, jotting) were developed and introduced into the practice of neurologist. PMID:20873190

Antonen, E G; Khianikia?nen, I V

2010-07-01

144

The influence of pre-existing structures on the evolution of the southern Kenya Rift Valley --- evidence from seismic and gravity studies  

Microsoft Academic Search

The Kenya Rift is an active continental rift that has developed since the Late Oligocene. Although a thermal origin for the rifting episode is indicated by the scale of volcanism and its relative timing with uplift and faulting, the influence of pre-existing lithospheric structural controls is poorly understood. The interpretation of a 430-km-long seismic refraction and gravity line across the

C. S. Birt; P. K. H. Maguire; M. A. Khan; H. Thybo; G. R. Keller; J. Patel

1997-01-01

145

The Effect of Pre-Existing Affect on the Sexual Responses of Women With and Without a History of Childhood Sexual Abuse  

Microsoft Academic Search

Women with a history of childhood sexual abuse (CSA) are at greater risk for experiencing sexual problems in their adult lives.\\u000a Yet, little is known about the possible role of cognitive and affective mechanisms in the development of sexual arousal difficulties\\u000a in this population. This study investigated the role of pre-existing affect (affect prior to exposure to sexual stimuli) on

Alessandra H. Rellini; Samantha Elinson; Erick Janssen; Cindy M. Meston

146

Modeling fault kinematics, segment interaction and transfer zone geometry as a function of pre-existing fabrics: the Albertine rift, East African Rift System.  

NASA Astrophysics Data System (ADS)

This study focuses on the development of the Rwenzori Mountains, an uplift horst block within the northern-most segment of the western branch of the East African Rift System (EARS). Attention is drawn to the role of pre-existing crustal weaknesses left behind by Proterozoic mobile belts that pass around cratonic Archean shields namely the Tanzanian Craton to the southeast and the Congo craton to the northwest. We study how the southward propagating sub-segment of the rift that contains Lake Albert to the north interacts with the northward propagating sub-segment that contains the lakes Edward and George and how this interaction produces the structural geometries observed within and around the Rwenzori horst block. Analogue experiments are used to simulate behavior of the upper crust with pre-cut rubber strips of varying overstep/overlap, placed oblique and/or orthogonal to the extension vector. The points of connection to the basal sheet present velocity discontinuities to localize deformation below the sand. Surface geometry of the developing rifts and section cuts are used to study the kinematics that result from the given boundary conditions. In general we try to model two parallel rifts that propagate towards each other and interact. Results show that greater overstep of rifts produces an oblique shear-dominated transfer zone with deep grabens (max.7.0km) in the adjoining segments. Smaller overlap ends in extension-dominated transfer, offset rift segments without oblique transfer faults to join two adjacent rift arms and produces moderately deep grabens (max.4.6km). When overlap doubles the overstep (SbR5), rifts propagate sub-orthogonal to the extension direction in a rotation-dominated transfer and form shallow valleys (max.2.9km). Whether a block like the Rwenzori Mountains is captured and rotates, depends on the overlap/overstep ratio where the rotation direction of a captured block is determined by the sense of overlap (right- or left-lateral). Fault orientation, fault kinematics and block rotation (once in play) re-enforce each other, and depending on the local kinematics different parts of a captured block can be rotated by different amounts but in the same general direction. The results are compared with the natural scenario. Keywords: Albertine rift; Analogue; Extension; Kinematics; Transfer zone

Aanyu, Kevin; Koehn, Daniel

2010-05-01

147

42 CFR 416.45 - Condition for coverage-Medical staff.  

Code of Federal Regulations, 2012 CFR

...2012-10-01 false Condition for coverage-Medical staff. 416.45 Section 416.45 Public Health...Coverage § 416.45 Condition for coverageâMedical staff. The medical staff of the ASC must be accountable to the...

2012-10-01

148

42 CFR 410.38 - Durable medical equipment: Scope and conditions.  

Code of Federal Regulations, 2010 CFR

...2009-10-01 2009-10-01 false Durable medical equipment: Scope and conditions...and Other Health Services § 410.38 Durable medical equipment: Scope and conditions...Part B pays for the rental or purchase of durable medical equipment, including...

2009-10-01

149

42 CFR 410.38 - Durable medical equipment: Scope and conditions.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 2010-10-01 false Durable medical equipment: Scope and conditions...and Other Health Services § 410.38 Durable medical equipment: Scope and conditions...Part B pays for the rental or purchase of durable medical equipment, including...

2010-10-01

150

The burden of influenza illness in children with asthma and other chronic medical conditions  

Microsoft Academic Search

Objective: Although influenza immunization is recommended for children with high-risk medical conditions, the majority of such children do not receive influenza vaccine. This study was designed to measure the burden of influenza among children with asthma and other chronic medical conditions. Study design: We performed a retrospective cohort study of children younger than 15 years with medically treated asthma or

Kathleen Maletic Neuzil; Peter F. Wright; Edward F. Mitchel; Marie R. Griffin

2000-01-01

151

Breast cancer risk in young women and history of selected medical conditions  

Microsoft Academic Search

Background Several common medical conditions are associated with altered hormone levels, and may thus plausibly influence breast cancer risk. Few studies have examined such relationships, and we utilized a population-based case-control study of young women in the US to examine breast cancer risk following a history of various medical conditions. Relationships between breast cancer and each medical con- dition examined

Helen A Weiss; Louise A Brinton; Nancy A Potischman; Donna Brogan; Ralph J Coates; Marilie D Gammon; Kathleen E Malonee; Janet B Schoenbergf

1999-01-01

152

Feasibility of Developing a Medical Condition Data Collection System for Driver Licensing.  

National Technical Information Service (NTIS)

The purpose of this project was to assess the feasibility of obtaining medical record data for particular medical conditions which could be linked to individuals' motor vehicle driving records. If this linkage could be achieved for sufficiently large sets...

T. J. Naughton J. Waller

1980-01-01

153

42 CFR 484.34 - Condition of participation: Medical social services.  

Code of Federal Regulations, 2010 CFR

...484.34 Condition of participation: Medical social services. If the agency furnishes medical social services, those services are given by a...qualified social worker or by a qualified social work assistant under the supervision of a...

2009-10-01

154

42 CFR 484.34 - Condition of participation: Medical social services.  

Code of Federal Regulations, 2010 CFR

...484.34 Condition of participation: Medical social services. If the agency furnishes medical social services, those services are given by a...qualified social worker or by a qualified social work assistant under the supervision of a...

2010-10-01

155

A Forecast of Events and Conditions That Might Affect Job and Training Requirements for Medical Librarians.  

National Technical Information Service (NTIS)

The Delphi method was used to obtain estimates from 15 experts in medical education and biomedical communications of events and conditions which might occur in the next 20 years in biocommunications, health care services, and medical education that would ...

C. D. Fink

1973-01-01

156

Interactions between x-ray induced transient defects and pre-existing damage precursors in DKDP crystals  

Microsoft Academic Search

Large-aperture laser systems, currently designed to achieve high energy densities at the target location (exceeding ~ 1011 J\\/m3), will enable studies of the physics of matter and radiation under extreme conditions. As a result, their optical components, such as the frequency conversion crystals (KDP\\/DKDP), may be exposed to X-rays and other ionizing radiation. This in turn may lead to a

R. A. Negres; C. K. Saw; S. G. Demos

2008-01-01

157

Legal framework conditions for the reprocessing of medical devices.  

PubMed

The processing of single-use products is permissible pursuant to medical device law. This is apparent both from the wording of the German Law on Medical Devices and from the purpose and the objectives underpinning the legislative materials. The prerequisite for processing is, however, compliance with the the Joint Recommendation of the Commission for Hospital Hygiene and the Prevention of Infection at the Robert Koch Institute (RKI) and the Federal Institute for Drugs and Medical Products (BfArM).For medical devices in the category "critical C", the RKI/BfArM-recommendation provides that the processor's quality management system must be certified by a body accredited by the Central Authority of the Federal States for Health Protection with regard to Medicinal Products and Medical Devices (Zentralstelle der Länder für Gesundheitsschutz bei Arzneimitteln und Medizinprodukten, ZLG). The certification must be carried out in accordance with EN ISO 13485:2003+AC:2007.On April 4, 2008 the Federal Health Ministry (Bundesministerium für Gesundheit, BMG) presented a progress report on the processing of medical devices. The BMG concludes that the legal framework for the processing of medical devices is sufficient, and that a prohibition on the processing of single-use products is inappropriate. PMID:20204096

Großkopf, Volker; Jäkel, Christian

2008-09-03

158

The influence of pre-existing diabetes mellitus on the host immune response and outcome of pneumonia: analysis of two multicenter cohort studies  

PubMed Central

Objective Although diabetes mellitus is implicated in susceptibility to infection, the association of diabetes with the subsequent course and outcome is unclear. Design and setting Retrospective analysis of two multicenter cohorts. We determined the association of pre-existing diabetes on the host immune response, acute organ function, and mortality in patients hospitalized with community-acquired pneumonia (CAP) in the GenIMS study (n=1895) and on mortality following either CAP or non-infectious hospitalizations in the population-based cohort study, Health ABC (n=1639). Measurements Mortality rate within first year, risk of organ dysfunction, and immune responses, including circulating inflammatory (tumor necrosis factor, interleukin-6, interleukin-10), coagulation (Factor IX, thrombin-antithrombin complexes, antithrombin), fibrinolysis (plasminogen-activator inhibitor-1, and D-dimer), and cell-surface markers (CD120a, CD120b, HLA-DR, TLR-2 and TLR-4). Results In GenIMS, diabetes increased mortality rate within first year after CAP (unadjusted hazard ratio [HR]=1.41, 95% confidence interval [CI]=1.12–1.76, p=0.002), even after adjusting for pre-existing cardiovascular and renal disease (adjusted HR=1.3, CI=1.03–1.65, p=0.02). In Health ABC, diabetes increased mortality rate within first year following CAP hospitalization, but not after hospitalization for non-infectious illnesses (significant interaction for diabetes and reason for hospitalization [p=0.04]; HR for diabetes on mortality over first year after CAP 1.87, CI=0.76–4.6, p=0.16 and after non-infectious hospitalization=1.16, CI=0.8–1.6, p=0.37). In GenIMS, immediate immune response was similar, as evidenced by similar circulating immune marker levels in the emergency department and during the first week. Those with diabetes had higher risk of acute kidney injury during hospitalization (39.3% vs. 31.7%, p=0.005) and they were more likely to die due to cardiovascular and kidney disease (34.4% vs. 26.8% and 10.4% vs. 4.5%, p=0.03). Conclusions Pre-existing diabetes was associated with a higher risk of death following CAP. The mechanism is not due to an altered immune response, at least as measured by a broad panel of circulating and cell surface markers, but may be due to worsening of pre-existing cardiovascular and kidney disease.

Yende, Sachin; van der Poll, Tom; Lee, MinJae; Huang, David T; Newman, Anne B; Kong, Lan; Kellum, John A; Harris, Tamara B; Bauer, Doug; Satterfield, Suzanne; Angus, Derek C

2012-01-01

159

The influence of pre-existing structures on the evolution of the southern Kenya Rift Valley - evidence from seismic and gravity studies  

Microsoft Academic Search

The Kenya Rift is an active continental rift that has developed since\\u000a the Late Oligocene. Although a thermal origin for the rifting episode is\\u000a indicated by the scale of volcanism and its relative timing with uplift\\u000a and faulting, the influence of pre-existing lithospheric structural\\u000a controls is poorly understood. The interpretation of a 430-km-long\\u000a seismic refraction and gravity line across the

C. S. Birt; P. K. H. Maguire; M. A. Khan; H. Thybo; G. R. Keller; J. Patel

1997-01-01

160

Relationship between Number of Medical Conditions and Quality of Care  

Microsoft Academic Search

We assessed measurements of the quality of medical care received in three cohorts of community-dwelling adult patients in the Community Quality Index study, the Assessing Care of Vulnerable Elders study, and the Veterans Health Administration project (7680 patients in total). We analyzed the relationship between the quality of care that patients received, defined as the percentage of quality indicators satisfied

Takahiro Higashi; Neil S. Wenger; John L. Adams; Constance Fung; Martin Roland; Elizabeth A. McGlynn; David Reeves; Steven M. Asch; Eve A. Kerr; Paul G. Shekelle

2010-01-01

161

Schoolchildren with Dysphagia Associated with Medically Complex Conditions  

ERIC Educational Resources Information Center

Purpose: This article reviews population trends and general characteristics of children with dysphagia in schools, provides an overview of dysphagia teams and the roles of the speech-language pathologist (SLP) in school and hospital settings, and describes assessment and treatment of swallowing and feeding problems in children with complex medical

Lefton-Greif, Maureen A.; Arvedson, Joan C.

2008-01-01

162

Schoolchildren With Dysphagia Associated With Medically Complex Conditions  

Microsoft Academic Search

Purpose: This article reviews population trends and general characteristics of children with dysphagia in schools, provides an overview of dysphagia teams and the roles of the speech-language pathologist (SLP) in school and hospital settings, and describes assessment and treatment of swallowing and feeding problems in children with complex medical histories. Method: A review of the literature of swallowing and feeding

Maureen A. Lefton-Greif; Joan C. Arvedson

2008-01-01

163

Cladodes, leaf-like organs in Asparagus, show the significance of co-option of pre-existing genetic regulatory circuit for morphological diversity of plants  

PubMed Central

Plants in the genus Asparagus have determinate leaf-like organs called cladodes in the position of leaf axils. Because of their leaf-like morphology, axillary position, and morphological variation, it has been unclear how this unusual organ has evolved and diversified. In the previous study, we have shown that cladodes in the genus Asparagus are modified axillary shoots and proposed a model that cladodes have arisen by co-option and deployment of genetic regulatory circuit (GRC) involved in leaf development. Moreover, we proposed that the alteration of the expression pattern of genes involved in establishment of adaxial/abaxial polarity has led to the morphological diversification from leaf-like to rod-like form of cladodes in the genus. Thus, these results indicated that the co-option and alteration of pre-existing GRC play an important role in acquisition and subsequent morphological diversification. Here, we present data of further expression analysis of A. asparagoides. The results suggested that only a part of the GRC involved in leaf development appears to have been co-opted into cladode development. Based on our study and several examples of the morphological diversification, we briefly discuss the importance of co-option of pre-existing GRC and its genetic modularity in the morphological diversity of plants during evolution.

Nakayama, Hokuto; Yamaguchi, Takahiro; Tsukaya, Hirokazu

2012-01-01

164

Medical conditions and the severity of commercial motor vehicle drivers' road accidents  

Microsoft Academic Search

In this research we studied the association between commercial motor vehicle drivers' medical conditions and crash severity. Some aspects of medical condition were considered. To our knowledge, no study has everisolated this association. The severity of a crash was measured by the total number of victims (injured and dead). We estimated nonlinear regression models (specifically, Poisson and negative binomial) which

Claire Laberge-Nadeau; Georges Dionne; Urs Maag; Denise Desjardins; Charles Vanasse; Jean-Marie Ékoé

1996-01-01

165

Physician Involvement in the Management of Obesity as a Primary Medical Condition  

Microsoft Academic Search

As the obesity epidemic escalates, increasing numbers of patients present with serious comorbidities related to excess body weight. Obesity should be recognized and treated as a primary medical condition that is progressive, chronic, and relapsing. Effective treatment of obesity has been shown to reduce cardiovascular risk factors and comorbid conditions. Physician involvement is necessary for medical assessment, management, counseling, and

James M. Rippe; Kyle J. McInnis; Kathleen J. Melanson

2001-01-01

166

Children with Chronic Medical Conditions: Recommendations for School Mental Health Clinicians  

Microsoft Academic Search

Children with chronic medical conditions are typically included in regular education settings. School mental health clinicians can play a key role in enhancing the social and cognitive development of these children. This manuscript presents a review of literature indicating ways to assist children with medical conditions in schools. Information about assessment, family-centered interventions, and school reintegration programs is reviewed. Additionally,

Laura A. Nabors; Heather D. Lehmkuhl

2004-01-01

167

Invasive pneumococcal infections among persons with and without underlying medical conditions: Implications for prevention strategies  

Microsoft Academic Search

BACKGROUND: The 23-valent pneumococcal polysaccharide vaccine (PPV23) is recommended for persons aged < 65 years with chronic medical conditions. We evaluated the risk and mortality from invasive pneumococcal disease (IPD) among persons with and without the underlying medical conditions which are considered PPV23 indications. METHODS: Population-based data on all episodes of IPD (positive blood or cerebrospinal fluid culture) reported by

Peter Klemets; Outi Lyytikäinen; Petri Ruutu; Jukka Ollgren; J Pekka Nuorti

2008-01-01

168

Reliability of data on medical conditions, menstrual and reproductive history provided by hospital controls  

Microsoft Academic Search

To assess the reliability of data on medical conditions, and menstrual or reproductive history, a sample of 294 controls interviewed in hospital between 1989 and 1992 for an Italian case–control study on digestive tract neoplasms was re-interviewed at home during 1993. A high agreement between responses at the two interviews (? ? 0.85) was observed for most medical conditions, including

Cristina Bosetti; Alessandra Tavani; Eva Negri; Dimitrios Trichopoulos; Carlo La Vecchia

2001-01-01

169

Systematic screening for unsafe driving due to medical conditions: Still debatable  

Microsoft Academic Search

BACKGROUND: Assessing people's ability to drive has become a public health concern in most industrialized countries. Although age itself is not a predictive factor of an increased risk for dangerous driving, the prevalence of medical conditions that may impair driving increases with age. Because the implementation of a screening for unsafe driving due to medical conditions is a public health

Sandy Leproust; Emmanuel Lagarde; L Rachid Salmi

2008-01-01

170

Adherence to Medication Regimens among Low-Income Patients with Multiple Comorbid Chronic Conditions  

PubMed Central

This qualitative study sought to explore facilitators and barriers to adherence to multiple medications among low-income patients with comorbid chronic physical and mental health conditions. The 50 focus group participants identified personal/contextual and health system factors as major impediments to adherence to multiple medications. These factors included medication side effects, fear of harm from medication, fear of dependence on medication, complex instructions, suboptimal communications with doctor, suspicion about doctors’ and pharmaceutical companies’ motives in prescribing medication, and the high cost of medications. Participants also identified motivators, both internal (self-initiated) and external (initiated by family, doctor, support groups), to ensure adherence to multiple medications. These motivators included self-discipline, sense of personal responsibility, faith, support from family members and doctors, and focused health education and self-management support. Three themes emerged that enhanced understanding of the complexity of adherence to multiple medications: (1) reaching one’s own threshold for medication adherence, (2) lack of shared information and decision making, and (3) taking less than the prescribed medication. Further analysis of the data revealed that the patients perceived a lack of shared decision making in the management of their comorbid chronic conditions and their medication regimen.

Gioia, Deborah; Childress, Saltanat; Barnet, Beth; Webster, Ramothea L.

2013-01-01

171

Patient Protection and Affordable Care Act: Enrollment and Spending in the Early Retiree Reinsurance and Pre-Existing Condition Insurance Plan Programs.  

National Technical Information Service (NTIS)

In March 2010, the Patient Protection and Affordable Care Act (PPACA) appropriated $5 billion each to establish and carry out two temporary programs--ERRP and PCIP. ERRP reimburses sponsors of employment-based health plans to help cover the cost of provid...

2013-01-01

172

28 CFR 79.16 - Proof of medical condition.  

Code of Federal Regulations, 2013 CFR

...Program to contact the appropriate state cancer or tumor registry. The Program will accept...condition verification from the state cancer or tumor registry that it possesses...appropriate authorities at the National Cancer Institute can make a diagnosis of...

2013-07-01

173

Hepatic abscess in a pre-existed simple hepatic cyst as a late complication of sigmoid colon ruptured diverticula: a case report  

PubMed Central

Introduction Hepatic abscesses have been reported as a rare complication of diverticulitis of the bowel. This complication is recognized more commonly at the time of the diagnosis of diverticulitis, or ruptured diverticula, but also can be diagnosed prior to surgery, or postoperatively. Case presentation This report describes a man who developed an hepatic abscess within a simple hepatic cyst, two months after operation for ruptured diverticula of the sigmoid colon. The abscess was drained surgically and the patient made a complete recovery. Conclusion The development of an hepatic abscess in a pre-existing hepatic cyst, secondary to diverticulitis, is a rare complication. A high degree of clinical suspicion is required for immediate diagnosis and treatment.

Chatzipetrou, Maria; Avgerinos, Efthimios; Christianakis, Efstratios; Barmparas, Galinos; Pashalidis, Nikolaos; Stathoulopoulos, Athanasios; Tsatsoulis, Panayiotis; Smailis, Dimitrios; Filippou, Dimitrios

2008-01-01

174

Fitness Conferred by BCR-ABL Kinase Domain Mutations Determines the Risk of Pre-Existing Resistance in Chronic Myeloid Leukemia  

PubMed Central

Chronic myeloid leukemia (CML) is the first human malignancy to be successfully treated with a small molecule inhibitor, imatinib, targeting a mutant oncoprotein (BCR-ABL). Despite its successes, acquired resistance to imatinib leads to reduced drug efficacy and frequent progression of disease. Understanding the characteristics of pre-existing resistant cells is important for evaluating the benefits of first-line combination therapy with second generation inhibitors. However, due to limitations of assay sensitivity, determining the existence and characteristics of resistant cell clones at the start of therapy is difficult. Here we combined a mathematical modeling approach using branching processes with experimental data on the fitness changes (i.e., changes in net reproductive rate) conferred by BCR-ABL kinase domain mutations to investigate the likelihood, composition, and diversity of pre-existing resistance. Furthermore, we studied the impact of these factors on the response to tyrosine kinase inhibitors. Our approach predicts that in most patients, there is at most one resistant clone present at the time of diagnosis of their disease. Interestingly, patients are no more likely to harbor the most aggressive, pan-resistant T315I mutation than any other resistance mutation; however, T315I cells on average establish larger-sized clones at the time of diagnosis. We established that for patients diagnosed late, the relative benefit of combination therapy over monotherapy with imatinib is significant, while this benefit is modest for patients with a typically early diagnosis time. These findings, after pre-clinical validation, will have implications for the clinical management of CML: we recommend that patients with advanced-phase disease be treated with combination therapy with at least two tyrosine kinase inhibitors.

Skaggs, Brian; Gorre, Mercedes; Sawyers, Charles L.; Michor, Franziska

2011-01-01

175

Bovine adenoviral vector-based H5N1 influenza vaccine overcomes exceptionally high levels of pre-existing immunity against human adenovirus.  

PubMed

Because of the high prevalence of adenovirus (Ad) infections in humans, it is believed that pre-existing Ad-neutralizing antibodies (vector immunity) may negatively impact the immune response to vaccine antigens when delivered by human Ad (HAd) vectors. In order to evaluate whether bovine Ad subtype 3 (BAd3), a non-HAd vector, can effectively elude high levels of pre-existing vector immunity, naïve and HAd serotype 5 (HAd)-primed mice were immunized with BAd-H5HA [BAd3 vector expressing the hemagglutinin (HA) gene from H5N1 influenza virus]. Even in the presence of very high levels of HAd-specific neutralizing antibody, no significant reductions in HA-specific humoral and cell-mediated immune (CMI) responses were observed in HAd-primed mice immunized with BAd-H5HA. In naïve mice immunized with HAd-H5HA (HAd5 vector expressing H5N1 HA) and boosted with BAd-H5HA, the humoral responses elicited were significantly higher (P < 0.01) than with either HAd-H5HA or BAd-H5HA alone, while the CMI responses were comparable in the groups. This finding underlines the importance of a heterologous prime-boost approach for achieving an enhanced immune response. The immunization of naïve or HAd-primed mice with BAd-H5HA bestowed full protection from morbidity and mortality following a potentially lethal challenge with A/Hong Kong/483/97. These results demonstrate the importance of BAd vectors as an alternate or supplement to HAd vectors for influenza pandemic preparedness. PMID:18301400

Singh, Neetu; Pandey, Aseem; Jayashankar, Lakshmi; Mittal, Suresh K

2008-02-26

176

Enhancing the performance of multi-crystalline silicon photovoltaic module by encapsulating high efficient Eu3+ complex into its pre-existing EVA layer  

NASA Astrophysics Data System (ADS)

Luminescent down shifting (LDS) technique is one effective way to improve the poor response of multi-crystalline silicon (mc-Si) photovoltaic (PV) modules at short wavelength less than 400 nm. Eu3+ complexes are effective LDS species for PV modules due to their large stokes' shift and high luminescent quantum efficiency (LQE). Although Eu3+ complexes have been utilized in PV modules as LDS species widely, they have not been encapsulated into the pre-existing poly-ethylene vinyl acetate (EVA) layer of modules between glass and solar cell by now. The aim of our work is to enhance the performance of mc-Si PV modules by encapsulating high efficient Eu3+ complexes into their pre-existing EVA layers which would not modify the well-established manufacturing process for PV modules. In this work, two Eu3+ complexes with different absorption spectrum were encapsulated into the commercial EVA layer by soaking method for the first time and used in the encapsulation of mc-Si PV modules. Hereinto, Eu(TTA)3(TPPO)2 (TTA = 2-thenoyltrifluoroacetonate, TPPO = triphenylphosphine oxide) (EuTT) with absorption spectrum less than 400 nm and high LQE (0.73) improves the external quantum efficiency of mc-Si PV module from 0.05 to 0.20, which produces a 0.42% increases in its power conversion efficiency. In addition, it is found that the enhancement brought by Eu(TTA)3(TPPO)2 can reduce cost of power generated by mc-Si devices from US$1/Wp to US$0.98/Wp according to the calculation. Therefore, Eu(TTA)3(TPPO)2 as LDS species with high LQE and low cost is promising for enhancing the performance of mc-Si PV modules in practical application.

Wang, Tongxin; Yu, Bo; Hu, Zhijia; Wang, Xin; Zou, Gang; Zhang, Qijin

2013-03-01

177

Ectopic Expression of Select Innexins in Individual Central Neurons Couples Them to Pre-Existing Neuronal or Glial Networks That Express the Same Innexin  

PubMed Central

Fifteen of the 21 innexin (Inx) genes (Hve-inx) found in the genome of the medicinal leech, Hirudo verbana, are expressed in the CNS (Kandarian et al., 2012). Two are expressed pan-neuronally, while the others are restricted in their expression to small numbers of cells, in some cases reflecting the membership of known networks of electrically coupled and dye-coupled neurons or glial cells. We report here that when Hve-inx genes characteristic of discrete coupled networks were expressed ectopically in neurons known not to express them, the experimental cells were found to become dye coupled with the other cells in that network. Hve-inx6 is normally expressed by only three neurons in each ganglion, which form strongly dye-coupled electrical connections with each other [Shortening-Coupling interneuron (S-CI) network] (Muller and Scott, 1981; Dykes and Macagno, 2006). But when Hve-inx6 was ectopically expressed in a variety of central embryonic neurons, those cells became dye coupled with the S-CI network. Similarly, Hve-inx2 is normally uniquely expressed by the ganglion's large glial cells, but when it was ectopically expressed in different central neurons, they became dye coupled to the glial cells. In contrast, overexpression of the pan-neuronal Inx genes Hve-inx1 and Hve-inx14 did not yield any novel instances of dye coupling to pre-existent neuronal networks. These results reveal that expression of certain innexins is sufficient to couple individual neurons to pre-existing networks in the CNS. We propose that a primary determinant of selective neuronal connectivity and circuit formation in the leech is the surface expression of unique subsets of gap junctional proteins.

Firme, Constantine P.; Natan, Ryan G.; Yazdani, Neema

2012-01-01

178

Vaccines expressing the innate immune modulator EAT-2 elicit potent effector memory T lymphocyte responses despite pre-existing vaccine immunity.  

PubMed

The mixed results from recent vaccine clinical trials targeting HIV-1 justify the need to enhance the potency of HIV-1 vaccine platforms in general. Use of first-generation recombinant adenovirus serotype 5 (rAd5) platforms failed to protect vaccinees from HIV-1 infection. One hypothesis is that the rAd5-based vaccine failed due to the presence of pre-existing Ad5 immunity in many vaccines. We recently confirmed that EAT-2-expressing rAd5 vectors uniquely activate the innate immune system and improve cellular immune responses against rAd5-expressed Ags, inclusive of HIV/Gag. In this study, we report that use of the rAd5-EAT-2 vaccine can also induce potent cellular immune responses to HIV-1 Ags despite the presence of Ad5-specific immunity. Compared to controls expressing a mutant SH2 domain form of EAT-2, Ad5 immune mice vaccinated with an rAd5-wild-type EAT-2 HIV/Gag-specific vaccine formulation significantly facilitated the induction of several arms of the innate immune system. These responses positively correlated with an improved ability of the vaccine to induce stronger effector memory T cell-biased, cellular immune responses to a coexpressed Ag despite pre-existing anti-Ad5 immunity. Moreover, inclusion of EAT-2 in the vaccine mixture improves the generation of polyfunctional cytolytic CD8(+) T cell responses as characterized by enhanced production of IFN-?, TNF-?, cytotoxic degranulation, and increased in vivo cytolytic activity. These data suggest a new approach whereby inclusion of EAT-2 expression in stringent human vaccination applications can provide a more effective vaccine against HIV-1 specifically in Ad5 immune subjects. PMID:22745373

Aldhamen, Yasser Ali; Seregin, Sergey S; Schuldt, Nathaniel J; Rastall, David P W; Liu, Chyong-Jy J; Godbehere, Sarah; Amalfitano, Andrea

2012-06-27

179

Ectopic expression of select innexins in individual central neurons couples them to pre-existing neuronal or glial networks that express the same innexin.  

PubMed

Fifteen of the 21 innexin (Inx) genes (Hve-inx) found in the genome of the medicinal leech, Hirudo verbana, are expressed in the CNS (Kandarian et al., 2012). Two are expressed pan-neuronally, while the others are restricted in their expression to small numbers of cells, in some cases reflecting the membership of known networks of electrically coupled and dye-coupled neurons or glial cells. We report here that when Hve-inx genes characteristic of discrete coupled networks were expressed ectopically in neurons known not to express them, the experimental cells were found to become dye coupled with the other cells in that network. Hve-inx6 is normally expressed by only three neurons in each ganglion, which form strongly dye-coupled electrical connections with each other [Shortening-Coupling interneuron (S-CI) network] (Muller and Scott, 1981; Dykes and Macagno, 2006). But when Hve-inx6 was ectopically expressed in a variety of central embryonic neurons, those cells became dye coupled with the S-CI network. Similarly, Hve-inx2 is normally uniquely expressed by the ganglion's large glial cells, but when it was ectopically expressed in different central neurons, they became dye coupled to the glial cells. In contrast, overexpression of the pan-neuronal Inx genes Hve-inx1 and Hve-inx14 did not yield any novel instances of dye coupling to pre-existent neuronal networks. These results reveal that expression of certain innexins is sufficient to couple individual neurons to pre-existing networks in the CNS. We propose that a primary determinant of selective neuronal connectivity and circuit formation in the leech is the surface expression of unique subsets of gap junctional proteins. PMID:23055495

Firme, Constantine P; Natan, Ryan G; Yazdani, Neema; Macagno, Eduardo R; Baker, Michael W

2012-10-10

180

Tests and Medical Conditions Associated with Dementia Diagnosis  

ERIC Educational Resources Information Center

|Diagnosis of dementia in adults with intellectual disabilities requires documentation of clinically significant declines in memory and other cognitive skills, as well as changes in everyday and emotional functioning. To improve diagnostic accuracy in adults with Down syndrome, the authors examined conditions often associated with dementia, as…

Burt, Diana B.; Primeaux-Hart, Sharon; Loveland, Katherine A.; Cleveland, Lynne A.; Lewis, Kay R.; Lesser, Jary; Pearson, Pamela L.

2005-01-01

181

28 CFR 79.26 - Proof of medical condition.  

Code of Federal Regulations, 2013 CFR

...section. (For claims relating to primary cancer of the liver, the claimant or eligible...Program to contact the appropriate state cancer or tumor registry. The Program will accept...condition verification from the state cancer or tumor registry that it...

2013-07-01

182

Evaluation of Two Relaxation Training Programs under Medication and No-Medication Conditions.  

ERIC Educational Resources Information Center

Evaluated two different taped relaxation training programs with 39 psychiatric inpatients, half of whom received minor tranquilizers in conjunction with relaxation training. The enhanced relaxation program produced slightly more therapeutic effects than the standard training program. Significant differences were found between the medicated and the…

Hoshmand, Lisa T.; And Others

1985-01-01

183

42 CFR 418.106 - Condition of participation: Drugs and biologicals, medical supplies, and durable medical equipment.  

Code of Federal Regulations, 2010 CFR

...and biologicals, medical supplies, and durable medical equipment. 418.106 Section...and biologicals, medical supplies, and durable medical equipment. Medical supplies...described in § 410.36 of this chapter; durable medical equipment, as described...

2010-10-01

184

42 CFR 418.106 - Condition of participation: Drugs and biologicals, medical supplies, and durable medical equipment.  

Code of Federal Regulations, 2010 CFR

...and biologicals, medical supplies, and durable medical equipment. 418.106 Section...and biologicals, medical supplies, and durable medical equipment. Medical supplies...described in § 410.36 of this chapter; durable medical equipment, as described...

2009-10-01

185

Adherence to Medication Regimens among Low-Income Patients with Multiple Comorbid Chronic Conditions  

ERIC Educational Resources Information Center

This qualitative study sought to explore facilitators and barriers to adherence to multiple medications among low-income patients with comorbid chronic physical and mental health conditions. The 50 focus group participants identified personal/contextual and health system factors as major impediments to adherence to multiple medications. These…

Mishra, Shiraz I.; Gioia, Deborah; Childress, Saltanat; Barnet, Beth; Webster, Ramothea L.

2011-01-01

186

Disclosure, confidentiality, and families: Experiences and attitudes of those with genetic versus nongenetic medical conditions  

Microsoft Academic Search

Despite policy attention to medical privacy and patient confidentiality, little empirical work exists documenting and comparing experiences of persons with genetic versus nongenetic medical conditions concerning persons' disclosure to others as well as their views about appropriate confidentiality to and within families. The goal of this cross-sectional interview study with nearly 600 participants was to document and compare the experiences,

Laura Plantinga; Marvin R. Natowicz; Nancy E. Kass; Sara Chandros Hull; Lawrence O. Gostin; Ruth R. Faden

2003-01-01

187

Adherence to Medication Regimens among Low-Income Patients with Multiple Comorbid Chronic Conditions  

ERIC Educational Resources Information Center

|This qualitative study sought to explore facilitators and barriers to adherence to multiple medications among low-income patients with comorbid chronic physical and mental health conditions. The 50 focus group participants identified personal/contextual and health system factors as major impediments to adherence to multiple medications. These…

Mishra, Shiraz I.; Gioia, Deborah; Childress, Saltanat; Barnet, Beth; Webster, Ramothea L.

2011-01-01

188

The Impact of Medical Conditions on the Support of Children with Profound Intellectual and Multiple Disabilities  

ERIC Educational Resources Information Center

Background: The aim of this study was to analyse the impact of medical conditions of children with profound intellectual and multiple disabilities on the professional support they receive in centres for special education. Method: The medical files, the daily records and daily communication records between parents and professionals were reviewed…

Zijlstra, H. P.; Vlaskamp, C.

2005-01-01

189

Depression Treatment in Patients With General Medical Conditions: Results From the CO-MED Trial  

PubMed Central

PURPOSE We studied the effect of 3 antidepressant treatments on outcomes (depressive severity, medication tolerability, and psychosocial functioning) in depressed patients having comorbid general medical conditions in the Combining Medications to Enhance Depression Outcomes (CO-MED) trial. METHODS Adult outpatients who had chronic and/or recurrent major depressive disorder (MDD) with and without general medical conditions were randomly assigned in 1:1:1 ratio to 28 weeks of single-blind, placebo-controlled antidepressant treatment with (1) escitalopram plus placebo, (2) bupropion-SR plus escitalopram, or (3) venlafaxine-XR plus mirtazapine. At weeks 12 and 28, we compared response and tolerability between participants with 0, 1, 2, and 3 or more general medical conditions. RESULTS Of the 665 evaluable patients, 49.5% reported having no treated general medical conditions, 23.8% reported having 1, 14.8% reported having 2, and 11.9% reported having at least 3. We found only minimal differences in antidepressant treatment response between these groups having different numbers of conditions; patients with 3 or more conditions reported higher rates of impairment in social and occupational functioning at week 12 but not at week 28. Additionally, we found no significant differences between the 3 antidepressant treatments across these groups. CONCLUSIONS Patients with general medical conditions can be safely and effectively treated for MDD with antidepressants with no additional adverse effect or tolerability burden relative to their counterparts without such conditions. Combination therapy is not associated with an increased treatment response beyond that found with traditional monotherapy in patients with MDD, regardless of the presence and number of general medical conditions.

Morris, David W.; Budhwar, Nitin; Husain, Mustafa; Wisniewski, Stephen R.; Kurian, Benji T.; Luther, James F.; Kerber, Kevin; Rush, A. John; Trivedi, Madhukar H.

2012-01-01

190

Cognitive impairment in common, noncentral nervous system medical conditions of adults and the elderly  

Microsoft Academic Search

Common, noncentral nervous system medical conditions linked with cognitive impairment in adults and the elderly include: acute respiratory distress syndrome; cancer; chronic kidney disease; chronic obstructive pulmonary disease; coronary heart disease; hypertension; obesity (bariatric surgical candidates); obstructive sleep apnea; and type 2 diabetes. Cross-condition comparison of the nature and frequency of cognitive impairment is difficult as these conditions often coexist,

Philip G. Gasquoine

2011-01-01

191

Chronic Medical Conditions among Jail Detainees in Residential Psychiatric Treatment: A Latent Class Analysis  

Microsoft Academic Search

Studies of incarcerates with serious mental illnesses have found elevated rates of chronic medical conditions such as asthma\\u000a and diabetes, and of infectious diseases such as tuberculosis compared with general population rates. This study explored\\u000a the pattern of chronic medical conditions in a sample of adult detainees in psychiatric treatment in a large urban jail to\\u000a develop a clinical profile

James A. Swartz

192

Patterns of Tobacco-Use Behavior Among Chinese Smokers with Medical Conditions  

Microsoft Academic Search

Understanding the characteristics of Chinese American smokers with medical conditions and factors associated with their tobacco-use\\u000a behaviors will guide effective cessation programs. In 2008, the authors described socio-demographic profiles of Chinese smokers\\u000a with medical conditions treated during the period 2002–2006, documented their tobacco-use behaviors (i.e., average daily cigarette\\u000a use, nicotine dependence, and number of past-year quit attempts), and drew comparisons

Candice C. Wong; Elisa K. Tong; Janice Y. Tsoh; Meng-Jinn Chen; Fred B. Hom

2009-01-01

193

Personalized management and comparison of medical condition and outcome based on profiles of community patients  

US Patent & Trademark Office Database

The invention can be directed toward a method for personalized management and comparison of medical condition and outcome based on patient profiles of a community of patients. The method can include the steps of providing a database of patient profiles, providing a user interface for inputting a query of the database from a user, generating a query result including one or more matching patient profiles from the database, and displaying the query result as a correlation medical condition parameters of the user with a medical outcome.

2012-04-17

194

Medical conditions affect the outcome of early intervention in preschool children with autism spectrum disorders.  

PubMed

The aim was to explore the frequency of genetic and other medical conditions, including epilepsy, in a population-based group of 208 preschool children with early diagnosis of Autism spectrum disorders (ASD) and to relate outcome at a 2-year follow-up to the co-existing medical findings. They had all received early intervention. The Vineland Adaptive Behaviour Scales (VABS-II) composite score served as the primary outcome measure. In the total group, 38/208 children (18 %) had a significant medical or genetic condition. Epilepsy was present in 6.3 % at the first assessment and in 8.6 % at follow-up and was associated with more severe intellectual impairment. A history of regression was reported in 22 %. Children with any medical/genetic condition, including epilepsy, as well as children with a history of regression had significantly lower VABS-II scores at the 2-year follow-up. Children with a medical/genetic condition, including epilepsy, had been diagnosed with ASD at an earlier age than those without such conditions, and early age at diagnosis also correlated negatively with adaptive functioning outcome. The results underscore the importance of considering medical/genetic aspects in all young children with ASD and the requirement to individualize and tailor interventions according to their specific needs. PMID:22836733

Eriksson, Mats Anders; Westerlund, Joakim; Hedvall, Åsa; Åmark, Per; Gillberg, Christopher; Fernell, Elisabeth

2012-07-27

195

If You Pop Over There: A Corpus-based Study of Conditionals in Medical Discourse.  

ERIC Educational Resources Information Center

Focuses on if conditionals in medical discourse. Three genres are examined: research articles, journal editorials, and doctor-patient consultations. Analyzes a variety of formal, semantic, and pragmatic aspects of conditionals across genres. Concludes with brief reflections on pedagogic implications. (Author/VWL)

Ferguson, Gibson

2001-01-01

196

Pneumococcal and influenza vaccination rates and their determinants in children with chronic medical conditions  

Microsoft Academic Search

BACKGROUND: To investigate the rates of pneumococcal and influenza vaccinations and their determinants in children with chronic medical conditions. PATIENTS AND METHODS: Children with HIV infection, cystic fibrosis, liver transplantation and diabetes mellitus were enrolled. Physicians of regional Reference Centres for each condition, primary care paediatricians and caregivers of children provided information through specific questionnaires. For diabetes, 3 Reference Centres

Antonietta Giannattasio; Veronica Squeglia; Andrea Lo Vecchio; Maria Teresa Russo; Alessandro Barbarino; Raffaella Carlomagno; Alfredo Guarino

2010-01-01

197

"If"-Conditionals in Medical Discourse: From Theory to Disciplinary Practice  

ERIC Educational Resources Information Center

"If"-conditionals are a highly valuable resource in academic discourses, whether spoken or written, as they can be used to hypothesize, hedge, manage interaction with the addressee, and promote or on the contrary circumscribe the scope of research claims. This article analyses how "if"-conditionals are brought into play in three genres of medical

Carter-Thomas, Shirley; Rowley-Jolivet, Elizabeth

2008-01-01

198

Factors associated with a patient-centered medical home among children with behavioral health conditions.  

PubMed

At some point in their lives, nearly one-half of all American children will have a behavioral health condition. Many will not receive the care they need from a fragmented health delivery system. The patient-centered medical home is a promising model to improve their care; however, little evidence exists. Our study aim was to examine the association between several behavioral health indicators and having a patient-centered medical home. 91,642 children's parents or guardians completed the 2007 National Survey of Children's Health. An indicator for patient-centered medical home was included in the dataset. Descriptive statistics, bivariate tests, and multivariate regression models were used in the analyses. Children in the sample were mostly Male (52 %), White (78 %), non-Hispanic (87 %), and did not have a special health care need (80 %). 6.2 % of the sample had at least one behavioral health condition. Conditions ranged from ADHD (6 %) to Autism Spectrum Disorder (ASD) (1 %). Frequency of having a patient-centered medical home also varied for children with a behavioral health condition (49 % of children with ADHD and 33 % of children with ASD). Frequency of having a patient-centered medical home decreased with multiple behavioral health conditions. Higher severity of depression, anxiety, and conduct disorder were associated with a decreased likelihood of a patient-centered medical home. Results from our study can be used to target patient-centered medical home interventions toward children with one or more behavioral health conditions and consider that children with depression, anxiety, and conduct disorder are more vulnerable to these disparities. PMID:23108741

Knapp, Caprice; Woodworth, Lindsey; Fernandez-Baca, Daniel; Baron-Lee, Jacqueline; Thompson, Lindsay; Hinojosa, Melanie

2013-11-01

199

Management of co-morbidities and general medical conditions in patients with rheumatoid arthritis  

Microsoft Academic Search

Rheumatologists, in addition to providing subspecialty care, are frequently called to treat general medical conditions in\\u000a their patients with rheumatoid arthritis (RA). Co-morbid medical problems are common in the RA population and may require\\u000a a different approach from standard practice recommendations. In this paper, we review the evaluation and treatment of cardiovascular\\u000a disease, chronic kidney disease, gastrointestinal disease, depression, and

Molly D. Magnano; Mark C. Genovese

2005-01-01

200

Active Medical Conditions Among Patients on an Assertive Community Treatment Team  

Microsoft Academic Search

The purpose of this cross-sectional study was to examine the number and type of active medical conditions among psychiatric\\u000a patients treated by an assertive community treatment (ACT) team in an urban setting. Psychiatric hospitalization admission\\u000a and discharge summaries of 70 patients were reviewed, and case managers on the treatment team were interviewed. Patients had\\u000a a median of three active medical

John W. Ceilley; Mario Cruz; Tim Denko

2006-01-01

201

Photosynthetic traits around budbreak in pre-existing needles of Sakhalin spruce (Picea glehnii) seedlings grown under elevated CO2 concentration assessed by chlorophyll fluorescence measurements.  

PubMed

To assess the effects of elevated CO(2) concentration ([CO(2)]) on the photosynthetic properties around spring budbreak, we monitored the total leaf sugar and starch content, and chlorophyll fluorescence in 1-year-old needles of Sakhalin spruce (Picea glehnii Masters) seedlings in relation to the timing of budbreak, grown in a phytotron under natural daylight at two [CO(2)] levels (ambient: 360??mol mol(-1) and elevated: 720??mol mol(-1)). Budbreak was accelerated by elevated [CO(2)] accompanied with earlier temporal declines in the quantum yield of PSII electron transport (?(PSII)) and photochemical quenching (q(L)). Plants grown under elevated [CO(2)] showed pre-budbreak leaf starch content twice as high with no significant difference in ?(PSII) from ambient-CO(2)-grown plants when compared at the same measurement [CO(2)], i.e., 360 or 720??mol mol(-1), suggesting that the enhanced pre-budbreak leaf starch accumulation might not cause down-regulation of photosynthesis in pre-existing needles under elevated [CO(2)]. Conversely, lower excitation pressure adjusted for the efficiency of PSII photochemistry ((1?-?q(P)) F(v)'/F(m)') was observed in plants grown under elevated [CO(2)] around budbreak when compared at their growth [CO(2)] (i.e., comparing (1?-?q(P)) F(v)'/F(m)' measured at 720??mol mol(-1) in elevated-CO(2)-grown plants with that at 360??mol mol(-1) in ambient-CO(2)-grown plants), which suggests lower rate of photoinactivation of PSII in the elevated-CO(2)-grown plants around spring budbreak. The degree of photoinhibition, as indicated by the overnight-dark-adapted F(v)/F(m), however, showed no difference between CO(2) treatments, thereby suggesting that photoprotection during the daytime or the repair of PSII at night was sufficient to alleviate differences in the rate of photoinactivation. PMID:22705862

Kitao, Mitsutoshi; Tobita, Hiroyuki; Utsugi, Hajime; Komatsu, Masabumi; Kitaoka, Satoshi; Maruyama, Yutaka; Koike, Takayoshi

2012-06-15

202

Impact of Pre-Existing Elastic Matrix on TGF-?1 and HA Oligomer-Induced Regenerative Repair by Rat Aortic Smooth Muscle Cells  

PubMed Central

Regenerating elastic matrices lost to disease (e.g. in aneurysms) is vital to re-establishing vascular homeostasis but is challenged by poor elastogenicity of post-neonatal cells. We previously showed exogenous hyaluronan oligomers (HA-o) and TGF-?1 to synergistically enhance tropo and matrix elastin deposition by healthy adult rat aortic SMCs (RASMCs). Towards treating aortic aneurysms (AAs), which exhibit cause- and site-specific heterogeneity in matrix content/structure and contain proteolytically-injured SMCs, we investigated impact of pre-existing elastic matrix degeneration on elastogenic induction of injured RASMCs. Elastin-rich RASMC layers at 21 days of culture, were treated with 0.15 U/ml (PPE15) and 0.75 U/ml (PPE75) of porcine pancreatic elastase to degrade the elastic matrix variably, or left uninjured (control). One set of cultures was harvested at 21d, before and after injury, to quantify viable cell count, matrix elastin loss. Other injured cell layers were cultured to 42d with or without factors (0.2 ?g/ml HA oligomers, 1 ng/ml TGF-?1). We showed that (a)ability of cultures to self-repair and regenerate elastic matrices following proteolysis is limited when elastolysis is severe, (b)HA oligomers and TGF-?1 elastogenically stimulate RASMCs in mildly-injured (i.e., PPE15) cultures to restore both elastic matrix amounts and elastic-fiber deposition to levels in healthy cultures, and (c) in severely injured (i.e., PPE75) cultures, the factors stimulate matrix elastin synthesis and crosslinking, though not to control levels. The outcomes underscore need to enhance elastogenic factor doses based on severity of elastin loss. This study will help customize therapies for elastin regeneration within AAs based on cause and location.

Gacchina, Carmen E.; Ramamurthi, Anand

2010-01-01

203

Problematic versus non-problematic ecstasy/MDMA use: the influence of drug usage patterns and pre-existing psychiatric factors.  

PubMed

Recreational ecstasy (3,4-methylenedioxymethamphetamine; MDMA) use has been increasingly associated with a number of psychiatric symptoms and psychological problems. However, previous studies assessing possible psychopathological effects have not identified whether users consider their ecstasy use "problematic" or not. In addition, research has generally failed to address the potential role of premorbid psychiatric status. This study aimed to assess whether premorbid psychiatric history and/or patterns of ecstasy use would be associated with the degree of self-reported problems attributable to ecstasy. Problematic ecstasy users (n = 53) who had reported problems attributable to their ecstasy use were compared with non-problematic ecstasy users (n = 62), polydrug controls (n = 62) and illegal drug-naive controls (n = 111) on a recreational drug use questionnaire; a questionnaire, which ascertained personal and family psychiatric histories, and the Brief Symptom Inventory (BSI). Problematic ecstasy users exhibited significantly higher scores on a number of dimensions of the BSI compared to illegal drug-naive and/or polydrug controls. Problematic ecstasy users also exhibited significantly elevated scores on somatization, depression, anxiety and negative psychobiology compared to non-problematic ecstasy users. BSI scores for the non-problematic ecstasy users did not differ from polydrug or illegal drug-naive controls. Problematic ecstasy users reported significantly higher levels of ecstasy use, including lifetime consumption, average dosage and binge consumption compared to non-problematic ecstasy users. Additionally, a greater number of problematic ecstasy users reported personal and family psychiatric histories compared to controls and non-problematic ecstasy users. This study demonstrates two distinct ecstasy using groups: non-problematic ecstasy users who are not showing signs of psychopathology and problematic ecstasy users who are showing evidence of a range of symptoms. This data therefore partially supports the link between ecstasy dosage and negative psychological sequelae, but highlights the importance of the need to consider ecstasy-related attributions, pre-existing mental health status and vulnerability. PMID:16574716

Soar, K; Turner, J J D; Parrott, A C

2006-05-01

204

Vaccines for persons at high risk due to medical conditions, occupation, environment, or lifestyle, 2003.  

PubMed

The safety and efficacy of current vaccines are reviewed for high-risk populations, such as those with underlying medical conditions or occupational or lifestyle circumstances. The morbidity and mortality from vaccine-preventable diseases are high among persons with underlying medical conditions; thus, influenza and pneumococcal polysaccharide vaccines are recommended for those with cardiac disease, diabetes mellitus, or chronic obstructive pulmonary disease. For the same reasons, influenza vaccine is recommended for pregnant women and for persons with asthma. Health-care workers are at risk for acquiring and transmitting hepatitis B, measles, and influenza; hence, vaccination against these diseases is recommended. PMID:12556276

Zimmerman, Richard Kent; Middleton, Donald B; Smith, Natalie J

2003-01-01

205

Relations of income inequality and family income to chronic medical conditions and mental health disorders  

Microsoft Academic Search

Abstract Objectives To analyse the relation between geographical,inequalities in income,and the prevalence,of common,chronic,medical,conditions and mental health disorders, and to compare it with the relation between,family income,and these health problems. Design Nationally representative,household telephone,survey conducted,in 1997›8. Setting 60 metropolitan,areas or economic,areas of the United States. Participants 9585 adults who,participated,in the community,tracking study. Main outcome measures Self report of 17 common chronic,medical,conditions;

Roland Sturm; Carole Roan Gresenz

206

Temporary Increases in Problem Behavior and Sleep Disruption Following Decreases in Medication: A Descriptive Analysis of Conditional Rates  

ERIC Educational Resources Information Center

Conditional rates of problem behavior for weeks that followed medication decreases and no medication changes were compared for 12 individuals who exhibited severe problem behavior (e.g., self-injury, aggression). The results indicate that conditional rates of problem behavior were higher following medication decreases than following no changes in…

Rapp, John T.; Swanson, Greg; Dornbusch, Kaitlin

2007-01-01

207

Medical Conditions and Symptoms Associated with Posttraumatic Stress Disorder in Low-Income Urban Women  

PubMed Central

Abstract Background Epidemiological studies have consistently reported rates of posttraumatic stress disorder (PTSD) in women that are twice that of men. In men and women, PTSD has been associated with comorbid medical conditions, medical symptoms and lower self-rating of health. In low-income urban women, rates of PTSD are even more elevated than in suburban women and may be related to observed health disparities. Methods In this study, 250 women seeking healthcare at an urban clinic were interviewed for a PTSD diagnosis, major depressive disorder (MDD), the experience of traumatic events, the experience of current and past common medical conditions and symptoms, and subjective rating of health. A chart review was used to assess healthcare use in the past year. Results More current (5.2 vs. 3.8, p?medical conditions (4.6 vs. 3.3, p?medical care to women.

Szanton, S.; Taylor, T.J.; Page, G.G; Campbell, J.C.

2009-01-01

208

Direct Medical Costs Attributable to Acute Myocardial Infarction and Ischemic Stroke in Cohorts with Atherosclerotic Conditions  

Microsoft Academic Search

Background: The cost of acute ischemic events in persons with established atherosclerotic conditions is unknown. Methods: The direct medical costs attributable to secondary acute myocardial infarction (AMI) or ischemic stroke among persons with established atherosclerotic conditions were estimated from 1995–1998 data on 1,143 patients enrolled in US managed care plans. Results: The average 180-day costs attributable to secondary AMI or

Elizabeth M. Sloss; Steven L. Wickstrom; Daniel F. McCaffrey; Steven Garber; Thomas S. Rector; Regina A. Levin; Peter M. Guzy; Philip B. Gorelick; Michael D. Dake; Barbara G. Vickrey

2004-01-01

209

The Value of Stress-Management Interventions in Life-Threatening Medical Conditions  

Microsoft Academic Search

Emotional stress has been associated with the development and progression of several chronic medical conditions. Recently, researchers have assessed the impact of stress-management interventions on patients' psychological functioning, quality of life, and various disease outcomes, including survival. This review summarizes the value of stress-management techniques in the treatment of two important, life-threatening conditions: coronary heart disease and cancer. Results from

Robyn Lewis Claar; James A. Blumenthal

2003-01-01

210

Coping and Depressive Symptoms in Adolescents with a Chronic Medical Condition: A Search for Intervention Targets  

ERIC Educational Resources Information Center

|The aim of the present study was to find relevant coping factors for the development of psychological intervention programs for adolescents with a chronic medical condition. A wide range of coping techniques were studied, including cognitive coping, behavioral coping and goal adjustment coping. A total of 176 adolescents participated. They were…

Kraaij, Vivian; Garnefski, Nadia

2012-01-01

211

Coping and Depressive Symptoms in Adolescents with a Chronic Medical Condition: A Search for Intervention Targets  

ERIC Educational Resources Information Center

The aim of the present study was to find relevant coping factors for the development of psychological intervention programs for adolescents with a chronic medical condition. A wide range of coping techniques were studied, including cognitive coping, behavioral coping and goal adjustment coping. A total of 176 adolescents participated. They were…

Kraaij, Vivian; Garnefski, Nadia

2012-01-01

212

Excluding medical and haematological conditions as a cause of bruising in suspected non-accidental injury  

Microsoft Academic Search

A mistaken diagnosis of child abuse can occur in a number of medical conditions, many of which can be readily diagnosed by experienced paediatricians. Bleeding disorders offer a greater challenge, especially when court proceedings may demand their exclusion. Some of these disorders are rare but more prevalent in areas which have a high incidence of consanguinity. We advocate two stages

A M B Minford; E M Richards

2010-01-01

213

Hospital Competition, Managed Care and Mortality After Hospitalization for Medical Conditions: Evidence From Three States  

Microsoft Academic Search

This study assessed the effect of hospital competition and HMO penetration on mortality after hospitalization for six medical conditions in California, New York, and Wisconsin. We used linked hospital discharge and vital statistics data to study adults hospitalized for myocardial infarction, hip fracture, stroke, gastrointestinal hemorrhage, congestive heart failure, or diabetes. We estimated logistic regression models with death within 30

José J. Escarce; Arvind K. Jain; Jeannette Rogowski

2006-01-01

214

The effect of medical conditions on the functional limitations of Mexican-American elderly  

Microsoft Academic Search

We examined the relationship of self-reported functional status to common medical conditions using a probability sample of 3050 noninstitutionalized Mexican-American men and women aged 65 or older and residing in the Southwestern United States (Arizona, California, Colorado, New Mexico, and Texas). All subjects were interviewed in person (n = 2,873) or by proxy (n = 177) in their homes during

Kyriakos S. Markides; Christine A. Stroup-Benham; James S. Goodwin; Linda C. Perkowski; Michael Lichtenstein; Laura A. Ray

1996-01-01

215

Academic and Family Conditions Associated with Intrinsic Academic Motivation in Japanese Medical Students: A Pilot Study  

ERIC Educational Resources Information Center

|Objective: Intrinsic academic motivation is one of the most important psychological concepts in education, and it is related to academic outcomes in medical students. This study examined the relationships between academic and family conditions and intrinsic academic motivation. Design: Cross-sectional design. Setting: The study group consisted of…

Tanaka, Masaaki; Watanabea, Yasuyoshi

2012-01-01

216

Uterine fibroids risk and history of selected medical conditions linked with female hormones  

Microsoft Academic Search

To understand the role of several medical conditions on the risk of uterine fibroids, we analysed the findings of a large case–control study. Cases were 843 women aged 54 or less (median age 43 years, range 21–54) with histologically confirmed uterine fibroids, whose clinical diagnosis dated back no more than 2 years. Indications for surgery were recurrent menorrhagia or ultrasound

Fabio Parazzini; Francesca Chiaffarino; Giampiero Polverino; Vito Chiantera; Matteo Surace; Carlo La Vecchia

2004-01-01

217

New Strategies in the Assessment of Psychological Factors Affecting Medical Conditions  

Microsoft Academic Search

In this article, we examine research that may lead to a better assessment of psychological factors affecting medical conditions. We performed a review of the psychosomatic literature using both Medline and manual searches. We selected papers that were judged to be relevant to new strategies of assessment, with particular reference to the use of the Diagnostic Criteria for Psychosomatic Research.

Laura Sirri; Stefania Fabbri; Giovanni A. Fava; Nicoletta Sonino

2007-01-01

218

Missed Opportunities for Influenza Vaccination in Children With Chronic Medical Conditions  

Microsoft Academic Search

Objectives: To assess the frequency and characteris- tics of missed opportunities for influenza immunization in children with chronic medical conditions and, among unimmunized children in that group, to explore parent- reported reasons for not vaccinating their child. Design: Prospective cohort study. Data were obtained from billing and immunization registry databases and tele- phone interviews of parents. Setting: Four pediatric practices

Matthew F. Daley; Brenda L. Beaty; Jennifer Barrow; Kellyn Pearson; Lori A. Crane; Stephen Berman; Allison Kempe

2005-01-01

219

Vaccines for persons at high risk due to medical conditions, occupation, environment, or lifestyle, 2005  

Microsoft Academic Search

The rates of morbidity and mortality due to influenza and pneumococcal diseases are high among persons with underlying medical conditions; thus, influenza and pneu- mococcal polysaccharide vaccines are recommended for those with cardiac disease, diabetes mellitus, chronic obstructive pulmonary disease, and other chronic illnesses. For the same reasons, influenza vaccine is recommended for pregnant women and for persons with asthma.

RICHARD KENT ZIMMERMAN; DONALD B. MIDDLETON

2005-01-01

220

Epidemiology of Autism Spectrum Disorder in Portugal: Prevalence, Clinical Characterization, and Medical Conditions  

ERIC Educational Resources Information Center

The objective of this study was to estimate the prevalence of autistic spectrum disorder (ASD) and identify its clinical characterization, and medical conditions in a paediatric population in Portugal. A school survey was conducted in elementary schools, targeting 332 808 school-aged children in the mainland and 10 910 in the Azores islands.…

Oliveira, Guiomar; Ataide, Assuncao; Marques, Carla; Miguel, Teresa S.; Coutinho, Ana Margarida; Mota-Vieira, Luisa; Goncalves, Esmeralda; Lopes, Nazare Mendes; Rodrigues, Vitor; Carmona da Mota, Henrique; Vicente, Astrid Moura

2007-01-01

221

Short report chronic medical conditions and life satisfaction in the elderly  

Microsoft Academic Search

The aim of this study was to examine the effect of chronic disease on life satisfaction in community dwelling elderly. A total of 5279 research participants, mean age 69.57 (SD = 8.04) yrs. were asked to judge their life satisfaction on the Seven Point Satisfaction Rating Scale. They were also administered a checklist of 18 chronic medical conditions. The results

Marko Jelicic; Gertrudis I. J. M. Kempen

1999-01-01

222

The [ldquo ]prudent layperson[rdquo ] definition of an emergency medical condition  

Microsoft Academic Search

The study objectives, based on federal and state legislative language, were to objectively define symptoms and signs commonly agreed on by [ldquo ]prudent laypersons[rdquo ] as [ldquo ]emergency medical conditions.[rdquo ] After comprehensive tabulation of symptom classifications from the International Classification of Diseases (ICD-9), we performed a survey of nonmedical laypersons. Data analysis included descriptive statistics, proportional calculations, and 95%

James Li; Hannah K. Galvin; Sandra C. Johnson

2002-01-01

223

Effect of Late-Preterm Birth and Maternal Medical Conditions on Newborn Morbidity Risk  

Microsoft Academic Search

OBJECTIVES. Late-preterm infants (34 -36 weeks' gestation) account for nearly three quarters of all preterm births in the United States, yet little is known about their morbidity risk. We compared late-preterm and term (37- 41 weeks' gestation) infants with and without selected maternal medical conditions and assessed the independent and joint effects of these exposures on newborn morbidity risk. METHODS.

Carrie K. Shapiro-Mendoza; Kay M. Tomashek; Milton Kotelchuck; Wanda Barfield; Angela Nannini; Judith Weiss; Eugene Declercq

2010-01-01

224

Ovarian cancer risk and history of selected medical conditions linked with female hormones  

Microsoft Academic Search

To investigate the role of selected medical conditions on the risk of ovarian cancer, we analysed data from a case-control study. Cases were 971 women below the age of 75 years with histologically confirmed epithelial ovarian cancer, admitted to a network of hospitals including the major teaching and general hospitals in the greater Milan area. Controls were 2758 women admitted

F. Parazzini; S. Moroni; C. La Vecchia; E. Negri; D. dal Pino; G. Bolis

1997-01-01

225

Development of Acoustic Instruments for Diagnosis and Management of Medical Conditions  

Microsoft Academic Search

Computerized analysis of lung sounds can play a very important role in management of patients with a variety of medical conditions, particularly those who are seriously ill. While single-channel devices can play an important role in making auscultation more objective, multi-channel instruments greatly improve the efficiency of data collection. This has a particular advantage in the rapid assessments of patients

RAYMOND MURPHY

2007-01-01

226

Recognition of co-occurring medical conditions among patients with serious mental illness.  

PubMed

We determined whether patients with serious mental illness (SMI) were less likely than non-SMI to self-report having a medical condition that was recorded in their medical record. We included all patients from the VA National Psychosis Registry diagnosed with SMI and a random sample of non-SMI patients in fiscal year 1999 who completed the Large Health Survey of Veteran Enrollees (N = 35,837). Among patients with diagnoses for any of 11 conditions recorded in administrative data, we evaluated whether patients reported having that same condition in the survey, using multivariable logistic regression and generalized estimating equations. Among patients diagnosed with a given condition, those with SMI were less likely to report being told by providers that they had seven of the 11 conditions examined: heart disease (OR = 0.68, p < 0.001), arthritis (OR = 0.79, p < 0.001), cancer (OR = 0.69, p < 0.001), diabetes (OR = 0.79, p < 0.001), back pain (OR = 0.81, p < 0.001), congestive heart failure (OR = 0.71, p < 0.001), and hypertension (OR = 0.77, p < 0.001). Patients with SMI were less aware of co-occurring medical conditions. PMID:16909068

Kilbourne, Amy M; McCarthy, John F; Welsh, Deborah; Blow, Frederic

2006-08-01

227

MANAGEMENT OF ACUTE SPORTS INJURIES AND MEDICAL CONDITIONS BY PHYSICAL THERAPISTS: ASSESSMENT VIA CASE SCENARIOS  

PubMed Central

Purpose/Background: Some physical therapists (PTs) provide services at sporting events, but there are limited studies investigating whether PTs are properly prepared to provide such services. The purpose of this study was to assess acute sports injury and medical condition management decision-making skills of PTs. Methods: A Web-based survey presented 17 case scenarios related to acute medical conditions and sport injuries. PTs from the Sports Physical Therapy Section of The American Physical Therapy Association were e-mailed a cover letter/Web link to the survey and invited to participate over a 30-day period. Data were analyzed using SPSS 18.0. Results: A total of 411 of 5158 PTs who were members of the Sports Physical Therapy Association in 2009 and had valid e-mail addresses completed the survey, of which 389 (7.5%) were appropriate for analysis. Over 75.0% of respondents felt “prepared” or “somewhat prepared” to provide immediate care for 13 out of 16 medical conditions, with seizures, spinal cord injuries, and internal organ injuries having the lowest percentages. Over 75.0% of the respondents made “appropriate” or “overly cautious” decisions for 11 of the 17 acute injury or medical condition cases. Conclusions: Results of the current study indicate that PTs felt more “prepared” and tended to make “appropriate” return to play decisions on the acute sports injury and medical condition case studies more often than coaches who participated in a similar study, regardless of level of importance of the game or whether the athlete was a starter vs. non-starter. However, for PTs who plan on assisting at sporting events, additional preparation/education may be recommended, such as what is taught in an emergency responder course.

Karges, Joy Renae; Salsbery, Mitchell A.; Smith, Danna; Stanley, Erica J.

2011-01-01

228

CHRONIC MEDICAL CONDITIONS AND REPRODUCIBILITY OF SELF-REPORTED AGE AT MENOPAUSE AMONG COMMUNITY DWELLING WOMEN  

PubMed Central

OBJECTIVE To examine the association between chronic medical conditions and reproducibility of self-reported age at menopause among community-dwelling women. METHOD Age at menopause was assessed in a population-based longitudinal survey of 240 women twice, in 1993 and 2004. Women who recalled age at menopause in 2004 within one year or less of the age at menopause recalled in 1993 (concordant) were compared with women who did not recall of age at menopause in 2004 within 1 year of age at menopause recalled in 1993 (discordant). Type of menopause (surgical or natural) and chronic medical conditions were assessed by self-report. RESULTS One hundred and forty three women (59.6%) reported surgical menopause and 97 (40.4%) reported natural menopause. In all, 130 (54.2%) of women recalled age at menopause in 2004 within one year or less of recalled age at menopause in 1994 while 110 (45.8%) women did not recall age at menopause in 2004 within one year or less of recalled age at menopause in 1994. Among women with surgical menopause, women with three or more medical conditions were less likely to have concordant recall of age at menopause than women with less than three chronic medical conditions (adjusted odds ratio (OR) = 0.36, 95% confidence interval (CI) [0.15, 0.91]) in multivariate models controlling for potentially influential characteristics including cognition and years from menopause. CONCLUSIONS Among women who underwent surgical menopause, the presence of three or more medical conditions is associated with decreased reproducibility of self-reported age at menopause.

de Vries, Heather F.; Northington, Gina M.; Kaye, Elise M.; Bogner, Hillary R.

2011-01-01

229

Development and validation of a continuous measure of patient condition using the Electronic Medical Record.  

PubMed

Patient condition is a key element in communication between clinicians. However, there is no generally accepted definition of patient condition that is independent of diagnosis and that spans acuity levels. We report the development and validation of a continuous measure of general patient condition that is independent of diagnosis, and that can be used for medical-surgical as well as critical care patients. A survey of Electronic Medical Record data identified common, frequently collected non-static candidate variables as the basis for a general, continuously updated patient condition score. We used a new methodology to estimate in-hospital risk associated with each of these variables. A risk function for each candidate input was computed by comparing the final pre-discharge measurements with 1-year post-discharge mortality. Step-wise logistic regression of the variables against 1-year mortality was used to determine the importance of each variable. The final set of selected variables consisted of 26 clinical measurements from four categories: nursing assessments, vital signs, laboratory results and cardiac rhythms. We then constructed a heuristic model quantifying patient condition (overall risk) by summing the single-variable risks. The model's validity was assessed against outcomes from 170,000 medical-surgical and critical care patients, using data from three US hospitals. Outcome validation across hospitals yields an area under the receiver operating characteristic curve(AUC) of ?0.92when separating hospice/deceased from all other discharge categories, an AUC of ?0.93 when predicting 24-h mortalityand an AUC of 0.62 when predicting 30-day readmissions. Correspondence with outcomesreflective of patient condition across the acuity spectrum indicates utility in both medical-surgical unitsand critical care units. The model output, which we call the Rothman Index, may provide clinicians witha longitudinal view of patient condition to help address known challenges in caregiver communication,continuity of care, and earlier detection of acuity trends. PMID:23831554

Rothman, Michael J; Rothman, Steven I; Beals, Joseph

2013-07-03

230

The relation of medical conditions to depressive symptoms among Latinos: Leisure time physical activity as a mediator  

Microsoft Academic Search

Individuals with medical conditions report more depressive symptoms than those without such conditions. This study assessed whether physical activity (PA) plays a mediational role in the association between medical conditions and depressive symptoms among Latino adults. Adjusting for socioeconomic factors, those who reported having been diagnosed with diabetes, cardio-related disease, hypertension, high cholesterol, arthritis, or sleep problems endorsed more symptoms

Elva M. Arredondo; Tamar Mendelson; John P. Elder; Simon J. Marshall; Lareina La Flair; Guadalupe X. Ayala

2012-01-01

231

[The working conditions of medical personnel handling the SMTA brand copper amalgam].  

PubMed

To assess the working conditions of medical staff the authors compared mercury vapor concentrations released during manipulations with various copper amalgams, TMAC-01 tableted copper amalgam manufactured by Nikitiv Mercury Plant, its foreign copper analog manufactured be "Becht" (Germany), and a new CMTA capsulated copper amalgam. Use of CMTA copper amalgam was found not hazardous for medical staff provided sanitary and hygienic regulations were adhered to. Moreover, mercury vapor concentrations released during work allow its use in rooms without ventilation cabinets, whereas tableted copper amalgams TMAC-01 and Becht may be used only in dentistry rooms equipped with such cabinets. PMID:7846722

Chuev, V P; Pobochina, V V; Chechina, G N

232

Working with Students in the Medication Era: Do We All Have to Know How to Diagnose and Treat Mental Conditions?  

ERIC Educational Resources Information Center

|A marked increase in the number of college students on medications for depression, attention deficit disorder, and other conditions may have intimidated counselors and educators into believing that they all need to be medical experts. The widespread practice of medicalizing behavior and experience contrasts dramatically with the approach in which…

Alishio, Kip

2005-01-01

233

20 CFR 30.611 - If a settlement or judgment is received for more than one medical condition, can the amount paid...  

Code of Federal Regulations, 2013 CFR

...judgment is received for more than one medical condition, can the amount paid...States is subrogated? (a) All medical conditions accepted by OWCP...except that an injury caused by medical malpractice in treating an illness...

2013-04-01

234

Seven chronic conditions: their impact on US adults' activity levels and use of medical services.  

PubMed Central

OBJECTIVES. This paper analyzes the impact of seven chronic conditions (three nonfatal: arthritis, visual impairment, hearing impairment; four fatal: ischemic heart disease, chronic obstructive pulmonary disease, diabetes mellitus, malignant neoplasms) on US adults aged 18 and older. Impact refers to how readily a condition prompts activity limitations, physician visits, and hospital stays. METHODS. Data come from three national health surveys and vital statistics. For comparability, a single disease classification scheme was applied, and new rates were estimated. Frequency, impact, and prominence of the target conditions are studied via rates, ratios of rates, and ranks, respectively. RESULTS. In young adulthood, the nonfatal conditions prompt limitations less readily than do the fatal ones, but by older ages, arthritis and visual impairment have a limiting impact equivalent to that of fatal conditions. Despite high prevalence and limitations, nonfatal conditions stand well below fatal conditions for health services use. CONCLUSIONS. Although statistics on frequency, impact, and prominence all indicate conditions "importance," they give only weak clues about specific service needs of affected persons. The persistent finding that nonfatal conditions do not receive health services care commensurate with their prevalence and impact reflects long-standing imbalanced attention on fatal conditions in research and medical care.

Verbrugge, L M; Patrick, D L

1995-01-01

235

Predicting declines in physical function in persons with multiple chronic medical conditions: What we can learn from the medical problem list  

Microsoft Academic Search

BACKGROUND: Primary care physicians are caring for increasing numbers of persons with comorbid chronic illness. Longitudinal information on health outcomes associated with specific chronic conditions may be particularly relevant in caring for these populations. Our objective was to assess the effect of certain comorbid conditions on physical well being over time in a population of persons with chronic medical conditions;

Elizabeth A. Bayliss; Martha S. Bayliss; John E Ware Jr; John F. Steiner

2004-01-01

236

Urinary heavy metals and associated medical conditions in the US adult population  

Microsoft Academic Search

Health effects of heavy metals have been widely investigated, but further evaluation is required to comprehensively delineate their toxicity. Using data from the 2007–2008 National Health and Nutrition Examination Survey, a multivariate logistic regression analysis was performed on 1,857 adults to examine the relationship between urinary heavy metals and various medical conditions. Cardiovascular diseases were correlated to cadmium (OR: 4.94,

Angelico Mendy; Janvier Gasana; Edgar Ramos Vieira

2012-01-01

237

Comparison of drug adherence rates among patients with seven different medical conditions  

Microsoft Academic Search

STUDY OBJECTIVE: To compare drug adherence rates among patients with gout, hypercholesterolemia, hypertension, hypothyroidism, osteoporosis, seizure disorders, and type 2 diabetes mellitus by using a standardized approach.\\u000aDESIGN: Longitudinal study.\\u000aDATA SOURCE: Health care claims data from 2001-2004.\\u000aPATIENTS: A total of 706,032 adults aged 18 years or older with at least one of the seven medical conditions and with

Becky A. Briesacher; Susan E. Andrade; Hassan Fouayzi; K. Arnold Chan

2008-01-01

238

Urinary heavy metals and associated medical conditions in the US adult population  

Microsoft Academic Search

Health effects of heavy metals have been widely investigated, but further evaluation is required to comprehensively delineate their toxicity. Using data from the 2007–2008 National Health and Nutrition Examination Survey, a multivariate logistic regression analysis was performed on 1,857 adults to examine the relationship between urinary heavy metals and various medical conditions. Cardiovascular diseases were correlated to cadmium (OR: 4.94,

Angelico Mendy; Janvier Gasana; Edgar Ramos Vieira

2011-01-01

239

Fall Mortality and Related Medical Conditions in the ElderlyThe Association with Pulmonary Embolism  

Microsoft Academic Search

To investigate whether selected medical conditions increase an older person's risk of fall mortality, we analyzed 1985 multiple-cause-of-death data for persons aged 65 years or older. The 8,713 cases had a fall listed as the underlying cause of death; the 1,438,872 controls all had noninjury causes of death. Pulmonary embolism, syncope, and alcohol dependence syndrome were all strongly associated with

James M. Mendlein; Richard W. Sattin; Richard J. Waxweiler; Kung Jong Lui; Daniel L. McGee

1990-01-01

240

Cytokines, “Depression Due to A General Medical Condition,” and Antidepressant Drugs  

Microsoft Academic Search

Activation of the immune system during various medical conditions produces neural, neuroendocrine, and behavioral effects.\\u000a The psychological and physiological effects of immune activation resemble many characteristics of depression. The essential\\u000a features of depression are depressed mood and loss of interest or pleasure in all, or almost all activities (anhedonia). Several\\u000a associated symptoms are also present, including, appetite disturbance, change in

Raz Yirmiya; Joseph Weidenfeld; Yehuda Pollak; Michal Morag; Avraham Morag; Ronit Avitsur; Ohr Barak; Edna Cohen; Yehuda Shavit; Haim Ovadia

241

Prevalence of Chronic Medical Conditions among Inmates in the Texas Prison System  

Microsoft Academic Search

Given the rapid growth and aging of the US prison population in recent years, the disease profile and health care needs of\\u000a inmates portend to have far-reaching public health implications. Although numerous studies have examined infectious disease\\u000a prevalence and treatment in incarcerated populations, little is known about the prevalence of non-infectious chronic medical\\u000a conditions in US prison populations. The purpose

Amy J. Harzke; Jacques G. Baillargeon; Sandi L. Pruitt; John S. Pulvino; David P. Paar; Michael F. Kelley

2010-01-01

242

Vaccination strategies for children with specific medical conditions: a paediatrician's viewpoint  

Microsoft Academic Search

Children with underlying medical conditions have to be given careful attention at the time of planned immunization in order\\u000a to define the individual benefit\\/risk ratio of a given vaccination. Analysis of available data demonstrates that vaccine administration\\u000a is indeed both safe and efficient in most children. Immunization of very premature infants may require specific vaccine strategies\\u000a consisting either of short-term

C.-A. Siegrist

1997-01-01

243

Diabetes, smoking, and other medical conditions in relation to Parkinson's disease risk  

Microsoft Academic Search

Associations of Parkinson's disease (PD) with diabetes mellitus (DM) and other medical conditions were investigated in a case–control study of 352 newly diagnosed PD case and 484 control subjects. Men with DM had a significantly lower risk of PD, than men without DM (odds ratio (OR)=0.52, 95% confidence interval (CI)=0.28, 0.97), whereas the association in women was weaker (OR=0.80, 95%

Karen M. Powers; Terri Smith-Weller; Gary M. Franklin; W LONGSTRETHJR; Phillip D. Swanson; Harvey Checkoway

2006-01-01

244

A prospective study of medical conditions, anthropometry, physical activity, and pancreatic cancer in male smokers (Finland)  

Microsoft Academic Search

Objective: To examine the association between several medical conditions, anthropometric measurements, occupational and leisure physical activity, and pancreatic cancer in a cohort of male Finnish smokers. Methods: We performed a cohort analysis of the 172 subjects who developed pancreatic cancer between 1985 and 1997 (median 10.2 years follow-up) among the 29,048 male smokers, 50–69 years old, who had complete baseline

Rachael Z. Stolzenberg-Solomon; Pirjo Pietinen; Philip R. Taylor; Jarmo Virtamo; Demetrius Albanes

2002-01-01

245

Statewide Investigation of Medically Attended Adverse Health Conditions of Persons With Spinal Cord Injury  

PubMed Central

Background/Objective: To report over a 10-year period the statewide prevalence and incidence of medically attended adverse health conditions in people with new traumatic spinal cord injury (TSCI). Design: Retrospective cohort study. Methods: (a) Identified all new TSCI cases discharged alive from statewide acute care hospitals, 1996 to 2000, using ICD-9-CM methodology. (b) Followed cases from 1996 to 2005 to quantify medically attended health conditions documented during emergency department visits, acute care hospitalizations, and outpatient hospital visits. (c) Used the life table method to calculate the prevalence and incidence of health conditions. (d) Examined Cox proportional hazard ratio of mortality by gender controlling for age and TSCI severity. Results: Nine hundred eighty-eight residents (257 women, 731 men) with TSCI were alive 90 days after discharge from acute care hospitalization from 1996 to 2000. Nine hundred twenty-three (251 female, 672 male) (93.4%) residents had an observed medically attended adverse health condition in the 10-year follow-up period. The most prevalent classes of diseases and disorders were (a) muscle and connective tissue, (b) renal and urinary, (c) digestive, (d) circulatory, (e) respiratory, (f) endocrine/nutritional/metabolic, and (g) infectious. Incidence of new injury was 29.0% for males and 26.9% for females. During the follow-up period, 49 women (19%) and 104 men (14%) died. Conclusions: People with TSCI experience diverse adverse health conditions in the 10 years after initial injury. An interdisciplinary health care provider team approach to allocating resources and implementing countermeasures to prevent or limit occurrence of these conditions is vital to these patients' continuum of care.

Pickelsimer, Elisabeth; Shiroma, Eric J; Wilson, Dulaney A

2010-01-01

246

Challenges of Self-Reported Medical Conditions and Electronic Medical Records Among Members of a Large Military Cohort.  

National Technical Information Service (NTIS)

Self-reported medical history data are frequently used in epidemiological studies. Self-reported diagnoses may differ from medical record diagnoses due to poor patient-clinician communication, self-diagnosis in the absence of a satisfactory explanation fo...

B. Smith E. J. Boyko L. K. Chu P. J. Amoroso T. C. Smith

2008-01-01

247

Hospital Competition, Managed Care, and Mortality after Hospitalization for Medical Conditions in California  

PubMed Central

Objective To assess the effect of hospital competition and health maintenance organization (HMO) penetration on mortality after hospitalization for six medical conditions in California. Data Source Linked hospital discharge and vital statistics data for short-term general hospitals in California in the period 1994–1999. The study sample included adult patients hospitalized for one of the following conditions: acute myocardial infarction (N = 227,446), hip fracture (N = 129,944), stroke (N = 237,248), gastrointestinal hemorrhage (GIH,N = 216,443), congestive heart failure (CHF,N = 355,613), and diabetes (N = 154,837). Study Design The outcome variable was 30-day mortality. We estimated multivariate logistic regression models for each study condition with hospital competition, HMO penetration, hospital characteristics, and patient severity measures as explanatory variables. Principal Findings Higher hospital competition was associated with lower 30-day mortality for three to five of the six study conditions, depending on the choice of competition measure, and this finding was robust to a variety of sensitivity analyses. Higher HMO penetration was associated with lower mortality for GIH and CHF. Conclusions Hospitals that faced more competition and hospitals in market areas with higher HMO penetration provided higher quality of care for adult patients with medical conditions in California. Studies using linked hospital discharge and vital statistics data from other states should be conducted to determine whether these findings are generalizable.

Rogowski, Jeannette; Jain, Arvind K; Escarce, Jose J

2007-01-01

248

The contribution of negative reproductive experiences and chronic medical conditions to depression and pain among Israeli women  

Microsoft Academic Search

This study of 302 Israeli women sought to investigate the associations among stressful reproductive experiences (e.g. fertility problems, abortions, and traumatic births), chronic medical conditions, pain, and depression. The specific aims of the study were to examine (1) the effect of stressful reproductive experiences, chronic medical conditions, and pain on depressive symptoms and (2) the effect of stressful reproductive experiences,

Orly Sarid; Dorit Segal-Engelchin; Julie Cwikel

2011-01-01

249

Cerebral oxygen saturation and electrical brain activity before, during, and up to 36 hours after arterial switch procedure in neonates without pre-existing brain damage: its relationship to neurodevelopmental outcome  

Microsoft Academic Search

Objective: To monitor the pattern of cerebral oxygen saturation (rSat), by use of NIRS, in term infants before, during and after the arterial switch operation and to evaluate its relation to neurodevelopmental outcome. Methods: In 20 neonates without pre-existing brain damage hemodynamics and arterial oxygen saturation (AO2-Sat) were monitored simultaneously with rSat and amplitude-integrated EEG (aEEG) from 4 h to 12 h

Mona C. Toet; Annebeth Flinterman; Ingrid van de Laar; Jaap W. de. Vries; Ger B. W. E. Bennink; Cuno S. P. M. Uiterwaal; Frank van Bel

2005-01-01

250

Gorlin-Goltz syndrome--a medical condition requiring a multidisciplinary approach.  

PubMed

Gorlin-Goltz syndrome is a rare genetic condition showing a variable expressiveness. It is inherited in a dominant autosomal way. The strongest characteristic of the disease includes multiple basal cell carcinomas, jaw cysts, palmar and plantar pits, skeletal abnormalities and other developmental defects. Owing to the fact that the condition tends to be a multisystemic disorder, familiarity of various medical specialists with its manifestations may reduce the time necessary for providing a diagnosis. It will also enable them to apply adequate methods of treatment and secondary prevention. In this study, we present symptoms of the disease, its diagnostic methods and currently used treatments. We searched 2 scientific databases: Medline (EBSCO) and Science Direct, for the years 1996 to 2011. In our search of abstracts, key words included nevoid basal cell carcinoma syndrome and Gorlin-Goltz syndrome. We examined 287 studies from Medline and 80 from Science Direct, all published in English. Finally, we decided to use 60 papers, including clinical cases and literature reviews. Patients with Gorlin-Goltz syndrome need particular multidisciplinary medical care. Knowledge of multiple and difficult to diagnose symptoms of the syndrome among professionals of various medical specialties is crucial. The consequences of the disease pose a threat to the health and life of patients. Therefore, an early diagnosis creates an opportunity for effective prevention and treatment of the disorder. Prevention is better than cure. PMID:22936202

Kiwilsza, Ma?gorzata; Sporniak-Tutak, Katarzyna

2012-09-01

251

Past medical conditions and K- ras mutations in pancreatic ductal adenocarcinoma: a hypothesis-generating study  

Microsoft Academic Search

Background  In pancreatic ductal adenocarcinoma (PDA) evidence on the etiopathogenic role of past medical conditions in the occurrence\\u000a and persistence of K-ras mutations is scant.\\u000a \\u000a \\u000a \\u000a Methods  Incident cases of PDA were interviewed face-to-face about past medical history and other factors. Logistic regression was\\u000a used to compare PDA cases (n = 120) with wild-type and mutated K-ras tumors (case–case study).\\u000a \\u000a \\u000a \\u000a Results  Patients with wild-type K-ras tumors

Marta Crous-Bou; Miquel Porta; Eva Morales; Tomàs López; Alfredo Carrato; Elisa Puigdomènech; Francisco X. Real

2009-01-01

252

20 CFR 10.719 - If a settlement or judgment is received for more than one wound or medical condition, can the...  

Code of Federal Regulations, 2010 CFR

...for more than one wound or medical condition, can the refundable disbursements...be attributed to different conditions for purposes of calculating...States? (a) All wounds, diseases or other medical conditions accepted by OWCP in...

2010-04-01

253

20 CFR 10.719 - If a settlement or judgment is received for more than one wound or medical condition, can the...  

Code of Federal Regulations, 2013 CFR

...for more than one wound or medical condition, can the refundable disbursements...be attributed to different conditions for purposes of calculating...States? (a) All wounds, diseases or other medical conditions accepted by OWCP in...

2013-04-01

254

20 CFR 10.719 - If a settlement or judgment is received for more than one wound or medical condition, can the...  

Code of Federal Regulations, 2010 CFR

...for more than one wound or medical condition, can the refundable disbursements...be attributed to different conditions for purposes of calculating...States? (a) All wounds, diseases or other medical conditions accepted by OWCP in...

2009-04-01

255

Manchester Clinical Placement Index (MCPI). Conditions for medical students' learning in hospital and community placements.  

PubMed

The drive to quality-manage medical education has created a need for valid measurement instruments. Validity evidence includes the theoretical and contextual origin of items, choice of response processes, internal structure, and interrelationship of a measure's variables. This research set out to explore the validity and potential utility of an 11-item measurement instrument, whose theoretical and empirical origins were in an Experience Based Learning model of how medical students learn in communities of practice (COPs), and whose contextual origins were in a community-oriented, horizontally integrated, undergraduate medical programme. The objectives were to examine the psychometric properties of the scale in both hospital and community COPs and provide validity evidence to support using it to measure the quality of placements. The instrument was administered twice to students learning in both hospital and community placements and analysed using exploratory factor analysis and a generalizability analysis. 754 of a possible 902 questionnaires were returned (84% response rate), representing 168 placements. Eight items loaded onto two factors, which accounted for 78% of variance in the hospital data and 82% of variance in the community data. One factor was the placement learning environment, whose five constituent items were how learners were received at the start of the placement, people's supportiveness, and the quality of organisation, leadership, and facilities. The other factor represented the quality of training-instruction in skills, observing students performing skills, and providing students with feedback. Alpha coefficients ranged between 0.89 and 0.93 and there were no redundant or ambiguous items. Generalisability analysis showed that between 7 and 11 raters would be needed to achieve acceptable reliability. There is validity evidence to support using the simple 8-item, mixed methods Manchester Clinical Placement Index to measure key conditions for undergraduate medical students' experience based learning: the quality of the learning environment and the training provided within it. Its conceptual orientation is towards Communities of Practice, which is a dominant contemporary theory in undergraduate medical education. PMID:22234383

Dornan, Tim; Muijtjens, Arno; Graham, Jennifer; Scherpbier, Albert; Boshuizen, Henny

2012-01-11

256

Factors Associated with Perceived Uncertainty among Parents of Children with Undiagnosed Medical Conditions  

PubMed Central

Uncertainty is a pervasive characteristic of illness. Yet little is known about the individual or situational factors that contribute to perceptions of uncertainty. The present study aims to examine the factors that contribute to perceived uncertainty among parents of a child with an undiagnosed condition. Two hundred sixty-six parents of a child, or children, affected by an undiagnosed medical condition for at least two years completed an electronically administered mixed-methods survey assessing theoretical predictors of perceived uncertainty. Multivariate linear regression analyses were used to identify the relationship of key variables to perceived uncertainty. Parents' perceived control and optimism were negatively associated with uncertainty (B = ?4.044, p ? 0.001, B = ?0.477, p ? 0.05). Subjective disease severity was positively associated with perceived uncertainty (B = 1.797, p ? 0.05). Our findings suggest that parents who experience greater uncertainty feel less control over their child's medical condition, which may lead to less effective coping and poorer adaptation. Parents who are less optimistic or who perceive their child's disease as more severe may benefit most from interventions that target situations where parents perceive the least control, thereby enhancing coping and ultimately, adaptation.

Madeo, Anne C.; O'Brien, Kathleen E.; Bernhardt, Barbara A.; Biesecker, Barbara B.

2012-01-01

257

Inappropriate hospital use by patients receiving care for medical conditions: targeting utilization review  

PubMed Central

OBJECTIVE: To describe characteristics associated with inappropriate hospital use by patients in Manitoba in order to help target concurrent utilization review. Utilization review was developed to reduce inappropriate hospital use but can be a very resource-intensive process. DESIGN: Retrospective chart review of a sample of adult patients who received care for medical conditions in a sample of Manitoba hospitals during the fiscal year 1993-94; assessment of patients at admission and for each day of stay with the use of a standardized set of objective, nondiagnosis-based criteria (InterQual). PATIENTS: A total of 3904 patients receiving care at 26 hospitals. OUTCOME MEASURES: Acute (appropriate) and nonacute (inappropriate) admissions and days of stay for adult patients receiving care for medical conditions. RESULTS: After 1 week, 53.2% of patients assessed as needing acute care at admission no longer required acute care. Patients 75 years of age or older consumed more than 50% of the days of stay, and 74.8% of these days of stay were inappropriate. Four diagnostic categories accounted for almost 60% of admissions and days, and more than 50% of those days of stay were inappropriate. Patients admitted through the emergency department were more likely to require acute care (60.9%) than others (41.7%). Patients who were Treaty Indians had a higher proportion of days of stay requiring acute care than others (45.9% v. 32.8%). Patients' income and day of the week on admission (weekday v. weekend) were not predictive factors of inappropriate use. CONCLUSION: Rather than conducting a utilization review for every patient, hospitals might garner more information by targeting patients receiving care for medical conditions with stays longer than 1 week, patients with nervous system, circulatory, respiratory or digestive diagnoses, elderly patients and patients not admitted through the emergency department.

DeCoster, C; Roos, N P; Carriere, K C; Peterson, S

1997-01-01

258

Prompt Reduction in Use of Medications for Comorbid Conditions After Bariatric Surgery  

Microsoft Academic Search

Background  Bariatric surgery leads to weight loss, but it is unclear whether surgery reduces conditions associated with obesity. We explored\\u000a this by assessing the change in use of medications to treat diabetes mellitus, hypertension, and hyperlipidemia in the year\\u000a following surgery.\\u000a \\u000a \\u000a \\u000a Methods  This is a cohort study using administrative data from 2002 to 2005 from seven Blue Cross\\/Blue Shield Plans. We compared

Jodi B. Segal; Jeanne M. Clark; Andrew D. Shore; Francesca Dominici; Thomas Magnuson; Thomas M. Richards; Jonathan P. Weiner; Eric B. Bass; Albert W. Wu; Martin A. Makary

2009-01-01

259

Vaccines for persons at high risk due to medical conditions, occupation, environment, or lifestyle, 2005.  

PubMed

The rates of morbidity and mortality due to influenza and pneumococcal diseases are high among persons with underlying medical conditions; thus, influenza and pneumococcal polysaccharide vaccines are recommended for those with cardiac disease, diabetes mellitus, chronic obstructive pulmonary disease, and other chronic illnesses. For the same reasons, influenza vaccine is recommended for pregnant women and for persons with asthma. Health care workers are at high risk for acquiring and transmitting hepatitis B, measles, varicella, and influenza; hence, vaccination against these diseases is recommended. PMID:15623392

Zimmerman, Richard Kent; Middleton, Donald B

2005-01-01

260

Personal Attitudes, perceived social norms, and health risk behavior among female adolescents with chronic medical conditions.  

PubMed

To examine whether perceived peer/parent norms or personal beliefs about adolescent substance use influence substance use among female adolescents with chronic medical conditions. Sixty-eight females reported on substance use, personal beliefs, and perceived peer/parent norms. Personal beliefs and perceived peer/parent norms were associated with adolescent's current and future substance use. Although perceived peer norms accounted for variance in current substance use, only personal beliefs accounted for variance in future alcohol use. Targeting perceived peer norms may be effective for intervention efforts among adolescents endorsing current substance use, whereas alcohol use prevention efforts should target personal beliefs. PMID:23524992

Kunz, Jennifer Hauser; Greenley, Rachel Neff; Mussatto, Kathleen A; Roth-Wojcicki, Betsy; Miller, Tami; Freeman, Mary Ellen; Lerand, Sarah

2013-03-22

261

Health-related quality of life among adults with serious psychological distress and chronic medical conditions  

Microsoft Academic Search

Objective  Determine the prevalence of serious psychological distress (SPD) among adults with and without chronic medical conditions\\u000a and examine the association between SPD and health-related quality of life (HRQOL).\\u000a \\u000a \\u000a \\u000a Methods  Cross-sectional data from the 2005 Los Angeles County Health Survey were used to estimate prevalence of SPD. The association\\u000a between SPD and HRQOL was evaluated using logistic regression and analysis of covariance,

Margaret Shih; Paul A. Simon

2008-01-01

262

Specific medical conditions associated with clinically significant depressive symptoms in men  

Microsoft Academic Search

Purpose  To define specific medical conditions associated with clinically significant depressive symptoms in men.\\u000a \\u000a \\u000a \\u000a Methods  A cross-sectional study was conducted in a community-based sample of Australian men (N = 1,195, aged 35–80 years; for 2002–2005). Depression was defined by: (1) symptomatic depression (current symptoms) or (2)\\u000a current prescription for antidepressant(s) or (3) previously diagnosed depression. Logistic regression was used to determine\\u000a prevalence odds ratios (OR)

Evan Atlantis; Kylie Lange; Robert D. Goldney; Sean Martin; Matthew T. Haren; Anne Taylor; Peter D. O’Loughlin; Villis Marshall; Wayne Tilley; Gary A. Wittert

263

Chronic medical conditions mediate the association between depression and cardiovascular disease mortality  

Microsoft Academic Search

Purpose  To determine whether chronic medical conditions mediate the association between depression and cardiovascular disease (CVD)\\u000a mortality.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Data analyzed were from 6,394 subjects aged 25–74 years who participated in extensive health examinations in the NHEFS conducted\\u000a between 1971 and 1975 and follow-up studies to 1992. CVD mortality was the endpoint. Depression predictors were clinically\\u000a significant depressive symptoms at baseline by the GWB-D,

Evan Atlantis; Zumin Shi; Brenda J. W. H. Penninx; Gary A. Wittert; Anne Taylor; Osvaldo P. Almeida

264

Challenges of self-reported medical conditions and electronic medical records among members of a large military cohort  

Microsoft Academic Search

BACKGROUND: Self-reported medical history data are frequently used in epidemiological studies. Self-reported diagnoses may differ from medical record diagnoses due to poor patient-clinician communication, self-diagnosis in the absence of a satisfactory explanation for symptoms, or the \\

Besa Smith; Laura K Chu; Tyler C Smith; Paul J Amoroso; Edward J Boyko; Tomoko I Hooper; Gary D Gackstetter; Margaret AK Ryan

2008-01-01

265

Patient-centered medical homes improve care for adults with chronic conditions.  

PubMed

The success of health care reform implementation in 2014 partly depends on more efficient delivery of care to the millions of California residents eligible to gain insurance. Emerging evidence supports the effectiveness of the patient-centered medical home (PCMH) as a potential model of care delivery, which improves health outcomes and reduces costs. Among other principles, PCMH entails receipt of care from a personal doctor, who coordinates the patient's care and develops an individualized treatment plan for the patient. These principles are particularly essential in delivery of care to those with chronic conditions who require more intensive care management. Using the 2009 California Health Interview Survey (CHIS 2009), this policy brief indicates that patients who reported meeting these fundamental PCMH principles were more likely to have visited the doctor and to have received flu shots, and they also had better communication with providers than those who did not report meeting these PCMH principles. The data also showed that uninsured individuals, Medi-Cal beneficiaries, those at or below 133% of the federal poverty level, Latinos, and Asian-Americans were less likely to report meeting all three PCMH principles. These findings highlight the population groups that would most benefit from the PCMH care delivery model, particularly Medi-Cal beneficiaries and those eligible for Covered California, the California health benefits exchange. PMID:23858570

Pourat, Nadereh; Lavarreda, Shana Alex; Snyder, Sophie

2013-05-01

266

Making choices about medical interventions: the experience of disabled young people with degenerative conditions.  

PubMed

Background? Current western policy, including the UK, advocates choice for service users and their families, taking greater control and being more involved in decision making. However, children's role in health decision making, especially from their own perspective, has received less research attention compared to doctors and parents' perspectives. Objective? To explore the perspective and experiences of disabled young people with degenerative conditions as they face significant medical interventions and engage in decision-making processes. Design and methods? Findings from a longitudinal qualitative study of 10 young people (13-22?years) with degenerative conditions are reported. Individual semi-structured interviews were conducted with participants over 3?years (2007-2010); the paper reports data from all three interview rounds. Interviews focused on medical intervention choices the young people identified as significant. Results? Although the young people in this study felt involved in the medical intervention choices discussed, findings demonstrate a complex and diverse picture of decision making. Results highlighted different decisional roles adopted by the young people, the importance of information heuristics and working with other people whilst engaging in complex processes weighing up different decisional factors. Discussion? Young people's experiences demonstrate the importance of moving beyond viewing health choices as technical or rational decisions. How each young person framed their decision was important. Recognizing this diversity and the importance of emerging themes, such as living a normal life, independence, fear of decisions viewed as 'irreversible' and the role of parents and peers in decision making highlights that, there are clear practice implications including, active practitioner listening, sensitivity and continued holistic family working. PMID:22296527

Mitchell, Wendy A

2012-02-01

267

Cluster analyses of association of weather, daily factors and emergent medical conditions.  

PubMed

The goal of this study was to evaluate associations between the meteorological conditions and the number of emergency cases for five distinctive causes of dispatch groups reported to SOS dispatch centre in Uppsala, Sweden. Center's responsibility include alerting to 17 ambulances in whole Uppsala County, area of 8,209 km2 with around 320,000 inhabitants representing the target patient group. Source of the medical data for this study is the database of dispatch data for the year of 2009, while the metrological data have been provided from Uppsala University Department of Earth Sciences yearly weather report. Medical and meteorological data were summoned into the unified data space where each point represents a day with its weather parameters and dispatch cause group cardinality. DBSCAN data mining algorithm was implemented to five distinctive groups of dispatch causes after the data spaces have gone through the variance adjustment and the principal component analyses. As the result, several point clusters were discovered in each of the examined data spaces indicating the distinctive conditions regarding the weather and daily cardinality of the dispatch cause, as well as the associations between these two. Most interesting finding is that specific type of winter weather formed a cluster only around the days with the high count of breathing difficulties, while one of the summer weather clusters made similar association with the days with low number of cases. Findings were confirmed by confidence level estimation based on signal to noise ratio for the observed data points. PMID:23697272

Malki?, Jasmin; Sarajli?, Nermin; Smrke, Barbara U R; Smrke, Dragica

2013-03-01

268

42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.  

Code of Federal Regulations, 2010 CFR

...participation: Special medical record requirements for psychiatric hospitals. 482.61 Section 482.61 Public Health...participation: Special medical record requirements for psychiatric hospitals. The medical records maintained by a...

2010-10-01

269

42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.  

Code of Federal Regulations, 2010 CFR

...participation: Special medical record requirements for psychiatric hospitals. 482.61 Section 482.61 Public Health...participation: Special medical record requirements for psychiatric hospitals. The medical records maintained by a...

2009-10-01

270

CORRELATES OF SELF-DIAGNOSIS OF CHRONIC MEDICAL AND MENTAL HEALTH CONDITIONS IN UNDERSERVED AFRICAN AMERICAN AND LATINO POPULATIONS  

Microsoft Academic Search

Objective: This study examines the correlates of self-diagnosis of chronic medical and mental health conditions in under-served minority populations. The Behavioral Model for Vulner- able Populations was employed to compare the predisposing and enabling characteristics of two groups: the first group consisted of individuals who self-reported their medical conditions without a presumptive or definitive physician diagnosis, while the second group

Chizobam Ani; Mohsen Bazargan; Shahrzad Bazargan-Hejazi; Ronald M. Andersen; David W. Hindman; Richard S. Baker

271

Pneumococcal and influenza vaccination rates and their determinants in children with chronic medical conditions  

PubMed Central

Background To investigate the rates of pneumococcal and influenza vaccinations and their determinants in children with chronic medical conditions. Patients and Methods Children with HIV infection, cystic fibrosis, liver transplantation and diabetes mellitus were enrolled. Physicians of regional Reference Centres for each condition, primary care paediatricians and caregivers of children provided information through specific questionnaires. For diabetes, 3 Reference Centres were included. Results Less than 25% of children in each group received pneumococcal vaccination. Vaccination rates against influenza were 73% in patients with HIV-infection, 90% in patients with cystic fibrosis, 76% in patients with liver transplantation, and ranged from 21% to 61% in patients with diabetes mellitus. Reference Centres rather than primary care paediatricians had a major role in promoting vaccinations. Lack of information was the main reason for missing vaccination. Awareness of the severity of pneumococcus infection by key informants of at-risk children was associated with higher vaccination rate. Conclusions Vaccination rates in children with chronic conditions were poor for pneumococcus and slightly better for influenza. Barriers to vaccination include lack of awareness, health care and organization problems.

2010-01-01

272

Highlighting differences between conditional and unconditional quantile regression approaches through an application to assess medication adherence.  

PubMed

The quantile regression (QR) framework provides a pragmatic approach in understanding the differential impacts of covariates along the distribution of an outcome. However, the QR framework that has pervaded the applied economics literature is based on the conditional quantile regression method. It is used to assess the impact of a covariate on a quantile of the outcome conditional on specific values of other covariates. In most cases, conditional quantile regression may generate results that are often not generalizable or interpretable in a policy or population context. In contrast, the unconditional quantile regression method provides more interpretable results as it marginalizes the effect over the distributions of other covariates in the model. In this paper, the differences between these two regression frameworks are highlighted, both conceptually and econometrically. Additionally, using real-world claims data from a large US health insurer, alternative QR frameworks are implemented to assess the differential impacts of covariates along the distribution of medication adherence among elderly patients with Alzheimer's disease. PMID:23616446

Borah, Bijan J; Basu, Anirban

2013-04-25

273

Primary central nervous system lymphoma interacting with a pre-existing cerebral amyloid angiopathy demonstrated as an old right frontal haemorrhage on imaging.  

PubMed

Primary CNS Lymphoma is rare aggressive malignancy that originates entirely in the central nervous system. It represents a diagnostic challenge to clinicians as symptoms are frequently non-specific, and overall represents 4% of intracranial neoplasms.(1) Cerebral amyloid angiopathy is characterised pathologically by deposition of amyloid in small and medium vessels arteries of the cortex and leptomeninges. It is usually restricted to the leptomeninges and grey matter and stops abruptly when a perforating vessel reaches the junction of the cortex and subcortex. This explains why the haemorrhages are almost always lobar, CAA Makes vessels fragile and more likely to rupture.(2) We present a case that has not been reported in previous literature of an 82 year old man first seen in clinic with probable transient ischemic attacks secondary to a heavily calcified right ICA in October 2012. Magnetic Resonance demonstrated a sizeable area of old hemorrhage in the right frontal lobe, and he discharged with clopidogrel. However he represented In December 2012 on three occasions over the course of a week with similar symptoms of left arm weakness and facial droop. Repeat MRI illustrated no new infarcts but a further hemorrhage in the right frontal region just caudal to the previous hemorrhage which has resolved. Further collateral revealed a 1 year history of cognitive decline and rapid deterioration in mobility since September 2012. Given the diagnostic uncertainty, an open right frontal biopsy was performed by the neurosurgeons. Histopathology demonstrated brain tissue with a focal infiltrate with large lymphoid cells with conspicuous nucleoli and a diffuse growth pattern consistent with a high grade CNS lymphoma. Immunostaining was Positive for CD20, CD79a, BCL-2, Negative for CD10, Cyclin D-1 and Tdt. Congo red staining was positive for amyloid in parenchymal vessels and Leptomeningeal vessels. Further lumbar puncture did not show any malignant cells. Therefore in addition to the Primary Diffuse Large B-Cell Lymphoma of the central nervous system he had co-existing cerebral amyloid angiopathy. Due to his poor performance status and multiple co-morbidities after review by the oncologists he was initiated on high dose dexamthasone, and consented for Palliative whole-brain radiotherapy. In the context of the current biopsy it was established that the two conditions have interacted because there is evidence of an old hemorrhage in addition to the deposit of the Lymphoma. Cerebral amyloid angiopathy due to beta amyloid (as in this case) can be associated with Alzheimer's disease. However cerebral amyloid angiopathy can be inherited or can also be sporadic. The load of amyloid plaques in the present biopsy was small and does not suggest co-existing Alzheimer's disease.(3.) PMID:24108996

Kirresh, Othman

2013-11-01

274

Black-White Disparity in Disability: The Role of Medical Conditions  

PubMed Central

OBJECTIVES To describe the independent contributions of selected medical conditions to the disparity between black and white people in disability rates, controlling for demographic and socioeconomic factors. DESIGN Cross-sectional analysis of a community-based cohort. SETTING Urban and rural counties of central North Carolina. PARTICIPANTS Two thousand nine hundred sixty-six adults aged 68 and older participating in the Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE). MEASUREMENTS Self-reported data on sociodemographic characteristics and medical conditions, Short Portable Mental Status Questionnaire, activities of daily living (ADLs). RESULTS Fifty-five percent of the cohort was black. Blacks were more likely than whites to report disability (odds ratio = 1.39, 95% confidence interval = 1.15–1.68). Controlling for age, sex, marital status, and socioeconomic status, blacks were more likely to be obese and have diabetes mellitus, and less likely to report vision problems, fractures, and heart attacks. The higher prevalence of obesity and diabetes mellitus in blacks, after adjustment for sociodemographic factors, accounted for more than 30% of the black–white difference in disability. Conversely, the black–white disability gap would be approximately 45% wider if whites had a lower prevalence of fractures and vision impairment, similar to their black peers. CONCLUSION Higher rates of obesity and diabetes mellitus in older black Americans account for a large amount of the racial disparity in disability, even after controlling for socioeconomic differences. Culturally appropriate interventions that lower the prevalence or the functional consequences of obesity and diabetes mellitus in blacks could substantially decrease this racial health disparity.

Whitson, Heather E.; Hastings, S. Nicole; Landerman, Lawrence R.; Fillenbaum, Gerda G.; Cohen, Harvey J.; Johnson, Kimberly S.

2011-01-01

275

Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study  

Microsoft Academic Search

Enhancing daily functioning and well-being is an increasingly advocated goal in the treatment of patients with chronic conditions. We evaluated the functioning and well-being of 9385 adults at the time of office visits to 362 physicians in three US cities, using brief surveys completed by both patients and physicians. For eight of nine common chronic medical conditions, patients with the

Anita L. Stewart; Sheldon Greenfield; Ron D. Hays; Kenneth Wells; William H. Rogers; Sandra D. Berry; Elizabeth A. McGlynn; Ware John E. Jr

1989-01-01

276

The relation of medical conditions to depressive symptoms among Latinos: leisure time physical activity as a mediator.  

PubMed

Individuals with medical conditions report more depressive symptoms than those without such conditions. This study assessed whether physical activity (PA) plays a mediational role in the association between medical conditions and depressive symptoms among Latino adults. Adjusting for socioeconomic factors, those who reported having been diagnosed with diabetes, cardio-related disease, hypertension, high cholesterol, arthritis, or sleep problems endorsed more symptoms of depression. Vigorous PA mediated the relation between depressive symptoms and hypertension. In other words, people with hypertension who engaged in vigorous PA reported less depressive symptoms. PA may be a promising avenue for improving hypertension and depressive symptoms. PMID:22021277

Arredondo, Elva M; Mendelson, Tamar; Elder, John P; Marshall, Simon J; La Flair, Lareina; Ayala, Guadalupe X

2011-10-21

277

Correlates of self-medication for anxiety disorders: results from the National Epidemiolgic Survey on Alcohol and Related Conditions.  

PubMed

Self-medication is a common behavior among individuals with anxiety disorders, yet few studies have examined the correlates of this behavior. The current study addresses this issue by exploring the pattern of mental health service use and quality of life among people who self-medicate for anxiety. Data came from the National Epidemiologic Survey on Alcohol and Related Conditions and was limited to the subsample of individuals meeting criteria for an anxiety disorder in the past 12 months (n = 4880). Multiple regression analyses compared 3 groups-(1) no self-medication, (2) self-medication with alcohol, and (3) self-medication with drugs, on mental health service use and quality of life. After adjusting for potentially confounding covariates, individuals who engaged in self-medication had significantly higher service use compared with people with anxiety disorders who did not self-medicate (adjusted odds ratio = 1.41, 95% CI = 1.06-1.89). Self-medication was also associated with a lower mental health-related quality of life compared with those who did not self-medicate. Clinicians should recognize and respond to the unique needs of this particular subpopulation of individuals with anxiety disorders. PMID:20010021

Robinson, Jennifer A; Sareen, Jitender; Cox, Brian J; Bolton, James M

2009-12-01

278

Symptoms and medical conditions in Australian veterans of the 1991 Gulf War: relation to immunisations and other Gulf War exposures  

PubMed Central

Aims: To investigate whether Australian Gulf War veterans have a higher than expected prevalence of recent symptoms and medical conditions that were first diagnosed in the period following the 1991 Gulf War; and if so, whether these effects were associated with exposures and experiences that occurred in the Gulf War. Methods: Cross-sectional study of 1456 Australian Gulf War veterans and a comparison group who were in operational units at the time of the Gulf War, but were not deployed to that conflict (n = 1588). A postal questionnaire was administered and the likelihood of the diagnosis of self-reported medical conditions was assessed and rated by a medical practitioner. Results: Gulf War veterans had a higher prevalence of all self-reported health symptoms than the comparison group, and more of the Gulf War veterans had severe symptoms. Increased symptom reporting was associated with several exposures, including having more than 10 immunisations, pyridostigmine bromide tablets, anti-biological warfare tablets, pesticides, insect repellents, reportedly being in a chemical weapons area, and stressful military service experiences in a strong dose-response relation. Gulf War veterans reported psychological (particularly post-traumatic stress disorder), skin, eye, and sinus conditions first diagnosed in 1991 or later more commonly than the comparison group. Over 90% of medical conditions reported by both study groups were rated by a medical practitioner as having a high likelihood of diagnosis. Conclusion: More than 10 years after the 1991 Gulf War, Australian veterans self-report all symptoms and some medical conditions more commonly than the comparison group. Further analysis of the severity of symptoms and likelihood of the diagnosis of medical conditions suggested that these findings are not due to over-reporting or to participation bias.

Kelsall, H; Sim, M; Forbes, A; Glass, D; McKenzie, D; Ikin, J; Abramson, M; Blizzard, L; Ittak, P

2004-01-01

279

The Social and Ethical Implications of Changing Medical Technologies: The Views of People Living with Genetic Conditions  

Microsoft Academic Search

This article presents empirical data on subjective levels of health and quality of life for individuals with early- or late-onset genetic conditions. Twelve adults with an early-onset condition (cystic fibrosis) and 12 adults with a late-onset condition in the family (Huntington’s disease) participated in semi-structured interviews. Questions investigated perceptions of the body, quality of life and views on medical technology

Elizabeth Chapman

2002-01-01

280

Perceptions of the impact of depression and anxiety and the medication for these conditions on safety in the workplace  

PubMed Central

Background: The number of people taking prescribed medication for anxiety and depression has increased greatly, but little is known of how this medication impacts on safety at work. Aims: To examine the relation between anxiety and depression, prescribed medication, performance, and safety in the workplace. Methods: The research involved nine focus groups with sufferers of anxiety and depression to investigate experiences of mental health problems and the impact of psychotropic drugs. A further three focus groups were conducted with staff in human resources, personnel, occupational health, and health and safety departments, to explore organisational perspectives. The sample comprised 74 individuals drawn from a wide range of occupational sectors. Finally, the results were presented to a panel of experts from occupational medicine, general practice, psychology, health and safety, and psychiatry, to consider the implications for practice. Results: Workers reported that both the symptoms and the medication impaired work performance. Participants described accidents which they attributed to their condition or to the medication. Workers with responsibilities for others, such as teachers, healthcare workers, and managers appeared to present a particular safety risk. Healthcare workers believed that they placed themselves and their patients at risk when carrying out medical procedures. Conclusions: Respondents in this study felt that their symptoms of anxiety and depression and the medication they took to treat these conditions placed them at risk with respect to safety in the workplace. Drawing on the results, the authors outline areas for improvement in the management of mental health problems at work.

Haslam, C; Atkinson, S; Brown, S; Haslam, R

2005-01-01

281

Management of Osteoporosis among the Elderly with Other Chronic Medical Conditions  

PubMed Central

Osteoporosis is a highly prevalent chronic disease in the US and worldwide. The most serious consequence of this disorder is fractures, which have a serious negative impact on quality of life and are often the trigger for accelerated deterioration, ultimately ending in death. Despite the availability of effective preventive treatments, osteoporosis is frequently underdiagnosed and/or undertreated, particularly among the elderly, who are also at greatest risk. In addition, the presence of co-morbid medical conditions may be both a barrier to osteoporosis care and a risk factor for falls; thus individuals with multiple co-morbid conditions may be a particularly high-risk group. The management of osteoporosis involves improving bone health via adequate nutrition, calcium and vitamin D supplements, and fall prevention strategies. Although these measures are important in the management of all patients, most elderly patients are likely to need additional pharmacological therapy to adequately reduce their fracture risk. Several pharmacological treatments have been shown to significantly reduce the risk of fracture, including bisphosphonates (e.g. alendronate, risedronate, ibandronate, zoledronic acid), denosumab, raloxifene, calcitonin and teriparatide. Despite recent advances in osteoporosis care, additional action is urgently needed to improve the quality of life of osteoporotic patients in general and of elderly patients in particular, since fracture outcomes are typically poorer in older than in younger patients. This article reviews the current status of osteoporosis management, emphasizing the need to improve osteoporosis care, with a particular focus on the US, by the use of quality- improvement measures and incentives, which might result in an increased awareness and improved treatment for this debilitating disease.

Curtis, Jeffrey R.; Safford, Monika M.

2013-01-01

282

Urinary heavy metals and associated medical conditions in the US adult population.  

PubMed

Health effects of heavy metals have been widely investigated, but further evaluation is required to comprehensively delineate their toxicity. Using data from the 2007-2008 National Health and Nutrition Examination Survey, a multivariate logistic regression analysis was performed on 1,857 adults to examine the relationship between urinary heavy metals and various medical conditions. Cardiovascular diseases were correlated to cadmium (OR: 4.94, 95% CI: 1.48-16.56) and lead (OR: 5.32, 95% CI: 1.08-26.21). Asthma was related to tungsten (OR: 1.72, 95% CI: 1.15-2.59) and uranium (OR: 1.52, 95% CI: 1.01-2.28). Hepatotoxicity was associated with molybdenum (OR: 3.09, 95% CI: 1.24-7.73) and uranium (OR: 4.79, 95% CI: 1.74-13.19). Surprising inverse relationships occurred for excessive weight with lead (OR: 0.72, 95% CI: 0.52-0.98), reduced visual acuity with cobalt (OR: 0.65, 95% CI: 0.44-0.95) and cesium (OR: 0.52, 95% CI: 0.35-0.77). This study supports some previous evidence of potential relationships and provides insights for future research. PMID:21854105

Mendy, Angelico; Gasana, Janvier; Vieira, Edgar Ramos

2011-08-19

283

Unplanned readmission rates, length of hospital stay, mortality, and medical costs of ten common medical conditions: a retrospective analysis of Hong Kong hospital data  

Microsoft Academic Search

Background  Studies on readmissions attributed to particular medical conditions, especially heart failure, have generally not addressed\\u000a the factors associated with readmissions and the implications for health outcomes and costs. This study aimed to investigate\\u000a the factors associated with 30-day unplanned readmission for 10 common conditions and to determine the cost implications.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  This population-based retrospective cohort study included patients admitted to all

Eliza LY Wong; Annie WL Cheung; Michael CM Leung; Carrie HK Yam; Frank WK Chan; Fiona YY Wong; Eng-Kiong Yeoh

2011-01-01

284

Clinical deterioration in the condition of patients with acute medical illness in Australian hospitals: improving detection and response.  

PubMed

Medical Assessment Units (MAUs) provide an opportunity for multidisciplinary staff to manage recently admitted acutely unwell patients with complex medical illnesses. We propose concerted development of robust mechanisms for identifying and managing patients whose condition is unstable as they move through hospital departments. Track, trigger and response (TTR) systems (eg, medical emergency team calls and early warning scores) have been introduced to hospital practice, but evidence for their effectiveness is, so far, incomplete. The current variation in TTR systems within and between hospitals impairs intersite comparisons. A range of outcome measures, including risk of physiological deterioration, mortality and projected hospital length of stay, could be usefully investigated by future intersite collaborative research. More deliberate, systematic, evidence-based design of "response" in TTR systems may help in identifying patients who need early attention from skilled medical staff. We need more uniform TTR systems, more research on TTR systems and more multisite research; MAUs are ideally situated to address this important area. PMID:21644875

Jenkins, Paul F; Thompson, Campbell H; Barton, Lorna L

2011-06-01

285

20 CFR 30.114 - What kind of evidence is needed to establish a compensable medical condition and how will that...  

Code of Federal Regulations, 2010 CFR

...illnesses, impairments or diseases, the claimant must also...physician's fully rationalized medical report showing a causal relationship...illness, impairment or disease and the compensable medical condition. (c) OWCP will...

2010-04-01

286

20 CFR 30.114 - What kind of evidence is needed to establish a compensable medical condition and how will that...  

Code of Federal Regulations, 2010 CFR

...illnesses, impairments or diseases, the claimant must also...physician's fully rationalized medical report showing a causal relationship...illness, impairment or disease and the compensable medical condition. (c) OWCP will...

2009-04-01

287

Oral Assessment and Postgraduate Medical Examinations: Establishing Conditions for Validity, Reliability and Fairness  

ERIC Educational Resources Information Center

|The purpose of this review was to examine the practice of oral assessment in postgraduate medical education in the context of the core assessment constructs of validity, reliability and fairness. Although oral assessment has a long history in the certification process of medical specialists and is a well-established part of such proceedings for a…

Memon, Muhammed Ashraf; Joughin, Gordon Rowland; Memon, Breda

2010-01-01

288

Common Medical Conditions in the Elderly:Impact on Pharyngeal Bolus Transit  

Microsoft Academic Search

Deglutition in the elderly may be impacted by the sequelae of medical diseases. It is unknown if the long-term presence of common medical diseases, such as arthritis and hypertension, leads to changes in neurologic and muscular function and thus swallowing ability. The aim of this project was to determine if the duration of bolus pharyngeal transit in nondysphagic elderly individuals

Katherine A. Kendall; Rebecca J. Leonard; Susan McKenzie

2004-01-01

289

Unexplained transient hyperphosphatemia is more common in acute psychiatric disorders than in acute medical–surgical conditions  

Microsoft Academic Search

Increased serum inorganic phosphorus associated with elevated serum calcium has been demonstrated to coincide with the onset of agitation and mania in periodic psychoses and bipolar disorders. We tested the hypothesis that unexplained transient hyperphosphatemia (UTHP) is more common in patients with psychiatric disorders than in controls with medical or surgical conditions. We studied 100 patients admitted to a psychiatric

Ali Ahmadi; Edward C. Lauterbach; Nasreen Malik; John Gonzales

2003-01-01

290

Relations Of Income Inequality And Family Income To Chronic Medical Conditions And Mental Health Disorders: National Survey In USA  

Microsoft Academic Search

Objectives To analyse the relation between geographical inequalities in income and the prevalence of common chronic medical conditions and mental health disorders, and to compare it with the relation between family income and these health problems. Design Nationally representative household telephone survey conducted in 1997-8. Setting 60 metropolitan areas or economic areas of the United States. Participants 9585 adults who

Roland Sturm; Carole Roan Gresenz

2002-01-01

291

Chronic musculoskeletal pain predicted hospitalisation due to serious medical conditions in a 10 year follow up study  

Microsoft Academic Search

BACKGROUND: The aim was to examine if self reported chronic regional pain (CRP) and chronic widespread pain (CWP) predicted inpatient care due to serious medical conditions such as cerebrovascular diseases, ischemic heart diseases, neoplasms and infectious diseases in a general population cohort over a ten year follow-up period. METHODS: A ten-year follow up of a cohort from the general adult

Hans Lindgren; Stefan Bergman

2010-01-01

292

Medical Surveillance for Biological Terrorism Agents  

Microsoft Academic Search

The first recognition of a bioterrorist attack may be sick patients. Recognition and subsequent notification of an attack at the earliest possible moment will assist in rapidly instituting protective measures. New methods of medical surveillance can assist with rapid detection. Syndromic surveillance is the use of newly created or pre-existing databases to track the health of communities. The data can

Julie A. Pavlin

2005-01-01

293

Impaired driving from medical conditions: a 70-year-old man trying to decide if he should continue driving.  

PubMed

Some medical disorders can impair performance, increasing the risk of driving safety errors that can lead to vehicle crashes. The causal pathway often involves a concatenation of factors or events, some of which can be prevented or controlled. Effective interventions can operate before, during, or after a crash occurs at the levels of driver capacity, vehicle and road design, and public policy. A variety of systemic, neurological, psychiatric, and developmental disorders put drivers at potential increased risk of a car crash in the short or long term. Medical diagnosis and age alone are usually insufficient criteria for determining fitness to drive. Strategies are needed for determining what types and levels of reduced function provide a threshold for disqualification in drivers with medical disorders. Evidence of decreased mileage, self-restriction to driving in certain situations, collisions, moving violations, aggressive driving, sleepiness, alcohol abuse, metabolic disorders, and multiple medications may trigger considerations of driver safety. A general framework for evaluating driver fitness relies on a functional evaluation of multiple domains (cognitive, motor, perceptual, and psychiatric) that are important for safe driving and can be applied across many disorders, including conditions that have rarely been studied with respect to driving, and in patients with multiple conditions and medications. Neurocognitive tests, driving simulation, and road tests provide complementary sources of evidence to evaluate driver safety. No single test is sufficient to determine who should drive and who should not. PMID:21364126

Rizzo, Matthew

2011-03-01

294

Physiologic changes associated with violence and abuse exposure: an examination of related medical conditions.  

PubMed

Although the extant evidence is replete with data supporting linkages between exposure to violence or abuse and the subsequent development of medical illnesses, the underlying mechanisms of these relationships are poorly defined and understood. Physiologic changes occurring in violence- or abuse-exposed individuals point to potentially common biological pathways connecting traumatic exposures with medical outcomes. Herein, the evidence describing the long-term physiologic changes in abuse- and violence-exposed populations and associated medical illnesses are reviewed. Current data support that (a) specific neurobiochemical changes are associated with exposure to violence and abuse; (b) several biological pathways have the potential to lead to the development of future illness; and (c) common physiologic mechanisms may moderate the severity, phenomenology, or clinical course of medical illnesses in individuals with histories of exposure to violence or abuse. Importantly, additional work is needed to advance our emerging understanding of the biological mechanisms connecting exposure to violence and abuse and negative health outcomes. PMID:22186168

Keeshin, Brooks R; Cronholm, Peter F; Strawn, Jeffrey R

2011-12-19

295

Levodopa medication does not influence motor inhibition or conflict resolution in a conditional stop-signal task in Parkinson's disease.  

PubMed

Evidence from animal, clinical, and imaging studies suggests that the basal ganglia and their frontal connections mediate motor inhibition, but the role of dopamine remains unclear. The aim of our study was to investigate, for the first time, whether levodopa medication influences motor inhibition and conflict resolution on the conditional stop-signal reaction time task in patients with Parkinson's disease (PD) tested on or off their medication. Sixteen PD patients and 17 healthy controls performed the conditional stop-signal reaction time (SSRT) task, which requires inhibition of responses when a stop signal is presented on "critical" trials. Additionally, on "non-critical" trials, participants are instructed to ignore the stop signal and respond, thus generating conflict between motor inhibition and initiation; and conflict-induced slowing (CIS) on these "non-critical" trials. Levodopa medication did not significantly influence response initiation, inhibition (SSRT) or the measure of conflict resolution (CIS). Compared to healthy controls, PD patients showed significantly worse response initiation and inhibition both on and off their levodopa medication. Our results suggest that motor inhibition or conflict-induced slowing on the conditional stop-signal RT task are not altered by dopamine replacement in PD. This conclusion is consistent with evidence from animal studies and clinical pharmacological investigations suggesting a role for noradrenaline in motor inhibition and impulsivity. PMID:21796541

Obeso, Ignacio; Wilkinson, Leonora; Jahanshahi, Marjan

2011-07-28

296

Enrollment factors and preexisting medical conditions in a prepaid capitated plan. A comparison of university and nonuniversity clinic enrollees.  

PubMed

Traditional wisdom suggests that academic medical centers attract sicker patients than nonacademic facilities, thereby incurring greater risk when caring for patients enrolled in prepaid health care plans. This study examines the affiliation of an academic medical center with a prepaid capitation-based medical plan in western Washington state and focuses on demographic characteristics, prior existing medical conditions, recent utilization, and factors affecting enrollee choice of health care plan, clinic, and physician. It was hypothesized that university clinic enrollees would differ from nonuniversity clinic enrollees with regard to many of these factors. A questionnaire was sent to a random sample of 400 university clinic enrollees and 759 enrollees in nonuniversity, private practice settings. The response rate was 56.1%. Results showed that, when compared with nonuniversity clinic enrollees in the same plan, university clinic enrollees were significantly younger and had more formal education. University clinic enrollees reported less health care utilization and expressed fewer strong preferences than nonuniversity clinic enrollees in choosing a health care plan, clinic, and physician. Based on this survey, there was no evidence that the academic medical center attracted sicker HMO enrollees than did nonuniversity clinics. PMID:2809528

Ellsbury, K E; Larson, E B; Raskind, W; Montano, D E; Kuykendall, D

1989-11-01

297

Manchester Clinical Placement Index (MCPI). Conditions for Medical Students' Learning in Hospital and Community Placements  

ERIC Educational Resources Information Center

|The drive to quality-manage medical education has created a need for valid measurement instruments. Validity evidence includes the theoretical and contextual origin of items, choice of response processes, internal structure, and interrelationship of a measure's variables. This research set out to explore the validity and potential utility of an…

Dornan, Tim; Muijtjens, Arno; Graham, Jennifer; Scherpbier, Albert; Boshuizen, Henny

2012-01-01

298

Manchester Clinical Placement Index (MCPI). Conditions for Medical Students' Learning in Hospital and Community Placements  

ERIC Educational Resources Information Center

The drive to quality-manage medical education has created a need for valid measurement instruments. Validity evidence includes the theoretical and contextual origin of items, choice of response processes, internal structure, and interrelationship of a measure's variables. This research set out to explore the validity and potential utility of an…

Dornan, Tim; Muijtjens, Arno; Graham, Jennifer; Scherpbier, Albert; Boshuizen, Henny

2012-01-01

299

Spiritually Competent Practice with Individuals and Families Dealing with Medical Conditions  

ERIC Educational Resources Information Center

Counselors and psychotherapists are increasingly expected to provide services that are spiritually competent. Those counseling individuals and families where medical concerns are a focus would do well to consider the implications of spiritual competence in their work. The article defines spiritual competence, describes spiritual competencies, and…

Sperry, Len

2011-01-01

300

Spiritually Competent Practice with Individuals and Families Dealing with Medical Conditions  

ERIC Educational Resources Information Center

|Counselors and psychotherapists are increasingly expected to provide services that are spiritually competent. Those counseling individuals and families where medical concerns are a focus would do well to consider the implications of spiritual competence in their work. The article defines spiritual competence, describes spiritual competencies, and…

Sperry, Len

2011-01-01

301

76 FR 15798 - Special Conditions: Boeing 747-468, Installation of a Medical Lift  

Federal Register 2010, 2011, 2012, 2013

...DO NOT OPERATE LIFT DURING TAXI, TAKEOFF, LANDING, OR TURBULENCE. c. AN APPROVED MEDICAL STRETCHER OR WHEELCHAIR MUST BE...Stow the lift for non-operation such as during TTL and turbulence. d. Operate the mechanical-override features in the...

2011-03-22

302

75 FR 27662 - Special Conditions: Boeing 747-468, Installation of a Medical Lift  

Federal Register 2010, 2011, 2012, 2013

...DO NOT OPERATE LIFT DURING TAXI, TAKEOFF, LANDING, OR TURBULENCE. c. AN APPROVED MEDICAL STRETCHER OR WHEELCHAIR MUST BE...Stow the lift for non-operation such as during TTL and turbulence. d. Operate the mechanical-override features in the...

2010-05-18

303

Long-term medical conditions and major depression in a Canadian population study at waves 1 and 2  

Microsoft Academic Search

Background: Cross-sectional studies have reported that certain long-term medical conditions are associated with major depression. Here, these associations are explored using a longitudinal analysis. Methods: Data from the first (1994\\/95) and second (1996\\/97) waves of the Canadian National Population Health Survey (NPHS) were utilized. The first wave of the NPHS utilized a probability sample of 17?626 members of the Canadian

Scott B. Patten

2001-01-01

304

Clinical effectiveness of influenza vaccination in persons younger than 65 years with high-risk medical conditions: the PRISMA Study  

Microsoft Academic Search

BACKGROUND: Influenza vaccination has consistently been shown to prevent all-cause death and\\u000ahospitalizations during influenza epidemics among seniors. However, such benefits have not yet been demonstrated among younger individuals with high-risk medical conditions. In the present study, we evaluated the effectiveness of influenza vaccine in persons recommended for vaccination of any age during an epidemic. METHODS: We conducted a case-control

E. Hak; E. Buskens; G. A. van Essen; D. H. de Bakker; D. E. Grobbee; M. A. J. B. Tacken; B. A. van Hout; Th. J. M. Verheij

2005-01-01

305

The Level of Comfort Among Nursing Students During Sexual Counseling to Patients Who Have Chronic Medical Conditions  

Microsoft Academic Search

The aim of this study is to determine the level of comfort among nursing students during sexual counseling to patients who\\u000a have chronic medical conditions. The sample of this descriptive study consisted of 161 students who study at the third and\\u000a fourth years at a health college. More than half of the students reported being comfortable or a slightly comfortable

Ayse Cil Akinci; Hicran Yildiz; Neriman Zengin

2011-01-01

306

Chronic medical conditions and mental health in older people: disability and psychosocial resources mediate specific mental health eects  

Microsoft Academic Search

Background. This study describes the dierences in psychological distress, disability and psychosocial resources between types of major medical conditions and sensory impairments (collectively denoted as CMCs); and tests whether disability and psychosocial resources mediate CMC-specific mental health eects. Methods. Data were obtained from a population-based, cross-sectional survey of 5078 non- institutionalized, late middle-aged and older Dutch persons. The predictors were

J. O RMEL; E. I. B RILMAN; A. T. F. B EEKMAN

1997-01-01

307

Spending And Service Use Among People With The Fifteen Most Costly Medical Conditions, 1997  

Microsoft Academic Search

This study addresses the Institute of Medicine's recommendation that AHRQ use MEPS data to identify a set of priority conditions to inform efforts at improving quality of care. Using MEPS data we identify the fifteen most expensive conditions in the U.S. in 1997: chronic diseases such as heart disease, cancer, and diabetes, and acute conditions such as trauma, pneumonia, and

Joel W. Cohen; Nancy A. Krauss

2003-01-01

308

The usefulness of trauma scores in determining the life threatening condition of trauma victims for writing medical-legal reports  

PubMed Central

Objectives: In the Turkish legal system the severity of the victim's injury determines the severity of the criminal penalty, and the life threatening condition stated in the medical-legal report is one of the main determinants for injury severity. The aim of this study is to investigate the effectiveness and usefulness of the trauma scores in determining the life threatening condition of trauma victims from the forensic aspect in order to write accurate medical-legal reports. Methods: Data of 296 forensic cases with blunt and penetrating trauma were obtained. The life threatening condition of patients stated in the medical-legal reports according to the criteria based on traditional forensic opinion were examined. For each case, Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) were calculated. The ROC curve analysis was used to investigate the success of the trauma scores in distinguishing patients with/without life threatening conditions. Logistic regression analysis was performed to measure the association between trauma scores and life threatening conditions. Results: The relations between all scores and groups (with and without life threatening risk) were found statistically significant. ISS was the most successful method in distinguishing traumatised patients both in a life threatening or non life threatening condition. Conclusions: Trauma scores can be used for making more objective, standardised, and accurate judgement on whether the injury was a life threatening one or not. These advantages of using trauma scores in such situations will also be helpful for the conclusion of the lawsuits shortly, but further studies are needed to confirm these findings.

Bilgin, N; Mert, E; Camdeviren, H

2005-01-01

309

Living conditions, ability to seek medical treatment, and awareness of health conditions and healthcare options among homeless persons in Tokyo, Japan.  

PubMed

Empirical data indicative of the health conditions and medical needs of homeless persons are scarce in Japan. In this study, with the aim of contributing to the formulation of future healthcare strategies for the homeless, we conducted a self-administered questionnaire survey and interviews at a park in Shinjuku Ward, Tokyo, to clarify the living conditions of homeless persons and their health conditions and awareness about the availability of medical treatment. Responses from 55 homeless men were recorded (response rate: 36.7%). With the exception of one person, none of them possessed a health insurance certificate. Half of the respondents reported having a current income source, although their modal monthly income was 30,000 yen($1 was approximately 90 yen). The number of individuals who responded "yes" to the questions regarding "Consulting a doctor on the basis of someone's recommendation" and "Being aware of the location of the nearest hospital or clinic" was significantly higher among those who had someone to consult when they were ill than among those who did not (the odds ratios [95% confidence intervals] were 15.00 [3.05-93.57] and 11.45 [1.42-510.68], respectively). This showed that whether or not a homeless person had a person to consult might influence his healthcare-seeking behavior. When queried about the entity they consulted (multiple responses acceptable), respondents mentioned "life support organizations" (61.1%) and "public offices" (33.3%). Overall, 94.5% of the respondents were aware of swine flu (novel influenza A (H1N1)). Their main sources of information were newspapers and magazines. On the basis of these findings, with regard to the aim of formulating healthcare strategies for homeless persons, while life support organizations and public offices play significant roles as conduits to medical institutions, print media should be considered useful for communicating messages to homeless persons. PMID:22189479

Ohtsu, Tadahiro; Toda, Ryouhei; Shiraishi, Tomonobu; Toyoda, Hirokuni; Toyozawa, Hideyasu; Kamioka, Yasuaki; Ochiai, Hirotaka; Shimada, Naoki; Shirasawa, Takako; Hoshino, Hiromi; Kokaze, Akatsuki

2011-12-01

310

Perception of stress-related working conditions in hospitals (iCept-study): a comparison between physicians and medical students  

PubMed Central

Background The students’ perception of working conditions in hospitals hasn’t been subject of research in Germany so far. However the perception plays an important role talking about the sustainability of working conditions. The iCept Study wants to examine the perception of medical students compared to the perception of practicing physicians. Methods/design The perception will be investigated with a redesigned questionnaire based upon two established and validated questionnaires. The two samples built for this study (students and physician) will be chosen from members of the labor union Marburger Bund. The iCept-Study is designed as an anonymized online-survey. Discussion The iCept-Study is thought to be the basis of ongoing further investigations regarding the perception of working conditions in hospitals. The results shall serve the facilitation of improving working conditions.

2013-01-01

311

HealthDoc: Customizing patient information and health education by medical condition and personal characteristics  

Microsoft Academic Search

The HealthDoc project aims to provide a comprehensive approach to the customization of patient-information and health-education materials through the development of so- phisticated natural language generation systems. We adopt a model of patient education that takes into account patient information ranging from simple medical data to complex cul- tural beliefs, so that our work provides both an impetus and testbed

Chrysanne DiMarco; Graeme Hirst; Leo Wanner; John Wilkinson

1995-01-01

312

Association between mental health conditions and rehospitalization, mortality, and functional outcomes in patients with stroke following inpatient rehabilitation  

PubMed Central

Background Limited evidence exists regarding the association of pre-existing mental health conditions in patients with stroke and stroke outcomes such as rehospitalization, mortality, and function. We examined the association between mental health conditions and rehospitalization, mortality, and functional outcomes in patients with stroke following inpatient rehabilitation. Methods Our observational study used the 2001 VA Integrated Stroke Outcomes database of 2162 patients with stroke who underwent rehabilitation at a Veterans Affairs Medical Center. Separate models were fit to our outcome measures that included 6-month rehospitalization or death, 6-month mortality post-discharge, and functional outcomes post inpatient rehabilitation as a function of number and type of mental health conditions. The models controlled for patient socio-demographics, length of stay, functional status, and rehabilitation setting. Results Patients had an average age of 68 years. Patients with stroke and two or more mental health conditions were more likely to be readmitted or die compared to patients with no conditions (OR: 1.44, p = 0.04). Depression and anxiety were associated with a greater likelihood of rehospitalization or death (OR: 1.33, p = 0.04; OR:1.47, p = 0.03). Patients with anxiety were more likely to die at six months (OR: 2.49, p = 0.001). Conclusions Patients with stroke with pre-existing mental health conditions may need additional psychotherapy interventions, which may potentially improve stroke outcomes post-hospitalization.

2011-01-01

313

Medical management of vulnerable populations and co-morbid conditions of victims of bioterrorism.  

PubMed

Planning for the medical response to bioterrorism has primarily focused around the needs of the population as a whole. There has been little discussion pertaining to certain vulnerable groups such as children, pregnant women, or immunocompromised patients, yet they will likely comprise a significant subset of the exposed population. In addition, they will be at increased risk for morbidity and mortality following an attack. The emergency response to bioterrorism will be more complex as it relates to these vulnerable populations. Careful consideration of their special needs, some of which are presented in this article, may refine our efforts. PMID:12120484

White, Suzanne R; Henretig, Fred M; Dukes, Richard G

2002-05-01

314

Influence of medical conditions on executive and memory functions in low socioeconomic status African Americans  

Microsoft Academic Search

We examined the association of total comorbid score and specific chronic conditions including cardiovascular diseases, musculoskeletal conditions, diabetes mellitus, stroke, hypertension, and cancer with several cognitive domains across four different age groups: young adults (ages 18–34), young middle-aged adults (ages 35–50), middle-aged adults (ages 51–64), and older adults (ages >64). Cognitive tests measuring global ability, executive function, memory function, and

Ha T. Nguyen; Michele K. Evans; Alan B. Zonderman

2007-01-01

315

On-site Basic Health Screening and Brief Health Counseling of Chronic Medical Conditions for Veterans in Methadone Maintenance Treatment.  

PubMed

BACKGROUND: In order to improve the delivery of health services for chronic medical conditions in our methadone clinic, we added an onsite health screening and brief health counseling to the treatment plans for patients receiving methadone maintenance treatment at the Atlanta Veterans Affairs Medical Center (VAMC). We then conducted a follow up retrospective chart review to assess whether this intervention improved health outcome for those patients. METHODS: We reviewed the charts of one hundred and two patients who received treatment at Atlanta VAMC methadone clinic between 2002 and 2008. We sought to determine whether our increased health education and screening intervention was associated with improved: 1) Improved drug addiction outcome (as measured by comparing percentage of opiate and cocaine positive drug screens from admission to most recent). 2) Basic health screening, (as measured by the patient's compliance with primary care physicians (PCP) appointments and current smoking status). 3) Management of co-occurring medical conditions (as measured by levels of LDL cholesterol, hemoglobin A1c, and systolic blood pressure (SBP). 4) Presence of QTc prolongation (difference in QTc between baseline and most recent EKG). RESULTS: Illicit drug use (opiate and cocaine) markedly decreased in patients overall. The effect was more robust for those successfully "retained" (n=55, p<0.0001) in treatment, compared to those who "dropped out" (n=40, p=0.05) of treatment. Compliance with PCP appointments was high (82% and 88% before and after the onsite intervention, respectively) for "retained" patients. LDL cholesterol level was within normal range for all patients. A1c improved by 40% after the onsite intervention as reflected by the decreased percentage of patients with A1c > 7 % from before to after the intervention (90% vs. 50%, p=0.05). However, the prevalence of uncontrolled hypertension did not significantly improve after the onsite intervention (38% vs. 28%, p=0.34). As might be expected with MMT, the prevalence of QTc prolongation actually increased from 399 m sec. (+/- 92) to 439 msec. (+/- 22) after the onsite intervention (p=0.003). CONCLUSIONS: Our retrospective study supports the previous literature that methadone maintenance therapy is effective in reducing illicit drug use. Although patients with history of heroin dependence and in methadone maintenance treatment are at increased risk for chronic medical conditions like hepatitis C and diabetes, there are minimal federal guidelines for medical care, except than a physical exam upon admission, and basic screening for some infectious diseases e.g. HIV and Hepatitis C for those patients. Our study demonstrated the need for and potential benefit of enhancing the delivery of health promotion services for chronic medical conditions in methadone maintained patients. Improving management of hepatitis C, diabetes, hypertension, and other related conditions, in this high risk, difficult-to-treat, and underserved population may reduce their morbidity and premature mortality. PMID:20823944

Fareed, Ayman; Musselman, Dominique; Byrd-Sellers, Johnita; Vayalapalli, Sreedevi; Casarella, Jennifer; Drexler, Karen; Phillips, Lawrence

2010-09-01

316

On-site Basic Health Screening and Brief Health Counseling of Chronic Medical Conditions for Veterans in Methadone Maintenance Treatment  

PubMed Central

Background In order to improve the delivery of health services for chronic medical conditions in our methadone clinic, we added an onsite health screening and brief health counseling to the treatment plans for patients receiving methadone maintenance treatment at the Atlanta Veterans Affairs Medical Center (VAMC). We then conducted a follow up retrospective chart review to assess whether this intervention improved health outcome for those patients. Methods We reviewed the charts of one hundred and two patients who received treatment at Atlanta VAMC methadone clinic between 2002 and 2008. We sought to determine whether our increased health education and screening intervention was associated with improved: 1) Improved drug addiction outcome (as measured by comparing percentage of opiate and cocaine positive drug screens from admission to most recent). 2) Basic health screening, (as measured by the patient's compliance with primary care physicians (PCP) appointments and current smoking status). 3) Management of co-occurring medical conditions (as measured by levels of LDL cholesterol, hemoglobin A1c, and systolic blood pressure (SBP). 4) Presence of QTc prolongation (difference in QTc between baseline and most recent EKG). Results Illicit drug use (opiate and cocaine) markedly decreased in patients overall. The effect was more robust for those successfully “retained” (n=55, p<0.0001) in treatment, compared to those who “dropped out” (n=40, p=0.05) of treatment. Compliance with PCP appointments was high (82% and 88% before and after the onsite intervention, respectively) for “retained” patients. LDL cholesterol level was within normal range for all patients. A1c improved by 40% after the onsite intervention as reflected by the decreased percentage of patients with A1c > 7 % from before to after the intervention (90% vs. 50%, p=0.05). However, the prevalence of uncontrolled hypertension did not significantly improve after the onsite intervention (38% vs. 28%, p=0.34). As might be expected with MMT, the prevalence of QTc prolongation actually increased from 399 m sec. (+/- 92) to 439 msec. (+/- 22) after the onsite intervention (p=0.003). Conclusions Our retrospective study supports the previous literature that methadone maintenance therapy is effective in reducing illicit drug use. Although patients with history of heroin dependence and in methadone maintenance treatment are at increased risk for chronic medical conditions like hepatitis C and diabetes, there are minimal federal guidelines for medical care, except than a physical exam upon admission, and basic screening for some infectious diseases e.g. HIV and Hepatitis C for those patients. Our study demonstrated the need for and potential benefit of enhancing the delivery of health promotion services for chronic medical conditions in methadone maintained patients. Improving management of hepatitis C, diabetes, hypertension, and other related conditions, in this high risk, difficult-to-treat, and underserved population may reduce their morbidity and premature mortality.

Fareed, Ayman; Musselman, Dominique; Byrd-Sellers, Johnita; Vayalapalli, Sreedevi; Casarella, Jennifer; Drexler, Karen; Phillips, Lawrence

2010-01-01

317

Anthropometrics, Physical Activity, Related Medical Conditions, and the Risk of Non-Hodgkin Lymphoma  

Microsoft Academic Search

Background: Recent reports suggest that obesity, or conditions associated with obesity, might be risk factors for non-Hodgkin lymphoma (NHL), a cancer with dramatically increasing incidence in western countries over the last several decades. Physical inactivity increases the risk of obesity and of type 2 diabetes, but there are few data on the association of physical activity with risk of NHL.

James R. Cerhan; Leslie Bernstein; Richard K Severson; Scott Davis; Joanne S. Colt; Aaron Blair; Patricia Hartge

2005-01-01

318

Five Most Costly Medical Conditions 1997 and 2002: Estimates for the Civilian Noninstitutionalized Population. Medical Expenditure Panel Survey (MEPS) Research Findings No. 80.  

National Technical Information Service (NTIS)

The Household Component of the Medical Expenditure Panel Survey (MEPS-HC) provides critical information for evaluating trends in health care expenditures. This Statistical Brief presents data from the MEPSHC concerning medical expenditures for the five mo...

G. L. Olin J. A. Rhoades

2005-01-01

319

A historical glimpse of toothpick use: etiquette, oral and medical conditions.  

PubMed

This article traces various historical and geographical aspects of multicultural toothpick use, dating back from prehistoric times to the present. This behavior appears to be one of the oldest and best documented of all human habits. Toothpicks (composed of bone, ivory, metal, plastic, quills, wood or other substances) have been used for ceremonial, oral hygiene and religious purposes. Throughout the ages, the act of toothpicking has been both encouraged and discouraged. In the 19-20th centuries, it was generally viewed as a disgusting breach of social etiquette and a significant threat to oral and general health. Authors of numerous dental articles have cautioned that indiscriminate toothpick use can lead to halitosis, dental caries, injury to the interdental papilla, mouth ulcers, allergic reactions, embedment of the device in the back of the mouth or throat, gingival abscesses, sensitive teeth, or abraded enamel, dentin or cementum of both permanent and primary dentitions. Additionally, both the dental and medical literature report anecdotal cases of life-threatening injuries and death caused by toothpick ingestion. PMID:12846259

Christen, Arden G; Christen, Joan A

2003-07-01

320

Consensus statement on epidemiological studies of medical conditions in tennis, April 2009  

Microsoft Academic Search

Background:The reported incidence, severity and nature of injuries sustained in tennis vary considerably between studies. While some of these variations can be explained by differences in sample populations and conditions, the main reasons are related to differences in definitions and methodologies employed in the studies.Objective:This statement aims to review existing consensus statements for injury surveillance in other sports in order

B M Pluim; C W Fuller; M E Batt; L Chase; B Hainline; S Miller; B Montalvan; P Renström; K A Stroia; K Weber; T O Wood

2009-01-01

321

Emergency Medical Services Outcomes Project I (EMSOP I): Prioritizing Conditions for Outcomes Research  

Microsoft Academic Search

Over the past several years, out-of-hospital EMS have come under increased scrutiny regarding the value of the range of EMS as currently provided. We used frequency data and expert opinion to rank-order EMS conditions for children and adults based on their potential value for the study of effectiveness of EMS care. Relief of discomfort was the outcome parameter EMS professionals

Ronald F Maio; Herbert G Garrison; Daniel W Spaite; Jeffrey S Desmond; Mary Ann Gregor; C. Gene Cayten; John L Chew; Elizabeth M Hill; Steven M Joyce; Ellen J MacKenzie; David R Miller; Patricia J O’Malley; Ian G Stiell

1999-01-01

322

Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?  

PubMed Central

Background Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. Methods A qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. Results According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the importance of considering telehealth within the broader organisation of health care services in remote and rural regions. Conclusion This study identified core elements that should be considered when implementing telehealth applications with the purpose of supporting medical practice in rural and remote regions. Decision-makers need to be aware of the specific conditions that could influence telehealth integration into clinical practices and health care organisations. Thus, strategies addressing the identified conditions for telehealth success would facilitate the optimal implementation of this technology.

Gagnon, Marie-Pierre; Duplantie, Julie; Fortin, Jean-Paul; Landry, Rejean

2006-01-01

323

Survey of medical ethnobotanicals for dental and oral medicine conditions and pathologies.  

PubMed

Ethnomedical questionnaires were distributed in Chicago, Costa Rica, and Colombia to identify the most common over-the-counter (OTC) plant or plant-based products advocated for treating oral pain, ulcerative conditions, and cancer within these locations. Over 100 plants or plant-based herbal preparations and commercial products, purchased from local botanical markets and pharmacies, were advocated for the treatment of oral medicine conditions. Locally familiar and common language names were attributed to the plant products at the time of purchase. Plant products or plant-based commercial products containing plant-based essential oils, anesthetic constituents, and or chemical compounds recommended as OTC oral medicine preparations were systematized, tabulated, and correlated with the published phytotherapeutic literature. Though pharmacognostic research is available for some of the species collected, further ethnographic research is needed to correlate common names with the accurate taxonomic identification for each plant species. Furthermore, epidemiological research is needed to verify the use and standardized dosage for OTC ethnomedicine preparations for oral medicine conditions. Pharmacognostic research and clinical trails which can verify taxonomy, dose, safety, active principles, and efficacy of these OTC oral medicine products must be enhanced in order to verify the claimed validity in contemporary, global, oral medicine practice. PMID:16735102

Colvard, Michael D; Cordell, Geoffrey A; Villalobos, Rodrigo; Sancho, Gina; Soejarto, Doel D; Pestle, William; Echeverri, Tatiana Lobo; Perkowitz, Kathleen M; Michel, Joanna

2006-04-18

324

Medical Conditions and Other Factors in Driver Risk. Report to the Legislature of the State of California. In Accord with Senate Bill 335, Chapter 985, 2000 Legislative Session.  

National Technical Information Service (NTIS)

This report addresses the effects of medical conditions and medications on the ability to operate a motor vehicle safely. It presents crash rates and crash odds ratios for broadly defined groups of drivers known to the Department of Motor Vehicles as havi...

M. K. Janke

2001-01-01

325

Prevention or Reversal of Deep Venous Insufficiency and Treatment: Why Are Spider Veins of the Legs a Serious and A Dangerous Medical Condition?  

Microsoft Academic Search

Spider veins (also known as spider hemangiomas) unlike varicose veins (dilated pre-existing veins) are acquired lesions caused by venous hypertension leading to proliferation of blood vessels in the skin and subcutaneous tissues due to the release of endothelial growth factors causing vascular neogenesis. More than 60% of the patients with spider veins of the legs have significant symptoms including pain,

Waheed Ahmad

326

The impact of diabetes mellitus and other chronic medical conditions on health-related Quality of Life: Is the whole greater than the sum of its parts?  

Microsoft Academic Search

BACKGROUND: Diabetes mellitus (DM) is an important public health concern, the impact of which is increased by the high prevalence of co-existing chronic medical conditions among subjects with DM. The aims of this study were therefore to (1) evaluate the impact of DM and co-existing chronic medical conditions on health-related quality of life (HRQoL) (which could be additive, synergistic or

Hwee-Lin Wee; Yin-Bun Cheung; Shu-Chuen Li; Kok-Yong Fong; Julian Thumboo

2005-01-01

327

A longitudinal study on changes of movement performance and their relation to medical conditions in a female population followed from age 70 to 78  

Microsoft Academic Search

We described longitudinal changes of movement performance in a population-based sample of women followed from age 70 to 78. We also studied the cross-sectional relationships between medical conditions and movement performance at baseline, and longitudinal relationships between baseline medical conditions and changes of movement performance. Two hundred and thirty-four women aged 70 years participated in the baseline study, and 88

Xinxin Guo; Michael Matousek; Ulla Sonn; Ingmar Skoog; Cecilia Björkelund; Bertil Steen

2003-01-01

328

Offering predictive testing for Huntington disease in a medical genetics clinic: Practical applications  

Microsoft Academic Search

Predictive testing for Huntington disease is presently offered in a select few medical genetics centers in the United States. This is in part due to the labor intensive counseling and psychological testing suggested by the research protocols. We discuss some specific suggestions for establishing programs for Huntington disease predictive testing within pre-existing medical genetics clinics to encourage more centers to

Robin L. Bennett; Thomas D. Bird; Linda Teri

1993-01-01

329

Syndromes of Brain Dysfunction Presenting with Cognitive Impairment or Behavioral Disturbance: Delirium, Dementia, and Mental Disorders Caused by a General Medical Condition  

Microsoft Academic Search

The disorders under consideration are the result of identifiable conditions. Historically, an arbitrary distinction has been\\u000a made between “organic” conditions, associated with a presumably clear pathological basis, and “functional” conditions, or\\u000a psychiatric disorders that lacked obvious disease processes. Delirium, however, is a disorder of cognitive dysfunction that\\u000a lacks a well-understood pathophysiology despite unequivocal association with multiple and various medical conditions.

Keith E. Isenberg; Keith Garcia

330

42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.  

Code of Federal Regulations, 2011 CFR

...patient's medical, nursing, and social needs can...adequately by the agency in the patient's place...plan of care developed in consultation with...medications and treatments, any safety measures to protect...personnel participate in developing the plan...

2011-10-01

331

42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.  

Code of Federal Regulations, 2012 CFR

...patient's medical, nursing, and social needs can...adequately by the agency in the patient's place...plan of care developed in consultation with...medications and treatments, any safety measures to protect...personnel participate in developing the plan...

2012-10-01

332

Concurrent Medical Conditions and Health Care Use and Needs among Children with Learning and Behavioral Developmental Disabilities, National Health Interview Survey, 2006–2010  

Microsoft Academic Search

Studies document various associated health risks for children with developmental disabilities (DDs). Further study is needed by disability type. Using the 2006–2010 National Health Interview Surveys, we assessed the prevalence of numerous medical conditions (e.g. asthma, frequent diarrhea\\/colitis, seizures), health care use measures (e.g. seeing a medical specialist and >9 office visits in past year), health impact measures (e.g. needing

Laura A. Schieve; Vanessa G. Jarquin; Sheree L. Boulet; Susanna N. Visser; Catherine E. Rice; Kim Van Naarden Braun; Coleen A. Boyle

333

Magnetic resonance imaging in patients with cardiac pacemakers: era of "MR Conditional" designs.  

PubMed

Advances in cardiac device technology have led to the first generation of magnetic resonance imaging (MRI) conditional devices, providing more diagnostic imaging options for patients with these devices, but also new controversies. Prior studies of pacemakers in patients undergoing MRI procedures have provided groundwork for design improvements. Factors related to magnetic field interactions and transfer of electromagnetic energy led to specific design changes. Ferromagnetic content was minimized. Reed switches were modified. Leads were redesigned to reduce induced currents/heating. Circuitry filters and shielding were implemented to impede or limit the transfer of certain unwanted electromagnetic effects. Prospective multicenter clinical trials to assess the safety and efficacy of the first generation of MR conditional cardiac pacemakers demonstrated no significant alterations in pacing parameters compared to controls. There were no reported complications through the one month visit including no arrhythmias, electrical reset, inhibition of generator output, or adverse sensations. The safe implementation of these new technologies requires an understanding of the well-defined patient and MR system conditions. Although scanning a patient with an MR conditional device following the strictly defined patient and MR system conditions appears straightforward, issues related to patients with pre-existing devices remain complex. Until MR conditional devices are the routine platform for all of these devices, there will still be challenging decisions regarding imaging patients with pre-existing devices where MRI is required to diagnose and manage a potentially life threatening or serious scenario. A range of other devices including ICDs, biventricular devices, and implantable physiologic monitors as well as guidance of medical procedures using MRI technology will require further biomedical device design changes and testing. The development and implementation of cardiac MR conditional devices will continue to require the expertise and collaboration of multiple disciplines and will need to prove safety, effectiveness, and cost effectiveness in patient care. PMID:22032338

Shinbane, Jerold S; Colletti, Patrick M; Shellock, Frank G

2011-10-27

334

conditions  

Microsoft Academic Search

Real-time scheduling is both based on a broad theoretical background and available through a multitude of tools and infrastructures. The central input parameters to this discipline are the demand for execution time and the real- time conditions given as deadlines or periods. The former has attracted a lot of research efforts, mainly in the scope of worst case execution time

Dieter Z

335

Conditions  

Microsoft Academic Search

A shallow, RDX (hexahydro-1,3,5-trinitro-1,3,5-triazine)- contaminated aquifer at Naval Submarine Base Bangor has been characterized as predominantly manganese-reducing, anoxic with local pockets of oxic conditions. The potential contribution of microbial RDX degradation to localized decreases observed in aquifer RDX concentrations was assessed in sediment microcosms amended with (U- 14 C) RDX. Greater than 85% mineralization of 14 C-RDX to 14 CO2

Paul M. Bradley; Richard S. Dinicola

336

[Characteristics of the medical status and living conditions of the homeless registered as tuberculosis patients in Nagoya City].  

PubMed

An Investigation by questionnaire was conducted in 1996 to know the tuberculosis (TB) status and living conditions of 50 homeless people registered as TB patients at one of Nagoya city's 16 health centers. 1. All patients had one or more symptoms of TB, 64% of them showed positive TB bacilli on smear, and 35.3% of them had a previous history of TB treatment. However, only 15.2% suspected they had TB at the onset of symptoms. 2. Main reasons of seeking medical treatment: 28.6% arrived by ambulance after falling down from exhaustion, 25.7% had consulted with welfare agencies after the onset of symptoms, and 20.0% had been diagnosed during the treatment of other diseases. 3. When they were admitted to the hospital they had many concerns: 29.0% loss of income, 19.4% living expenses, 19.4% smoking prohibition, 12.9% admission fee, and 9.7% privacy. 4. They lived in the following: 42.9% construction camps, 20.0% parks or streets, 17.1% single room occupancy hotels, 17.1% daily or monthly paid apartments, and 11.4% sauna baths. 5. Past medical histories of the subjects included 40.6% injuries by labor accidents, and 25.0% stomach ulcers. Current diseases were 15.6% mental diseases, 15.6% liver diseases, 15.6% diabetes mellitus, and 9.4% alcoholic dependence. Seventy percent of them consumed alcohol daily (average pure ethanol 125 ml per day). 6. From the results outlined above, the following proposals relating to TB control of the homeless should be considered. 1) Educating the homeless as to the need for a health check when TB symptoms are present. 2) Opening a clinic for the homeless for easy access to consultation on TB. 3) Directly observed therapy short-course, for TB in the homeless. 4) Health examination of the employees of single-room occupancy hotels and sauna baths which are used frequently by the homeless. 5) A fundamental countermeasure to deal with alcoholic dependency among the homeless. PMID:10191602

Yamanaka, K; Akashi, T; Miyao, M; Ishihara, S

1999-02-01

337

Medical futility  

Microsoft Academic Search

Physicians may employ the concept of medical futility to justify a decision not to pursue certain treatments that may be requested\\u000a or demanded by patients or surrogates. Medical futility means that the proposed therapy should not be performed because available\\u000a data show that it will not improve the patient’s medical condition. Medical futility remains ethically controversial for several\\u000a reasons. Some

James L. Bernat

2005-01-01

338

Medical Comorbidity of Full and Partial Posttraumatic Stress Disorder in United States Adults: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions  

PubMed Central

Objective This study examined associations between lifetime trauma exposures, PTSD and partial PTSD, and past-year medical conditions in a nationally representative sample of U.S. adults. Methods Face-to-face interviews were conducted with 34,653 participants in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression analyses evaluated associations of trauma exposure, PTSD and partial PTSD with respondent-reported medical diagnoses. Results After adjustment for sociodemographic characteristics and comorbid Axis I and II disorders, respondents with full PTSD were more likely than traumatized respondents without full or partial PTSD (comparison group) to report diagnoses of diabetes mellitus, noncirrhotic liver disease, angina pectoris, tachycardia, hypercholesterolemia, other heart disease, stomach ulcer, HIV seropositivity, gastritis, and arthritis (odds ratios [ORs]=1.2-2.5). Respondents with partial PTSD were more likely than the comparison group to report past-year diagnoses of stomach ulcer, angina pectoris, tachycardia, and arthritis (ORs=1.3-1.6). Men with full and partial PTSD were more likely than controls to report diagnoses of hypertension (both ORs=1.6), and both men and women with PTSD (ORs=1.8 and 1.6, respectively), and men with partial PTSD (OR=2.0) were more likely to report gastritis. Total number of lifetime traumatic event types was associated with many assessed medical conditions (ORs=1.04-1.16), reducing the magnitudes and rendering non-significant some of the associations between PTSD status and medical conditions. Conclusions Greater lifetime trauma exposure and PTSD are associated with numerous medical conditions, many of which are stress-related and chronic, in U.S. adults. Partial PTSD is associated with intermediate odds of some of these conditions.

Pietrzak, Robert H.; Goldstein, Rise B.; Southwick, Steven M.; Grant, Bridget F.

2011-01-01

339

Concurrent Medical Conditions and Health Care Use and Needs among Children with Learning and Behavioral Developmental Disabilities, National Health Interview Survey, 2006-2010  

ERIC Educational Resources Information Center

Studies document various associated health risks for children with developmental disabilities (DDs). Further study is needed by disability type. Using the 2006-2010 National Health Interview Surveys, we assessed the prevalence of numerous medical conditions (e.g. asthma, frequent diarrhea/colitis, seizures), health care use measures (e.g. seeing a…

Schieve, Laura A.; Gonzalez, Vanessa; Boulet, Sheree L.; Visser, Susanna N.; Rice, Catherine E.; Braun, Kim Van Naarden; Boyle, Coleen A.

2012-01-01

340

EFFECTIVENESS OF THE EMERGENCY RESPONSE COURSE IN IMPROVING STUDENT PHYSICAL THERAPISTS' AND LICENSED PHYSICAL THERAPISTS' DECISION-MAKING RELATED TO ACUTE SPORTS INJURIES AND MEDICAL CONDITIONS  

PubMed Central

Purpose: To analyze the effectiveness of the American Red Cross Emergency Response Course (ARC ERC) in improving decision?making skills of physical therapists (PTs) and third semester clinical doctorate student physical therapists (SPTs) when assessing acute sports injuries and medical conditions. Methods: An existing questionnaire was modified, with permission from the original authors of the instrument. The questionnaire was administered to PTs and SPTs before the start of and immediately after the completion of 5 different ARC ERCs. The overall percentages of “Appropriate” responses for the 17 case scenarios were calculated for each participant for the pre?and post?tests. Participants also rated their perceived level of preparedness for managing various conditions using a 5?point Likert Scale (ranging from Prepared to Unprepared). The overall percentage of “Prepared/Somewhat Prepared” responses for the 16 medical conditions was calculated for each participant for the pre?and post?tests. In addition, mean Likert scale scores were calculated for level of perceived preparedness for each of the 16 medical conditions. Paired t?tests, calculated with SPSS 20.0, were used to analyze the data. Results: 37 of 37 (100.0%) of eligible PTs and 45 of 48 (93.8%) of eligible SPTs completed the pre? and post?test questionnaires. The percentage of “Appropriate” responses for all 17 cases in the aggregate (PTs: 76.8% pre?test, 89.0% post?test; SPTs: 68.5%, 84.3%), as well as the percentage of “Prepared/Somewhat Prepared” responses for all conditions in the aggregate (PTs: 67.5%, 96.5%; SPTs: 37.1%, 90.6%) were significantly different from pre?test to post?test (P = .000). There was also a significant difference (P < .05) in the mean overall preparedness Likert scale scores from pre?test to post?test for each medical condition for the SPT's, and 15 of the 16 medical conditions (muscle strains: P = .119) for the PTs. Conclusions: The ARC ERC appears to be effective in improving both PTs' and SPTs' decision?making skills related to acute sports injuries and medical conditions, as both “Appropriate” responses and perceived level of preparedness improved. Level of Evidence: Level 3

Cross, Patrick Stephen; Hauer, Patrick L.; Blom, Heather; Burcham, Jared; Myers, Amanda K.; Grimsrud, Casey

2013-01-01

341

The Most Expensive Medical Conditions In America This nationwide study finds that the most disabling conditions are not necessarily the ones we spend the most to treat  

Microsoft Academic Search

This study uses a nationally representative survey to identify the most expen- sive conditions in the United States and to examine the association between spending and disability. The most expensive conditions at a population level were ischemic heart disease and motor vehicle accidents; at the per capita level they were respiratory malignancies. There was not a significant association between rank

Benjamin G. Druss; Steven C. Marcus; Mark Olfson; Harold Alan Pincus

342

Health Problems and Medical Utilization Associated With Gambling Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions  

Microsoft Academic Search

Objective: Pathologic gambling is believed to be associated with adverse health consequences, but no prior studies have rigorously evaluated these relationships. We sought to examine medical disorders and health service utilization associated with problem and pathologic gambling. Method: A total of 43,093 adults aged 18 years and older were evaluated in the 2001 to 2002 National Epidemiologic Survey on Alcohol

BENJAMIN J. MORASCO; ROBERT H. PIETRZAK; CARLOS BLANCO; BRIDGET F. GRANT; DEBORAH HASIN; NANCY M. PETRY

2006-01-01

343

Teachers' Drug Reference: A Guide to Medical Conditions and Drugs Commonly Used in School-Aged Children.  

ERIC Educational Resources Information Center

|This book provides a guide to approximately 175 drugs used with children. An introduction precedes the three major sections of the guide. Section 1 provides an overview of pharmacology and therapeutics in chapters on the basics of pharmacology, the language of pharmacology and therapeutics, compliance, side effects, and medications in school.…

Agins, Alan P.

344

Parent & Educators' Drug Reference: A Guide to Common Medical Conditions & Drugs Used in School-Aged Children.  

ERIC Educational Resources Information Center

|This book provides a guide to more than 180 drugs used for children. An introduction precedes the four major sections of the guide. Section 1 provides an overview of pharmacology and therapeutics in chapters on the basics of pharmacology, the language of pharmacology and therapeutics, compliance, side effects, medications in school, and drug…

Agins, Alan P.

345

Do differences in methods for constructing SF36 physical and mental health summary measures change their associations with chronic medical conditions and utilization?  

Microsoft Academic Search

Background and objective: Various approaches have been employed to derive physical health and mental health summary scores for the SF-36 and the RAND-36, but head-to-head comparisons of alternative scoring algorithms are rare. We determined whether the associations of the physical and mental health summary scores with chronic medical conditions and utilization would differ depending on the scoring algorithm used. Methods:

William E. Cunningham; Terry T. Nakazono; Kai Li Tsai; Ron D. Hays

2003-01-01

346

Medical Assistants  

NSDL National Science Digital Library

For a concise summary of the medical assistant profession the Medical Assistants entry in the Bureau of Labor Statistics' Occupational Outlook Handbook is must read. The site covers topics ranging from the nature of the profession, working conditions, earnings, and more. The section on training, qualifications and advancement will be of special interest to medical assistant faculty and students. The section on sources of addition information will also be a good launching point for anyone seeking additional online resources.

2006-11-01

347

Medication patterns for attention-deficit/hyperactivity disorder and comorbid psychiatric conditions in a low-income population.  

PubMed

The aims of this study were two-fold: (1) to describe the patterns of comorbid psychiatric diagnosis and psychotropic drug therapy for children enrolled in a Medicaid-managed care program and diagnosed with attention-deficit/hyperactivity disorder (ADHD) in 2000 and (2) to examine child and provider characteristics associated with psychotropic medication patterns for this population. Multivariate logistic regression models were used to examine correlates of stimulant and seven nonstimulant psychotropic medication classes (alpha-agonists, mood stabilizer/anticonvulsant, antianxiety, standard antipsychotic, atypical antipsychotic, and tricyclic antidepressant (TCA)/other antidepressant and selective serotonin reuptake inhibitor (SSRI) antidepressant). With the exception of conduct disorders (odds ratio, 1.22; 95% confidence interval, 1.06-1.40), comorbid disorders had a significant protective effect (odds ratio less than 1) on dispensing stimulants. After adjusting for covariates, stimulant dispensing was strongly correlated with the interactions of geographic region with race/ethnicity and provider type. Children residing in the upstate New York region had an approximately ten-fold greater chance of being dispensed a stimulant compared to similar children in New York City. Utilizing a mental health provider increased the chance of being dispensed a stimulant by factor of two for children from New York City of any race/ethnicity group. Models predicting nonstimulant drug dispensing were distinct from the stimulant model. After adjusting for covariates, nonstimulant psychotropic medication dispensing was correlated with clinical factors, including comorbid disorder category and use of a mental health provider, as well as notable sociodemographic factors. Complex psychotropic medication and comorbid psychiatric disorder patterns were evident for this low-income population of children with ADHD. The roles of clinical, patient, and provider factors need to be better understood to explain these patterns of stimulant and nonstimulant psychotropic medications dispensed. PMID:15741785

Radigan, Marleen; Lannon, Peter; Roohan, Patrick; Gesten, Foster

2005-02-01

348

Association of maternal medical conditions and unfavorable birth outcomes: findings from the 1996-2003 Mississippi linked birth and death data.  

PubMed

This study aimed to identify factors contributing to high rates of preterm birth (PTB), low birth weight (LBW) and infant mortality in Mississippi while considering both traditional risk factors and maternal medical conditions. The retrospective cohort study used 1996-2003 Mississippi linked birth and infant death files. Multiple logistic regression was used to investigate association between maternal medical conditions and unfavorable birth outcomes. Along with traditional risk factors, hypertension was significantly associated with PTB and LBW. Women with hypertension were about 2.2 and 3.2 times as likely to have PTB and LBW, respectively. Hydramnios/oligohydramnios increased 1.8-4.4 folds of risk for PTB, LBW and infant death and was significantly associated with the unfavorable birth outcomes. Non-Hispanic black women were about 1.5-2.0 times as likely to have an unfavorable birth outcome compared to non-Hispanic white women. Maternal education and prenatal care effect appeared to be modified by maternal race. Certain maternal medical conditions may be contributing to PTB, LBW and infant mortality rates identifying preconception and prenatal healthcare as possible strategies for reducing unfavorable outcomes. Results suggest that different risk profiles for unfavorable outcomes may exist according to maternal race highlighting the need to consider racial groups separately when further exploring the sociodemographic and/or health-related factors that contribute to unfavorable birth outcomes. PMID:19760166

Zhang, Lei; Cox, Reagan G; Graham, Juanita; Johnson, Dick

2011-10-01

349

Regional anesthesia and pre-existing neurological disease — II  

Microsoft Academic Search

To the Editor: Dhir et aL ~ should be congratulated for successfully administering regional anesthesia to a small series of patients with Charcot-Marie-Tooth disease. In reading the aforementioned case reports, it not only becomes apparent that dissimilar approaches to the brachial plexus were utilized but also that different local anesthetic solutions and volumes were employed. 1 Universally absent from these

Todd Nelson; Shalini Dhir; Shyam Balasubramanian; Joanne Guay

2008-01-01

350

Pregnancy outcome in women with pre-existing lupus nephritis.  

PubMed

The aim of the present study was to assess the fetal and maternal outcome in a cohort of patients with lupus nephritis. Twenty-four pregnancies in 22 women with lupus nephritis occurring between 1991 and 2000 were analysed retrospectively. Lupus nephritis was biopsy proven before pregnancy in all cases. Women were followed from the beginning of pregnancy up to 6 months postpartum. Close fetal-maternal monitoring and frequent laboratory investigations were applied routinely to all patients. All women were prescribed steroid therapy from the beginning of the pregnancy. There were 18 live births, four spontaneous abortions and two stillbirths. Of the 18 live births, 14 were premature and four were term deliveries, representing a 25% fetal loss rate and 58% prematurity rate. There were two fetuses with congenital heart block. We recorded hypertension in 42%, proteinuria in 50% and pre-eclampsia in 25% of our patients. Proteinuria was irreversible in four cases. No maternal deaths or postpartum exacerbation of the disease were recorded in the study period. All renal flares were reversed postpartum. Patients positive for antiphospholipid antibodies had a worse perinatal outcome. Hypertension, proteinuria and antiphospholipid antibodies appear to be associated with adverse perinatal outcome and pregnancy complications. Pregnancy is not contraindicated in women with lupus nephritis, but is associated with significant fetal and maternal risks. PMID:16147600

Soubassi, L; Haidopoulos, D; Sindos, M; Pilalis, A; Chaniotis, D; Diakomanolis, E; Antsaklis, A; Zerefos, N

2004-09-01

351

Environmental controls, scarcity rents, and pre-existing distortions  

Microsoft Academic Search

One might suppose that an emissions tax has an advantage over command and control (CAC) regulations since it raises revenue that can be used to cut other distorting taxes. In this paper, we show that the focus on revenue raising is misplaced. In a simple analytical general equilibrium model, we show that the same welfare effects of environmental protection can

Don Fullerton; Gilbert E. Metcalf

2001-01-01

352

Environmental Taxes and Pre-Existing Distortions: The Normalization Trap  

Microsoft Academic Search

The double-dividend hypothesisclaims that green taxes will both improve the environment andreduce the distortions of existing taxes. According to the earlierliterature on the double dividend the tax rate for pollutinggoods should be higher than the Pigovian tax which fully internalizesthe marginal social damage from pollution, in order to obtaina ’second dividend‘. On the contrary, Bovenberg and de Mooij(1994) argue that

Ronnie Schöb

1997-01-01

353

[Two cases of leprosy related conditions and relevant issues on medical services for ex-leprosy patients who live in communities in Japan].  

PubMed

In Japan people affected by leprosy who were forced to admit to national leprosy sanatoria under leprosy prevention/segregation law (1953) have ever been promoted to return to live in community, after destruction of the law in 1996. In this paper two cases are shown with some comments who had already been discharged from leprosy sanatoria and came late to OPD of National Suruga Sanatorium for consultations of their leprosy related conditions. One case is a 60 year-old male who developed squamous cell carcinoma (SCC) from chronic planter ulcer. The other is a 69 year-old female who developed relapse after more than 20 years BI negativity. In these cases, periods until consultation to our clinic were one year and five months, and five years and five months respectively. One reason is that there is no follow-up system of leprosy related conditions for ex-patients in current medical service of Japan. Another reason may be that patients hesitated to consult local doctors for their leprosy related conditions. Since national leprosy sanatoria will come to be closed in near future, services should be available for leprosy related conditions, such as prevention of disability (POD), prevention of worsening disability (POWD), early detection of relapse and leprosy reaction, in general medical service of Japan. PMID:20169978

Ishida, Yutaka; Inoue, Taro; Tsuchiya, Ichiro; Maeda, Mitsuyoshi; Hirano, Akira

2010-02-01

354

Integrating Care for People With Co-Occurring Alcohol and Other Drug, Medical, and Mental Health Conditions  

PubMed Central

Most people with alcohol and other drug (AOD) use disorders suffer from co-occurring disorders (CODs), including mental health and medical problems, which complicate treatment and may contribute to poorer outcomes. However, care for the patients’ AOD, mental health, and medical problems primarily is provided in separate treatment systems, and integrated care addressing all of a patient’s CODs in a coordinated fashion is the exception in most settings. A variety of barriers impede further integration of care for patients with CODs. These include differences in education and training of providers in the different fields, organizational factors, existing financing mechanisms, and the stigma still often associated with AOD use disorders and CODs. However, many programs are recognizing the disadvantages of separate treatment systems and are attempting to increase integrative approaches. Although few studies have been done in this field, findings suggest that patients receiving integrated treatment may have improved outcomes. However, the optimal degree of integration to ensure that patients with all types and degrees of severity of CODs receive appropriate care still remains to be determined, and barriers to the implementation of integrative models, such as one proposed by the Institute of Medicine, remain.

Sterling, Stacy; Chi, Felicia; Hinman, Agatha

2011-01-01

355

Multiple Chronic Medical Conditions and Health-Related Quality of Life in Older Adults, 2004-2006  

PubMed Central

Introduction Understanding longitudinal relationships among multiple chronic conditions, limitations in activities of daily living, and health-related quality of life is important for identifying potential opportunities for health promotion and disease prevention among older adults. Methods This study assessed longitudinal associations between multiple chronic conditions and limitations in activities of daily living on health-related quality of life among older adults (?65 years) from 2004 through 2006, using data from the Medicare Health Outcomes Survey (N = 27,334). Results Using a longitudinal path model, we found the numbers of chronic conditions at baseline and 2-year follow-up were independently associated with more limitations in activities of daily living at 2-year follow-up. In addition, more limitations in activities of daily living at 2-year follow-up were associated with worse health-related quality of life during the follow-up time period. The association between multiple chronic conditions and indices of health-related quality of life was mediated by changes in limitations in activities of daily living. Conclusion Both baseline and new multiple chronic conditions led to worse health in terms of activities of daily living and health-related quality of life and should be considered important outcomes to intervene on for improved long-term health. In addition, public health practitioners should consider addressing classes of multiple chronic conditions by using interventions designed to reduce the emergence of multiple chronic conditions, such as physical activity, reductions in smoking rates, and improved and coordinated access to health care services.

Thompson, William W.; Zack, Matthew M.; Krahn, Gloria L.; Horner-Johnson, Willi; Bowen, Sonya E.

2013-01-01

356

Mothers of Children Diagnosed with Attention-Deficit/Hyperactivity Disorder: Health Conditions and Medical Care Utilization in Periods Before and After Birth of the Child  

PubMed Central

Background Analyzing health conditions and medical utilization of mothers of children with attention-deficit/hyperactivity disorder (ADHD) can shed light on biological, environmental, and psychosocial factors relating to ADHD. Objective To examine health conditions, health care utilization, and costs of mothers of children with ADHD in periods before the child was diagnosed. Methods Using automated data from Northern California Kaiser Permanente we identified mothers of children with ADHD, mothers of children without ADHD, and mothers of children with asthma. Mothers’ diagnostic clusters, health care utilization, and costs were compared. Mothers of children with ADHD were compared to mothers of children without ADHD and, separately, to mothers of children with asthma. Results Compared to mothers of children without ADHD, mothers of children with ADHD were more likely to be diagnosed with numerous medical and mental health problems in the two years after birth of their child, including depression (Odds Ratio (OR): 1.88), anxiety neuroses (OR: 1.64), obesity (OR: 1.70), and musculoskeletal symptoms (OR: 1.51). Results were similar for the year before delivery. Mothers of children with ADHD also had higher total health care costs per person in the year before ($1003) and the two years after ($953) the birth of their child. Mothers of children with ADHD also were diagnosed with more health conditions and had higher health care costs than mothers of children with asthma. Conclusions Our findings suggest that the likelihood of being diagnosed with ADHD is related to maternal conditions and use of health services that precede the child’s diagnosis. Future studies are needed to clarify whether this is due to biologic, psychosocial, or environmental factors, or a combination.

Ray, G. Thomas; Croen, Lisa A.; Habel, Laurel A.

2009-01-01

357

Validation of comorbid conditions on the end-stage renal disease medical evidence report: the CHOICE study. Choices for Healthy Outcomes in Caring for ESRD.  

PubMed

Since 1995, the Medical Evidence Report for end-stage renal disease (Form 2728) has been used nationally to collect information on comorbid conditions. To date, these data have not been validated. A national cross-sectional study of 1005 incident dialysis patients (734 hemodialysis and 271 peritoneal dialysis) enrolled between October 1995 and June 1998 was conducted using clinical data to validate 17 comorbid conditions on Form 2728. Sensitivity and specificity were calculated for each condition. The relationship between patient characteristics and sensitivity was assessed in multivariate analysis. Sensitivity was fairly high (0.67 to 0.83) for HIV disease, diabetes, and hypertension; intermediate (0.40 to 0.52) for peripheral vascular disease, neoplasm, myocardial infarction, cerebrovascular disease, coronary artery disease, cardiac arrest, and congestive heart failure; and poor (<0.36) for dysrhythmia, ambulation status, pericarditis, chronic obstructive pulmonary disease, and smoking. Sensitivity did not change significantly over calendar time. The sensitivity of Form 2728 averaged across all 17 conditions was 0.59 (95% confidence interval, 0.43 to 0.75). The average sensitivity was 0.10 greater in peritoneal dialysis than hemodialysis patients. 0.11 greater in diabetic patients than nondiabetic patients, and 0.04 less with each added comorbid condition. The specificity was very good for hypertension (0.91) and excellent (>0.95) for the other 16 conditions. Comorbid conditions are significantly underreported on Form 2728, but diagnoses are not falsely attributed to patients. Scientific research, quality of care comparisons, and payment policies that use Form 2728 data should take into account these limitations. Considerable effort should be expended to improve Form 2728 coding if it is to provide accurate estimates of total disease burden in end-stage renal disease patients. PMID:10703676

Longenecker, J C; Coresh, J; Klag, M J; Levey, A S; Martin, A A; Fink, N E; Powe, N R

2000-03-01

358

[The provision of comfortable conditions while working with medical endoscopes and illuminators with halogen-filament lamps].  

PubMed

An analytical relationship has been established between the electric parameters of an illuminator and the lighting parameters and the service life of halogen lamps when operating on industrial mains power supplies. The paper shows a way of improving the above characteristics to provide comfortable working conditions and to enhance labour productivity by applying the constant power sources with the preset voltage stabilization factor. Plots of luminous flux instability and service life against voltage stabilization factor have been constructed from the derived formulas for a K[symbol see text]15-150 halogen filament. Recommendations are given to calculate a stabilization factor for a constant power source. PMID:8926846

Sosnov, D L

359

Mortality and Readmission at Safety Net and Non-Safety Net Hospitals for Three Common Medical Conditions  

PubMed Central

Safety net hospitals remain under financial strain, possibly affecting quality of care, and face uncertain financial consequences under the Patient Protection and Affordable Care Act. We compared risk-standardized mortality and readmission rates among fee-for-service Medicare beneficiaries admitted for acute myocardial infarction, heart failure, or pneumonia to urban hospitals within metropolitan statistical areas containing at least one safety net and non-safety net hospital. There was substantial variation in both mortality and readmission rates among safety-net and non-safety net hospitals for all three conditions, although safety-net hospitals had marginally worse outcomes. Herein we discuss the clinical and policy implications of these findings.

Ross, Joseph S.; Bernheim, Susannah M.; Lin, Zhenqiu; Drye, Elizabeth E.; Chen, Jersey; Normand, Sharon-Lise T.; Krumholz, Harlan M.

2012-01-01

360

Health-related quality of life measurements in elderly Canadians with osteoporosis compared to other chronic medical conditions: a population-based study from the Canadian Multicentre Osteoporosis Study (CaMos)  

Microsoft Academic Search

The objective of this research was to determine the relative decrement in health-related quality of life, as measured by the health utilities index mark 3 (HUI3), in osteoporosis compared to other chronic medical conditions. The impact of chronic medical conditions other than osteoporosis on HUI3 measurements had been previously established in the 1996\\/1997 Canadian National Population Health Survey (NPHS). The Canadian

A. M. Sawka; L. Thabane; A. Papaioannou; A. Gafni; G. Ioannidis; E. A. Papadimitropoulos; W. M. Hopman; A. Cranney; D. A. Hanley; L. Pickard; J. D. Adachi

2005-01-01

361

Major depressive disorder is a risk factor for low bone mass, central obesity, and other medical conditions  

PubMed Central

Major depressive disorder (MDD) is one of the most common psychiatric illnesses in the adult population. It is often associated with an increased risk of cardiovascular disease. Osteoporosis is also a major public health threat. Multiple studies have reported an association between depression and low bone mineral density, but a causal link between these two conditions is disputed. Here the most important findings of the POWER (Premenopausal, Osteoporosis Women, Alendronate, Depression) Study, a large prospective study of bone turnover in premenopausal women with major depression, are summarized. The endocrine and immune alterations secondary to depression that might affect bone mass, and the possible role of poor lifestyle in the etiology of osteoporosis in subjects with depression, are also reviewed, as is the potential effect of antidepressants on bone loss. It is proposed that depression induces bone loss and osteoporotic fractures, primarily via specific immune and endocrine mechanisms, with poor lifestyle habits as potential contributory factors.

Cizza, Giovanni

2011-01-01

362

Targeting and retrofitting pre-existing libraries of transposon insertions with FRT and oriV elements for in-vivo generation of large quantities of any genomic fragment 1 Published in conjunction with A Wisconsin Gathering Honoring Waclaw Szybalski on occasion of his 75th year and 20years of Editorship-in-Chief of Gene, 10–11 August 1997, University of Wisconsin, Madison, WI, USA. 1  

Microsoft Academic Search

A procedure is described that converts the pre-existing transposon insertion libraries to a collection of `pop-out' strains, each allowing generation of 20- to 100-kb genomic fragments directly from the genome. The procedure consists of two steps: (1) single transposon insertions are targeted and retrofitted with excision and amplification elements (FRT and oriV), by homologous recombination with an FRT–oriV-carrying plasmid; and

Jadwiga Wild; Marian Sektas; Zdenka Hrade?ná; Waclaw Szybalski

1998-01-01

363

Weather conditions and visits to the medical wing of emergency rooms in a metropolitan area during the warm season in Israel: a predictive model  

NASA Astrophysics Data System (ADS)

Global climate changes affect health and present new challenges to healthcare systems. The aim of the present study was to analyze the pattern of visits to the medical wing of emergency rooms (ERs) in public hospitals during warm seasons, and to develop a predictive model that will forecast the number of visits to ERs 2 days ahead. Data on daily visits to the ERs of the four largest medical centers in the Tel-Aviv metropolitan area during the warm months of the year (April-October, 2001-2004), the corresponding daily meteorological data, daily electrical power consumption (a surrogate marker for air-conditioning), air-pollution parameters, and calendar information were obtained and used in the analyses. The predictive model employed a time series analysis with transitional Poisson regression. The concise multivariable model was highly accurate ( r 2 = 0.819). The contribution of mean daily temperature was small but significant: an increase of 1°C in ambient temperature was associated with a 1.47% increase in the number of ER visits ( P < 0.001). An increase in electrical power consumption significantly attenuated the effect of weather conditions on ER visits by 4% per 1,000 MWh ( P < 0.001). Higher daily mean SO2 concentrations were associated with a greater number of ER visits (1% per 1 ppb increment; P = 0.017). Calendar data were the main predictors of ER visits ( r 2 = 0.794). The predictive model was highly accurate in forecasting the number of visits to ERs 2 days ahead. The marginal effect of temperature on the number of ER visits can be attributed to behavioral adaptations, including the use of air-conditioning.

Novikov, Ilya; Kalter-Leibovici, Ofra; Chetrit, Angela; Stav, Nir; Epstein, Yoram

2012-01-01

364

Quality in health care. Medical or managerial?  

PubMed

Explores the notion that the introduction of total quality management (TQM) in the public health-care sector indicates a conceptual break with a tradition in which the authority to define and interpret the meaning of medical practice has been located solely within the medical profession. It also serves to shift the focus of medical practice away from its contextual and interactional character towards numerical representations and codification in monetary terms. Further, it is argued that the realization of management ideals in everyday practice is dependent more on the availability of pre-existing technologies and standard procedures than on the ingenuity of particular organizational and institutional actors. These arguments are illustrated with the reutilization for TQM purposes of "local incident reports" in a Swedish hospital organization. PMID:11200301

Hansson, J

2000-01-01

365

Medical thoracoscopy in an Australian regional hospital.  

PubMed

Medical thoracoscopy is not widely available in Australia. A medical thoracoscopy service has been set up in a regional hospital using no specialized equipment and at minimal cost. Of the first 100 procedures carried out, 89 were for investigation of pleural effusion, 6 for pneumothorax and 6 for empyema. Of the 89 pleural effusions, 73 were diagnosed as malignant (43 carcinoma, 24 mesothelioma, 3 lymphoma, 2 melanoma and 1 sarcoma). The sensitivity for a malignant diagnosis was 94.5%, with 100% specificity. Four patients had unsuspected tuberculous effusions. Pleurodesis was carried out with instillation of dry sterile talc in 67 cases. In 92.5% of these, no further drainage procedure was needed. There was one fatality caused by pre-existing sepsis in a debilitated patient with disseminated carcinoma. Medical thoracoscopy is a simple, safe and cost-effective technique for diagnosing and treating pleural effusions and provides a useful service in the setting of a regional hospital. PMID:17388868

Simpson, G

2007-04-01

366

76 FR 14600 - Dental Conditions  

Federal Register 2010, 2011, 2012, 2013

...service-connected medical condition (Class III...complicating a medical condition currently under...insure successful medical treatment) (Class...service-connected condition for which compensation...of periodontal disease or calculus,...

2011-03-17

367

The use of psychotropic medications with breastfeeding women: applying the available evidence.  

PubMed

Breastfeeding women may be prescribed a psychotropic medication to treat a pre-existing illness such as bipolar disorder or schizophrenia, or to treat an illness that develops as a direct result of pregnancy and childbirth, such as depression. Mental health nurses are often not aware that many psychotropic medications are considered relatively safe for the infant as well as the breastfeeding woman. This paper provides the clinician with an overview of the major psychotropic medications for breastfeeding women and outlines their potential impact on the infant. Guidelines for the use of these medications are also provided for mental health nurses based on the available evidence. PMID:16594886

Usher, Kim; Foster, Kim

368

The Effect of Different Storage Conditions on the Physical Properties of Pigmented Medical Grade I Silicone Maxillofacial Material  

PubMed Central

Objective. This study aimed to evaluate the effect of different storage solutions that simulate acidic, alkaline, and sebum conditiions on the physical properties of pigmented (colorant elastomer) cosmesil M511 maxillofacial prosthetic material. Materials and Methods. Sixty specimens were prepared according to the manufacturer's instructions and were tested before and after immersion of different storage conditions for six months at 37?°C. The following tests were performed: color changes (group I), solution absorption (group II), surface roughness (group III), and scanning electron microscopy (group IV). Results. There were no significant changes observed in the color and solution absorption tests while surface roughness revealed significant difference between control group and other testing storage medium groups, and this result was supported by SEM analysis that revealed limited surface changes. Conclusions. Cosmaseil material is an acceptable cross-linked formulation that withstands storage in different solutions with variable pH. The addition of pigment cannot vary the physical properties of these materials. Surface roughness test as well as SEM microscopic study showed moderate changes indicating a limited effect on the surface of the material.

Al-Dharrab, Ayman A.; Tayel, Seham B.; Abodaya, Mona H.

2013-01-01

369

Adverse health outcomes after Hurricane Katrina among children and adolescents with chronic conditions.  

PubMed

Children with chronic conditions may be at risk of increased disruptions in health care following natural disasters such as Hurricane Katrina. The objective of this cross-sectional study was to evaluate differences between children and adolescents with and without chronic conditions immediately following Katrina. Of 531 participants, there were 79.8% younger than 13 years old, 50.5% male, 42.8% African American. Participants with pre-existing conditions (39.4% of the total sample) were more likely than those without to be at the clinic for a non-chronic health condition rather than another problem (43.5 vs. 16.2%), to take asthma medication (37.4 vs. 3.9%), to have asthma worsen (16.3 vs. 1.9%), to miss a visit (49.2 vs. 39.8%), to run out of medications (33.9 vs. 7.9%), to live with flood damage (19.7 vs. 11.3%) or mold (23.6 vs. 15.8%), and to experience disruption in care (58.4 vs. 38.3%) or negative psychological consequences (ranging from 2.5% to 12.9%). While the medical differences are unsurprising, given the groups being compared, the other differences between the groups merit attention from policymakers and health care providers. Children and adolescents with chronic conditions are at increased risk of adverse outcomes following a natural disaster. Providers may be able to reduce negative effects on this population by developing condition-specific preparedness care mechanisms. PMID:17483568

Rath, Barbara; Donato, Jessica; Duggan, Alyson; Perrin, Keith; Bronfin, Daniel R; Ratard, Raoult; VanDyke, Russell; Magnus, Manya

2007-05-01

370

Medical liabilities of the French physician passenger during a commercial air flight.  

PubMed

Nearly two billion passengers travel each year on commercial air flights. More elderly people and/or people with a pre-existing condition are taking to the air and with the anticipated growth of air travel, in-flight illnesses and injuries are expected to increase as well. Even if in-flight medical events and deaths are still uncommon, physician passengers are occasionally called upon to render assistance. Although no case law exists as yet in France, physicians who often travel on commercial flights should be aware of the risks they run if they do not respond to the well-known call, 'Is there a doctor on board?', or if they assist a sick passenger. This paper describes in-flight resources available to a physician who is called upon to treat an ill or injured passenger. Two questions concerning the French physician passenger are discussed: What are the liabilities of the physician who does not respond to the call of a medical event aboard an aircraft? What are the liabilities of the physician providing assistance to a sick passenger? The different liabilities and also the legal status of the French physician passenger are examined. PMID:17345889

Dedouit, F; Tournel, G; Barguin, P; Becart-Robert, A; Hedouin, V; Gosset, D

2007-01-01

371

Gender role stereotype and poor working condition pose obstacles for female doctors to stay in full-time employment: alumnae survey from two private medical schools in Japan.  

PubMed

The shortage of physicians has become a serious problem in Japan. It has been pointed out that an increase in the number of female doctors may contribute to the aggravation of this shortage because it is known that women work fewer hours than male doctors. Here, we investigated how many female doctors had ever resigned from a full-time position, and elucidated the reasons why female doctors find it difficult to stay in full-time employment. An alumnae survey of 2 private medical schools was conducted in 2007. A self-administered questionnaire was sent to 1423 graduates and 711 responded with informed consent (response rate, 50%; mean age, 39 years). Overall, 55% of the respondents had previously resigned from full-time employment, of which 90% resigned within 10 years of graduating from medical school. The difficulty in balancing work, childbirth and child rearing (45%) were the top 2 reasons for resignation, followed by physical problems (12%) and long working hours (8%). Among those who resigned, only 33% returned to full-time employment. Women who had at least 1 child were only 30% of those who had never resigned and 84% of those who had previously resigned. The majority of study subjects, regardless of experience of resignation (88%), agreed that women should continue to work even after childbirth. In conclusion, the results of this study suggested that many female doctors resigned from a full-time position within 10 years of graduating from medical school, largely because of the gender role stereotype and poor working conditions. PMID:23474840

Izumi, Miki; Nomura, Kyoko; Higaki, Yuko; Akaishi, Yu; Seki, Masayasu; Kobayashi, Shizuko; Komoda, Takayuki; Otaki, Junji

2013-01-01

372

Socioeconomic inequalities in mortality from conditions amenable to medical interventions: do they reflect inequalities in access or quality of health care?  

PubMed Central

Background Previous studies have reported large socioeconomic inequalities in mortality from conditions amenable to medical intervention, but it is unclear whether these can be attributed to inequalities in access or quality of health care, or to confounding influences such as inequalities in background risk of diseases. We therefore studied whether inequalities in mortality from conditions amenable to medical intervention vary between countries in patterns which differ from those observed for other (non-amenable) causes of death. More specifically, we hypothesized that, as compared to non-amenable causes, inequalities in mortality from amenable causes are more strongly associated with inequalities in health care use and less strongly with inequalities in common risk factors for disease such as smoking. Methods Cause-specific mortality data for people aged 30–74 years were obtained for 14 countries, and were analysed by calculating age-standardized mortality rates and relative risks comparing a lower with a higher educational group. Survey data on health care use and behavioural risk factors for people aged 30–74 years were obtained for 12 countries, and were analysed by calculating age-and sex-adjusted odds ratios comparing a low with a higher educational group. Patterns of association were explored by calculating correlation coefficients. Results In most countries and for most amenable causes of death substantial inequalities in mortality were observed, but inequalities in mortality from amenable causes did not vary between countries in patterns that are different from those seen for inequalities in non-amenable mortality. As compared to non-amenable causes, inequalities in mortality from amenable causes are not more strongly associated with inequalities in health care use. Inequalities in mortality from amenable causes are also not less strongly associated with common risk factors such as smoking. Conclusions We did not find evidence that inequalities in mortality from amenable conditions are related to inequalities in access or quality of health care. Further research is needed to find the causes of socio-economic inequalities in mortality from amenable conditions, and caution should be exercised in interpreting these inequalities as indicating health care deficiencies.

2012-01-01

373

Medical Device Safety  

MedlinePLUS

A medical device is any product used to diagnose, cure, or treat a condition, or to prevent disease. They ... may need one in a hospital. To use medical devices safely Know how your device works. Keep ...

374

The Generation of a Conditional Reporter That Enables Bioluminescence Imaging of Cre\\/loxP-Dependent Tumorigenesis in Mice1  

Microsoft Academic Search

The ability to noninvasively quantitate tumor burden from conditional (Cre\\/loxP-dependent) mouse cancer models would greatly increase their range of useful applications. We now report the generation of a reporter mouse that enables visualization of spontaneous tumor development from pre-existing conditional mouse tumor models via in vivo bioluminescence imaging. We demonstrate that bioluminescence can be \\

Scott K. Lyons; Ralph Meuwissen; Paul Krimpenfort; Anton Berns

2003-01-01

375

10 CFR 850.34 - Medical surveillance.  

Code of Federal Regulations, 2013 CFR

...to beryllium, and any other medical condition that would place the worker...including all tests results and any medical condition related to beryllium exposure...diagnoses that are not related to medical conditions that may be affected by...

2013-01-01

376

Are there lessons to be learned from a more scientific approach to mental condition defences?  

PubMed

The timing of the English Law Commission's consideration of reform to the law of insanity coincides with increasing scientific and in particular neuroscientific understanding of the brain. The work of researchers is leading to a greater comprehension of what had been termed irresistible impulses to commit crime and of the impact of brain damage, particularly evidence of brain lesions and frontal lobe damage on behaviour. There remain problems in establishing causal relationships which might diminish or eliminate criminal responsibility for crimes committed by those suffering from pre existing mental conditions at the time they commit a criminal offence. This is especially the case where those mental conditions are of short duration. However, the law should not ignore the best available scientific knowledge. Neuroscientific advances are already informing court deliberations in England and Wales: assisting in considerations of guilt, fitness to plead and in sentencing. In terms of the insanity defence the questions that the law seeks to address are not necessarily the most medically or scientifically pertinent questions. They remain grounded in 19th century scientific understanding. It is argued that the more nuanced Dutch approach to mental condition defences warrants very serious consideration by those charged with making proposals to reform the English law. PMID:22296969

Claydon, Lisa

2012-01-30

377

[Social conditions in which medical students from the faculty of medicine of the National University of Mexico (UNAM) perform their Social Service in rural areas].  

PubMed

The aim of this work is to describe the conditions in which medical students perform their Social Service, highlighting their experiences in areas such as: information before they move and the motivation to leave home; the perception of personal and environmental lack of safety; the institutional support that they receive during their work in the community and the financial support provided. The methodological design of the study included an exploratory phase, in which collective interviews were performed, using the focal group technique, with students who had been in rural areas. Three hundred sixty cases were considered, 72.8% corresponded to rural areas, and 27.7% to Mexico City. According to the findings, the following actions are proposed: give better information and improve the process of vacancy selection; increase the scholarship received by students in Social Service; establish legal, police, and community support mechanisms to guarantee the student's personal safety; pay attention to aspects such as the student's emotional and social situation, and design programs with gender perspective to enhance certainty and safety. PMID:22820362

Hamui-Sutton, Alicia

378

[Surprises during urological interventions due to incomplete medical histories].  

PubMed

Two men, aged 37 and 47 years old, visited the urologist because of secondary infertility. These underwent an examination whilst under general anaesthesia; the examination was converted to a vasovasostomy, as in both cases it was found that a vasectomy had previously been performed. A third man, 56 years old, wished to undergo vasovasostomy; a few months later he appeared to have pre-existent retrograde ejaculation after an earlier bladder neck incision. For various reasons, no adequate information about the psychosocial and medical history was available. These case histories stress the importance of all of the patient records being available prior to an intervention. PMID:14587137

Breeuwsma, A J; van Driel, M F; Mensink, H J

2003-10-11

379

10 CFR 850.35 - Medical removal.  

Code of Federal Regulations, 2013 CFR

...2013-01-01 false Medical removal. 850.35... CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM...Requirements § 850.35 Medical removal. (a) Medical...responsible employer may condition the provision of medical removal...

2013-01-01

380

Health Care Expenditures for the Five Most Common Children's Conditions, 2008: Estimates for U.S. Civilian Noninstitutionalized Children, Ages 0-17. Medical Expenditure Panel Survey Statistical Brief No. 349.  

National Technical Information Service (NTIS)

Health care expenditures for the treatment of children's ailments have been on the rise in the U.S. Typically, medical expenditures are concentrated in the treatment of certain types of highly prevalent conditions or for which treatment entails frequent o...

M. Roemer

2011-01-01

381

Nontraumatic dental condition-related visits to emergency departments on weekdays, weekends and night hours: findings from the National Hospital Ambulatory Medical Care survey  

PubMed Central

Objective To determine whether the rates of nontraumatic dental condition (NTDC)-related emergency department (ED) visits are higher during the typical working hours of dental offices and lower during night hours, as well as the associated factors. Methods We analyzed data from the National Hospital Ambulatory Medical Care Survey for 1997 through 2007 using multivariate binary and polytomous logistic regression adjusted for survey design to determine the effect of predictors on specified outcome variables. Results Overall, 4,726 observations representing 16.4 million NTDC-related ED visits were identified. Significant differences in rates of NTDC-related ED visits were observed with 40%–50% higher rates during nonworking hours and 20% higher rates on weekends than the overall average rate of 170 visits per hour. Compared with 19–33 year olds, subjects < 18 years old had significantly higher relative rates of NTDC-related ED visits during nonworking hours [relative rate ratio (RRR) = 1.6 to 1.8], whereas those aged 73 and older had lower relative rates during nonworking hours (RRR = 0.4; overall P = 0.0005). Compared with those having private insurance, Medicaid and self-pay patients had significantly lower relative rates of NTDC visits during nonworking and night hours (RRR = 0.6 to 0.7, overall P < 0.0003). Patients with a dental reason for visit were overrepresented during the night hours (RRR = 1.3; overall P = 0.04). Conclusion NTDC-related visits to ED occurred at a higher rate during nonworking hours and on weekends and were significantly associated with age, patient-stated reason for visit and payer type.

Okunseri, Christopher; Okunseri, Elaye; Fischer, Melissa Christine; Sadeghi, Saba Noori; Xiang, Qun; Szabo, Aniko

2013-01-01

382

10 CFR 712.14 - Medical assessment.  

Code of Federal Regulations, 2013 CFR

...self-reporting or by medical or psychological...or (5) Medical conditions such as cardiovascular disease, endocrine...other neurologic disease, or the use...treatment of conditions that may adversely...initial or annual medical...

2013-01-01

383

Medical Issues in Adoption  

MedlinePLUS

... weight, and medical conditions of the birth parents diseases or medical conditions that run in the child's family the health of the child's siblings information about whether the birth mother drank ... transmitted diseases (STDs) that might affect the child's health the ...

384

[French physicians in independent practice: opinions on their conditions of work and the issue of over/under staffing of medical workforce in their areas].  

PubMed

In France, ambulatory care is provided to patients mostly by independent physicians, GPs and specialists, paid on a fee-for-service basis. A national agreement between the Sickness Insurance Fund and the medical associations sets the price of different medical services. Due to the numerus clausus imposed upon the medical schools since the 70's, the yearly number of new graduates has sharply decreased and a feeling of manpower shortage has spread throughout the health system, in the public hospitals and the ambulatory care sector as well. Moreover increased dissatisfaction has been perceived among independent practitioners (they were 56 % of all the medical profession in early 2004). In this context, an opinion survey was undertaken among a sample of 3000 independent doctors whose one thousand have answered to the postal questionnaire. PMID:16739775

Doan, Bui Dang Ha; Lévy, Danièle

385

ADHD Medications  

MedlinePLUS

Managing ADHD With Medication Just about everyone has trouble concentrating or paying attention in class from time to time. ... to develop new medications for ADHD. Continue Are ADHD Medications Safe? Most experts agree that ADHD medications ...

386

Blooming of Irganox 3114® antioxidant onto a medical grade elastomer. Impact of the recrystallization conditions on the antioxidant polymorphism, on the film wettability and on the antioxidant leachability.  

PubMed

Studying the blooming and recrystallization of additives onto the surface of polymer medical devices is of a great interest because it can affect the biocompatibility of the material. The polymorphism of a phenolic antioxidant (Irganox 3114(®)) used as an additive in medical devices and pharmaceutical packaging was studied: two different polymorphs were characterized by differential scanning measurements, FTIR and X-ray diffraction analyses. Then, the behavior of the additive in medical grade polyurethane films was described: a recrystallization into the stable polymorphic form was observed onto the polymer surface after annealing at different temperatures. The morphology observed depends not only on the additive/polymer ratio but also on the whole amount of additive in the polymer film. Depending on the recrystallization morphology, the wettability with water could be lowered and the leachability of the additives into aqueous media could be favored. PMID:22884835

Saunier, J; Mazel, V; Aymes-Chodur, C; Yagoubi, N

2012-08-04

387

Therapeutic Antioxidant Medical Gas  

PubMed Central

Medical gases are pharmaceutical gaseous molecules which offer solutions to medical needs and include traditional gases, such as oxygen and nitrous oxide, as well as gases with recently discovered roles as biological messenger molecules, such as carbon monoxide, nitric oxide and hydrogen sulphide. Medical gas therapy is a relatively unexplored field of medicine; however, a recent increasing in the number of publications on medical gas therapies clearly indicate that there are significant opportunities for use of gases as therapeutic tools for a variety of disease conditions. In this article, we review the recent advances in research on medical gases with antioxidant properties and discuss their clinical applications and therapeutic properties.

Nakao, Atsunori; Sugimoto, Ryujiro; Billiar, Timothy R; McCurry, Kenneth R

2009-01-01

388

Physical Functioning in Female Caregivers of Children With Physical Disabilities Compared With Female Caregivers of Children With a Chronic Medical Condition  

Microsoft Academic Search

Objectives: To evaluate if physical functioning is dif- ferent in female caregivers of children with physical dis- abilities compared with female caregivers of children with nondisabling medical illnesses, and to investigate the fac- tors associated with functioning level. Design: Cross-sectional survey. Setting: University-based clinics. Patients: Ninety consecutive female caregivers of chil- dren presenting to a pediatric physical medicine and rehabilitation

J. Dennis Fortenberry; Edward J. Brizendine; Barry P. Katz; Donald P. Orr; Henry C. Tong; Geeta Kandala; Andrew J. Haig; Virginia S. Nelson; Karen S. J. Yamakawa; Ki Y. Shin; Mascha Kamphuis; Ton Vogels; Jaap Ottenkamp; Ernst E. van der Wall; S. Pauline Verloove-Vanhorick; Hubert W. Vliegen; Susan M. Sweeney; Karen Wiss; Susan Bayliss Mallory; Dennis M. Gorman; J. David Hawkins; Heather S. Lonczak; Robert D. Abbott; Rick Kosterman; Richard F. Catalano

2002-01-01

389

Medical manslaughter.  

PubMed

On November 29, 2011 Dr Conrad Murray was sentenced to four years in prison after being convicted of the involuntary manslaughter of Michael Jackson. Expert witness statements indicated that Murray's actions were an "extreme departure from the standard of care", particularly with regard to (1) inappropriately treating insomnia with a surgical anaesthetic (propofol); (2) failing to acquire sufficiently informed consent; (3) administering propofol without the necessary monitoring equipment; (4) delaying contacting the emergency services; and (5) making ineffective resuscitation efforts. Further medical evidence argued that Murray's care of Jackson contained "17 egregious violations", defined as acts that posed a foreseeable danger to the patient's life. These deficiencies, it was stated, constituted gross negligence. Such events might seem remote from daily medical practice in Ireland. However, medical errors resulting in patient death are reported to be unfortunately frequent, even if such fatalities are rarely as dramatic, or as public, as that of Michael Jackson. Medical care is not necessarily straightforward, and any treatment outcome is dependent on clinician skill, the nature of the intervention, and on the pathological condition of the patient. Regardless of these latter two factors, a poor outcome still may occur through physician omissions or the commission of errors or violations. Merry and McCall Smith distinguish between errors and violations on the following basis: (1) errors are not deliberate, and result in unintentional actions and consequences; (2) violations, on the other hand, entail a deliberate deviation from accepted rules or norms. It was alleged that much of Dr Murray's professional conduct in this case fell into the latter category. PMID:23472376

Lyons, B

2013-01-01

390

Patients Hospitalized with pH1N1 Influenza in an Academic Community Medical Center  

PubMed Central

Background: The emergence of a novel strain of pandemic influenza (pH1N1) in 2009 presented significant challenges to health care facilities worldwide. In our academic community medical center in suburban Philadelphia, we noted our first pH1N1 diagnosis in September 2009. We sought to assess the impact of pH1N1 disease on our hospitalized patient population. Methods: We prospectively collected clinical and epidemiological data on 29 consecutive patients that were admitted to our hospital with a primary or secondary diagnosis of influenza from October 1-November 30, 2009. Data were obtained through care of the patients and chart review. Results: Prominent symptoms on admission included fever, hypoxia, cough, myalgias, and diarrhea, with leukocytosis and neutrophilia. Pre-existing medical conditions included asthma, pregnancy, immunosuppressive therapy, and sickle cell disease. All but 5 of the patients were under 60 years of age. Three patients had culture-documented bacterial or mycoplasma infections. All but two of the patients received oseltamivir. Six required admission to the intensive care unit but only one patient died. Conclusions: Our population of hospitalized patients with novel pH1N1 influenza demonstrated many of the features that have been associated with pH1N1 disease in other populations. Most of the patients were women and none of the patients died directly as a complication of influenza. We observed a cluster of patients with a tetrad of features comprising a history of asthma, obesity, female gender, and African-American race. Individuals with this constellation of factors should be specifically targeted for pH1N1 vaccination.

Bergman, Hagit; Livornese Jr, Lawrence L; Sambhara, Suryaprakash; Santoro, Jerome; Dessain, Scott K

2011-01-01

391

Botox (Medical)  

MedlinePLUS

... Eye Glossary Current News How to Help Botox (Medical) Share with a friend Botox (Medical) A link to this article will be included ... list. Close without sharing. Give Us Feedback Botox (Medical) Your name First Name MI Laast Name Your ...

392

Abortion - medical  

MedlinePLUS

Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...

393

The Effects of Dysthymic Disorder on Health-Related Quality of Life and Disability Days in Persons with Comorbid Medical Conditions in the General Population  

Microsoft Academic Search

Background: We aimed to investigate in medical disorders the effects of comorbid dysthymic disorder as compared to major depressive disorder (MDD) on health-related quality of life (HR-QoL) and disability days in the general population. Methods: In a population-based study 4,181 individuals were assessed for the presence of dysthymic disorder and depression, utilizing the Composite International Diagnostic Interview. Each participant received

Bernhard T. Baune; Riccardo N. Caniato; Volker Arolt; Klaus Berger

2009-01-01

394

Psychotropic Medications for Children.  

ERIC Educational Resources Information Center

|Reviews the clinical conditions and medications used with children who have emotional and behavioral problems including hyperactivity, enuresis, anxiety, depression, mental retardation, and Tourette's Syndrome. Discusses the role of the social worker, ethical issues, and training needs. (JAC)|

Cordoba, Oscar A.; And Others

1983-01-01

395

21 CFR 107.50 - Terms and conditions.  

Code of Federal Regulations, 2013 CFR

...an unusual medical or dietary...terms and conditions that a manufacturer...management for diseases or conditions...section, the medical, nutritional...specific diseases or conditions that are...specific disease, disorder, or medical condition;...

2013-04-01

396

32 CFR 564.37 - Medical care.  

Code of Federal Regulations, 2013 CFR

...facilities or by civilian medical and dental personnel...authorized. The medical care authorized...treatment of the disease or injury incurred under the conditions outlined herein... (1) By Army medical facilities....

2013-07-01

397

Training Psychiatric Patients to Discuss Medication IssuesEffects on Patient Communication and Knowledge of Medications  

Microsoft Academic Search

Psychiatric inpatients were randomly assigned to a medication-related communication skills program or to a control condition that consisted of a medication education program. The medication communication program emphasized learning to ask physicians questions about medications, to describe current problems, and to make relevant requests. Although patients in both groups improved their knowledge of medications, the medication communication skills program had

Michael G. Dow; Mary Beth Verdi; William P. Sacco

1991-01-01

398

Children Who Are Medically Fragile in North Carolina: Prevalence and Medical Care Costs in 2002  

Microsoft Academic Search

SC Objectives: Children with serious and complicated medical conditions often require intensive medical treat- ment and have very high medical care costs. This study estimates the total number of children in North Caro- lina of pre-school age who are medically fragile and profiles their medical care costs. Some of these children might be appropriately placed in a medical child care

Paul A. Buescher; Timothy Whitmire; R. N. Deborah Nelson; Eleanor E. Howell; Catherine E. Kluttz-Hile

399

Medical scribes.  

PubMed

Medical scribes and electronic health records (EHRs) are increasingly being introduced into ambulatory clinics with variable outcomes. Characteristics of a successful implementation of medical scribes are described. Tips for optimization of the composition and presentation of the EHR as well as medical processes associated with medical documentation are presented. PMID:23373160

Baugh, Reginald; Jones, James E; Trott, K; Takyi, Valerie E; Abbas, Jihad T

400

Variants Near FOXE1 Are Associated with Hypothyroidism and Other Thyroid Conditions: Using Electronic Medical Records for Genome- and Phenome-wide Studies  

PubMed Central

We repurposed existing genotypes in DNA biobanks across the Electronic Medical Records and Genomics network to perform a genome-wide association study for primary hypothyroidism, the most common thyroid disease. Electronic selection algorithms incorporating billing codes, laboratory values, text queries, and medication records identified 1317 cases and 5053 controls of European ancestry within five electronic medical records (EMRs); the algorithms' positive predictive values were 92.4% and 98.5% for cases and controls, respectively. Four single-nucleotide polymorphisms (SNPs) in linkage disequilibrium at 9q22 near FOXE1 were associated with hypothyroidism at genome-wide significance, the strongest being rs7850258 (odds ratio [OR] 0.74, p = 3.96 × 10?9). This association was replicated in a set of 263 cases and 1616 controls (OR = 0.60, p = 5.7 × 10?6). A phenome-wide association study (PheWAS) that was performed on this locus with 13,617 individuals and more than 200,000 patient-years of billing data identified associations with additional phenotypes: thyroiditis (OR = 0.58, p = 1.4 × 10?5), nodular (OR = 0.76, p = 3.1 × 10?5) and multinodular (OR = 0.69, p = 3.9 × 10?5) goiters, and thyrotoxicosis (OR = 0.76, p = 1.5 × 10?3), but not Graves disease (OR = 1.03, p = 0.82). Thyroid cancer, previously associated with this locus, was not significantly associated in the PheWAS (OR = 1.29, p = 0.09). The strongest association in the PheWAS was hypothyroidism (OR = 0.76, p = 2.7 × 10?13), which had an odds ratio that was nearly identical to that of the curated case-control population in the primary analysis, providing further validation of the PheWAS method. Our findings indicate that EMR-linked genomic data could allow discovery of genes associated with many diseases without additional genotyping cost.

Denny, Joshua C.; Crawford, Dana C.; Ritchie, Marylyn D.; Bielinski, Suzette J.; Basford, Melissa A.; Bradford, Yuki; Chai, High Seng; Bastarache, Lisa; Zuvich, Rebecca; Peissig, Peggy; Carrell, David; Ramirez, Andrea H.; Pathak, Jyotishman; Wilke, Russell A.; Rasmussen, Luke; Wang, Xiaoming; Pacheco, Jennifer A.; Kho, Abel N.; Hayes, M. Geoffrey; Weston, Noah; Matsumoto, Martha; Kopp, Peter A.; Newton, Katherine M.; Jarvik, Gail P.; Li, Rongling; Manolio, Teri A.; Kullo, Iftikhar J.; Chute, Christopher G.; Chisholm, Rex L.; Larson, Eric B.; McCarty, Catherine A.; Masys, Daniel R.; Roden, Dan M.; de Andrade, Mariza

2011-01-01

401

Variants near FOXE1 are associated with hypothyroidism and other thyroid conditions: using electronic medical records for genome- and phenome-wide studies.  

PubMed

We repurposed existing genotypes in DNA biobanks across the Electronic Medical Records and Genomics network to perform a genome-wide association study for primary hypothyroidism, the most common thyroid disease. Electronic selection algorithms incorporating billing codes, laboratory values, text queries, and medication records identified 1317 cases and 5053 controls of European ancestry within five electronic medical records (EMRs); the algorithms' positive predictive values were 92.4% and 98.5% for cases and controls, respectively. Four single-nucleotide polymorphisms (SNPs) in linkage disequilibrium at 9q22 near FOXE1 were associated with hypothyroidism at genome-wide significance, the strongest being rs7850258 (odds ratio [OR] 0.74, p = 3.96 × 10(-9)). This association was replicated in a set of 263 cases and 1616 controls (OR = 0.60, p = 5.7 × 10(-6)). A phenome-wide association study (PheWAS) that was performed on this locus with 13,617 individuals and more than 200,000 patient-years of billing data identified associations with additional phenotypes: thyroiditis (OR = 0.58, p = 1.4 × 10(-5)), nodular (OR = 0.76, p = 3.1 × 10(-5)) and multinodular (OR = 0.69, p = 3.9 × 10(-5)) goiters, and thyrotoxicosis (OR = 0.76, p = 1.5 × 10(-3)), but not Graves disease (OR = 1.03, p = 0.82). Thyroid cancer, previously associated with this locus, was not significantly associated in the PheWAS (OR = 1.29, p = 0.09). The strongest association in the PheWAS was hypothyroidism (OR = 0.76, p = 2.7 × 10(-13)), which had an odds ratio that was nearly identical to that of the curated case-control population in the primary analysis, providing further validation of the PheWAS method. Our findings indicate that EMR-linked genomic data could allow discovery of genes associated with many diseases without additional genotyping cost. PMID:21981779

Denny, Joshua C; Crawford, Dana C; Ritchie, Marylyn D; Bielinski, Suzette J; Basford, Melissa A; Bradford, Yuki; Chai, High Seng; Bastarache, Lisa; Zuvich, Rebecca; Peissig, Peggy; Carrell, David; Ramirez, Andrea H; Pathak, Jyotishman; Wilke, Russell A; Rasmussen, Luke; Wang, Xiaoming; Pacheco, Jennifer A; Kho, Abel N; Hayes, M Geoffrey; Weston, Noah; Matsumoto, Martha; Kopp, Peter A; Newton, Katherine M; Jarvik, Gail P; Li, Rongling; Manolio, Teri A; Kullo, Iftikhar J; Chute, Christopher G; Chisholm, Rex L; Larson, Eric B; McCarty, Catherine A; Masys, Daniel R; Roden, Dan M; de Andrade, Mariza

2011-10-01

402

Over-the-horizon, connected home/office (OCHO): situation management of environmental, medical, and security conditions at remote premises via broadband wireless access  

NASA Astrophysics Data System (ADS)

Broadband wireless access standards, together with advances in the development of commercial sensing and actuator devices, enable the feasibility of a consumer service for a multi-sensor system that monitors the conditions within a residence or office: the environment/infrastructure, patient-occupant health, and physical security. The proposed service is a broadband reimplementation and combination of existing services to allow on-demand reports on and management of the conditions by remote subscribers. The flow of on-demand reports to subscribers and to specialists contracted to mitigate out-of-tolerance conditions is the foreground process. Service subscribers for an over-the-horizon connected home/office (OCHO) monitoring system are the occupant of the premises and agencies, contracted by the service provider, to mitigate or resolve any observed out-of-tolerance condition(s) at the premises. Collectively, these parties are the foreground users of the OCHO system; the implemented wireless standards allow the foreground users to be mobile as they request situation reports on demand from the subsystems on remote conditions that comprise OCHO via wireless devices. An OCHO subscriber, i.e., a foreground user, may select the level of detail found in on-demand reports, i.e., the amount of information displayed in the report of monitored conditions at the premises. This is one context of system operations. While foreground reports are sent only periodically to subscribers, the information generated by the monitored conditions at the premises is continuous and is transferred to a background configuration of servers on which databases reside. These databases are each used, generally, in non-real time, for the assessment and management of situations defined by attributes like those being monitored in the foreground by OCHO. This is the second context of system operations. Context awareness and management of conditions at the premises by a second group of analysts and decision makers who extract information from the OCHO data in the databases form the foundation of the situation management problem.

Hortos, William S.

2010-04-01

403

Health of women after wartime deployments: correlates of risk for selected medical conditions among females after initial and repeat deployments to Afghanistan and Iraq, active component, U.S. Armed Forces.  

PubMed

Women account for approximately 10 percent of all U.S. military deployers to Afghanistan and Iraq. This analysis estimates the percentages of female deployers (n=154,548) who were affected by selected illnesses and injuries after first through third deployments to Iraq/Afghanistan in relation to age group, service branch, military occupation, marital status, pre-deployment medical history, "dwell time" prior to 2nd and 3rd deployments, and length of deployment. Of these factors, diagnosis of a condition before deployment was by far the strongest predictor of diagnosis of the condition after deployment. Durations of dwell times before repeat deployments were not strong predictors of post-deployment diagnoses of any of the conditions considered. For several conditions (e.g., PTSD, disorders of joints, peripheral enthesopathies, infertility), the percentages of deployers diagnosed with the conditions sharply increased with deployment length. Post-deployment morbidity moderately increased with increasing numbers of deployments in the case of some conditions (e.g., PTSD, migraine, musculoskeletal disorders), but not others. The findings suggest that limiting wartime deployments to nine months may have broad beneficial effects on the post-deployment health of female service members. However, limiting the number of wartime deployments and lengthening "dwell times" before repeat deployments would likely not have strong and broad beneficial effects on the health of female veterans. Further research to mitigate the effects of heavy loads and repetitive stresses on the musculoskeletal systems of combat deployed females is indicated. PMID:22876800

2012-07-01

404

Medical marijuana: legal considerations.  

PubMed

In 1998, Washington State passed a law, Initiative 692 (I-692), that gives individuals who are charged with possession of marijuana for medical purposes a possible affirmative defense. The law lets these individuals provide a note from their doctor or a copy of their medical records stating they have a condition that may benefit from the use of marijuana. I-692 does not legalize the medical use of marijuana and does not affect Federal law, which makes obtaining, possessing, and growing marijuana illegal. The Washington law limits the amount of marijuana a patient can possess to a 60-day supply and defines the conditions for which medical marijuana may be used. These conditions include HIV, cancer, multiple sclerosis, and epilepsy. PMID:11366751

Schouten, J T

1999-01-01

405

Healthcare services for those with musculoskeletal conditions: a rheumatology service. Recommendations of the European Union of Medical Specialists Section of Rheumatology/European Board of Rheumatology 2006  

PubMed Central

Musculoskeletal conditions are very common across Europe. They affect all age groups, and the associated physical disability is an enormous burden on individuals and society. They can be effectively prevented and controlled in many situations, but this is not at present fully achieved. This report outlines what is required to achieve this and the role of rheumatology in providing these healthcare services. Strategies are given for the prevention and management of musculoskeletal conditions. The needs of people with these conditions are expressed in the PARE Manifesto and the clinical needs have been identified. The healthcare services required to implement these strategies and meet these needs are considered focusing on what services a rheumatology centre should provide. A key principle is that management of musculoskeletal conditions requires a coordinated, integrated, multidisciplinary and multiprofessional approach providing access to a combination of expertise and competencies. Guidance is given of what a rheumatology service should be expected to offer. For a rheumatology centre to provide these services, the need for appropriate facilities and resources is identified, which considers physical resources as well as personnel, training and management needs. Maintaining high standards of care and achieving the best outcomes at all times needs the monitoring of quality indicators as well as ongoing education and research. In conclusion, improving musculoskeletal health is dependent on access to effective treatments and this document shows how the services provided by a rheumatology centre is central to this.

Rheumatology, Anthony D Woolf and The European Union of Medical Specialists Section of

2007-01-01

406

LOOK AT POSSIBLE MEDICAL CAUSES FOR ENURESIS AND KNOW ABOUT INVESTIGATIONS AND POSSIBLE ORTHODOX TREATMENT INVOLVED. LOOK AT 6-8 REMEDIES WITH PARTICULAR ASSOCIATION WITH THIS CONDITION  

Microsoft Academic Search

'Enuresis is a term which is reserved for incontinence in children. It is the involuntary passing of urine at night when asleep. The existence of incontinence during the day suggests a kidney or bladder condition. It is mainly a disorder found in boys and affects 10% of boys aged 4-11 years. There are estimated to be 500,000 cases in Britain

Wendy Howard

407

The Effect of Prevalent Cardiovascular Conditions on the Association between Alcohol Consumption and Mortality among Older Mexican American Men  

PubMed Central

Purpose To examine the association between alcohol consumption and mortality among older Mexican American men, with and without pre-existing cardiovascular conditions. Methods We conducted survival analysis among 908 men aged 65-80 years from the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE), a longitudinal population-based study of older Mexican Americans who reside in the southwestern United States. Men were categorized into four alcohol-consumption groups: lifetime abstainers, former drinkers, low risk drinkers (?30 drinks/month and ?3 drinks/occasion) and at-risk drinkers (>30 drink/month or >3 drink/occasion) and stratified into two groups: those with and those without pre-existing cardiovascular conditions. Mortality was ascertained from 1993-1994 to 2007. Results Among participants without pre-existing cardiovascular conditions, former, low risk, and at-risk drinkers had a lower risk for all-cause mortality compared to lifetime abstainers [HR: 0.70, 95% CI (0.50-0.99), 0.64 (0.42-0.97) and 0.60 (0.40-0.92), respectively]. There was no statistically significant association between mortality and any of the alcohol consumption groups among those with cardiovascular conditions. Conclusions Among older Mexican-American men without cardiovascular conditions, former and current drinkers had lower mortality compared to abstainers. No such associations were observed between alcohol use and mortality among those with cardiovascular conditions.

AlGhatrif, Majd; Markides, Kyriakos S.; Kuo, Yong-fang; Ray, Laura A.; Moore, Alison A.

2013-01-01

408

32 CFR 732.21 - Medical board.  

Code of Federal Regulations, 2013 CFR

...guidance. (a) Chronic conditions requiring a medical board include (but...Gout, (5) Heart disease, (6) Hypertension... (8) Psychiatric conditions, and (9) Allergic...may be referred to a medical board by the...

2013-07-01

409

42 CFR 410.132 - Medical nutrition therapy.  

Code of Federal Regulations, 2010 CFR

...2009-10-01 2009-10-01 false Medical nutrition therapy. 410.132 Section 410.132...MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for...

2009-10-01

410

42 CFR 410.132 - Medical nutrition therapy.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 2010-10-01 false Medical nutrition therapy. 410.132 Section 410.132...MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for...

2010-10-01

411

Medication Use During Pregnancy: Risk Factors for Birth Defects?  

MedlinePLUS

... serious illness. Women should not change medications or stop taking medications without first talking with their doctor ... serious conditions. Women should not change medications or stop taking medications without first talking with their doctor ...

412

Medical Device Safety  

MedlinePLUS

... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Medical Devices Home Medical Devices Medical Device Safety - Section Contents ... Medical Product Safety Network Emergency Situations (Medical Devices) - Medical Device Safety Search the Medical Device Safety Section Medical ...

413

Evaluation of the Reliability of Electronic Medical Record Data in Identifying Comorbid Conditions among Patients with Advanced Non-Small Cell Lung Cancer.  

PubMed

Background. Traditional methods for identifying comorbidity data in EMRs have relied primarily on costly and time-consuming manual chart review. The purpose of this study was to validate a strategy of electronically searching EMR data to identify comorbidities among cancer patients. Methods. Advanced stage NSCLC patients (N = 2,513) who received chemotherapy from 7/1/2006 to 6/30/2008 were identified using iKnowMed, US Oncology's proprietary oncology-specific EMR system. EMR data were searched for documentation of comorbidities common to advanced stage cancer patients. The search was conducted by a series of programmatic queries on standardized information including concomitant illnesses, patient history, review of systems, and diagnoses other than cancer. The validity of the comorbidity information that we derived from the EMR search was compared to the chart review gold standard in a random sample of 450 patients for whom the EMR search yielded no indication of comorbidities. Negative predictive values were calculated. Results. The overall prevalence of comorbidities of 22%. Overall negative predictive value was 0.92 in the 450 patients randomly sampled patients (36 of 450 were found to have evidence of comorbidities on chart review). Conclusion. Results of this study suggest that efficient queries/text searches of EMR data may provide reliable data on comorbid conditions among cancer patients. PMID:21765829

Muehlenbein, Catherine E; Hoverman, J Russell; Gruschkus, Stephen K; Forsyth, Michael; Chen, Clara; Lopez, William; Lawson, Anthony; Hartnett, Heather J; Pohl, Gerhardt

2011-05-02

414

Medical Care Costs Associated with Traumatic Brain Injury over the Full Spectrum of Disease: A Controlled Population-Based Study  

PubMed Central

Abstract Data on traumatic brain injury (TBI) economic outcomes are limited. We used Rochester Epidemiology Project (REP) resources to estimate long-term medical costs for clinically-confirmed incident TBI across the full range of severity after controlling for pre-existing conditions and co-occurring injuries. All Olmsted County, Minnesota, residents with diagnoses indicative of potential TBI from 1985–2000 (n=46,114) were identified, and a random sample (n=7175) was selected for medical record review to confirm case status, and to characterize as definite (moderate/severe), probable (mild), or possible (symptomatic) TBI. For each case, we identified one age- and sex-matched non-TBI control registered in REP in the same year (±1 year) as case's TBI. Cases with co-occurring non-head injuries were assessed for non-head-injury severity and assigned similar non-head-injury-severity controls. The 1145 case/control pairs for 1988–2000 were followed until earliest death/emigration of either member for medical costs 12 months before and up to 6 years after baseline (i.e., injury date for cases and comparable dates for controls). Differences between case and control costs were stratified by TBI severity, as defined by evidence of brain injury; comparisons used Wilcoxon signed-rank plus multivariate modeling (adjusted for pre-baseline characteristics). From baseline until 6 years, each TBI category exhibited significant incremental costs. For definite and probable TBI, most incremental costs occurred within the first 6 months; significant long-term incremental medical costs were not apparent among 1-year survivors. By contrast, cost differences between possible TBI cases and controls were not as great within the first 6 months, but were substantial among 1-year survivors. Although mean incremental costs were highest for definite cases, probable and possible cases accounted for>90% of all TBI events and 66% of total incremental costs. Preventing probable and possible events might facilitate substantial reductions in TBI-associated medical care costs.

Brown, Allen W.; Hall Long, Kirsten; Ransom, Jeanine E.; Mandrekar, Jay; Osler, Turner M.; Malec, James F.

2012-01-01

415

Controversy over the classification of medication-overuse headache.  

PubMed

Medication-overuse headache (MOH) is a relatively common and impactful disorder, affecting 1% to 2% of the population, characterized by daily or near-daily headache aggravated by chronic acute medication intake. Primary headache patients do not necessarily develop MOH after acute medication overuse, although a pre-existing primary headache is inevitably present. Likewise, headache patients may deteriorate in terms of frequency without medication overuse, or suffer from chronic headache in the presence of drug abuse without any causal relationship. To classify and define diagnostic criteria for MOH in the absence of objective biomarkers is a difficult task that is presently based on clinical grounds and is limited in part by the relative lack of research in this field. The present criteria are less restrictive but also less precise than the previous versions because they allow the diagnosis without the previously required MOH confirmation after medication withdrawal. MOH should remain as a distinct secondary disorder based on the available clinical and pathophysiological evidence. PMID:22068432

Vincent, Maurice B

2012-02-01

416

Medical confidence.  

PubMed Central

If medical confidentiality is not observed patients may well be reluctant to disclose information to their doctors or even to seek medical advice. Therefore, argues the author, it is of the utmost importance that doctors strive to protect medical confidentiality, particularly now when it is under threat not only in this country but also overseas. The profession must cease to regard ethical issues to do with confidentiality, and indeed to do with all areas of medical practice, as abstract phenomena requiring no justification. If it does not then it will come under increasing and justified criticism from the community it serves.

Havard, J

1985-01-01

417

20 CFR 404.1513 - Medical and other evidence of your impairment(s).  

Code of Federal Regulations, 2013 CFR

...medical evidence from acceptable medical sources (containing the clinical and laboratory findings) and other medical sources not listed in paragraph...information you give us about your medical condition(s) and how it affects...

2013-04-01

418

College students' use of widely advertised medications  

Microsoft Academic Search

The authors describe college and university students' use of widely advertised pharmaceutical products. Four hundred seventy-one students from three institutions completed self-administered questionnaires that addressed the use of advertised medications, attention to magazine ads for medications, communications with physicians about medications, and the conditions the medications address. Results indicated that the majority of the students used at least one of

Lydia J. Burak; Amy Damico

2000-01-01

419

Medication reviews  

PubMed Central

Recent years have seen a formalization of medication review by pharmacists in all settings of care. This article describes the different types of medication review provided in primary care in the UK National Health Service (NHS), summarizes the evidence of effectiveness and considers how such reviews might develop in the future. Medication review is, at heart, a diagnostic intervention which aims to identify problems for action by the prescriber, the clinican conducting the review, the patient or all three but can also be regarded as an educational intervention to support patient knowledge and adherence. There is good evidence that medication review improves process outcomes of prescribing including reduced polypharmacy, use of more appropriate medicines formulation and more appropriate choice of medicine. When ‘harder’ outcome measures have been included, such as hospitalizations or mortality in elderly patients, available evidence indicates that whilst interventions could improve knowledge and adherence they did not reduce mortality or hospital admissions with one study showing an increase in hospital admissions. Robust health economic studies of medication reviews remain rare. However a review of cost-effectiveness analyses of medication reviews found no studies in which the cost of the intervention was greater than the benefit. The value of medication reviews is now generally accepted despite lack of robust research evidence consistently demonstrating cost or clinical effectiveness compared with traditional care. Medication reviews can be more effectively deployed in the future by targeting, multi-professional involvement and paying greater attention to medicines which could be safely stopped.

Blenkinsopp, Alison; Bond, Christine; Raynor, David K

2012-01-01

420

Medication safety in neonates.  

PubMed

Newborn intensive care units (NICUs) are high-risk areas of care, where complex medical interventions are performed, and are recognized as a resource for improved outcome in premature and low-birth-weight infants or those presenting with acute conditions. This critical environment, along with the vulnerable nature of the population it serves, places patients at risk for medication errors, which can result in permanent harm or death. Promoting safe medication practices requires participation of all individuals involved in the medication use process (e.g., physicians, nurses, nurse practitioners, physician assistants, pharmacists, respiratory therapists, pharmacy technicians). The following recommendations, organized in accordance with the Institute for Safe Medication Practices' Key Elements of the Medication Use System™, will focus on significant areas of concern within the NICU. All individuals caring for neonates, supported by administrators and organizational leaders, should recognize themselves as active partners responsible for the safety of this fragile patient population by participating in the design and sustainment of a safe and efficient medication use system. PMID:21861251

Dabliz, Rabih; Levine, Stuart

2011-08-22

421

Myasthenia Gravis Medication Information Card (Drugs to be Avoided or Used with Caution in Myasthenia Gravis)  

MedlinePLUS

My Name _______________________________________________ Address ________________________________________________ City ______________________ State _______ Zip __________ Phone ( _______ ) ____________ or ( _______ ) _____________ Birthdate _______________________________________________ Contact in Emergency: Name __________________________________________________ Phone ( _______ ) ____________ or ( _______ ) _____________ Other Medical Conditions: ____________________________ ____________________________ ____________________________ Current Medications: ____________________________ ____________________________ ____________________________ MYASTHENIA GRAVIS MEDICATION ...

422

[A medical-pharmaceutical partnership model as a contributor to the success in conditioning regimen for allogenic hematopoietic stem cell transplantation in adults: a cross-reflection on our organizations].  

PubMed

Allogeneic hematopoietic stem-cell transplant (allo-SCT) remains the only cure for many hematological malignancies and some benign and congenital diseases. Busulfan, proposed in its injectable form, has quickly become a mainstay of pharmacological and myeloablative (or non-myeloablative) conditioning. This is following the outbreak in 2010 of a multicenter international clinical phase II trial, we tested the robustness and reliability of our organization in a complex model of organization and multifactorial partnership. In this type "BuCy2" protocol based on a classical treatment duration of 4 consecutive days, the administration of IV busulfan is given in one single daily infusion instead of the conventional 16 infusions, while keeping the same total dose. Under these conditions, the treatment is totally secured using a therapeutic drug monitoring of busulfan, applied in real-time. The process is technically complex and requires the very close cooperation of the teams involved. A strength, weakness, opportunity and threat (SWOT) analysis has been constructed; it fully supports continuous quality improvement to the triple benefit of the nursing chain, the patients and their environment. Several critical points were identified and corrected. The experiment strongly contributes to the safety and security of the medication circuit at the hospital and, improves the performance of allo-SCT. It also contributes to the protection of all actors in the health field and their working environment via a well-functioning quality management system. PMID:22645281

Bourget, Philippe; Falaschi, Ludivine; Suarez, Felipe; Galland, Valérie; Blot, Dominique; Trompette, Caroline; Sibon, David; Fontbrune, Flore Sicre de; Merlette, Christophe; Vidal, Fabrice; Corriol, Odile; Giraud, Bérénice; Broissand, Christine; Clement, Rozenn; Hermine, Olivier

2012-06-01

423

Medical pleuroscopy.  

PubMed

There has been an exciting expansion in the practice of medical pleuroscopy in recent years. As technology has become more available and confidence in the use of equipment has grown, medical thoracoscopy has become a core diagnostic and therapeutic tool in pleural disease care. Despite this, many areas of medical pleuroscopy practice remain conspicuously devoid of well-established evidence. More knowledge is needed in those areas where there is currently a degree of equipoise. Many areas where pleuroscopy currently has a marginal role require high-quality randomized trials be undertaken with a view to informing future practice and guidelines. PMID:23993819

Bhatnagar, Rahul; Maskell, Nick A

2013-06-18

424

Travelers with Disabilities and Medical Conditions  

MedlinePLUS

Official website of the Department of Homeland Security Transportation Security Administration User menu global search Home Contact Social Media Search form Search using USASearch Status message Due to the ...

425

Treating Child Obesity and Associated Medical Conditions  

Microsoft Academic Search

Summary With American children on course to grow into the most obese generation of adults in history, Sonia Caprio argues that it is critical to develop more effective strategies for preventing child- hood obesity and treating serious obesity-related health complications. She notes that although pediatricians are concerned about the obesity problem, most are ineffective in addressing it. Treatment should begin,

Sonia Caprio

2006-01-01

426

Psychotropic Medications and HIV  

Microsoft Academic Search

Patients with human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome have high rates of psychiatric illness. The effective management of these psychiatric conditions can improve a patient's quality of life and may improve antiretroviral adherence. Care providers for patients with HIV infection frequently encounter clinical situations in which psychotropic medications are needed or are being used. Those clinical

Alex Thompson; Benjamin Silverman; Liz Dzeng; Glenn Treisman

427

Pelvic Arterial Embolisation in a Trauma Patient with a Pre-Existing Aortobifemoral Graft  

SciTech Connect

Pelvic fractures secondary to blunt trauma are associated with a significant mortality rate due to uncontrolled bleeding. Interventional radiology (IR) can play an important and central role in the management of such patients, offering definitive minimally invasive therapy and avoiding the need for high-risk surgery. Rapid access to whole-body computed tomography has been shown to improve survival in polytrauma patients and allows rapid diagnosis of vascular injury and assessment of suitability for endovascular therapy. IR can then target and treat the specific area of bleeding. Embolisation of bleeding pelvic arteries has been shown to be highly effective and should be the treatment of choice in this situation. The branches of the internal iliac artery (IIA) are usually involved, and these arteries are accessed by way of IIA catheterisation after abdominal aortography. Occasionally these arteries cannot be accessed by way of this conventional route because of recent IIA ligation carried out surgically in an attempt to stop the bleeding or because (in the rare situation we describe here) these vessels are excluded secondary to previous aortoiliac repair. In this situation, knowledge of pelvic arterial collateral artery pathways is important because these will continue to supply pelvic structures whilst making access to deep pelvic branches challenging. We describe a rare case, which has not been previously reported in the literature, in which successful embolisation of a bleeding pelvic artery was carried out by way of the collateral artery pathways.

Abulaban, Osama; Hopkins, Jonathan; Willis, Andrew P.; Jones, Robert G., E-mail: robert.jones@uhb.nhs.uk [Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust (United Kingdom)

2011-02-15

428

Character displacement: in situ evolution of novel phenotypes or sorting of pre-existing variation?  

Microsoft Academic Search

Character displacement - the divergence of traits between species in response to competition for resources or mates - has long been viewed as a major cause of adaptive diversification and species coexistence. Yet, we lack answers to basic questions concerning the causes and consequences of character displacement, not the least of which is why some species are more prone than

A. M. RICE; D. W. PFENNIG

2007-01-01

429

Effect of pre-existing carrier immunity on the efficacy of synthetic influenza vaccine  

Microsoft Academic Search

In our previous studies on the development of synthetic peptide-based vaccines, we have evaluated flagellin from a Salmonella typhi vaccine strain as a carrier molecule for synthetic peptides derived from the influenza virus. The results indicated that the use of recombinant flagella, expressing defined influenza epitopes, is adequate for induction of protection against a challenge infection. It is of importance

T Ben-Yedidia; R Arnon

1998-01-01

430

Pre-existent vertebral rotation in the human spine is influenced by body position.  

PubMed

Human bipedalism appears to be a prerequisite for the development of idiopathic scoliosis. The objective of this study was to examine the effect of different positions of the human spine on vertebral rotation in vivo. Thirty asymptomatic volunteers underwent MRI scanning of the spine in three different body positions; upright, quadrupedal-like and supine. Vertebral rotation in the local transverse plane was measured and compared at different spinal levels between the three body positions. It was shown that in all three positions the mid and lower thoracic vertebrae were predominantly rotated to the right. However, rotation was significantly less in certain areas of the spine in the quadrupedal-like position than in both the standing upright and supine positions. We hypothesize that the erect position of the human spine, but also the supine position, increases dorsally directed shear loads that may increase the tendency of certain spinal segments to rotate. PMID:20543402

Janssen, Michiel M A; Vincken, Koen L; Kemp, Bastiaan; Obradov, Marina; De Kleuver, Marinus; Viergever, Max A; Castelein, René M; Bartels, Lambertus W

2010-01-01

431

Pre-existing Inland Fisheries Management in Thailand: The Case of the Lower Songkhram River Basin  

Microsoft Academic Search

\\u000a The livelihoods and food security of many Thai rural communities depend on inland capture fisheries, which are characterized\\u000a by multiple species, diverse habitats and complex ecosystems. Current fisheries management in Thailand can neither control\\u000a levels of exploitation and illegal fishing, nor can it achieve an equitable sharing of resources, which have become degraded\\u000a and the focus of serious conflict. The

Malasri Khumsri

432

A PRE-EXISTENT HYPOXIC GENE SIGNATURE PREDICTS IMPAIRED ISLET GRAFT FUNCTION AND GLUCOSE HOMEOSTASIS.  

PubMed

We examined whether hypoxic exposure prior to the event of transplantation would have a positive or negative effect upon later islet graft function. Mouse islets, exposed to hypoxic culture were transplanted into syngeneic recipients. Islet graft function, beta cell physiology, as well as molecular changes were examined. Expression of hypoxia-response genes in human islets pre- and post-transplant was examined by microarray. Hypoxia-pre-exposed murine islet grafts provided poor glycemic control in their syngeneic recipients, marked by persistent hyperglycemia and pronounced glucose intolerance with failed first and second phase glucose-stimulated insulin secretion in vivo. Mechanistically, hypoxic pre-exposure stabilized HIF-1? with a concomitant increase in hypoxic-response genes including LDHA; a molecular gene set which would favor glycolysis and lactate production and impair glucose sensing. Indeed, static incubation studies showed hypoxia-exposed islets exhibited dysregulated glucose responsiveness with elevated basal insulin secretion. Isolated human islets, prior to transplantation, express a characteristic hypoxiaresponse gene expression signature, including high levels of LDHA, which is maintained post transplant. Hypoxic pre-exposure of an islet graft drives a HIF-dependent switch to glycolysis with subsequent poor glycemic control and loss of GSIS. Early intervention to reverse or prevent these hypoxia-induced metabolic gene changes may improve clinical islet transplantation. PMID:23127310

Cantley, James; Walters, Stacey N; Jung, Min-Ho; Weinberg, Anita; Cowley, Mark J; Whitworth, P Tess; Kaplan, Warren; Hawthorne, Wayne J; O'Connell, Philip J; Weir, Gordon; Grey, Shane T

2012-10-31

433

Role of a pre-existing neuropathy on the course of bortezomib-induced peripheral neurotoxicity.  

PubMed

We investigated a series of bortezomib-treated patients and correlated the course of bortezomib-induced peripheral neurotoxicity with the presence or absence of peripheral neuropathy at baseline. Forty-eight patients were examined with the total neuropathy score reduced version (TNSr), visual analogue score (VAS) for pain, and nerve conduction studies at baseline and after two and four cycles of chemotherapy. Twenty-three patients had a baseline TNSr = 0-2, and 25 patients had a baseline TNSr >2 (median = 6, range 3-13). The course of bortezomib-induced peripheral neurotoxicity was generally more severe in those patients with the highest baseline TNSr. However, among those subjects with a normal baseline TNSr, two patients developed a clinically relevant peripheral neuropathy with a marked increase in TNSr as early as after two cycles of bortezomib treatment (TNSr = 10 and 15, respectively), while after four cycles, three other patients with normal baseline TNSr had a TNSr of 11, 12, and 13. VAS reporting confirmed that painful neuropathy is frequent after bortezomib administration. Our results indicate that the course of bortezomib-induced peripheral neurotoxicity can be severe in subjects with normal neurological examination at baseline, and therefore, careful monitoring during treatment is suggested in these patients. PMID:19192066

Lanzani, Francesca; Mattavelli, Laura; Frigeni, Barbara; Rossini, Fausto; Cammarota, Sara; Petrò, Daniela; Jann, Stefano; Cavaletti, Guido

2008-12-01

434

Comparison of atropine and glycopyrronium in patients with pre-existing cardiac disease.  

PubMed

The effects of atropine and glycopyrronium, when given intravenously with neostigmine during the reversal of neuromuscular blockade in patients with cardiovascular disease, were compared in a double blind trial. Atropine was associated with a significantly greater elevation of heart rate and rate-pressure product than glycopyrronium. This elevation was also more sustained with atropine. The entire atropine population also showed a significantly greater incidence of ST-segment depression on the electrocardiogram than that observed in those who had received glycopyrronium. Furthermore, patients with ischaemic heart disease and previous myocardial infarction who received atropine showed a significantly greater incidence of dysrhythmias than those given glycopyrronium. It is suggested that at the time of reversal of neuromuscular blockade in patients with cardiovascular disease, glycopyrronium is a more suitable agent than atropine. PMID:6517248

Mostafa, S M; Vucevic, M

1984-12-01

435

Synchronous mucinous adenocarcinoma of the rectosigmoid seeding onto a pre-existing anal fistula  

PubMed Central

Carcinoma within a long-standing fistula-in-ano is rare and may be defined by specific neoplastic involvement of the fistulous track in the absence of rectal mucosal carcinoma. The presence of a carcinoma of mucinous histology occurring synchronously in the perianal region and the colon is exceptionally rare. We present a case with a review of the literature concerning its aetiopathogenesis and treatment. A 72-year-old man with a 2 months history of dark red rectal bleeding and mucus per rectum with alternating constipation and diarrhoea, was observed. Clinical examination and a barium enema showed a perianal fistula and an annular stenosing lesion of the rectosigmoid. Preoperative CT scan confirmed the colonic lesion. Colonic resection and wide fistula excision were performed. Histology showed an adenocarcinoma with a clear resection margins. The fistula also showed a similar histology. Chemoradiation (5-Fluorouracil (425 mg/m2) and Leucovorin (20 mg/m2) with 4500 cGy external beam radiotherapy was utilized. Subsequent clinical follow-up and CT examination of the patient has not revealed recurrent disease at 14 months.

Sandiford, Nemandra; Prussia, Patsy R; Chiappa, Antonio; Zbar, Andrew P

2006-01-01

436

Synchronous mucinous adenocarcinoma of the rectosigmoid seeding onto a pre-existing anal fistula.  

PubMed

Carcinoma within a long-standing fistula-in-ano is rare and may be defined by specific neoplastic involvement of the fistulous track in the absence of rectal mucosal carcinoma. The presence of a carcinoma of mucinous histology occurring synchronously in the perianal region and the colon is exceptionally rare. We present a case with a review of the literature concerning its aetiopathogenesis and treatment. A 72-year-old man with a 2 months history of dark red rectal bleeding and mucus per rectum with alternating constipation and diarrhoea, was observed. Clinical examination and a barium enema showed a perianal fistula and an annular stenosing lesion of the rectosigmoid. Preoperative CT scan confirmed the colonic lesion. Colonic resection and wide fistula excision were performed. Histology showed an adenocarcinoma with a clear resection margins. The fistula also showed a similar histology. Chemoradiation (5-Fluorouracil (425 mg/m2) and Leucovorin (20 mg/m2) with 4500 cGy external beam radiotherapy was utilized. Subsequent clinical follow-up and CT examination of the patient has not revealed recurrent disease at 14 months. PMID:16961916

Sandiford, Nemandra; Prussia, Patsy R; Chiappa, Antonio; Zbar, Andrew P

2006-09-08

437

Involvement in Listening to Music from a Computer: The Effects of Pre-Existing Mood  

Microsoft Academic Search

We examined the effects of autobiographically induced mood states on involvement when listening to emotional music from a\\u000a computer in 48 subjects. We found that pleasant mood and music elicited higher involvement in listening to music than unpleasant\\u000a mood and music. We also found that, in connection with the arousal dimension of emotion the interaction between mood and music\\u000a supported

Kari Kallinen; Timo Saari; Niklas Ravaja; Mikko Salminen

438

The effects of pre-existing moods on the emotional responses to music  

Microsoft Academic Search

In the present paper, we examined the effects of autobio- graphically induced mood and music on emotional evalua- tions of and psychophysiological responses to music in 48 subjects. Participants listened to music after a mood induc- tion. Both music and induction varied on the dimensions of valence (pleasant - unpleasant) and arousal (high - low). During mood induction and listening

Kari Kallinen; Timo Saari; Niklas Ravaja; Mikko Salminen

2006-01-01

439

Repair of fractured abutment teeth under pre-existing crowns: an alternative approach.  

PubMed

This article describes a technique for repair of abutment tooth which fractured during removal of a provisional restoration before bisque trial. The technique uses plastic templates to fabricate new composite core foundation for the existing crowns. This technique helps the dentist to rebuild the core in a single appointment. PMID:23852248

Mascarenhas, Kennedy; Aras, Meena A; Fernandes, Aquaviva S

440

Using Pre-existing Microarray Datasets to Increase Experimental Power: Application to Insulin Resistance  

Microsoft Academic Search

Although they have become a widely used experimental technique for identifying differentially expressed (DE) genes, DNA microarrays are notorious for generating noisy data. A common strategy for mitigating the effects of noise is to perform many experimental replicates. This approach is often costly and sometimes impossible given limited resources; thus, analytical methods are needed which increase accuracy at no additional

Bernie J. Daigle; Alicia Deng; Tracey McLaughlin; Samuel W. Cushman; Margaret C. Cam; Gerald Reaven; Philip S. Tsao; Russ B. Altman

2010-01-01

441

Localization of volcanic activity: 2. Effects of pre-existing structure  

Microsoft Academic Search

The capture of vertically rising dikes by faults is examined with a combination of an analytic solution, numerical simulations and field observations. One of the numerical solutions and the field observations also provide insight into the intrusion of sills into the hanging wall of faults that are reactivated when lubricated by magma. The approximate analytic solution indicates that dike capture

Edward S. Gaffney; Branko Damjanac; Greg A. Valentine

2007-01-01

442

Robot-assisted laparoscopic radical prostatectomy in patients with pre-existing inflatable penile prosthesis  

Microsoft Academic Search

Patients with clinically localized prostate cancer presenting for extirpative therapy often have a prior history of pelvic\\u000a surgery. This must be taken into account when offering various surgical options. We present two patients who underwent robot-assisted\\u000a laparoscopic radical prostatectomy (RALRP) after having previously undergone implantation of three-piece inflatable penile\\u000a prostheses. A video is provided for illustration of our technique.

Aaron Sulman; Jeffery Piaccitelli; Li-Ming Su

2008-01-01

443

Medical Imaging.  

ERIC Educational Resources Information Center

Discusses four main types of medical imaging (x-ray, radionuclide, ultrasound, and magnetic resonance) and considers their relative merits. Describes important recent and possible future developments in image processing. (Author/MKR)

Barker, M. C. J.

1996-01-01

444

Medication Errors  

Center for Drug Evaluation (CDER)

... The DMEPA also works closely with federal partners, patient safety organizations such as Institute for Safe Medication Practices (ISMP), standard ... More results from www.fda.gov/drugs/drugsafety/medicationerrors

445

Cardiac Medications  

MedlinePLUS

... Prinivil, Zestril) Moexipril (Univasc) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik) What the Medication Does Expands ... include: Acebutolol (Sectral) Atenolol (Tenormin) Betaxolol ... (Ziac) Bisoprolol (Zebeta) Carteolol (Cartrol) Metoprolol (Lopressor, Toprol ...