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1

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

2

Pre-existing cardiovascular conditions and high altitude travel. Consensus statement of the Medical Commission of the Union Internationale des Associations d'Alpinisme (UIAA MedCom) Travel Medicine and Infectious Disease.  

PubMed

The number of persons visiting high altitude regions for various purposes (recreation, business etc.), and the age of people who do so, increases. Therefore there are more and more patients who need specific and individual advice to prevent emergency situations at altitude and to deal with emergencies if the safety strategy should fail. Since literature concerning cardiocirculatory diseases at altitude is scarce and studies with a controlled setting and high evidence level are missing, UIAA MedCom has checked all available literature for specific information to enable physicians who are active in travel or high altitude medicine to advise the patients at the highest possible level of evidence. It must be pointed out that there are several other medical fields where such information is mandatory, e.g. in occupational medicine, when employees depart to high altitude destinations for business purposes. The recommendations are based on a detailed literature research (databases, handbooks and the respective references). For easier use the paper has been structured as follows: general information, cardiocirculatory system and ECG at altitude, several cardiocirculatory diseases and their specific recommendations. The commission concludes, that a general "don't go!" is no state-of-the-art advice for the patients. With the information presented here a safe trip to altitude should be possible for many patients. PMID:24675141

Donegani, Enrico; Hillebrandt, David; Windsor, Jeremy; Gieseler, Ulf; Rodway, George; Schöffl, Volker; Küpper, Thomas

2014-01-01

3

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

4

Using an E-Health Intervention to Promote the Health of Cancer Survivors with Pre-Existing Disabling Conditions  

PubMed Central

While there has been research on the use of e-health for cancer patients and those living with disabilities, no interventions focus on cancer survivors who had a disabling condition prior to their cancer. Therefore, we developed and piloted the feasibility of the online health-promotion program LiveAble. Based on a theoretically driven health promotion program previously shown to be effective among people with various chronic conditions, LiveAble was adapted to be an e-heath intervention for cancer survivors with pre-existing disabilities. Eleven cancer survivors reviewed LiveAble and provided feedback. The group’s average age was 54 years. Most had neuromuscular impairments prior to their cancer; about half were breast cancer survivors. Average scores on the Self- Efficacy for Health Practices Scale increased. Participants rated LiveAble useful, attractively presented, and relevant to people with disabilities. Their feedback also suggested areas for change, such as a system that was easier to navigate and more individualized. Only 51% of these participants agreed that LiveAble motivated them to take action to improve their health. To turn information into action, participants may need additional assistance and encouragement. While preliminary results were promising, future efforts should determine the efficacy of LiveAble with larger and more diverse groups of survivors.

Becker, Heather; Mackert, Mike; Kang, Sook Jung

2012-01-01

5

Intrauterine device practice guidelines: medical conditions.  

PubMed

Contraception selection poses special challenges to women with pre-existing medical problems and clinicians often lack the knowledge to counsel these women. The IUD represents an excellent option for many US women with medical problems. Because IUDs have no direct systemic effects other than increasing circulating immunoglobulins and possibly copper ions, they are unlikely to affect a woman's underlying disease process or to interact with medications used in disease treatment. Currently available IUDs may be appropriate for women with cardiovascular disease, diabetes mellitus with vascular disease, hematologic disorders, neurologic conditions, and psychiatric disorders. Other candidates for IUD use include women with a history of breast cancer or other hormone-sensitive cancers, active liver disease, hypertriglyceridemia, a sensitivity to hormonal contraception, and smokers over 40 years old. IUDs are contraindicated in women with diseases that increase their vulnerability to infection (e.g., AIDS, leukemia, and intravenous drug abuse), diseases or medications that produce profuse uterine bleeding, and conditions that distort the uterine cavity. Given the deleterious impact of unintended pregnancy on the clinical course of many diseases, information on contraception for women with pre-existing medical conditions should be more broadly disseminated among clinicians. PMID:9807694

Nelson, A L

1998-09-01

6

15 CFR 922.47 - Pre-existing authorizations or rights and certifications of pre-existing authorizations or rights.  

Code of Federal Regulations, 2010 CFR

...Pre-existing authorizations or rights and certifications of pre-existing authorizations or rights. 922.47 Section 922...ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT...Pre-existing authorizations or rights and certifications of...

2010-01-01

7

Depression in Pregnancy is Associated with Pre-existing but not Pregnancy-induced Hypertension  

PubMed Central

Background To examine whether depression is associated with pre-existing hypertension or pregnancy-induced hypertension in a large sample of women attending a university-based obstetrics clinic. Methods In this prospective study, participants were 2398 women receiving ongoing prenatal care at a university-based obstetrics clinic from January 2004 through January 2009. Prevalence of depression was measured using the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria based on the Patient Health Questionnaire-9 as well as the self-reported use of antidepressant medication. Evidence of pre-existing hypertension, pregnancy-induced hypertension and preeclampsia/eclampsia was determined by obstetrician ICD-9 codes. Logistic regression was used to quantify the association between hypertension in pregnancy and antenatal depression. Results After adjusting for sociodemographic variables, chronic medical conditions, smoking and prior pregnancy complications, women with pre-existing hypertension had an increased risk of Any Depression (minor, major, use of antidepressants) (OR = 1.55, 95% CI 1.08, 2.23) and Major Depression and/or use of antidepressants) (OR = 1.65, 95% CI 1.10, 2.48) compared to women without hypertension. No differences were seen in risk of depression in women with pregnancy-induced hypertension or preeclampsia/eclampsia compared to those without hypertension. Conclusion Women with pre-existing hypertension, but not pregnancy induced hypertension are more likely to meet criteria for an antenatal depressive disorder and/or to be treated with antidepressants and could be targeted by obstetricians for screening for depression and enhanced treatment.

Katon, Wayne J.; Russo, Joan E.; Melville, Jennifer L.; Katon, Jodie; Gavin, Amelia

2011-01-01

8

17 CFR 151.9 - Pre-existing positions.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 false Pre-existing positions. 151.9 Section 151.9 Commodity...COMMODITY FUTURES TRADING COMMISSION POSITION LIMITS FOR FUTURES AND SWAPS § 151.9 Pre-existing positions. (a) Non-spot-month...

2013-04-01

9

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

10

78 FR 30218 - Pre-Existing Condition Insurance Plan Program  

Federal Register 2010, 2011, 2012, 2013

...by the Center for Studying Health System Change, about 60...prescription due to cost. Lack of health coverage often leads to significant...expensive care at sites such as emergency rooms, shifting these costs in the health system to people with...

2013-05-22

11

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

12

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

13

[Regional anesthesia in patients with pre-existing infections or immunosuppression].  

PubMed

Regional anesthesia is the most effective procedure for acute pain therapy. Whether neuraxial and peripheral blocks in patients with pre-existing infectious conditions, immune deficits or other risk factors increase the risk of additional infections is unclear. Analyzing the available literature currently seems to indicate that the incidence of severe infectious complications is generally low. Diabetes, steroid therapy or malignant diseases are apparently present in many cases in which infections associated with regional anesthesia and analgesia have been described. A strict contraindication in patients with pre-existing systemic or local infections seems unjustifiable. A clear and documented risk-benefit ratio in these patients is mandatory. PMID:23515533

List, F; Kessler, P; Volk, T

2013-03-01

14

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

PubMed Central

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.

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

2013-01-01

15

The Magnetospheric Source of the Pre-existing Auroral Arc  

NASA Astrophysics Data System (ADS)

An auroral substorm commences when a discrete auroral arc brightens and subsequently expands poleward and azimuthally. The arc that brightens is usually the most equatorward of several quiescent auroral arcs present for a few to tens of minutes before the break-up commences. This arc is referred to as the "pre-existing auroral arc (PAA)" or the "growth-phase arc". Till now, the magnetospheric manifestation of the PAA during the growth phase and at substorm onset are not well understood. This dissertation addresses the magnetospheric location and source of the field-aligned current (FAC) of the PAA by analyzing measurements from magnetic and optical observatories on the ground and spacecraft at low and high altitudes. In order to understand the magnetospheric location of the PAA relative to the inner edge of the electron plasma sheet (IEEPS), 2 years of THEMIS plasma data are surveyed to characterize the location of IEEPS on the equatorial plane. The IEEPS is found to lie at 7˜8 RE in the pre-midnight sector and 6˜7 RE in the post-midnight sector at geomagnetically quiet times. Next, from 5 events obtained between 2007 and early 2009 in which FAST crosses the flux tube linking to a PAA imaged by THEMIS all-sky imagers before an auroral substorm, the PAA is found to be located 1˜2 degree poleward of the equatorward boundary of the 1 keV trapped electrons in the ionosphere. This latitudinal separation maps to a 2˜3 RE radial separation from the IEEPS at the equator by the T96 model, and it places the PAA at 8˜10 RE for typical growth phase conditions and further tailward for a very stretched magnetotail. In addition, the PAA is found to be located very close to the boundary between the Region 1 and Region 2 FACs but shifted into the upward FAC region. The source of the FAC of the PAA is examined from observations in the ionosphere and in the magnetosphere. ˜200 PAA events identified from the FAST measurements in 1998 show that an ionospheric flow shear is present in the vicinity of the PAA, where westward flow increases within 0.5 degree equatorward of the PAA in the premidnight sector and eastward flow increases within 0.5 degree poleward of the PAA in the postmidnight sector. Corresponding magnetospheric flow shear is observed by the THEMIS probes in a region estimated to be located near the PAA's source. Two events with THEMIS in-situ and ASI observations show that flow shear is the primary source of the FAC of the PAA during the growth phase and contributes significantly to the FAC system of the onset arc shortly before the auroral breakup.

Jiang, Feifei

16

Sodium valproate induced gingival enlargement with pre-existing chronic periodontitis.  

PubMed

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. PMID:23055600

Joshipura, Vaibhavi

2012-04-01

17

Estimation of plasticity-induced crack closure in a pre-existing plastic zone  

Microsoft Academic Search

To estimate the plasticity-induced crack closure in a pre-existing plastic zone using Newman's strip-yield model, the interactions between the crack plasticity and the pre-existing plasticity must be known. In the current study, the total plasticity of a fatigue crack propagating in a pre-existing overload plastic zone and a notch plastic zone was studied using finite element analysis. The calculated total

C.-Y. Hou; J.-J. Charng

1996-01-01

18

[Metformin-associated lactic acidosis in a patient with pre-existing risk factors].  

PubMed

Lactic acidosis is a serious clinical situation associated with a high case fatality rate. Lactic acidosis is particularly found in conditions with an insufficient supply of oxigen in the tissue. Other causes for lactic acidosis can be hepatic or renal insufficiency. For the therapy of overweight patients with type 2 diabetes metformin is the first choice if diet and physical training have been ineffective. Metformin, however, has the potential to increase serumlactate. Therefore its ability to cause lactic acidosis is controversely discussed. We present a 64-year-old female patient with metformin-associated lactic acidosis. She had several pre-existing risk factors to develop a lactic acidosis. On her referral to the hospital she suffered from acute renal failure which is considered to be a contraindication for the use of metformin. PMID:16190374

Becker, C; Luginbühl, A; Pittl, U; Schlienger, R

2005-09-01

19

The Near Earth Asteroid Medical Conditions List  

NASA Technical Reports Server (NTRS)

Purpose: The Exploration Medical Capability (ExMC) element is one of six elements within NASA s Human Research Program (HRP) and is responsible for addressing the risk of "the inability to adequately recognize or treat an ill or injured crewmember" for exploration-class missions. The Near Earth Asteroid (NEA) Medical Conditions List, constructed by ExMC, is the first step in addressing the above-mentioned risk for the 13-month long NEA mission. The NEA mission is being designed by NASA's Human Space Flight Architecture Team (HAT). The purpose of the conditions list is to serve as an evidence-based foundation for determining which medical conditions could affect a crewmember during the NEA mission, which of those conditions would be of concern and require treatment, and for which conditions a gap in knowledge or technology development exists. This information is used to focus research efforts and technology development to ensure that the appropriate medical capabilities are available for exploration-class missions. Scope and Approach: The NEA Medical Conditions List is part of a broader Space Medicine Exploration Medical Conditions List (SMEMCL), which incorporates various exploration-class design reference missions (DRMs). The conditions list contains 85 medical conditions which could occur during space flight and which are derived from several sources: Long-Term Surveillance of Astronaut Health (LSAH) in-flight occurrence data, The Space Shuttle (STS) Medical Checklist, The International Space Station (ISS) Medical Checklist, and subject matter expert opinion. Each medical condition listed has been assigned a clinical priority and a clinical priority rationale based on incidence, consequence, and mitigation capability. Implementation: The conditions list is a "living document" and as such, new conditions can be added to the list, and the priority of conditions on the list can be adjusted as the DRM changes, and as screening, diagnosis, or treatment capabilities change. The NEA medical conditions list was used recently as the basis for identifying gaps in in-flight medical evaluation (screening) capabilities. Learning Objectives: The audience will become familiar with the approach taken by NASA's Exploration Medical Capability element in addressing the risk of inability to recognize and treat medical conditions in the setting of a Near Earth Asteroid mission. Which one of the following statements is incorrect? a) The Near Earth Asteroid (NEA) medical conditions list includes 85 medical conditions which could occur during space flight. b) Each condition on the NEA medical conditions list has been assigned a clinical priority and a clinical priority rationale. c) The NEA medical conditions list targets a mission to Mars. d) The NEA medical conditions list should be viewed as a "living document" where new conditions can be added and clinical priorities adjusted to address changes in the design reference mission or medical capabilities. The incorrect answer is c). The NEA medical conditions list targets a mission to a Near Earth Asteroid.

Barr, Yael R.; Watkins, S. D.

2011-01-01

20

Medical Conditions and Nearly Lethal Suicide Attempts.  

ERIC Educational Resources Information Center

This population-based, case-control study examined physical illness as a risk factor for suicidal behavior. Case patients were more likely than controls to report having any serious medical conditions. Results suggest that young men with medical conditions are at increased risk for nearly lethal suicide attempts. (Contains 33 references and 3…

Ikeda, Robin M.; Kresnow, Marcie-jo; Mercy, James A.; Powell, Kenneth E.; Simon, Thomas R.; Potter, Lloyd B.; Durant, Tonji M.; Swahn, Monica H.

2002-01-01

21

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

22

Three-dimensional numerical analysis of magma transport through a pre-existing fracture in the crust  

NASA Astrophysics Data System (ADS)

Magmas are transported through pre-existing fractures in many repeatedly erupting volcanoes. The study of this special process of magma transport is fundamentally important to understand the mechanisms and conditions of volcanic eruptions. In this paper, we numerically simulate the magma propagation process through a pre-existing vertical fracture in the crust by using the combined finite difference method (FDM), finite element method (FEM) and discontinuous deformation analysis (DDA) approach. FDM is used to analyze magma flow in the pre-existing fracture, FEM is used to calculate the opening of the fracture during magma intrusion, and DDA is used to deal with the contact of the closed fracture surfaces. Both two-dimensional (2D) and three-dimensional (3D) examples are presented. Parametric studies are carried out to investigate the influence of various physical and geometric parameters on the magma transport in the pre-existing fracture. We have considered magma chamber depth ranging from 7 km to 10 km under the crust surface, magma viscosity ranging from 2 × 10?2 to 2 × 10?7 MPa s, and the density difference between the magma and host rock ranging from 300 to 700 kg/m3. The numerical results indicate that (1) the fluid pressure p varies gradually along the depth, (2) the shape of the magma body during propagation is like a torch bar and its width ranges from 2 m to 4 m approximately in the 3D case and 10 m to 50 m in the 2D case for the same physical parameters used, (3) the crust surface around the pre-existing fracture begins to increase on both sides of the fracture, forms a trough between them, then gradually uplifts during the transport of the magma, and finally takes the shape of a crater when the magma reaches the surface. We have also examined the influence of physical and geometric parameters on the minimum overpressure for magma transport in the 3D case. The numerical results show that our numerical technique presented in this paper is an effective tool for simulating magma transport process through pre-existing fractures in the crust.

Chen, Zuan; Cheng, Xu; Huang, Xiaoge; Bai, Wuming; Jin, Zhi-He

2014-05-01

23

Mechanical and microstructural development of Carrara marble with pre-existing deformation history in torsion experiments  

NASA Astrophysics Data System (ADS)

The deformation behaviour of Carrara marble has been studied mostly by performing deformation experiments on initially undeformed samples. In this study, torsion experiments on Carrara marble with a pre-existing deformation history have been conducted and analysed in terms of both mechanical and microstructural development. Torsion experiments have been conducted to deform initially deformed Carrara marble samples until a bulk shear strain of gamma 1 or 2.6 was reached. For Carrara marble experiments typically yielding is followed by strain hardening until a peak stress is reached around a shear strain gamma = 1 , after which a weakening phase occurs. Weakening gradually develops into a steady-state creep. During hardening, a shear microstructure and CPO develops; afterwards dynamic recrystallization becomes increasingly effective resulting in pervasively recrystallized microstructure and recrystallization CPO at gamma 5 and higher. Starting material of the new experiments are sandwich samples consisting of three equally sized segments: a top segment previously deformed counter clockwise, an undeformed centre segment and a previously clockwise deformed segment in the bottom. Shear strain of the deformed bottom and top segments are equal in magnitude but opposite in sense and correspond with the shear strain of the actual experiments (e.g. sample of the gamma 1 experiment, consists of initially gamma 1 deformed top and bottom segments). All torsion experiments were conducted using a Paterson type internally heated gas-medium deformation apparatus equipped with a torsion actuator, under temperature and pressure conditions of 1000K and 300 MPa, respectively. Angular displacement rates during the experiments correspond to a strain rate of 3.0x10-4 s-1 at the outer cylinder periphery. The second deformation event imposed on the sandwich sample is always counter clockwise (or dextral). The sandwich experiment to gamma 1 shows a weakly developed strain partitioning between the three segments. Most strain is accommodated in the initially undeformed centre segment, whereas the top segment appears least deformed during this experiment. For the higher strain experiment (gamma 2.6), strain partitioning is enhanced and reversed, i.e. maximum and minimum strains are accommodated by the top and centre segment respectively. This strain partitioning can be explained by the strength evolution of Carrara marble with shear strain. For Carrara marble at gamma 1, deformation is harder than undeformed, due to hardening of the material caused by shearing microstructure. At higher strain, Carrara marble starts recrystallizing instead of shearing, weakening the material. Therefore, for the gamma 2.6 experiment deformation is easier in the initially deformed segments than in the undeformed segment. Consequently, strain partitioning can be an onset for strain localization. The observed microstructures reflect the finite strain (pre-existing plus added) in the sample segments of same sense of shear, which are shear microstructures for 0+1 and 1+1, and recrystallization microstructures for 0+2.6, and 2.6 + 2.6. For the segments of reversed sense of shear, the segment 1-1 appears like undeformed with respect to grain shape, but contains larger amounts of intragranular defects; the segment 2.6-2.6 is mostly recrystallized to a fine grained matrix with some ‘un-stretched' clasts embedded. Similarly, the CPO in segments 0+1 and 1+1 resembles shear textures, while segments 0+2.6, 2.6+2.6 and 2.6-2.6 show recrystallization CPO. In segment 1-1, the pre-existing shear CPO is nearly annihilated by the second deformation in reversed sense.

Bruijn, R. H. C.; Burlini, L.; Kunze, K.

2009-04-01

24

The Space Medicine Exploration Medical Condition List  

NASA Technical Reports Server (NTRS)

Exploration Medical Capability (ExMC) is an element of NASA s Human Research Program (HRP). ExMC's goal is to address the risk of the "Inability to Adequately Recognize or Treat an Ill or Injured Crewmember." This poster highlights the approach ExMC has taken to address this risk. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to define the set of medical conditions that are most likely to occur during exploration space flight missions. The list was derived from the International Space Station Medical Checklist, the Shuttle Medical Checklist, in-flight occurrence data from the Lifetime Surveillance of Astronaut Health, and NASA subject matter experts. The list of conditions was further prioritized for eight specific design reference missions with the assistance of the ExMC Advisory Group. The purpose of the SMEMCL is to serve as an evidence-based foundation for the conditions that could affect a crewmember during flight. This information is used to ensure that the appropriate medical capabilities are available for exploration missions.

Watkins, Sharmi; Barr, Yael; Kerstman, Eric

2011-01-01

25

Pre-existing biotherapeutic-reactive antibodies: survey results within the American Association of Pharmaceutical Scientists.  

PubMed

The immunogenicity profile of a biotherapeutic is determined by a multitude of product and patient-related risk factors that can influence the observed incidence and clinical consequences of immunogenicity. Pre-existing antibodies, i.e., biotherapeutic-reactive antibodies present in samples from treatment-naïve subjects, have been commonly observed during immunogenicity assessments; however their relevance in terms of the safety and efficacy of a biotherapeutic is poorly understood. An American Association of Pharmaceutical Scientists-sponsored survey was conducted to gather information about the prevalence, nature, and consequences of pre-existing antibodies in clinical and nonclinical studies. The survey results indicate that pre-existing antibodies against a variety of biotherapeutics (e.g., mAbs, fusion proteins) are frequently encountered, especially in the context of autoimmune diseases, but that the methods and approaches used to detect, characterize, and report these antibodies vary. In most cases, pre-existing antibodies did not appear to have clinical consequences; however, a few of the respondents reported having observed an effect on pharmacokinetic, pharmacodynamic, safety, and/or efficacy parameters. The findings from this survey are an important first step in evaluating the potential risks associated with the presence of pre-existing antibodies and highlight the importance of standardizing the approaches for detection and characterization of these antibodies. Cross-industry sharing of case studies and relevant data collection will help better inform biotherapeutic risk/benefit profiles and provide deeper understanding of the biological consequences of pre-existing antibodies. PMID:23620231

Xue, Li; Fiscella, Michele; Rajadhyaksha, Manoj; Goyal, Jaya; Holland, Claire; Gorovits, Boris; Morimoto, Alyssa

2013-07-01

26

Metabolic effects of milk protein intake strongly depend on pre-existing metabolic and exercise status  

PubMed Central

Milk protein intake has recently been suggested to improve metabolic health. This Perspective provides evidence that metabolic effects of milk protein intake have to be regarded in the context of the individual’s pre-existing metabolic and exercise status. Milk proteins provide abundant branched-chain amino acids (BCAAs) and glutamine. Plasma BCAAs and glutamine are increased in obesity and insulin resistance, but decrease after gastric bypass surgery resulting in weight loss and improved insulin sensitivity. Milk protein consumption results in postprandial hyperinsulinemia in obese subjects, increases body weight of overweight adolescents and may thus deteriorate pre-existing metabolic disturbances of obese, insulin resistant individuals.

2013-01-01

27

Psoriasis Increases Risk for Some Medical Conditions  

MedlinePLUS

PsoriasisNet Spotlight Article Psoriasis Increases Risk for Some Medical Conditions If you have psoriasis, you may have an increased risk for getting some ... joints. Psoriatic arthritis Risk: Yes, people who have psoriasis can get this type of arthritis. Psoriatic arthritis ...

28

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

29

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

30

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 false Condition: Medical records. 494.170 Section 494...Administration § 494.170 Condition: Medical records. The dialysis facility must...information. (1) Current medical records and those of discharged...

2013-10-01

31

Size and distribution of particles and voids pre-existing in equal channel angular pressed 5083 Al alloy: their effect on cavitation during low-temperature superplastic deformation  

Microsoft Academic Search

An ultrafine grained 5083 Al alloy was prepared by equal channel angular pressing with route Bc and an effective strain of ?4 or ?8. The changes of the size and distribution of second phase particles and voids pre-existing in the alloy during equal channel angular pressing (ECAP) were examined in detail. Under the present ECAP conditions, a portion of particles

Kyung-Tae Park; Seong-Hyun Myung; Dong Hyuk Shin; Chong Soo Lee

2004-01-01

32

Influence of pre-existing salt structures in the 3D pattern of multilayer folding  

NASA Astrophysics Data System (ADS)

Upward movement of the Precambrian Hormuz salt in the Fars region of the Zagros is supposed to have started as early as Late Cretaceous. The Late Cretaceous - Tertiary deformation events that lead to the folding of the sedimentary cover in this area would have therefore, enhance the upward salt movement by squeezing the pre-existing salt structures. How these salt diapirs evolve under such compressive events has already been previously addressed using analogue models (e.g. Callot et al. 2012). The same authors observed that pre-existing salt structures control the size and geometry of folds in sandbox models. Our previous work has shown that 3D folding instability gives rise to a wide variety of fold shapes (e.g. from dome shape structures to long en echelon or straight anticlines), resulting of the interactions between growing fold segments. The three dimensional growth of these folds, the wavelength and the lateral propagation, is itself controlled by physical parameters. However, the existence of initial weak zones such as pre-existing salt plugs within the sedimentary cover can affect the development of such folds by localizing part of the deformation. In this study we have used numerical modeling to investigate how the fold pattern in 3D multilayer folding is affected by pre-existing salt structures. High-resolution 3D folding simulations (with and without pre-existing salt structures) were performed with the parallel code LaMEM. Cylindrically shaped diapirs with different diameters and heights have been added to a multilayer folding setup. The use of a finite element based landscape evolution model (both erosion and sedimentation) allows for initially buried salt diapirs to be exposed at the surface during folding evolution. Acknowledgements Funding was provided by the European Research Council under the European Community's Seventh Framework program (FP7/2007-2013) ERC Grant agreement #258830. 3D simulations are performed in the IBM Blue Gene/Q JUQUEEN supercomputer of the Forschungszentrum Juelich, Germany References Callot, J.P., Trocme, V., Letouzey, J., Albouy, E., Jahani, S. and Sherkati S., 2012, Pre-existing salt structures and the folding of the Zagros Mountains. Geological Society, London, Special Publications, 363, 545-561, doi: 10.1144/SP363.27

Fernandez, Naiara; Kaus, Boris J. P.; Collignon, Marine

2014-05-01

33

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

34

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

35

An Introduction to Pre-existing Local Management Systems in Southeast Asia  

Microsoft Academic Search

\\u000a Although known from colonial times, pre-existing systems of fisheries management in tropical nations have not usually been\\u000a used as an alternative to introduced Western scientific approaches. During the colonial era non-Western models were disparaged\\u000a openly, whereas nowadays commonly they are dismissively labeled as ‘traditional’ or ‘special’ cases. Often predicated on misguided\\u000a theories, during the 1950s and 1960s a massive and

Kenneth Ruddle; Arif Satria

36

Malignant Precursor Cells Pre-Exist in Human Breast DCIS and Require Autophagy for Survival  

Microsoft Academic Search

BackgroundWhile it is accepted that a majority of invasive breast cancer progresses from a ductal carcinoma in situ (DCIS) precursor stage, very little is known about the factors that promote survival of DCIS neoplastic cells within the hypoxic, nutrient deprived intraductal microenvironment.Methodology and Principal FindingsWe examined the hypothesis that fresh human DCIS lesions contain pre-existing carcinoma precursor cells. We characterized

Virginia Espina; Brian D. Mariani; Rosa I. Gallagher; Khoa Tran; Stacey Banks; Joy Wiedemann; Heather Huryk; Claudius Mueller; Luana Adamo; Jianghong Deng; Emanuel F. Petricoin; Lucia Pastore; Syed Zaman; Geetha Menezes; James Mize; Jasbir Johal; Kirsten Edmiston; Lance A. Liotta; Yu Wang

2010-01-01

37

Relationship of pre-existing antibody to subsequent infection by Mycoplasma pneumoniae in adults.  

PubMed

An extensive study of the epidemiological and serological characteristics of Mycoplasma pneumoniae infection was carried out in a military population. There was an increase in the infection rate at Camp Lejeune during the summer months as indicated by a relative increase in isolations, seroconversions, and hospitalizations for M. pneumoniae pneumonia. Twenty-three percent of the trainees who later became infected had detectable, pre-existing antilipid antibody to M. pneumoniae. When the whole organism was used as antigen, a pre-existing complement fixation (CF) titer of 1:4 or greater correlated with resistance to M. pneumoniae disease as defined by the absence of a fourfold rise in CF antibody, shedding of organisms, and clinical illness. Pre-existing antilipid fraction CF antibody titers of 1:16 or greater correlated with protection against mild and severe M. pneumoniae disease. Antilipid CF antibody titers of 1:4 and 1:8 were related to protection against mild disease but were not associated with protection against pneumonia which required hospitalization. The severity of illness was directly related to the CF antibody response in trainees with acute respiratory disease and pneumonia due to M. pneumoniae. The findings provide a basis for the development of a M. pneumoniae vaccine. PMID:4587385

McCormick, D P; Wenzel, R P; Senterfit, L B; Beam, W E

1974-01-01

38

Relationship of Pre-Existing Antibody to Subsequent Infection by Mycoplasma pneumoniae in Adults  

PubMed Central

An extensive study of the epidemiological and serological characteristics of Mycoplasma pneumoniae infection was carried out in a military population. There was an increase in the infection rate at Camp Lejeune during the summer months as indicated by a relative increase in isolations, seroconversions, and hospitalizations for M. pneumoniae pneumonia. Twenty-three percent of the trainees who later became infected had detectable, pre-existing antilipid antibody to M. pneumoniae. When the whole organism was used as antigen, a pre-existing complement fixation (CF) titer of 1:4 or greater correlated with resistance to M. pneumoniae disease as defined by the absence of a fourfold rise in CF antibody, shedding of organisms, and clinical illness. Pre-existing antilipid fraction CF antibody titers of 1:16 or greater correlated with protection against mild and severe M. pneumoniae disease. Antilipid CF antibody titers of 1:4 and 1:8 were related to protection against mild disease but were not associated with protection against pneumonia which required hospitalization. The severity of illness was directly related to the CF antibody response in trainees with acute respiratory disease and pneumonia due to M. pneumoniae. The findings provide a basis for the development of a M. pneumoniae vaccine.

McCormick, David P.; Wenzel, Richard P.; Senterfit, Laurence B.; Beam, Walter E.

1974-01-01

39

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

40

Exploring mucosal immunization with a recombinant influenza virus carrying an HIV-polyepitope in mice with pre-existing immunity to influenza.  

PubMed

HIV-1 vaccines based on recombinant vectors have been developed to elicit immune responses; however, the failure of the STEP HIV-1 vaccine trial has caused concern regarding the impact on vaccine efficacy of pre-existing vector seropositivity in humans. By using a mouse model of infection, we evaluated the immune responses elicited by intranasal and vaginal immunization with the recombinant influenza virus WSN/CKG carrying the PCLUS3-P18 peptide and a Gag epitope in its hemagglutinin, and the impact of pre-existing vector immunity on protection against recombinant vaccinia virus challenge. We found that despite the protective immunity induced in naïve mice by the WSN/CKG virus via either route, the vaginal immunization of mice with pre-existing influenza immunity restricted vPE16 replication more significantly in the ovaries than intranasal immunization. Thus, successful vaccination strategies under limiting conditions, such as pre-existing vector immunity, require the local induction of mucosal immunity at the site of virus infection. PMID:24662706

Garulli, Bruno; Di Mario, Giuseppina; Stillitano, Maria Giuseppina; Kawaoka, Yoshihiro; Castrucci, Maria Rita

2014-05-01

41

The Effect of Particle Pre-Existing Charge on Unipolar Charging and Its Implication on Electrical Aerosol Measurements  

Microsoft Academic Search

We investigated the effect of particle pre-existing charges on unipolar charging. Particles carrying a defined number and polarity of pre-existing charges were used to study the unipolar charging process in a unipolar diffusion charger with positive ions. It was found that the particles initially carrying negative charges have almost the same amount of positive charges as the initially uncharged particles

Chaolong Qi; Christof Asbach; Weon Gyu Shin; Heinz Fissan; David Y. H. Pui

2009-01-01

42

Conducting qualitative research in the context of pre-existing peer and collegial relationships.  

PubMed

Aim To highlight issues and challenges faced in recruitment and interviewing during a study that sought to explore the transition of nurses into academic life and the associated ethical implications. Background This paper explores the challenges faced in conducting research where the potential participants are peers and workplace colleagues. There are advantages when conducting research with those among whom a pre-existing relationship is shared. However, difficulties can also arise. Review methods A methodological review was undertaken. Key database searches included CINAHL, MEDLINE, PubMed, Scopus and Google Scholar using the keywords as search terms. Studies were included if they described in detail issues surrounding qualitative interviewing of peers and colleagues. Discussion Management of the issues involved is discussed, with emphasis on boundaries, trust and rapport, the use of self-disclosure and maintaining confidentiality. Conclusion Research involving peers and colleagues has received relatively little consideration in the literature. There are difficulties associated with interviewing participants with whom the researcher has a pre-existing and ongoing relationship in the same organisation. To ensure ethical conduct, strategies can be used to mitigate negative situations such as issues surrounding dual roles, practising reflexivity, trust and rapport, self-disclosure and confidentiality. Implications for research/practice It is imperative that dual roles are declared and acknowledged. Researchers need to be mindful of the difficulties that may occur and prioritise participants' confidentiality and privacy. PMID:24877908

McDermid, Fiona; Peters, Kath; Jackson, Debra; Daly, John

2014-05-30

43

Malignant Precursor Cells Pre-Exist in Human Breast DCIS and Require Autophagy for Survival  

PubMed Central

Background While it is accepted that a majority of invasive breast cancer progresses from a ductal carcinoma in situ (DCIS) precursor stage, very little is known about the factors that promote survival of DCIS neoplastic cells within the hypoxic, nutrient deprived intraductal microenvironment. Methodology and Principal Findings We examined the hypothesis that fresh human DCIS lesions contain pre-existing carcinoma precursor cells. We characterized these cells by full genome molecular cytogenetics (Illumina HumanCytoSNP profile), and signal pathway profiling (Reverse Phase Protein Microarray, 59 endpoints), and demonstrated that autophagy is required for survival and anchorage independent growth of the cytogenetically abnormal tumorigenic DCIS cells. Ex vivo organoid culture of fresh human DCIS lesions, without enzymatic treatment or sorting, induced the emergence of neoplastic epithelial cells exhibiting the following characteristics: a) spontaneous generation of hundreds of spheroids and duct-like 3-D structures in culture within 2–4 weeks; b) tumorigenicity in NOD/SCID mice; c) cytogenetically abnormal (copy number loss or gain in chromosomes including 1, 5, 6, 8, 13, 17) compared to the normal karyotype of the non-neoplastic cells in the source patient's breast tissue; d) in vitro migration and invasion of autologous breast stroma; and e) up-regulation of signal pathways linked to, and components of, cellular autophagy. Multiple autophagy markers were present in the patient's original DCIS lesion and the mouse xenograft. We tested whether autophagy was necessary for survival of cytogenetically abnormal DCIS cells. The lysosomotropic inhibitor (chloroquine phosphate) of autophagy completely suppressed the generation of DCIS spheroids/3-D structures, suppressed ex vivo invasion of autologous stroma, induced apoptosis, suppressed autophagy associated proteins including Atg5, AKT/PI3 Kinase and mTOR, eliminated cytogenetically abnormal spheroid forming cells from the organ culture, and abrogated xenograft tumor formation. Conclusions Cytogenetically abnormal spheroid forming, tumorigenic, and invasive neoplastic epithelial cells pre-exist in human DCIS and require cellular autophagy for survival.

Espina, Virginia; Mariani, Brian D.; Gallagher, Rosa I.; Tran, Khoa; Banks, Stacey; Wiedemann, Joy; Huryk, Heather; Mueller, Claudius; Adamo, Luana; Deng, Jianghong; Petricoin, Emanuel F.; Pastore, Lucia; Zaman, Syed; Menezes, Geetha; Mize, James; Johal, Jasbir; Edmiston, Kirsten; Liotta, Lance A.

2010-01-01

44

Effects of Pre-Existing Target Structure on the Formation of Large Craters  

NASA Technical Reports Server (NTRS)

The shapes of large-scale craters and the mechanics responsible for melt generation are influenced by broad and small-scale structures present in a target prior to impact. For example, well-developed systems of fractures often create craters that appear square in outline, good examples being Meteor Crater, AZ and the square craters of 433 Eros. Pre-broken target material also affects melt generation. Kieffer has shown how the shock wave generated in Coconino sandstone at Meteor crater created reverberations which, in combination with the natural target heterogeneity present, created peaks and troughs in pressure and compressed density as individual grains collided to produce a range of shock mineralogies and melts within neighboring samples. In this study, we further explore how pre-existing target structure influences various aspects of the cratering process. We combine experimental and numerical techniques to explore the connection between the scales of the impact generated shock wave and the pre-existing target structure. We focus on the propagation of shock waves in coarse, granular media, emphasizing its consequences on excavation, crater growth, ejecta production, cratering efficiency, melt generation, and crater shape. As a baseline, we present a first series of results for idealized targets where the particles are all identical in size and possess the same shock impedance. We will also present a few results, whereby we increase the complexities of the target properties by varying the grain size, strength, impedance and frictional properties. In addition, we investigate the origin and implications of reverberations that are created by the presence of physical and chemical heterogeneity in a target.

Barnouin-Jha, O. S.; Cintala, M. J.; Crawford, D. A.

2003-01-01

45

Pre-Existing Hypertension Dominates ??T Cell Reduction in Human Ischemic Stroke  

PubMed Central

T lymphocytes may play an important role in the evolution of ischemic stroke. Depletion of ??T cells has been found to abrogate ischemia reperfusion injury in murine stroke. However, the role of ??T cells in human ischemic stroke is unknown. We aimed to determine ??T cell counts and ??T cell interleukin 17A (IL-17A) production in the clinical setting of ischemic stroke. We also aimed to determine the associations of ??T cell counts with ischemic lesion volume, measures of clinical severity and with major stroke risk factors. Peripheral blood samples from 43 acute ischemic stroke patients and 26 control subjects matched on race and gender were used for flow cytometry and complete blood count analyses. Subsequently, cytokine levels and gene expression were measured in ??T cells. The number of circulating ??T cells was decreased by almost 50% (p?=?0.005) in the stroke patients. ??T cell counts did not correlate with lesion volume on magnetic resonance diffusion-weighted imaging or with clinical severity in the stroke patients, but ??T cells showed elevated levels of IL-17A (p?=?0.048). Decreased ??T cell counts were also associated with older age (p?=?0.004), pre-existing hypertension (p?=?0.0005) and prevalent coronary artery disease (p?=?0.03), with pre-existing hypertension being the most significant predictor of ??T cell counts in a multivariable analysis. ??T cells in human ischemic stroke are reduced in number and show elevated levels of IL-17A. A major reduction in ??T lymphocytes also occurs in hypertension and may contribute to the development of hypertension-mediated stroke and vascular disease.

Adamski, Mateusz G.; Li, Yan; Wagner, Erin; Yu, Hua; Seales-Bailey, Chloe; Durkin, Helen; Hao, Qing; Soper, Steven A.; Murphy, Michael; Baird, Alison E.

2014-01-01

46

Pre-existing hypertension dominates ??T cell reduction in human ischemic stroke.  

PubMed

T lymphocytes may play an important role in the evolution of ischemic stroke. Depletion of ??T cells has been found to abrogate ischemia reperfusion injury in murine stroke. However, the role of ??T cells in human ischemic stroke is unknown. We aimed to determine ??T cell counts and ??T cell interleukin 17A (IL-17A) production in the clinical setting of ischemic stroke. We also aimed to determine the associations of ??T cell counts with ischemic lesion volume, measures of clinical severity and with major stroke risk factors. Peripheral blood samples from 43 acute ischemic stroke patients and 26 control subjects matched on race and gender were used for flow cytometry and complete blood count analyses. Subsequently, cytokine levels and gene expression were measured in ??T cells. The number of circulating ??T cells was decreased by almost 50% (p?=?0.005) in the stroke patients. ??T cell counts did not correlate with lesion volume on magnetic resonance diffusion-weighted imaging or with clinical severity in the stroke patients, but ??T cells showed elevated levels of IL-17A (p?=?0.048). Decreased ??T cell counts were also associated with older age (p?=?0.004), pre-existing hypertension (p?=?0.0005) and prevalent coronary artery disease (p?=?0.03), with pre-existing hypertension being the most significant predictor of ??T cell counts in a multivariable analysis. ??T cells in human ischemic stroke are reduced in number and show elevated levels of IL-17A. A major reduction in ??T lymphocytes also occurs in hypertension and may contribute to the development of hypertension-mediated stroke and vascular disease. PMID:24840735

Adamski, Mateusz G; Li, Yan; Wagner, Erin; Yu, Hua; Seales-Bailey, Chloe; Durkin, Helen; Hao, Qing; Soper, Steven A; Murphy, Michael; Baird, Alison E

2014-01-01

47

Medical Care of Acute Conditions, United States, 1973-1974.  

National Technical Information Service (NTIS)

Statistics are presented and discussed on medical attention status, advice from nonphysicians (such as relatives and friends) about the condition, time interval before consulting doctor and reason for waiting to consult one, site of medical attention, obj...

L. M. Verbrugge

1979-01-01

48

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

49

Pre-existing diabetes mellitus increases the risk of gastric cancer: A meta-analysis  

PubMed Central

AIM: To systematically assess the association between diabetes and incidence of gastric cancer. METHODS: We searched MedLine (PubMed), EMBASE, and the Cochrane Library without any limitations with respect to publication date or language, we also searched the references of qualifying articles. Case-control studies and cohort studies comparing the risk of gastric cancer between diabetic patients and control subjects were included. We excluded studies reporting only standardized incidence ratios without control groups and those that investigated only mortality but not incidence. Seventeen studies met our criteria, and the qualities of these studies were assessed using the Newcastle-Ottawa Quality Assessment Scale. We performed a meta-analysis of pre-existing diabetes and gastric cancer incidence using the DerSimonian-Laird method for random-effects. For subgroup analyses, we separated the studies by study type, region, sex and method to determine confounding factors and reliability. We also conducted subgroup analyses to examine the effects of smoking, Helicobacter pylori (H. pylori) infection, and cancer site. Publication bias was evaluated using Begg’s test. RESULTS: A random-effects model meta-analysis showed an increased gastric cancer risk in diabetic patients [relative risk (RR) = 1.19; 95%CI: 1.08-1.31]. Subgroup analyses indicated that this result persisted in cohort studies (RR = 1.20; 95%CI: 1.08-1.34), in studies on populations of both Western (RR = 1.18; 95%CI: 1.03-1.36) and Eastern countries (RR = 1.19; 95%CI: 1.02-1.38), in a female subgroup (RR=1.24; 95%CI: 1.01-1.52), and in highly qualified studies (RR = 1.17; 95%CI: 1.05-1.31). Moreover, these results persisted when the analysis was confined to studies adjusted for well-known gastric cancer risk factors such as smoking (RR = 1.17; 95%CI: 1.01-1.34) and H. pylori infection (RR = 2.35; 95%CI: 1.24-4.46). CONCLUSION: Pre-existing diabetes mellitus may increase the risk of gastric cancer by approximately 19%. This effect seems to be unrelated to geographical region.

Yoon, Jae Moon; Son, Ki Young; Eom, Chun Sick; Durrance, Daniel; Park, Sang Min

2013-01-01

50

Effect of 17-beta estradiol on pre-existing atherosclerotic lesions: role of the endothelium.  

PubMed

The atheroprotective effects of estrogen during the process of atherogenesis is well documented, whereas limited information is available about the effect of estrogen on pre-existing atherosclerotic lesions. After bilateral ovariectomy, 24 New Zealand White rabbits were randomized into three groups of eight animals each and subsequently fed a 0.5% cholesterol diet. In group I, the vessels were excised at day 84, whereas in group II, the cholesterol diet was continued for a total of 168 days. In group III, the animals were first fed with a cholesterol diet for 84 days; in the second phase of the experiment, the cholesterol diet was continued for a further 84 days with a combined estrogen treatment (1 mg estradiol valerate per kg body weight per week intramuscularly). At the end of the experiment, the proximal aortic arch, right carotid artery, thoracical aorta and abdominal aorta of each animal were excised and prepared for histological and immunohistological examination. By day 168, morphometrical analysis displayed a significantly lower plaque development under estrogen therapy in the carotid artery (0.08+/-0.18 mm(2) vs. 0.60+/-0.39 mm(2)), the thoracic aorta (0.56+/-0.94 mm(2) vs. 3.63+/-2.06 mm(2)), and in the abdominal aorta (0.55+/-0.70 mm(2) vs. 1.71+/-1.05 mm(2)) in comparison with the corresponding 168 day control group. However, estrogen treatment has failed to reduce further atherosclerotic plaque development in the aortic arch (9.42+/-1.79 mm(2) vs. 11. 64+/-3.29 mm(2)). Immunohistological detection of the 'anti-human factor VIII related antigen', i.e. the 'von Willebrand factor' (vWF), showed a significantly lower number of luminal cells positive for vWF in the aortic arch in the 84-day cholesterol group, compared with the corresponding controls of normocholesterolemic rabbits (65. 9+/-12.4% vs. 83.1+/-6.2%; P<0.05). Estradiol was able to inhibit the further progression of atherosclerosis when moderate vessel wall alterations were present, whereas pre-existing severe atherosclerosis was associated with a failure of the anti-atherosclerotic estrogen action. As suggested by the in situ detection of vWF as a morphological marker for endothelial cells, an intact endothelial layer might play an important role in mediating the beneficial effect of estrogen in the process of atherosclerosis. PMID:10525133

Hanke, H; Kamenz, J; Hanke, S; Spiess, J; Lenz, C; Brehme, U; Bruck, B; Finking, G; Hombach, V

1999-11-01

51

Psychological distress in an earthquake-devastated area with pre-existing high rate of suicide.  

PubMed

On 12 March 2011 an earthquake devastated the Matsunoyama and Matsudai districts of T?kamachi City, Niigata, Japan. These areas had high pre-existing suicide rates, especially among the elderly. We investigated whether mental health status became worse among the sufferers 5 months after the earthquake, and what kind of factors were implicated in any changes. A 15-item questionnaire that tapped earthquake-related variables and the Kessler 10 Psychological Distress Scale to measure psychological distress were distributed to 1923 residents aged over 40 years. The mean age (S.D.) of the total 1731 respondents (male, 805; female, 926) was 68.2 (13.1) years. Of these, we assessed K10 scores from 1346 respondents. The mean scores (S.D.) for K10 and K6 (six selected items from the K10) were 5.8 (6.3) and 3.4 (3.9), respectively. Among the respondents, 9.1% and 3.2% obtained a score of K10 ?15 and K6 ?13, respectively. These scores showed slightly higher psychological distress, especially among the elderly, in comparison with existing community-based data. Categorical regression analysis revealed significant and relatively strong effects of initial psychological impact, decrease in sleep hours, advanced age, and decrease in interpersonal relationships within the community on the K10 score. The last item suggests the importance of socio-environmental factors in post-disaster mental health. PMID:24928758

Tachibana, Akira; Kitamura, Hideaki; Shindo, Masanobu; Honma, Hiroko; Someya, Toshiyuki

2014-10-30

52

Dendritic spine dynamics in synaptogenesis after repeated LTP inductions: dependence on pre-existing spine density.  

PubMed

Not only from our daily experience but from learning experiments in animals, we know that the establishment of long-lasting memory requires repeated practice. However, cellular backgrounds underlying this repetition-dependent consolidation of memory remain largely unclear. We reported previously using organotypic slice cultures of rodent hippocampus that the repeated inductions of LTP (long-term potentiation) lead to a slowly developing long-lasting synaptic enhancement accompanied by synaptogenesis distinct from LTP itself, and proposed this phenomenon as a model system suitable for the analysis of the repetition-dependent consolidation of memory. Here we examined the dynamics of individual dendritic spines after repeated LTP-inductions and found the existence of two phases in the spines' stochastic behavior that eventually lead to the increase in spine density. This spine dynamics occurred preferentially in the dendritic segments having low pre-existing spine density. Our results may provide clues for understanding the cellular bases underlying the repetition-dependent consolidation of memory. PMID:23739837

Oe, Yuki; Tominaga-Yoshino, Keiko; Hasegawa, Sho; Ogura, Akihiko

2013-01-01

53

"Stress" hyperglycaemia during acute myocardial infarction: an indicator of pre-existing diabetes?  

PubMed

Hyperglycaemia occurring at admission in patients with suspected acute myocardial infarction is generally held to represent stress hyperglycaemia. 26 patients, not previously known to be diabetic, had blood glucose values greater than or equal to 10 mmol/l on admission to a coronary care unit. 16 survived for 2 months at which time a 75 g oral glucose tolerance test (OGTT) showed diabetes in 10 (63%) and impaired glucose tolerance in 1 (WHO criteria). All those with abnormal glucose tolerance at 2 months had had raised glycosylated haemoglobin (HbA1) (greater than 7.5%) on admission, indicating pre-existing diabetes. All those with a HbA1 level over 8% had abnormal glucose tolerance. 7 of the 10 who died or did not have an OGTT also had raised HbA1 at admission. An admission blood glucose greater than or equal to 10 mmol/l in patients with severe chest pain is more likely to indicate previously undiagnosed diabetes than "stress" hyperglycaemia. There is no evidence that myocardial infarction precipitates diabetes. The glycosylated haemoglobin concentration can be used to distinguish between stress hyperglycaemia and hyperglycaemia caused by diabetes. PMID:6135025

Husband, D J; Alberti, K G; Julian, D G

1983-07-23

54

Evidence for Pre-existing Dust in the Bright Type IIn SN 2010jl  

NASA Astrophysics Data System (ADS)

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 ?m and JHK observations of SN 2010jl ~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 sun of dust exists in a circumstellar torus around the SN located 6 × 1017 cm away from the SN and inclined between 60° and 80° 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 ~ 450. It is likely this dust was created in a luminous blue variable (LBV) like mass-loss event of more than 3 M sun, which is large but consistent with other LBV progenitors such as ? Carinae.

Andrews, J. E.; Clayton, Geoffrey C.; Wesson, R.; Sugerman, B. E. K.; Barlow, M. J.; Clem, J.; Ercolano, B.; Fabbri, J.; Gallagher, J. S.; Landolt, A.; Meixner, M.; Otsuka, M.; Riebel, D.; Welch, D. L.

2011-08-01

55

Dendritic spine dynamics in synaptogenesis after repeated LTP inductions: Dependence on pre-existing spine density  

PubMed Central

Not only from our daily experience but from learning experiments in animals, we know that the establishment of long-lasting memory requires repeated practice. However, cellular backgrounds underlying this repetition-dependent consolidation of memory remain largely unclear. We reported previously using organotypic slice cultures of rodent hippocampus that the repeated inductions of LTP (long-term potentiation) lead to a slowly developing long-lasting synaptic enhancement accompanied by synaptogenesis distinct from LTP itself, and proposed this phenomenon as a model system suitable for the analysis of the repetition-dependent consolidation of memory. Here we examined the dynamics of individual dendritic spines after repeated LTP-inductions and found the existence of two phases in the spines' stochastic behavior that eventually lead to the increase in spine density. This spine dynamics occurred preferentially in the dendritic segments having low pre-existing spine density. Our results may provide clues for understanding the cellular bases underlying the repetition-dependent consolidation of memory.

Oe, Yuki; Tominaga-Yoshino, Keiko; Hasegawa, Sho; Ogura, Akihiko

2013-01-01

56

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

2013-04-01

57

Yellowstone Hotspot Melting And Its Relation To Pre-Existing Crustal Structures And Great Basin Extension  

NASA Astrophysics Data System (ADS)

Topography and geophysical data suggest that the path of Yellowstone hotspot (YSHS) volcanism was controlled by pre-existing crustal structures associated with the Snake River Plain (SRP), and that Great Basin (GB) extension is intimately tied to hotspot melting. From its point of inception (Glen and Ponce, 2002), the YSHS migrated south to the southern Snake River Plain (SRP) where it began a steady migration northeast along the eastern SRP to its present position under the Yellowstone caldera. In doing so, however, it had to move through a 90° counter-clockwise turn that is not consistent with a fixed hotspot and its predicted path based on plate motions, and assuming a fixed hotspot. We present evidence suggesting that the SRPs western and eastern branches form a continuous deep crustal structure that guided YSHS volcanism along a track from its inception in eastern Oregon to its present position under the Yellowstone caldera. The western and eastern segments of the SRP, which are interpreted to have different origins and ages, nonetheless form a single topographic depression that curves 180° along a circular arc. Also associated with the SRP is a broad and continuous gravity anomaly indicating a relatively deep-seated crustal structure extending across the western and eastern SRP. Heat flow data, which show an uninterrupted corridor of high heat flow values extending from Yellowstone caldera through the SRP to the inferred inception point of the hotspot, might reflect either the thermal footprint of the hotspot's path or the control on heat flow by a regional-scale crustal discontinuity. While the path of the hotspot could have been directed by crustal structures, the location and timing of mid- to late-Tertiary extension in the GB might, in turn, have been controlled by hotspot melting. Well known is the age-progressive hotspot track along the eastern SRP, presently marked by active volcanism at the Yellowstone caldera. Less well known, is a second age-progressive track trending northwest across the Oregon Plateau ending at the historically active Newberry craters. The present locations of these active melting fronts, at Yellowstone and Newberry, coincide with the eastern and western margins, respectively, of the GB. This remarkable correlation, while suggesting a link between hotspot melting and GB extension, does not reveal whether melting controls the bounds of GB extension or whether GB extension controls the propagation of hotspot volcanism. Another characteristic of GB extension, however, that might reflect a causal relation between magmatism and rifting, is the geometry and orientation of basins and ranges in the GB. The trends of basins and ranges fan out from north-northwest in the eastern GB to northeast in the west. When extrapolated, these trends intersect near the SRP close to where the age-progressive YSHS trend began ˜ 12-14 Ma, suggesting a relationship between the formation of the GB and this period of the hotspot's path. We infer that this fracturing pattern is related to the SRP, perhaps induced by the ˜ 12-14 m.y. old hotspot, and that subsequent extension in the GB exploited these pre-existing crustal weaknesses.

Glen, J. M.; Ponce, D. A.; Sepulveda, E.

2004-12-01

58

Differentiation of pre-existing trapped methane from thermogenic methane in an igneous-intruded coal by hydrous pyrolysis  

USGS Publications Warehouse

So as to better understand how the gas generation potential of coal changes with increasing rank, same-seam samples of bituminous coal from the Illinois Basin that were naturally matured to varying degrees by the intrusion of an igneous dike were subjected to hydrous pyrolysis (HP) conditions of 360 °C for 72 h. The accumulated methane in the reactor headspace was analyzed for ?13C and ?2H, and mol percent composition. Maximum methane production (9.7 mg/g TOC) occurred in the most immature samples (0.5 %Ro), waning to minimal methane values at 2.44 %Ro (0.67 mg/g TOC), and rebounding to 3.6 mg/g TOC methane in the most mature sample (6.76 %Ro). Methane from coal with the highest initial thermal maturity (6.76 %Ro) shows no isotopic dependence on the reactor water and has a microbial ?13C value of ?61‰. However, methane from coal of minimal initial thermal maturity (0.5 %Ro) shows hydrogen isotopic dependence on the reaction water and has a ?13C value of ?37‰. The gas released from coals under hydrous pyrolysis conditions represents a quantifiable mixture of ancient (270 Ma) methane (likely microbial) that was generated in situ and trapped within the rock during the rapid heating by the dike, and modern (laboratory) thermogenic methane that was generated from the indigenous organic matter due to thermal maturation induced by hydrous pyrolysis conditions. These findings provide an analytical framework for better assessment of natural gas sources and for differentiating generated gas from pre-existing trapped gas in coals of various ranks.

Dias, Robert F.;Lewan, Michael D.;Birdwell, Justin E.;Kotarba, Maciej J.

2014-01-01

59

The effect of multiple pre-existing weaknesses on formation and evolution of faults in extended sandbox models  

NASA Astrophysics Data System (ADS)

High-resolution three-dimensional seismic data show that fault distribution and evolution in rift basins can be very complicated and inconsistent with the classic model of fault formation and propagation. Fault development in the presence of multiple pre-existing weaknesses is still not clearly studied. Trying to understand the role of multiple pre-existing weaknesses in sand models, two series of experiments were prepared. In the first series of models, the mechanical properties of pre-existing weaknesses were the same but their orientations were different, whereas in the second series of models, both mechanical properties and orientations were different. The basic characteristics of fault formation and evolution in a rift basin revealed by the models are as follows: 1) weakness-reactivated faults (faults that formed directly along and above the pre-existing weaknesses) and weakness-related faults (faults which are not located above the pre-existing weaknesses, but have similar orientation) form much earlier than weakness-unrelated faults. The order of formation of different weakness-reactivated faults is determined by the relative reactivation tendency factors (fa) of the weaknesses; 2) weakness-reactivated faults and weakness-related faults develop mainly along or parallel to pre-existing weaknesses. In contrast, weakness-unrelated faults develop nearly perpendicular to the extension direction; 3) a complicated fault system can form during a single extension phase in the presence of multiple pre-existing weaknesses; and 4) the mode of fault formation and propagation and the increase in length and number of faults have close ties to the nature of pre-existing weaknesses. Fault displacement and length do not have a power law relationship for the majority of faults, and there is no unique relationship for different kinds of faults. In addition to providing new insights to the formation of complex fault systems, the experiment results presented here could be reasonably explained using the Reactivation Tendency Theory. They can also be applied to the complicated fault system in rift basin.

Tong, Hengmao; Koyi, Hemin; Huang, Scott; Zhao, Haitao

2014-06-01

60

PRE-EXISTING COGNITIVE IMPAIRMENT IN WOMEN PRIOR TO CARDIAC SURGERY AND ITS RELATION WITH C-REACTIVE PROTEIN CONCENTRATIONS  

PubMed Central

Preoperative cognitive state is seldom considered when investigating the effects of cardiac surgery on cognition. The purpose of this study was to determine the prevalence of cognitive impairment in women scheduled for cardiac surgery using non-hospitalized volunteers as a reference group, and to examine the relationship between C-reactive protein levels and cognitive impairment. Psychometric testing was performed in 108 postmenopausal women scheduled for cardiac surgery and in 58 control women of similar age. High sensitivity C-reactive protein levels were measured in the surgical patients. Cognitive impairment in surgical patients was defined as > 2 SD lower scores on ? 2 tests compared with the controls. Elevated C-reactive protein level was defined as > 95% confidence interval for the surgical cohort. Cognitive impairment was present in 49 of 108 (35%) patients. C-reactive protein levels were higher for patients with compared to those without cognitive impairment (23.2±37.5 mg/L vs 14.3±14.3 mg/L, p=0.04). Based on multivariate logistic regression analysis, patient age, lower attained level of education, type 2 diabetes mellitus, and prior myocardial infarction identified risk for cognitive impairment (p < 0.05) but not C-reactive protein levels (p=0.09). In conclusion, cognitive impairment is prevalent in women undergoing cardiac surgery. C-reactive protein levels are elevated in women with this condition but the relationship between this inflammatory marker and pre-existing cognitive impairment is likely secondary to the acute phase reactant serving as a marker for other conditions including widespread cardiovascular disease.

Hogue, Charles W.; Hershey, Tamara; Dixon, David; Fucetola, Robert; Nassief, Abdullah; Freedland, Kenneth E.; Thomas, Betsy; Schechtman, Kenneth

2007-01-01

61

Better Conditions for Ship Medical Personnel.  

National Technical Information Service (NTIS)

The specific working conditions in the fleet and the comparatively small amount of therapeutic activities lead to a situation where, after several years of work on the vessels, the physicians lose their skills. This entails a significant turnover among th...

L. M. Matsevich

1972-01-01

62

Impact of pre-existing sulphate on retention of imported chloride and nitrate in variable charge soil profiles  

Microsoft Academic Search

In variable charge soils, anion retention and accumulation through adsorption at exchange sites is a competitive process. The objectives of this study in the wet tropics of far north Queensland were to investigate (i) whether the pre-existing high sulphate in variable charge soils had any impact on the retention of chloride and nitrate, derived mostly from the applied fertilizer; and

V. Rasiah; J. D. Armour; N. W. Menzies; D. H. Heiner; M. J. Donn

2004-01-01

63

Proteasome inhibition is partially effective in attenuating pre-existing immunity against recombinant adeno-associated viral vectors.  

PubMed

Pre-existing immunity against adeno-associated virus (AAV) remains a major challenge facing the clinical use of systemic administration of recombinant AAV vectors for the treatment of genetic and acquired diseases using gene therapy. In this study, we evaluated the potential of bortezomib (marketed under trade name Velcade) to abrogate a pre-existing immunity to AAV in mice, thereby allowing subsequent transduction by a recombinant AAV vector of the same serotype. We demonstrate that bortezomib efficiently reduces AAV-specific IgG titres and moderates the cytotoxic T cell response in mice that have a pre-existing immunity to AAV2/8. Significant depletion of AAV2/8-specific IgG-producing plasma cells in secondary lymphoid organs and bone marrow was observed. However, this inhibition of the immune response by bortezomib was insufficient to allow subsequent re-infection with a recombinant AAV vector of a similar serotype. We show that this shortcoming is probably due to the combination of residual antibody levels and the inability of bortezomib to completely deplete the memory B cells that are re-activated in response to a repeated infection with a recombinant AAV vector. Taken together, the results of this study argue for the use of immunosuppressive therapies that target both plasma and memory B cells for the efficient elimination of pre-existing immunity against AAV2/8 vectors. PMID:22514654

Karman, Jozsef; Gumlaw, Nathan K; Zhang, Jinhua; Jiang, Ji-Lei; Cheng, Seng H; Zhu, Yunxiang

2012-01-01

64

The role of pre-existing faults in the structural evolution of thrust systems: Insights from the Ligurian Alps (Italy)  

NASA Astrophysics Data System (ADS)

New structural and stratigraphic data for a selected area of the Ligurian Alps are combined in order to assess and discuss the role played by extensional structures in the southernmost segment of the Western Alps during thrusting. Restored cross-sections and field data suggest that the structural style in the external sector of the chain may depend upon the presence of pre-orogenic normal faults ascribed to three extensional events linked to different geodynamic contexts: (i) Permian post-Variscan plate reorganisation, (ii) Mesozoic rifting-drifting phases leading to the opening of the Alpine Tethys, and (iii) Eocenic development of the European foreland basins. During positive inversion in Eocene times, a thin-skinned thrust system developed in this area, followed by a thick-skinned phase. In both situations the inherited extensional structures played fundamental roles: during the thin-skinned phase they conditioned the thrusting sequence, also producing large-scale buckle folds and partial reactivations; during the thick-skinned phase the strain was compartmentalized and partitioned by pre-existing faults. The kinematic model of the external sectors of the Ligurian chain also allows the re-assessment of the Alpine evolution of the front-foreland transition, including: (i) indirect confirmation that in the Eocene the Ligurian Briançonnais and Dauphinois domains were not separated by the Valais-Pyrenean oceanic basin; (ii) that the thin-skinned phase progressively changed into thick-skinned; (iii) the assertion that there were no significant deformations from the Oligocene to the present-day, and the Corsica-Sardinia block rotation only produced a change in orientation of previously formed structures and normal fault system development.

Bonini, Lorenzo; Dallagiovanna, Giorgio; Seno, Silvio

2010-01-01

65

Prevalence of medically compromised conditions in dental patients  

Microsoft Academic Search

Objectives: To study the prevalence of medically compromised conditions in patients seeking dental treatments at the Faculty of Dentistry, Chulalongkorn University. Study design: The fi les of 58,317 patients seeking dental treatments at the Faculty of Dentistry, Chulalongkorn University from 2002-2004 were retrieved and reviewed for medically compromised conditions. Results: From a total of 58,317 patients, 7,167 patients (12.2%) had

Kittipong Dhanuthai; Kraisorn Sappayatosok; Panruthai Bijaphala; Sirinya Kulvit; Thanasit Sereerat

66

Medical conditions in Ashkenazi schizophrenic pedigrees.  

PubMed

To limit the genetic heterogeneity of schizophrenia, this study focused on the widely extended pedigrees of Ashkenazi Jewish schizophrenia probands. The hypothesis posed is that the increased prevalence among the Ashkenazim of the rare lysosomal enzyme disorders, Tay Sachs disease (TDS), caused by low levels of hexosaminidase A, and Gaucher's disease (GD), caused by low levels of glucocerebrosidase, might contribute to the demonstrated increased vulnerability to schizophrenia in this ethnic group. Signs and symptoms characterizing the candidate illnesses were systematically queried by the family history method. Rates and relative risks for symptoms characterizing these disorders and for several nonautosomal illnesses associated with TSD and/or GD (i.e., amyotrophic lateral sclerosis and Hodgkin's disease, leukemia and lymphoma) are significantly elevated in the schizophrenia pedigrees, compared to controls. The conditions with elevated rates and risks have been associated with chromosomal regions 1q21 and 15q23-q24. These areas are suggested as candidate regions for future targeted deoxyribonucleic acid (DNA) research in schizophrenia. PMID:7973467

Goodman, A B

1994-01-01

67

Requirement for pre-existing of p21 to prevent doxorubicin-induced apoptosis through inhibition of caspase-3 activation.  

PubMed

Doxorubicin (DOX)-induced apoptosis is suppressed by p21 (waf1/cip1/sdi1), a cyclin dependent kinase (CDK) inhibitor. Here we show that exogenous expression of p21 before, but not after, the DOX-treatment protected p21-deficient human colorectal cancer cell line DLD1 from DOX-induced apoptosis. In previous work, we demonstrated that p21 inhibits DOX-induced apoptosis via its CDK-binding and CDK-inhibitory activity. Here we report that pre-existing p21 can associate with pro-caspase-3 and inhibit caspase-3 activation in the cells, which was at least in part responsible for enhancing survival of DOX-treated cells. Furthermore, the N-terminal domain of p21 was found to interact with pro-caspase-3 in DLD1 cells. Thus, we propose that pre-existing p21 is required to prevent DOX-induced apoptosis. PMID:16909308

Tang, J J; Shen, C; Lu, Y J

2006-10-01

68

The experience of altered states of consciousness in shamanic ritual: the role of pre-existing beliefs and affective factors.  

PubMed

Much attention has been paid recently to the role of anomalous experiences in the aetiology of certain types of psychopathology, e.g. in the formation of delusions. We examine, instead, the top-down influence of pre-existing beliefs and affective factors in shaping an individual's characterisation of anomalous sensory experiences. Specifically we investigated the effects of paranormal beliefs and alexithymia in determining the intensity and quality of an altered state of consciousness (ASC). Fifty five participants took part in a sweat lodge ceremony, a traditional shamanic ritual which was unfamiliar to them. Participants reported significant alterations in their state of consciousness, quantified using the 'APZ' questionnaire, a standardized measure of ASC experience. Participants endorsing paranormal beliefs compatible with shamanic mythology, and those showing difficulty identifying feelings scored higher on positive dimensions of ASC experience. Our findings demonstrate that variation in an individual's characterisation of anomalous experiences is nuanced by pre-existing beliefs and affective factors. PMID:20558090

Polito, Vince; Langdon, Robyn; Brown, Jac

2010-12-01

69

How Commonly Are Known Medical Conditions Associated with Autism?  

ERIC Educational Resources Information Center

A study of 211 children and adults with autism (n=81), other pervasive development disorders (PDD) (n=24), and conditions other than PDD (n=106) found the prevalence of medical conditions with suspected etiologic relationships with autism varies between 10 and 15%, depending on the diagnostic system employed. (Author/CR)

Barton, Michelle; Volkmar, Fred

1998-01-01

70

Recombinant Lysyl Oxidase Propeptide Protein Inhibits Growth and Promotes Apoptosis of Pre-Existing Murine Breast Cancer Xenografts  

Microsoft Academic Search

Lysyl oxidase propeptide (LOX-PP) ectopic overexpression inhibits the growth of cancer xenografts. Here the ability and mode of action of purified recombinant LOX-PP (rLOX-PP) protein to inhibit the growth of pre-existing xenografts was determined. Experimental approaches employed were direct intratumoral injection (i.t.) of rLOX-PP protein into murine breast cancer NF639 xenografts, and application of a slow release formulation of rLOX-PP

Manish V. Bais; Matthew A. Nugent; Danielle N. Stephens; S. Selva Sume; Kathrin H. Kirsch; Gail E. Sonenshein; Philip C. Trackman

2012-01-01

71

Phenotypic T Cell Exhaustion in a Murine Model of Bacterial Infection in the Setting of Pre-Existing Malignancy  

PubMed Central

While much of cancer immunology research has focused on anti-tumor immunity both systemically and within the tumor microenvironment, little is known about the impact of pre-existing malignancy on pathogen-specific immune responses. Here, we sought to characterize the antigen-specific CD8+ T cell response following a bacterial infection in the setting of pre-existing pancreatic adenocarcinoma. Mice with established subcutaneous pancreatic adenocarcinomas were infected with Listeria monocytogenes, and antigen-specific CD8+ T cell responses were compared to those in control mice without cancer. While the kinetics and magnitude of antigen-specific CD8+ T cell expansion and accumulation was comparable between the cancer and non-cancer groups, bacterial antigen-specific CD8+ T cells and total CD4+ and CD8+ T cells in cancer mice exhibited increased expression of the coinhibitory receptors BTLA, PD-1, and 2B4. Furthermore, increased inhibitory receptor expression was associated with reduced IFN-? and increased IL-2 production by bacterial antigen-specific CD8+ T cells in the cancer group. Taken together, these data suggest that cancer's immune suppressive effects are not limited to the tumor microenvironment, but that pre-existing malignancy induces phenotypic exhaustion in T cells by increasing expression of coinhibitory receptors and may impair pathogen-specific CD8+ T cell functionality and differentiation.

Mittal, Rohit; Wagener, Maylene; Breed, Elise R.; Liang, Zhe; Yoseph, Benyam P.; Burd, Eileen M.; Farris, Alton B.

2014-01-01

72

Sexual dysfunction among Ghanaian men presenting with various medical conditions  

PubMed Central

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 cross-sectional study was to obtain data on the prevalence of male sexual dysfunction (SD) among Ghanaians with various medical conditions residing in Kumasi. Methods The Golombok Rust Inventory of Sexual Satisfaction (GRISS) was administered to 150 Ghanaian men with various medical conditions between 19 and 66 years old (mean ± standard deviation: 40.01 ± 12.32 years) domiciled in the Kumasi metropolis. Results Out of the total 150 questionnaires administered, 105 (70.0%) men returned the questionnaires. Questionnaires from 3 men were incomplete, leaving 102 complete and evaluable questionnaires, indicating a 68.0% response rate. Of the remaining 102 men, 88.2% were married, 70.6% had attained higher education, 88.2% were non-smokers. Whereas 54.9% were engaged in exercise, 61.8% indulged in alcoholic beverages. The prevalence of the various medical conditions include: diabetes (18%), hypertension (24.5%), migraine (11.8%), ulcer (7.8%), surgery (6.9%), STD (3.9) and others (26.5%). The prevalence of SD among the respondents in the study was 59.8%. The highest prevalence of SD was seen among ulcer patients (100%), followed by patients who have undergone surgery (75%), diabetes (70%), hypertension (50%), STD (50%) and the lowest was seen among migraine patients (41.7%). Conclusions SD rate is high among Ghanaian men with medical conditions (about 60%) and vary according to the condition and age.

2010-01-01

73

Better recovery of kidney function in patients with de novo chronic kidney disease after partial nephrectomy compared with those with pre-existing chronic kidney disease.  

PubMed

We compared kidney functional recovery between patients with pre-existing chronic kidney disease, those with de novo chronic kidney disease and those with normal kidney function, after partial nephrectomy. A total of 311 patients who underwent partial nephrectomy at Tokyo Women's Medical University Hospital, Tokyo, Japan, between January 2004 and July 2011 with sufficient kidney functional data participated in the study. Patients with pre-existing chronic kidney disease (group1: 78 patients) were defined as those with estimated glomerular filtration rate under 60?mL/min/m(2) before partial nephrectomy. Patients with de novo chronic kidney disease (group?2: 49) were defined as those with estimated glomerular filtration rate over 60?mL/min/m(2) before surgery and who developed estimated glomerular filtration rate under 60?mL/min/m(2) 3 months after partial nephrectomy. Normal patients (group?3: 184) were defined as those with estimated glomerular filtration rate over 60?mL/min/m(2) both before and after partial nephrectomy. Group?1 was associated with older age and higher comorbidity, including hypertension and diabetes mellitus, compared with other groups. R.E.N.A.L. score was not significantly different between the groups. Although the percent change of estimated glomerular filtration rate between the preoperative period and 3 months after partial nephrectomy in group?2 was significantly decreased compared with that in other groups (group?1: -6.8%, group?2: -18%, group?3: -7.3%), the renal functional recovery between 3 and 12 months after partial nephrectomy in group?2 was better than that in other groups (group?1: -0.5%, group?2: 5.6%, group?3: -0.4%). Patients with de novo chronic kidney disease had better kidney functional recovery than the other two groups, which might suggest that they were surgically assaulted and developed chronic kidney disease in the early postoperative period, and were essentially different from those with pre-existing chronic kidney disease. PMID:24286523

Takagi, Toshio; Kondo, Tsunenori; Iizuka, Junpei; Omae, Kenji; Kobayashi, Hirohito; Hashimoto, Yasunobu; Yoshida, Kazuhiko; Tanabe, Kazunari

2014-06-01

74

Acute elevation of plasma PLTP activity strongly increases pre-existing atherosclerosis  

Microsoft Academic Search

Objective - A transgenic mouse model was generated that allows conditional expression of human PLTP, based on the tetracycline-responsive gene system, to study the effects of an acute increase in plasma PLTP activity as may occur in inflammation. Methods and Results - The effects of an acute elevation of plasma PLTP activity on the metabolism of apolipoprotein B-containing lipoproteins and

M. Moerland; H. Samyn; T. van Gent; R. van Haperen; G. M. Dallinga-Thie; F. G. Grosveld; A. van Tol; Crom de M. P. G

2008-01-01

75

Superimposition of wind seas on pre-existing swells off Goa coast  

NASA Astrophysics Data System (ADS)

An analysis of wind and wave data collected in the coastal region of Goa, west coast of India, during fair weather season reveals a distinct and systematic diurnal variation in wind speed, wave height and wave period, especially simultaneous increase in wave height and decrease in wave period with increase in local wind speeds due to sea breeze system. During a typical daily cycle, the wave height reaches its peak early in the afternoon, then it decays progressively back to the swell conditions within 5 or 6 h. Measured wave spectra distinctly bring out salient features of deep water swell and wind seas generated by the local sea breeze. Numerical simulations reproduce the characteristics of this daily cycle. The exposure of Goa coast to long distant swells from the southwest and to the local wind seas from the northwest leads to complex cross-sea conditions.

Vethamony, P.; Aboobacker, V. M.; Menon, H. B.; Kumar, K. Ashok; Cavaleri, L.

2011-07-01

76

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

77

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

78

Using conditioned place preference to identify relapse prevention medications.  

PubMed

Stimuli, including contexts, which predict the availability or onset of a drug effect, can acquire conditioned incentive motivational properties. These conditioned properties endure after withdrawal, and can promote drug-seeking which may result in relapse. Conditioned place preference (CPP) assesses the associations between drugs and the context in which they are experienced. Here, we review the potential utility of CPP procedures in rodents and humans to evaluate medications that target conditioned drug-seeking responses. We discuss the translational potential of the CPP procedure from rodents to humans, and review findings with FDA-approved treatments that support the use of CPP to develop relapse-reduction medications. We also discuss challenges and methodological questions in applying the CPP procedure to this purpose. We argue that an efficient and valid CPP procedure in humans may reduce the burden of full clinical trials with drug-abusing patients that are currently required for testing promising treatments. PMID:23680702

Napier, T Celeste; Herrold, Amy A; de Wit, Harriet

2013-11-01

79

Mechanical and microstructural development of Carrara marble with pre-existing strain variation  

NASA Astrophysics Data System (ADS)

A series of two-stage torsion experiments on Carrara marble were conducted to constrain the influence of known prior deformation on rheological response and microstructural evolution. Comparison with previous experimental data on Carrara marble flow and fabric evolution during single-stage torsion deformation experiments provided direct insights into the significance of initial deformation at various conditions. Our experiments were conducted at 727 °C temperature and 300 MPa confining pressure, while maintaining a constant strain rate of 3 × 10 - 4 s - 1 on the periphery of the cylindrical samples. Under these conditions, the marble is known to deform in power-law ( n = 6-10) ductile flow. All torsion experiments were performed with a Paterson type gas-medium testing machine equipped with a torsion actuator module. Prior (D1) and subsequent (D2) deformation are accomplished by two torsion experiments in sequence on same sample segments. The effect of D1 strain history is investigated during D2 by applying counter-clockwise torsion to a sandwich sample consisting of three segments with different D1 rotation sense. D2 samples experienced continued, first and reversed shearing deformation in top, centre and bottom segments, respectively. D2 bulk strain was chosen equal to D1 strain in top and bottom segments. D1 experiments followed the typical single-stage deformation behaviour of Carrara marble under the applied experimental conditions. Yielding was followed by strain hardening until a peak stress was reached at a shear strain around 1, after which work softening occurred. Weakening gradually evolved into a constant stress regime. During hardening, a shear microstructure and crystallographic preferred orientation (CPO) developed. Afterwards the volume fraction of smaller dynamic recrystallised grains increased continuously, resulting in a recrystallisation microstructure and CPO at shear strains of 5 and higher. The new D2 experiments displayed a strain variation between homogeneously deformed sample segments that increased with increasing D1 strain. The stress-strain behaviour of the D2 bulk sandwich samples showed less pronounced work-hardening and -softening when compared with single-stage deformation experiments. Furthermore, constant flow stress was attained at increasingly lower strain with increasing D1 strain. In most D2 segments, fabric development is equivalent to single-stage experiments at corresponding absolute strain. The fabrics differed markedly from those in single-stage experiments in the case of reversed two-stage deformation at moderate strain (D1 shear strain 1 and 2.6). Experiments show that grain shape by shearing of relict grains is defined by finite strain and thus affected by strain reversal. Recrystallisation is controlled by absolute strain and not influenced by strain reversal.

Bruijn, Rolf H. C.; Kunze, Karsten; Mainprice, David; Burlini, Luigi

2011-04-01

80

Do Medical Conditions Affect Cognition in Older Adults?  

Microsoft Academic Search

Analyses of a nationally representative sample who completed a list recall task (weighted n = 6,446) and 2 mental status tasks (weighted n = 6,646) were conducted to determine whether specific medical conditions such as high blood pressure and diabetes as well as general health ratings predict cognitive performance in adults aged 70 to 103. Presence of stroke and poorer

Elizabeth M. Zelinski; Eileen Crimmins; Sandra Reynolds; Teresa Seeman

1998-01-01

81

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

82

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

83

N-acetylcysteine for preventing acute kidney injury in cardiac surgery patients with pre-existing moderate renal insufficiency  

Microsoft Academic Search

Purpose  N-acetylcysteine may prevent acute kidney injury after cardiac surgery. To determine if N-acetylcysteine warrants definitive\\u000a evaluation in a large multicentre trial, we evaluated its effects on a surrogate outcome, estimated glomerular filtration\\u000a rate (eGFR), in a randomized trial.\\u000a \\u000a \\u000a \\u000a Methods  One-hundred-seventy-seven cardiac surgery patients with moderate pre-existing renal insufficiency (eGFR ? 60 mL.min-1) were recruited in a blinded (patients, clinicians, data-collectors) placebo-controlled

Duminda N. Wijeysundera; W. Scott Beattie; Vivek Rao; John T. Granton; Christopher T. Chan

2007-01-01

84

Requirement for pre-existing of p21 to prevent doxorubicin-induced apoptosis through inhibition of caspase-3 activation  

Microsoft Academic Search

Doxorubicin (DOX)-induced apoptosis is suppressed by p21 (waf1\\/cip1\\/sdi1), a cyclin dependent kinase (CDK) inhibitor. Here we show that exogenous expression of p21 before, but not after, the DOX-treatment protected p21-deficient human colorectal cancer cell line DLD1 from DOX-induced apoptosis. In previous work, we demonstrated that p21 inhibits DOX-induced apoptosis via its CDK-binding and CDK-inhibitory activity. Here we report that pre-existing

J. J. Tang; C. Shen; Y. J. Lu

2006-01-01

85

Liver gene therapy by lentiviral vectors reverses anti-factor IX pre-existing immunity in haemophilic mice  

PubMed Central

A major complication of factor replacement therapy for haemophilia is the development of anti-factor neutralizing antibodies (inhibitors). Here we show that liver gene therapy by lentiviral vectors (LVs) expressing factor IX (FIX) strongly reduces pre-existing anti-FIX antibodies and eradicates FIX inhibitors in haemophilia B mice. Concomitantly, plasma FIX levels and clotting activity rose to 50–100% of normal. The treatment was effective in 75% of treated mice. FIX-specific plasma cells (PCs) and memory B cells were reduced, likely because of memory B-cell depletion in response to constant exposure to high doses of FIX. Regulatory T cells displaying FIX-specific suppressive capacity were induced in gene therapy treated mice and controlled FIX-specific T helper cells. Gene therapy proved safer than a regimen mimicking immune tolerance induction (ITI) by repeated high-dose FIX protein administration, which induced severe anaphylactoid reactions in inhibitors-positive haemophilia B mice. Liver gene therapy can thus reverse pre-existing immunity, induce active tolerance to FIX and establish sustained FIX activity at therapeutic levels. These data position gene therapy as an attractive treatment option for inhibitors-positive haemophilic patients.

Annoni, Andrea; Cantore, Alessio; Della Valle, Patrizia; Goudy, Kevin; Akbarpour, Mahzad; Russo, Fabio; Bartolaccini, Sara; D'Angelo, Armando; Roncarolo, Maria Grazia; Naldini, Luigi

2013-01-01

86

Investigation on the Automatic Geo-Referencing of Archaeological UAV Photographs by Correlation with Pre-Existing Ortho-Photos  

NASA Astrophysics Data System (ADS)

We present a method for the automatic geo-referencing of archaeological photographs captured aboard unmanned aerial vehicles (UAVs), termed UPs. We do so by help of pre-existing ortho-photo maps (OPMs) and digital surface models (DSMs). Typically, these pre-existing data sets are based on data that were captured at a widely different point in time. This renders the detection (and hence the matching) of homologous feature points in the UPs and OPMs infeasible mainly due to temporal variations of vegetation and illumination. Facing this difficulty, we opt for the normalized cross correlation coefficient of perspectively transformed image patches as the measure of image similarity. Applying a threshold to this measure, we detect candidates for homologous image points, resulting in a distinctive, but computationally intensive method. In order to lower computation times, we reduce the dimensionality and extents of the search space by making use of a priori knowledge of the data sets. By assigning terrain heights interpolated in the DSM to the image points found in the OPM, we generate control points. We introduce respective observations into a bundle block, from which gross errors i.e. false matches are eliminated during its robust adjustment. A test of our approach on a UAV image data set demonstrates its potential and raises hope to successfully process large image archives.

Karel, W.; Doneus, M.; Briese, C.; Verhoeven, G.; Pfeifer, N.

2014-06-01

87

"Mohr space" and its applications to weakness reactivation, strength decrease and anisotropies with pre-existing weakness(es)  

NASA Astrophysics Data System (ADS)

Mohr circle, which was introduced by Otto Mohr (1882), is one of the most used and useful tool in structural geology, but it can be used in two dimension only. In this paper, a new graphical technique ("Mohr space") for any tri-axial stress state (principal stress axis may tilt), is proposed, and Mohr circle is expanded for three dimensional stress analysis. By compilation of the contour diagram of two orientation angles of any plane in "Mohr space", the correspondence between the pole (?n, ?n) and the orientation for any plane in "Mohr space" is established. As a result, the normal stress (?n) and shear stress (?n) of any plane (including weakness plane) can be conveniently and intuitively expressed in "Mohr-space", which may be much easier to understand than that of equations for most geologists. The results show that, the shape of "Mohr space" (including the feature of "Mohr space", the contours characteristics of two orientation angles) is determined by (?1-?2) / (?2-?3) or the relative ?2 value, and the size of "Mohr space" is determined by (?1-?3). "Mohr-space" can be used to predict the activation and relative activation of pre-existing weakness, and evaluate shear strength decrease and Anisotropies with Pre-existing Weakness(es). Because of its intuitive and convenience, "Mohr space" is expected to have broad application prospects.

Tong, H.

2012-12-01

88

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

89

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

90

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

Code of Federal Regulations, 2013 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...

2013-10-01

91

41 CFR 105-64.208 - What special conditions apply to release of medical records?  

Code of Federal Regulations, 2013 CFR

... What special conditions apply to release of medical records? 105-64.208 Section 105-64.208... What special conditions apply to release of medical records? Medical records containing information that may have an...

2013-07-01

92

Protective efficacy of a single immunization with capripoxvirus-vectored recombinant peste des petits ruminants vaccines in presence of pre-existing immunity.  

PubMed

Sheeppox, goatpox and peste des petits ruminants (PPR) are highly contagious ruminant diseases widely distributed in Africa, the Middle East and Asia. Capripoxvirus (CPV)-vectored recombinant PPR vaccines (rCPV-PPR vaccines), which have been developed and shown to protect against both Capripox (CP) and PPR, would be critical tools in the control of these important diseases. In most parts of the world, these disease distributions overlap each other leaving concerns about the potential impact that pre-existing immunity against either disease may have on the protective efficacy of these bivalent rCPV-PPR vaccines. Currently, this question has not been indisputably addressed. Therefore, we undertook this study, under experimental conditions designed for the context of mass vaccination campaigns of small ruminants, using the two CPV recombinants (Kenya sheep-1 (KS-1) strain-based constructs) developed previously in our laboratory. Pre-existing immunity was first induced by immunization either with an attenuated CPV vaccine strain (KS-1) or the attenuated PPRV vaccine strain (Nigeria 75/1) and animals were thereafter inoculated once subcutaneously with a mixture of CPV recombinants expressing either the hemagglutinin (H) or the fusion (F) protein gene of PPRV (10(3) TCID50/animal of each). Finally, these animals were challenged with a virulent CPV strain followed by a virulent PPRV strain 3 weeks later. Our study demonstrated full protection against CP for vaccinated animals with prior exposure to PPRV and a partial protection against PPR for vaccinated animals with prior exposure to CPV. The latter animals exhibited a mild clinical form of PPR and did not show any post-challenge anamnestic neutralizing antibody response against PPRV. The implications of these results are discussed herein and suggestions made for future research regarding the development of CPV-vectored vaccines. PMID:24837763

Caufour, Philippe; Rufael, Tesfaye; Lamien, Charles Euloge; Lancelot, Renaud; Kidane, Menbere; Awel, Dino; Sertse, Tefera; Kwiatek, Olivier; Libeau, Geneviève; Sahle, Mesfin; Diallo, Adama; Albina, Emmanuel

2014-06-24

93

Sleep disorders, medical conditions, and road accident risk.  

PubMed

Sleep disorders and various common acute and chronic medical conditions directly or indirectly affect the quality and quantity of one's sleep or otherwise cause excessive daytime fatigue. This article reviews the potential contribution of several prevalent medical conditions - allergic rhinitis, asthma, chronic obstructive pulmonary disease, rheumatoid arthritis/osteoarthritis - and chronic fatigue syndrome and clinical sleep disorders - insomnia, obstructive sleep apnea, narcolepsy, periodic limb movement of sleep, and restless legs syndrome - to the risk for drowsy-driving road crashes. It also explores the literature on the cost-benefit of preventive interventions, using obstructive sleep apnea as an example. Although numerous investigations have addressed the impact of sleep and medical disorders on quality of life, few have specifically addressed their potential deleterious effect on driving performance and road incidents. Moreover, since past studies have focused on the survivors of driver crashes, they may be biased. Representative population-based prospective multidisciplinary studies are urgently required to clarify the role of the fatigue associated with common ailments and medications on traffic crash risk of both commercial and non-commercial drivers and to comprehensively assess the cost-effectiveness of intervention strategies. PMID:21130215

Smolensky, Michael H; Di Milia, Lee; Ohayon, Maurice M; Philip, Pierre

2011-03-01

94

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

95

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

96

Medical Transport of Children with Complex Chronic Conditions  

PubMed Central

One of the most notable trends in child health has been the increase in the number of children with special health care needs, including those with complex chronic conditions. Care of these children accounts for a growing fraction of health care resources. We examine recent developments in health care, especially with regard to medical transport and prehospital care, that have emerged to adapt to this remarkable demographic trend. One such development is the focus on care coordination, including the dissemination of the patient-centered medical home concept. In the prehospital setting, the need for greater coordination has catalyzed the development of the emergency information form. Training programs for prehospital providers now incorporate specific modules for children with complex conditions. Another notable trend is the shift to a family-centered model of care. We explore efforts toward regionalization of care, including the development of specialized pediatric transport teams, and conclude with recommendations for a research agenda.

Lerner, Carlos F.; Kelly, Robert B.; Hamilton, Leslie J.; Klitzner, Thomas S.

2012-01-01

97

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

98

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

99

Mycosis on mycosis fungoides: zoophilic dermatophytosis selectively superimposed on pre-existing cutaneous T-cell lymphoma (mycosis fungoides) plaques.  

PubMed

We report a case of tinea corporis caused by a cattle-derived strain of Trichophyton mentagrophytes in a 44-year-old male affected by cutaneous T-cell lymphoma (CTCL, so-called mycosis fungoides). Fungal colonization of glabrous skin was strictly confined within pre-existing lymphomatous plaques. Either oral itraconazole or griseofulvin, or topical terbinafine were ineffective until the patient, who was treated with systemic retinoids and interferon-alpha for his CTCL, was shifted from leucocyte to lymphoblastoid interferon. The hypothesis that a local immunodisturbance could be responsible for the selective superimposition of tinea on CTCL lesions ('mycosis on mycosis'), and that such an immunodisturbance could be partially corrected by the interferon switch is discussed. PMID:12588488

Capella, G L; Altomare, G F

2003-02-01

100

Aggravation of Pre-Existing Atrioventricular Block, Wenckebach Type, Provoked by Application of X-Ray Contrast Medium  

SciTech Connect

Background. Significant bradycardia followed by cardiac arrest related to single bolus administration of X-ray contrast medium into a peripheral artery has not, to our knowledge, been described in the literature. Methods and Results. While performing a percutaneous transluminal angioplasty of the left superficial femoral artery in a 68-year old patient with a pre-existing atrioventricular (AV) block, Wenckebach type, he developed an AV block III after a single bolus injection of intra-arterial X-ray contrast medium. Conclusion. We believe that application of contrast medium causes a transitory ischemia in the obstructed vessel and therefore elevation of endogenous adenosine. In the case of a previously damaged AV node this elevation of endogenous adenosine may be responsible for the development of a short period of third-degree AV block.

Brodmann, Marianne, E-mail: marianne.brodmann@meduni-graz.at; Seinost, Gerald [Medizinische Universitaet Graz, Division of Angiology, Department of Internal Medicine (Austria); Stark, Gerhard [LKH Deutschlandsberg, Department of Internal Medicine (Austria); Pilger, Ernst [Medizinische Universitaet Graz, Division of Angiology, Department of Internal Medicine (Austria)

2006-12-15

101

Prudent layperson definition of an emergent pediatric medical condition.  

PubMed

This study was designed to assess how well parents rated pediatric medical conditions based on their perceived degree of urgency so as to determine if the "Prudent Layperson Standard'' is reasonable. A self-administered, supervised survey was given to a convenience sample of 340 caregivers in the emergency department of an urban children's hospital. Respondents were asked to rank the urgency of 15 scenarios. A caregiver response within 1 point of the physician score was considered concordant with medical opinion. A 2-week-old infant with a rectal temperature of 103.7 degrees F was the only emergent scenario underestimated by caregivers. A 1 1/2-yr-old child with an upper respiratory tract infection, a 7-year-old child with ringworm, an 8-month-old infant with a simple forehead contusion, and a 4-year-old child with conjunctivitis were the non-urgent scenarios overestimated by caregivers. Laypeople are able to identify cases constructed to represent obvious pediatric medical emergencies. Several patient subgroups frequently overestimate medical urgency. PMID:16528435

Huang, Craig J; Poirier, Michael P; Cantwell, John R; Ermis, Peter R; Isaacman, Daniel J

2006-03-01

102

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

103

28 CFR 79.16 - Proof of medical condition.  

Code of Federal Regulations, 2013 CFR

...cancer or tumor registry that it possesses medical records or abstracts of medical records of the claimant that contain a verified diagnosis...If the designated state does not possess medical records or abstracts of medical records that...

2013-07-01

104

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

105

Effect of Pre-Existing Immunity to One of the Antigens of Associated Vaccine Against Plague, Tularemia, and Brucellosis on Immunizing Properties of Its Other Components. Report IV.  

National Technical Information Service (NTIS)

The presence of pre-existing immunity to plague and brucellosis among guinea pigs does not reduce the effectiveness of administration of tularemia antigen as part of associated vaccine against plague, tularemia, and brucellosis. Formation of immunity amon...

V. G. Pilipenko

1968-01-01

106

Evaluation of pre-existing antibody presence as a risk factor for posttreatment anti-drug antibody induction: analysis of human clinical study data for multiple biotherapeutics.  

PubMed

Biotherapeutic-reactive antibodies in treatment-naïve subjects (i.e., pre-existing antibodies) have been commonly detected during clinical immunogenicity assessments; however information on pre-existing antibody prevalence, physiological effects, and impact on posttreatment anti-drug antibody (ADA) induction remains limited. In this analysis, pre-existing antibody prevalence and impact on posttreatment ADA induction were determined using ADA data from 12 biotherapeutics analyzed in 32 clinical studies. Approximately half (58%) of the biotherapeutics were associated with some level of pre-existing antibodies and 67% of those were associated with posttreatment ADA induction. Across all studies, 5.6% of study subjects demonstrated presence of pre-existing antibodies, among which, 17% of the individual subjects had posttreatment increases in their ADA titers while 16% had decreased titers and 67% had no change in titers. However, in studies conducted in the rheumatoid arthritis (RA) population, 14.8% of RA patients were associated with pre-existing antibodies and 30% of those had posttreatment titer increases. The results suggest that in most study subjects, pre-existing antibodies pose a low risk for posttreatment ADA induction. That said, the high risk of induction implicated for RA patients, primarily observed in treatments evaluating novel antibody-based constructs, indicates that further understanding of the contribution of product and disease-specific factors is needed. Cross-industry efforts to collect and analyze a larger data set would enhance understanding of the prevalence, nature, and physiological consequences of pre-existing antibodies, better inform the immunogenicity risk profiles of products associated with these antibodies and lead to better fit-for-purpose immunogenicity management and mitigation strategies. PMID:23761225

Xue, Li; Rup, Bonita

2013-07-01

107

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

108

Visualizing Multivariate Time Series Data to Detect Specific Medical Conditions  

PubMed Central

Efficient unsupervised algorithms for the detection of patterns in time series data, often called motifs, have been used in many applications, such as identifying words in different languages, detecting anomalies in ECG readings, and finding similarities between images. We present a process that creates a personalized multivariate time series representation—a Multivariate Time Series Amalgam (MTSA) — of physiological data and laboratory results that physicians can visually interpret. We then apply a technique that has demonstrated success with the interpretation of univariate data, named Symbolic Aggregate Approximation (SAX), to visualize patterns in the MTSAs that may differentiate between medical conditions such as renal and respiratory failure.

Ordonez, Patricia; desJardins, Marie; Feltes, Carolyn; Lehmann, Christoph U.; Fackler, James

2008-01-01

109

Visualizing multivariate time series data to detect specific medical conditions.  

PubMed

Efficient unsupervised algorithms for the detection of patterns in time series data, often called motifs, have been used in many applications, such as identifying words in different languages, detecting anomalies in ECG readings, and finding similarities between images. We present a process that creates a personalized multivariate time series representation a Multivariate Time Series Amalgam (MTSA) of physiological data and laboratory results that physicians can visually interpret. We then apply a technique that has demonstrated success with the interpretation of univariate data, named Symbolic Aggregate Approximation (SAX), to visualize patterns in the MTSAs that may differentiate between medical conditions such as renal and respiratory failure. PMID:18999033

Ordóñez, Patricia; DesJardins, Marie; Feltes, Carolyn; Lehmann, Christoph U; Fackler, James

2008-01-01

110

The effects of aerobic- versus strength-training on body image among young women with pre-existing body image concerns.  

PubMed

This experiment compared the effects of aerobic-training (AT) versus strength-training (ST) on body image among young women with pre-existing body image concerns. Theory-based correlates of body image change were also examined. Participants were 46 women (M age=21.5 years), randomly assigned to an 8-week AT or ST intervention consisting of supervised exercise 3 days/week. Multidimensional measures of body image were administered pre- and post-intervention, along with measures of physical fitness, perceived fitness, and exercise self-efficacy. Women in the AT condition reported greater reductions in social physique anxiety (p=.001) and tended to report greater improvements in appearance evaluation (p=.06) than women in the ST condition. Changes in perceived fatness, perceived aerobic endurance and aerobic self-efficacy were significantly correlated with body image change (ps<.003). Results provide direction for prescribing exercise to improve body image and advancing theory to account for the effects of exercise. PMID:24958656

Martin Ginis, Kathleen A; Strong, Heather A; Arent, Shawn M; Bray, Steven R; Bassett-Gunter, Rebecca L

2014-06-01

111

Impact of pre-existing MSP142-allele specific immunity on potency of an erythrocytic Plasmodium falciparum vaccine  

PubMed Central

Background MSP1 is the major surface protein on merozoites and a prime candidate for a blood stage malaria vaccine. Preclinical and seroepidemiological studies have implicated antibodies to MSP1 in protection against blood stage parasitaemia and/or reduced parasite densities, respectively. Malaria endemic areas have multiple strains of Plasmodium falciparum circulating at any given time, giving rise to complex immune responses, an issue which is generally not addressed in clinical trials conducted in non-endemic areas. A lack of understanding of the effect of pre-existing immunity to heterologous parasite strains may significantly contribute to vaccine failure in the field. The purpose of this study was to model the effect of pre-existing immunity to MSP142 on the immunogenicity of blood-stage malaria vaccines based on alternative MSP1 alleles. Methods Inbred and outbred mice were immunized with various recombinant P. falciparum MSP142 proteins that represent the two major alleles of MSP142, MAD20 (3D7) and Wellcome (K1, FVO). Humoral immune responses were analysed by ELISA and LuminexTM, and functional activity of induced MSP142-specific antibodies was assessed by growth inhibition assays. T-cell responses were characterized using ex vivo ELISpot assays. Results Analysis of the immune responses induced by various immunization regimens demonstrated a strong allele-specific response at the T cell level in both inbred and outbred mice. The success of heterologous regimens depended on the degree of homology of the N-terminal p33 portion of the MSP142, likely due to the fact that most T cell epitopes reside in this part of the molecule. Analysis of humoral immune responses revealed a marked cross-reactivity between the alleles. Functional analyses showed that some of the heterologous regimens induced antibodies with improved growth inhibitory activities. Conclusion The development of a more broadly efficacious MSP1 based vaccine may be hindered by clonally imprinted p33 responses mainly restricted at the T cell level. In this study, the homology of the p33 sequence between the clonally imprinted response and the vaccine allele determines the magnitude of vaccine induced responses.

2012-01-01

112

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

113

Distribution of long-term Quaternary Deformation and Correlation with Pre-existing Tectonic Structures in the Central US  

NASA Astrophysics Data System (ADS)

The processes governing earthquakes in intraplate regions are still poorly understood, mostly because the very occurrence of such earthquakes violates plate tectonic theory, recurrence intervals are long, and seismicity occurs in quiescent areas where structures are buried/unexposed. In the central US, most of the seismicity is concentrated along the faults of the New Madrid seismic zone, located in the heart of the Mississippi embayment. However, the clash between the high level of present, historical and prehistorical seismicity, the geodetic vectors, and the puzzling lack of deformation at the surface and in the subsurface suggests that the New Madrid seismic zone might have not been the only fault system active in the region. Indeed, evidence is mounting that Quaternary deformation has been accommodated along structures that are presently aseismic. If seismicity has been migrating throughout the central US during the Quaternary, then what controls the location of seismicity? Here we present the results of ~950 km marine and land high-resolution seismic reflection data acquired along and near the Mississippi River in the Mississippi embayment between 2008 and 2011. The data clearly document Quaternary deformation within the New Madrid seismic zone and at 3 locations well beyond the seismically active region, with displacement of all the unconsolidated sedimentary units from the top of the Paleozoic sedimentary rocks to the base of the Quaternary river alluvium. Beside documenting Quaternary deformation in the region, perhaps one of the most important results of the ~950 km-long seismic survey is that deformation is not uniformly distributed throughout the profile, but is focused along distinct structures, which spatially coincide with the margin of the failed Paleozoic Reelfoot Rift and with the southern margin of the Proterozoic Laurentian continent, marked in this region by the Alabama-Oklahoma transform fault. This spatial correlation indicates a tectonic control, possibly imposed by pre-existing structures, which are capable of concentrating strain and stress and localizing intraplate deformation. Surprisingly, no Quaternary deformation is detected across the buried Paleozoic Ouachita orogenic belt, indicating that under the same stress field, not all the pre-existing structures appear to be capable of focusing deformation.

Magnani, M.; McIntosh, K. D.; Guo, L.; Hao, Y.

2012-12-01

114

28 CFR 79.26 - Proof of medical condition.  

Code of Federal Regulations, 2010 CFR

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

2010-07-01

115

28 CFR 79.26 - Proof of medical condition.  

Code of Federal Regulations, 2010 CFR

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

2009-07-01

116

28 CFR 79.26 - Proof of medical condition.  

Code of Federal Regulations, 2013 CFR

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

2013-07-01

117

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

118

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

PubMed Central

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 (named APAC), which homes to activated platelets. Like our previously described SLK (which targets newly deposited fibrin strands surrounding the platelet thrombus), APAC destroys platelet aggregates ex vivo in an identical fashion with 85% destruction of platelet aggregates at 2 hours. The combined application of APAC and SLK demonstrated a ?2 fold greater platelet thrombus dissolution than either agent alone at a low concentration (0.025 µM). Platelet-rich clot lysis experiments demonstrated the time required for 50% platelet-rich fibrin clot lysis (T50%) by APAC (95±6.1 min) or SLK (145±7.1 min) was much longer than that by combined APAC+SLK (65±7.6 min) at the final concentration of 0.025 µM (APAC+SLK vs APAC, p<0.05; APAC+SLK vs SLK, p<0.01). Thus these low concentrations of a combination of both agents are likely to be more effective and less toxic when used therapeutically in vivo.

Dang, Suying; Hong, Tao; Wisniewski, Thomas; Zhang, Wei

2011-01-01

119

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

2013-01-01

120

Nasal delivery of an adenovirus-based vaccine bypasses pre-existing immunity to the vaccine carrier and improves the immune response in mice.  

PubMed

Pre-existing immunity to human adenovirus serotype 5 (Ad5) is common in the general population. Bypassing pre-existing immunity could maximize Ad5 vaccine efficacy. Vaccination by the intramuscular (I.M.), nasal (I.N.) or oral (P.O.) route with Ad5 expressing Ebola Zaire glycoprotein (Ad5-ZGP) fully protected naïve mice against lethal challenge with Ebola. In the presence of pre-existing immunity, only mice vaccinated I.N. survived. The frequency of IFN-gamma+ CD8+ T cells was reduced by 80% and by 15% in animals vaccinated by the I.M. and P.O. routes respectively. Neutralizing antibodies could not be detected in serum from either treatment group. Pre-existing immunity did not compromise the frequency of IFN-gamma+ CD8+ T cells (3.9+/-1% naïve vs. 3.6+/-1% pre-existing immunity, PEI) nor anti-Ebola neutralizing antibody (NAB, 40+/-10 reciprocal dilution, both groups). The number of INF-gamma+ CD8+ cells detected in bronchioalveolar lavage fluid (BAL) after I.N. immunization was not compromised by pre-existing immunity to Ad5 (146+/-14, naïve vs. 120+/-16 SFC/million MNCs, PEI). However, pre-existing immunity reduced NAB levels in BAL by approximately 25% in this group. To improve the immune response after oral vaccination, the Ad5-based vaccine was PEGylated. Mice given the modified vaccine did not survive challenge and had reduced levels of IFN-gamma+ CD8+ T cells 10 days after administration (0.3+/-0.3% PEG vs. 1.7+/-0.5% unmodified). PEGylation did increase NAB levels 2-fold. These results provide some insight about the degree of T and B cell mediated immunity necessary for protection against Ebola virus and suggest that modification of the virus capsid can influence the type of immune response elicited by an Ad5-based vaccine. PMID:18958172

Croyle, Maria A; Patel, Ami; Tran, Kaylie N; Gray, Michael; Zhang, Yi; Strong, James E; Feldmann, Heinz; Kobinger, Gary P

2008-01-01

121

Secondary organic aerosol formation from alpha-pinene and toluene: Laboratory studies examining the role of pre-existing particles, relative humidity and oxidant type  

NASA Astrophysics Data System (ADS)

Secondary organic aerosol (SOA) is a major fraction of fine particulate matter (PM2.5), thus impacting air quality and climate. In the first section of this thesis, experiments were performed to investigate SOA formation from both ozonolysis and hydroxyl radical (OH)-initiated oxidation (so-called photooxidation) of alpha-pinene under conditions with varying relative humidity (RH) and seed aerosol acidity at the UNC dual outdoor smog chamber facility. Formation of dimer esters was observed only in SOA derived from alpha-pinene ozonolysis with increased concentrations at high RH, indicating these compounds could serve as tracers for SOA enhanced by anthropogenic pollution. In the second section of this thesis, toluene photooxidation experiments in presence of nitric oxide were conducted to examine the effect of the pre-existing titanium dioxide (TiO2) seed aerosol, as an instance of engineered metal oxide nanomaterials, considering their unique photocatalytic properties. Results indicate that TiO2 aerosol enhanced and accelerated SOA formation from toluene.

Cui, Tianqu

122

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

2012-04-01

123

Pre-existing type 2 diabetes and risk of lung cancer: a report from two prospective cohort studies of 133 024 Chinese adults in urban Shanghai  

PubMed Central

Objectives Observational studies of type 2 diabetes (T2D) and lung cancer risk are limited and controversial. We thus examined the association between T2D and risk of incident lung cancer using a cohort design. Setting Data from two ongoing population-based cohorts (the Shanghai Men's Health Study, SMHS, 2002–2006 and the Shanghai Women's Health Study, SWHS, 1996–2000) were used. Cox proportional-hazards regression models with T2D as a time-varying exposure were modelled to estimate HRs and 95% CIs. Participants The study population included 61?491 male participants aged 40–74?years from SMHS and 74?941 female participants aged 40–70?years from SWHS. Outcome measure Lung cancer cases were identified through annual record linkage to the Shanghai Cancer Registry and Shanghai Municipal Registry of Vital Statistics, and were further verified through home visits and a review of medical charts by clinical and/or pathological experts. Outcome data until 31 December 2010 for men and women were used for the present analysis. Results After a median follow-up of 6.3?years for SMHS and 12.2?years for SWHS, incident lung cancer cases were detected in 492 men and 525 women. A null association between T2D and lung cancer risk was observed in men (HR=0.87, 95% CI 0.62 to 1.21) and women (HR=0.92, 95% CI 0.69 to 1.24) after adjustments for potential confounders. Similar results were observed among never smokers. Conclusions There is little evidence that pre-existing T2D may influence the incidence of lung cancer.

Yang, Wan-Shui; Yang, Yang; Yang, Gong; Chow, Wong-Ho; Li, Hong-Lan; Gao, Yu-Tang; Ji, Bu-Tian; Rothman, Nat; Zheng, Wei; Shu, Xiao-Ou; Xiang, Yong-Bing

2014-01-01

124

Pre-existing Schistosoma japonicum infection alters the immune response to Plasmodium berghei infection in C57BL/6 mice  

PubMed Central

Background Since helminths and malaria parasites are often co-endemic, it is important to clarify the immunoregulatory mechanism that occurs during the process of co-infection. A previous study confirmed that dendritic cells (DCs) are involved in the establishment and regulation of the T-cell-mediated immune response to malaria infection. In the current study, distinct response profiles for splenic DCs and regulatory T cell (Treg) responses were assessed to evaluate the effects of a pre-existing Schistosoma japonicum infection on malaria infection. Methods Malaria parasitaemia, survival rate, brain histopathology and clinical experimental cerebral malaria (ECM) were assessed in both Plasmodium berghei ANKA-mono-infected and S. japonicum-P. berghei ANKA-co-infected mice. Cell surface/intracellular staining and flow cytometry were used to analyse the level of splenic DC subpopulations, toll-like receptors (TLRs), DC surface molecules, Tregs (CD4+CD25+Foxp3+), IFN-?/IL-10-secreting Tregs, and IFN-?+/IL-10+-Foxp3-CD4+ T cells. IFN-?, IL-4, IL-5, IL-10 and IL-13 levels were determined in splenocyte supernatants using enzyme-linked immunosorbent assay (ELISA). Results The co-infected mice had significantly higher malaria parasitaemia, compared with the mono-infected mice, on days 2, 3, 7 and 8 after P. berghei ANKA infection. Mono-infected mice had a slightly lower survival rate, while clinical ECM symptoms, and brain pathology, were significantly more severe during the period of susceptibility to ECM. On days 5 and 8 post P. berghei ANKA infection, co-infected mice had significantly lower levels of CD11c+CD11b+, CD11c+CD45R/B220+, CD11c+TLR4+, CD11c+TLR9+, CD11c+MHCII+, CD11c+CD86+, IFN-?-secreting Tregs, and IFN-?+Foxp3-CD4+ T cells in single-cell suspensions of splenocytes when compared with P. berghei ANKA-mono-infected mice. Co-infected mice also had significantly lower levels of IFN-? and higher levels of IL-4, IL-5, and IL-13 in splenocyte supernatants compared to mono-infected mice. There were no differences in the levels of IL-10-secreting Tregs or IL-10+Foxp3-CD4+ T cells between co-infected and mono-infected mice. Conclusions A Tregs-associated Th2 response plays an important role in protecting against ECM pathology. Pre-existing S. japonicum infection suppressed TLR ligand-induced DC maturation and had an anti-inflammatory effect during malaria infection not only by virtue of its ability to induce Th2 responses, but also by directly suppressing the ability of DC to produce pro-inflammatory mediators.

2013-01-01

125

A C-level flare observed in an arch filament system: reconnection between pre-existing and emerging field lines?  

NASA Astrophysics Data System (ADS)

Context: Observations show that solar flares are often caused by the emergence of new magnetic flux from subphotospheric layers and by the interaction of the rising field lines with the ambient magnetic field. In this framework, recent theoretical models of magnetic flux emergence have investigated the effectiveness of magnetic reconnection as a function of the old and new flux system relative orientations. Aims: We aim to compare phenomena that occurred in an active region, before and during a small flare, with the effects of magnetic reconnection between nearly parallel magnetic field lines, foreseen by these models. Methods: We analyzed high resolution photospheric and chromospheric data acquired during a coordinated observational campaign performed with the THEMIS telescope in IPM mode, as well as MDI magnetograms and TRACE 1600 and 171 Å images, to investigate the dynamics and the magnetic configuration of the active region hosting the flare. Results: An emerging arch filament system (AFS) was observed in the area between the two main sunspots: it showed typical upward motion at the arch tops and plasma downward motion at the footpoints. A C-level flare, characterized by a factor of 3 peak enhancement in the GOES X-ray emission with respect to the pre-event background, occurred in this zone, where the configuration of the emerging magnetic field lines showed a small (˜ 12°) relative inclination with respect to the old flux system. Conclusions: In an active region (age ?6 days) a new magnetic flux bundle emerged between the two main polarity spots. It gave rise to the formation of pores in the photosphere and to an AFS in the chromosphere. The interaction between the new and the pre-existing field lines, characterized by a small relative inclination, might have caused a weak reconnection process and given rise to the C-level flare. This result is in broad agreement with numerical simulations predicting very limited reconnection when the two flux systems have an almost parallel orientation.

Zuccarello, F.; Battiato, V.; Contarino, L.; Guglielmino, S.; Romano, P.; Spadaro, D.

2008-09-01

126

Recombinant lysyl oxidase propeptide protein inhibits growth and promotes apoptosis of pre-existing murine breast cancer xenografts.  

PubMed

Lysyl oxidase propeptide (LOX-PP) ectopic overexpression inhibits the growth of cancer xenografts. Here the ability and mode of action of purified recombinant LOX-PP (rLOX-PP) protein to inhibit the growth of pre-existing xenografts was determined. Experimental approaches employed were direct intratumoral injection (i.t.) of rLOX-PP protein into murine breast cancer NF639 xenografts, and application of a slow release formulation of rLOX-PP implanted adjacent to tumors in NCR nu/nu mice (n?=?10). Tumors were monitored for growth, and after sacrifice were subjected to immunohistochemical and Western blot analyses for several markers of proliferation, apoptosis, and for rLOX-PP itself. Direct i.t. injection of rLOX-PP significantly reduced tumor volume on days 20, 22 and 25 and tumor weight at harvest on day 25 by 30% compared to control. Implantation of beads preloaded with 35 micrograms rLOX-PP (n?=?10) in vivo reduced tumor volume and weight at sacrifice when compared to empty beads (p<0.05). A 30% reduction of tumor volume on days 22 and 25 (p<0.05) and final tumor weight on day 25 (p<0.05) were observed with a reduced tumor growth rate of 60% after implantation. rLOX-PP significantly reduced the expression of proliferation markers and Erk1/2 MAP kinase activation, while prominent increases in apoptosis markers were observed. rLOX-PP was detected by immunohistochemistry in harvested rLOX-PP tumors, but not in controls. Data provide pre-clinical findings that support proof of principle for the therapeutic anti-cancer potential of rLOX-PP protein formulations. PMID:22363577

Bais, Manish V; Nugent, Matthew A; Stephens, Danielle N; Sume, S Selva; Kirsch, Kathrin H; Sonenshein, Gail E; Trackman, Philip C

2012-01-01

127

Recombinant Lysyl Oxidase Propeptide Protein Inhibits Growth and Promotes Apoptosis of Pre-Existing Murine Breast Cancer Xenografts  

PubMed Central

Lysyl oxidase propeptide (LOX-PP) ectopic overexpression inhibits the growth of cancer xenografts. Here the ability and mode of action of purified recombinant LOX-PP (rLOX-PP) protein to inhibit the growth of pre-existing xenografts was determined. Experimental approaches employed were direct intratumoral injection (i.t.) of rLOX-PP protein into murine breast cancer NF639 xenografts, and application of a slow release formulation of rLOX-PP implanted adjacent to tumors in NCR nu/nu mice (n?=?10). Tumors were monitored for growth, and after sacrifice were subjected to immunohistochemical and Western blot analyses for several markers of proliferation, apoptosis, and for rLOX-PP itself. Direct i.t. injection of rLOX-PP significantly reduced tumor volume on days 20, 22 and 25 and tumor weight at harvest on day 25 by 30% compared to control. Implantation of beads preloaded with 35 micrograms rLOX-PP (n?=?10) in vivo reduced tumor volume and weight at sacrifice when compared to empty beads (p<0.05). A 30% reduction of tumor volume on days 22 and 25 (p<0.05) and final tumor weight on day 25 (p<0.05) were observed with a reduced tumor growth rate of 60% after implantation. rLOX-PP significantly reduced the expression of proliferation markers and Erk1/2 MAP kinase activation, while prominent increases in apoptosis markers were observed. rLOX-PP was detected by immunohistochemistry in harvested rLOX-PP tumors, but not in controls. Data provide pre-clinical findings that support proof of principle for the therapeutic anti-cancer potential of rLOX-PP protein formulations.

Bais, Manish V.; Nugent, Matthew A.; Stephens, Danielle N.; Sume, S. Selva; Kirsch, Kathrin H.; Sonenshein, Gail E.; Trackman, Philip C.

2012-01-01

128

Intranasal Sendai viral vector vaccination is more immunogenic than intramuscular under pre-existing anti-vector antibodies.  

PubMed

Viral vectors are promising vaccine tools for eliciting potent cellular immune responses. Pre-existing anti-vector antibodies, however, can be an obstacle to their clinical use in humans. We previously developed a Sendai virus (SeV) vector vaccine and showed the potential of this vector for efficient CD8(+) T-cell induction in macaques. Here, we investigated the immunogenicity of SeV vector vaccination in the presence of anti-SeV antibodies. We compared antigen-specific CD8(+) T-cell responses after intranasal or intramuscular immunization with a lower dose (one-tenth of that in our previous studies) of SeV vector expressing simian immunodeficiency virus Gag antigen (SeV-Gag) between naive and pre-SeV-infected cynomolgus macaques. Intranasal SeV-Gag immunization efficiently elicited Gag-specific CD8(+) T-cell responses not only in naive but also in pre-SeV-infected animals. In contrast, intramuscular SeV-Gag immunization induced Gag-specific CD8(+) T-cell responses efficiently in naive but not in pre-SeV-infected animals. These results indicate that both intranasal and intramuscular SeV administrations are equivalently immunogenic in the absence of anti-SeV antibodies, whereas intranasal SeV vaccination is more immunogenic than intramuscular in the presence of anti-SeV antibodies. It is inferred from a recent report investigating the prevalence of anti-SeV antibodies in humans that SeV-specific neutralizing titers in more than 70% of people are no more than those at the SeV-Gag vaccination in pre-SeV-infected macaques in the present study. Taken together, this study implies the potential of intranasal SeV vector vaccination to induce CD8(+) T-cell responses even in humans, suggesting a rationale for proceeding to a vaccine clinical trial using this vector. PMID:21939708

Moriya, Chikaya; Horiba, Satoshi; Kurihara, Kyoko; Kamada, Takeo; Takahara, Yusuke; Inoue, Makoto; Iida, Akihiro; Hara, Hiroto; Shu, Tsugumine; Hasegawa, Mamoru; Matano, Tetsuro

2011-11-01

129

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...

2004-07-01

130

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...

2012-07-01

131

28 CFR 79.26 - Proof of medical condition.  

Code of Federal Regulations, 2010 CFR

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

2003-07-01

132

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...

2011-07-01

133

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...

2008-07-01

134

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...

2006-07-01

135

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...

2007-07-01

136

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...

2005-07-01

137

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

138

The impact of pre-existing antibody on subsequent immune responses to meningococcal A-containing vaccines.  

PubMed

Major epidemics of serogroup A meningococcal meningitis continue to affect the African meningitis belt. The development of an affordable conjugate vaccine against the disease became a priority for World Health Organization (WHO) in the late 1990s. Licensing of meningococcal vaccines has been based on serological correlates of protection alone, but such correlates might differ in different geographical regions. If high pre-vaccination antibody concentrations/titers impacts on the response to vaccination and possibly vaccine efficacy, is not clearly understood. We set out to define the pre-vaccination Meningococcal group A (Men A) antibody concentrations/titers in The Gambia and study their impact on the immunogenicity of Men A containing vaccines. Data from subjects originally enrolled in studies to test the safety and immunogenicity of the MenA vaccine recently developed for Africa meningococcal A polysaccharide conjugated to tetanus toxoid, MenAfriVac(®) (PsA-TT) were analyzed. Participants had been randomized to receive either the study vaccine PsA-TT or the reference quadrivalent plain polysaccharide vaccine containing meningococcal groups A, C, W, and Y, Mencevax(®) ACWY, GlaxoSmithKline (PsACWY) in a 2:1 ratio. Venous blood samples were collected before and 28 days after vaccination. Antibodies were assayed by enzyme-linked immunosorbent assay (ELISA) for geometric mean concentrations and serum bactericidal antibody (SBA) for functional antibody. The inter age group differences were compared using ANOVA and the pre and post-vaccination differences by t test. Over 80% of the ?19 year olds had pre-vaccination antibody concentrations above putatively protective concentrations as compared to only 10% of 1-2 year olds. Ninety-five percent of those who received the study vaccine had ?4-fold antibody responses if they had low pre-vaccination concentrations compared to 76% of those with high pre-vaccination concentrations. All subjects with low pre-vaccination titers attained ?4-fold responses as compared to 76% with high titers where study vaccine was received. Our data confirm the presence of high pre-vaccination Men A antibody concentrations/titers within the African meningitis belt, with significantly higher concentrations in older individuals. Although all participants had significant increase in antibody levels following vaccination, the four-fold or greater response in antibody titers were significantly higher in individuals with lower pre-existing antibody titers, especially after receiving PsA-TT. This finding may have some implications for vaccination strategies adopted in the future. PMID:24863486

Idoko, Olubukola T; Okolo, Seline N; Plikaytis, Brian; Akinsola, Adebayo; Viviani, Simonetta; Borrow, Ray; Carlone, George; Findlow, Helen; Elie, Cheryl; Kulkarni, Prasad S; Preziosi, Marie-Pierre; Ota, Martin; Kampmann, Beate

2014-07-16

139

Guide to Geriatric Syndromes: Common and Often Related Medical Conditions in Older Adults  

MedlinePLUS

... problems among older adults include nearsightedness, glaucoma, cataracts, diabetic eye disease, presbyopia, (age-related changes in the ... certain medications, and certain medical conditions such as thyroid problems, can increase the risk of osteoporosis. Osteoporosis ...

140

A Review of Foods for Medical Purposes: Specially Formulated Products for Nutritional Management of Medical Conditions.  

National Technical Information Service (NTIS)

The report reviews the history, current status, and expected development of special dietary products intended for use under medical supervision. Proposed definitions are presented for these products, which have been designated medical foods. The nutrition...

K. D. Fisher J. M. Talbot C. J. Carr

1977-01-01

141

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

142

Patterns and Pre-existing Risk Factors of 30-day Mortality after a Primary Discharge Diagnosis of Syncope or Near Syncope  

PubMed Central

Objectives The risk of short-term mortality after an emergency department (ED) visit for syncope is poorly understood, resulting in prognostic uncertainty and frequent hospital admission. The authors determined patterns and risk factors for short-term mortality after a diagnosis of syncope or near syncope to aid in medical decision-making. Methods A retrospective cohort study was performed of adult members of Kaiser Permanente Southern California seen at 11 EDs from 2002 to 2006 with a primary discharge diagnosis of syncope or near syncope (ICD-9 780.2). The outcome was 30-day mortality. Proportional hazards time-to-event regression models were used to identify risk factors. Results There were 22,189 participants with 23,951 ED visits, resulting in 307 deaths by 30 days. A relatively lower risk of death was reached within two weeks for ages 18 to 59 years, but not until three months or more for ages 60 and older. Pre-existing comorbidities associated with increased mortality included heart failure (hazard ratio [HR] 14.3 in ages 18 to 59 years, HR 3.09 in ages 60 to 79 years, HR 2.34 in ages 80 years plus, all P < 0.001), diabetes (HR 1.49, P = 0.002), seizure (HR 1.65, P = 0.016), and dementia (HR 1.41, P = 0.034). If the index visit followed one or more visits for syncope in the previous 30 days, it was associated with increased mortality (HR 1.86, P = 0.024). Absolute risk of death at 30 days was under 0.2% in those under 60 years without heart failure and >2.5% across all ages in those with heart failure. Conclusions The low risk of death after an ED visit for syncope or near syncope in patients younger than 60 years old without heart failure, may be helpful when deciding who to admit for inpatient evaluation. The presence of one or more comorbidities that predict death, and a prior visit for syncope, should be considered in clinical decisions and risk stratification tools for patients with syncope. Close clinical follow-up seems advisable in patients 60 years and older due to a prolonged risk of death.

Derose, Stephen F.; Gabayan, Gelareh Z.; Chiu, Vicki Y.; Sun, Benjamin C.

2012-01-01

143

14 CFR 67.213 - General medical condition.  

Code of Federal Regulations, 2013 CFR

... (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 structural disease, defect, or limitation that...

2013-01-01

144

14 CFR 67.313 - General medical condition.  

Code of Federal Regulations, 2013 CFR

... (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 structural disease, defect, or limitation that...

2013-01-01

145

14 CFR 67.113 - General medical condition.  

... (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 structural disease, defect, or limitation that...

2014-01-01

146

14 CFR 67.113 - General medical condition.  

Code of Federal Regulations, 2013 CFR

... (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 structural disease, defect, or limitation that...

2013-01-01

147

14 CFR 67.113 - General medical condition.  

Code of Federal Regulations, 2010 CFR

... (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 structural disease, defect, or limitation that...

2010-01-01

148

14 CFR 67.113 - General medical condition.  

Code of Federal Regulations, 2012 CFR

... (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 structural disease, defect, or limitation that...

2012-01-01

149

14 CFR 67.213 - General medical condition.  

Code of Federal Regulations, 2010 CFR

... (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 structural disease, defect, or limitation that...

2010-01-01

150

14 CFR 67.213 - General medical condition.  

Code of Federal Regulations, 2011 CFR

... (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 structural disease, defect, or limitation that...

2011-01-01

151

14 CFR 67.313 - General medical condition.  

Code of Federal Regulations, 2012 CFR

... (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 structural disease, defect, or limitation that...

2012-01-01

152

14 CFR 67.313 - General medical condition.  

Code of Federal Regulations, 2011 CFR

... (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 structural disease, defect, or limitation that...

2011-01-01

153

14 CFR 67.213 - General medical condition.  

... (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 structural disease, defect, or limitation that...

2014-01-01

154

14 CFR 67.213 - General medical condition.  

Code of Federal Regulations, 2012 CFR

... (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 structural disease, defect, or limitation that...

2012-01-01

155

14 CFR 67.313 - General medical condition.  

... (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 structural disease, defect, or limitation that...

2014-01-01

156

14 CFR 67.313 - General medical condition.  

Code of Federal Regulations, 2010 CFR

... (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 structural disease, defect, or limitation that...

2010-01-01

157

14 CFR 67.113 - General medical condition.  

Code of Federal Regulations, 2011 CFR

... (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 structural disease, defect, or limitation that...

2011-01-01

158

42 CFR 482.22 - Condition of participation: Medical staff.  

Code of Federal Regulations, 2013 CFR

...medical staff must include doctors of medicine or osteopathy. In accordance...the hospital has evidence of an internal review of the distant-site physician's...the committee must be doctors of medicine or osteopathy. (3) The...

2013-10-01

159

Archean tonalites are not derived by melting of hot subducted slabs: They are produced by differentiation of mafic, hydrous magmas and melting of pre-existing crust  

NASA Astrophysics Data System (ADS)

Slab melting in a subduction zone has been called upon to produce high-MgO, high- silica magmas known as adakites (EOS, 2001, 82: 65-69). Adakites are rare, volumetrically minor in subduction zone settings, and appear to be associated with subduction of young, "hot" oceanic crust which is inferred to be easier to melt. These conditions are often hypothesized to have been more common in the Archean, resulting in the gregarious tonalite-trondjhemite-granite (TTG) suites thought to characterize Archean cratons. There are at least two difficulties with this hypothesis. 1) Most Archean TTGs are not compositionally similar to adakites. Although the Archean TTGs share some trace element characteristics (e.g. high Sr and low Y), they do not have the high magnesium contents that are a distinctive hallmark of adakites. The important major element characteristics of Archean TTGs are strikingly similar to modern silica-rich igneous rocks that formed through a combination of complex petrologic processes that include: fractionation of more mafic subduction-related basalts, re-melting of underplated basalt in the lower crust (+/- garnet-bearing amphibolites), and melting and assimilation of pre-existing crustal rocks. In arc settings, these processes all occur within the overriding plate, not in the subducted slab. 2) Adakites are not produced by hot slab melting, but by wet slab fluid loss or low extents of water-saturated melting. Experimental calibration of the melting conditions that formed primitive adakite magmas at Mt. Shasta, California indicate that mantle melting occurs when a water-rich fluid component released from the cooler slab encounters hotter overlying mantle at the base of the mantle wedge and melts at the vapor-saturated solidus. Melting continues as the hydrous mantle melts ascends into hotter, shallower mantle wedge, and a cool, hydrous magma is separated at the top of the wedge and delivered to the crust. Thus, the major element and trace-element signatures are in large part decoupled. The slab contributes mostly trace elements; including the elements that are used to argue for slab melting. Understanding the sources of elemental contributions to the magma is important, because of the enormous implications for models of Archean crustal composition and formation. Trace-element signatures alone suggest a major slab component, but the major elements like SiO2 were contributed to the primary melt from the mantle wedge. In our view, Archean TTGs are hybrid rocks and contain mixed trace and major element signatures that are contributed from several sources.

Grove, T. L.; Bowring, S. A.

2001-05-01

160

Pre-existing herpes simplex virus 1 (HSV1) immunity decreases, but does not abolish, gene transfer to experimental brain tumors by a HSV1 vector  

Microsoft Academic Search

The influence of pre-existing anti-herpes simplex type 1 (HSV-1) immunity on HSV-1 vector-mediated gene transfer to glioma cells was analyzed in this gene marking study using intracranial D74 gliomas in syngeneic Fischer rats. The HSV-1 mutant virus used, hrR3, is defective in ribonucleotide reductase and bears the marker genes E. coli lacZ and HSV-1 thymidine kinase (HSVtk). Initial marker gene

U Herrlinger; CM Kramm; KS Aboody-Guterman; JS Silver; K Ikeda; KM Johnston; PA Pechan; RF Barth; D Finkelstein; EA Chiocca; DN Louis; XO Breakefield

1998-01-01

161

Oral vaccination with modified vaccinia virus Ankara attached covalently to TMPEG-modified cationic liposomes overcomes pre-existing poxvirus immunity from recombinant vaccinia immunization  

PubMed Central

Development of a safe and effective vaccine for induction of mucosal immunity to the human immunodeficiency virus (HIV) envelope glycoprotein (Env, gp160) represents the best hope for containing the spread of an HIV epidemic worldwide. The highly attenuated modified vaccinia virus Ankara (MVA) is a laboratory virus well suited as a safe vaccine vector. However, the presence of pre-existing immunity to Vaccinia virus in the adult population represents a hindrance that limits the application of the MVA vector for inducing immunity to HIV antigens. Here, cationic liposomes were covalently attached to the surface of recombinant MVA expressing the HIV-1 strain IIIB Env glycoprotein and ?-galactosidase (MVAIIIB/?-gal) using tresylmonomethoxypolyethylene glycol (TMPEG) grafted into a lipid membrane without compromising viral infectivity in vitro and in vivo. The orally administered MVAIIIB/?-gal–TMPEG/liposome complexes were capable of delivering the transgenes to mucosal tissues in mice with pre-existing poxvirus immunity based on ?-galactosidase gene expression in intestinal tissues measured 18 h after infection. Importantly, the MVAIIIB/?-gal–TMPEG/liposome complexes enhanced Env-specific cellular and humoral immune responses in the mucosal and systemic tissues after repeated oral immunization of BALB/c mice. This approach may prove useful for induction of protective immunity against infectious diseases and cancer in populations with pre-existing immunity to vaccinia from smallpox vaccination.

Naito, Toshio; Kaneko, Yutaro; Kozbor, Danuta

2008-01-01

162

Temperature-Dependent Structural Changes of Parkinson's Alpha-Synuclein Reveal the Role of Pre-Existing Oligomers in Alpha-Synuclein Fibrillization  

PubMed Central

Amyloid fibrils of ?-synuclein are the main constituent of Lewy bodies deposited in substantial nigra of Parkinson's disease brains. ?-Synuclein is an intrinsically disordered protein lacking compact secondary and tertiary structures. To enhance the understanding of its structure and function relationship, we utilized temperature treatment to study ?-synuclein conformational changes and the subsequent effects. We found that after 1 hr of high temperature pretreatment, >80°C, ?-synuclein fibrillization was significantly inhibited. However, the temperature melting coupled with circular dichroism spectra showed that ?-synuclein was fully reversible and the NMR studies showed no observable structural changes of ?-synuclein after 95°C treatment. By using cross-linking and analytical ultracentrifugation, rare amount of pre-existing ?-synuclein oligomers were found to decrease after the high temperature treatment. In addition, a small portion of C-terminal truncation of ?-synuclein also occurred. The reduction of pre-existing oligomers of ?-synuclein may contribute to less seeding effect that retards the kinetics of amyloid fibrillization. Overall, our results showed that the pre-existing oligomeric species is a key factor contributing to ?-synuclein fibrillization. Our results facilitate the understanding of ?-synuclein fibrillization.

Ariesandi, Winny; Chang, Chi-Fon; Chen, Tseng-Erh; Chen, Yun-Ru

2013-01-01

163

Comparison of outcomes from sepsis between patients with and without pre-existing left ventricular dysfunction: a case-control analysis  

PubMed Central

Introduction The aim of this study was to determine if there are differences between patients with pre-existing left ventricular dysfunction and those with normal antecedent left ventricular function during a sepsis episode in terms of in-hospital mortality and mortality risk factors when treated in accordance with a sepsis treatment algorithm. Methods We performed a retrospective case-control analysis of patients selected from a quality improvement database of 1,717 patients hospitalized with sepsis between 1 January 2005 and 30 June 2010. In this study, 197 patients with pre-existing left ventricular systolic dysfunction and sepsis were compared to 197 case-matched patients with normal prior cardiac function and sepsis. Results In-hospital mortality rates (P?=?0.117) and intubation rates at 24 hours (P?=?0.687) were not significantly different between cases and controls. There was no correlation between the amount of intravenous fluid administered over the first 24 hours and the PaO2/FiO2 ratio at 24 hours in either cases or controls (r2?=?0.019 and r2?=?0.001, respectively). Mortality risk factors for cases included intubation status (P?=?0.016, OR?=?0.356 for no intubation), compliance with a sepsis bundle (P?=?0.008, OR?=?3.516 for failed compliance), a source of infection other than the lung (P?=?0.019, OR?=?2.782), and the initial mixed venous oxygen saturation (P?=?0.004, OR?=?0.997). Risk factors for controls were the initial platelet count (P?=?0.028, OR?=?0.997) and the serum lactate level (P?=?0.048, OR?=?1.104). Patients with pre-existing left ventricular dysfunction who died had a lower initial mean mixed venous oxygen saturation than those who survived (61?±?18% versus 70?±?16%, P?=?0.002). Conclusions Clinical outcomes were not different between septic patients with pre-existing left ventricular dysfunction and those with no cardiac disease. There was no correlation between fluid administration and oxygenation at 24 hours in either cohort. The mortality risk factor profile of patients with pre-existing left ventricular dysfunction was different when compared with control patients, and may be related to oxygen delivery determinants.

2014-01-01

164

Comment on “Structural controls on a carbon dioxide-driven mud volcano field in the Northern Apennines (Pieve Santo Stefano, Italy): Relations with pre-existing steep discontinuities and seismicity”  

NASA Astrophysics Data System (ADS)

Bonini (2009, Structural controls on a carbon dioxide-driven mud volcano field in the Northern Apennines (Pieve Santo Stefano, Italy): relations with pre-existing steep discontinuities and seismicity. Journal of Structural Geology 31, 44-54) presents a 2D mechanical analysis to infer the failure conditions responsible for the seismicity distribution during an M w = 4.6 seismic sequence nucleating during 2001 in the Northern Apennines. In my view the mechanical analysis presented in this paper has some weakness or is not well constrained, in particular: 1) the assumption of a dip angle of 50°, is not consistent with the activated structures; 2) the P f = ?3 condition, difficult to be attained along a cohesionless fault dipping at 50°; 3) the isotropic stress state, i.e. ?2 = ?3, that is not consistent with the active or recent stress field in the area.

Collettini, Cristiano

2009-08-01

165

A Comparison of Expedition Medical Condition List Treatment Directives with Integrated Medical Model Simulation Data Presentation and Briefing Report  

NASA Technical Reports Server (NTRS)

This aerospace medicine clerkship project is under the direction of Dr. Sharmila Watkins and is in cooperation with Dr. Eric Kerstman and Dr. Ronak Shah. The questions of the research project are: 1. What are the main drivers of evacuation and loss of crew life (LOCL) on three Design Reference Missions (DRMs): Near Earth Asteroid (NEA), Lunar Sortie and Lunar Outpost using an inexhaustible International Space Station medical kit 2. What are the treatment designations for these driving medical conditions as listed in Expedition Medical Condition List (EMCL) 3. Do the drivers make sense in the context of the given Design Reference Mission (DRM) 4. Do any EMCL treatment designations need re-assessing.

Lewis, Robert

2013-01-01

166

[The work of the Serbian Medical Society--the Medical Society of Vojvodina under present conditions].  

PubMed

The content of work of medical society in Vojvodina has always been primarily set by the founder with its main goal: the physicians professional and scientific specialization. In recent years there have been many socio-political, moral and social changes which have had great influence on the work of medical organizations. The poverty of the whole society, especially of the health service, has completely disabled organization of big professional meeting so that the professional activity meant mostly one-day meetings in health institutions. Although there was a threatening possibility to stop publishing the professional journal "Medical Review" after 47 years of appearing in print, today problem is solved by financial help by the government. Apart from professional work, other activities of physicians organizations are becoming important today. An appropriate attitude toward war generally speaking was declared in 1992 as an "Appeal for Peace". A request was made to distinguish profession and politics in the work of physicians so that the society acted only as a professional organization without political involvement and there is an initiative to found a medical association. Physicians gave their best in this hard situation to maintain work of the health service, but as it was not possible any more at one moment, an extra congress of physicians of Serbia was organized verifying serious consequences of war considering the health of the whole population. Society has been extremely engaged in solving numerous problems of ethics which have appeared due to war such as lack of medicines and health care materials as well as abuse of the private medical practice. PMID:7739433

Borota, R

1994-01-01

167

Does Pre-existing Antiplatelet Treatment Influence Post-thrombolysis Intracranial Hemorrhage in Community-treated Ischemic Stroke Patients? An Observational Study  

PubMed Central

Objectives Intracranial hemorrhage (ICH) after acute stroke thrombolysis is associated with poor outcomes. Previous investigations of the relationship between pre-existing antiplatelet use and the safety of intravenous (IV) thrombolysis have been limited by low event rates. The objective of this study was to determine whether pre-existing antiplatelet therapy increased the risk of ICH following acute stroke thrombolysis. The primary hypothesis was that antiplatelet use would not be associated with radiographic evidence of ICH after controlling for relevant confounders. Methods Consecutive cases of thrombolysis patients treated in the emergency department (ED) were identified using multiple methods. Retrospective data were collected from four hospitals from 1996 to 2004, and 24 distinct hospitals from 2007 to 2010 as part of a cluster randomized trial. The same chart abstraction tool was used during both time periods, and data were subjected to numerous quality control checks. Hemorrhages were classified using a pre-specified methodology: ICH was defined as presence of hemorrhage in radiographic interpretations of follow-up imaging (primary outcome). Symptomatic ICH (sICH) was defined as radiographic ICH with associated clinical worsening. A multivariable logistic regression model was constructed to adjust for clinical factors previously identified to be related to post-thrombolysis ICH. Sensitivity analyses were conducted where the unadjusted and adjusted results from this study were combined with those of previously published external studies on this topic via meta-analytic techniques. Results There were 830 patients included, with 47% having documented pre-existing antiplatelet treatment. The mean age was 69 years (SD ± 15 years), and the cohort was 53% male. The unadjusted proportion of patients with any ICH was 15.1% without antiplatelet use, and 19.3% with antiplatelet use (absolute risk difference 4.2%, 95% CI = ?1.2% to 9.6%); for sICH this was 6.1% without antiplatelet use and 9% with antiplatelet use (absolute risk difference 3.1%, 95% CI = ?1% to 6.7%). After adjusting for confounders, antiplatelet use was not significantly associated with radiographic ICH (odds ratio 1.1, 95% CI = 0.8 to 1.7), or sICH (odds ratio 1.3, 95% CI = 0.7 to 2.2). In patients 81 years and older, there was a higher risk of radiographic ICH (absolute risk difference 11.9%, 95% CI = 0.1% to 23.6%). The meta-analyses combined the findings of this investigation with previous similar work and found increased unadjusted risks of radiographic ICH (absolute risk difference 4.9%, 95% CI = 0.7% to 9%) and sICH (absolute risk difference 4%, 95% CI = 2.3% to 5.6%). The meta-analytic adjusted odds ratio of sICH for antiplatelet use was 1.6 (95% CI = 1.1 to 2.4). Conclusions The authors did not find that pre-existing antiplatelet use was associated with post-thrombolysis ICH or sICH in this cohort of community treated patients. Pre-existing tobacco use, younger age, and lower severity were associated with lower odds of sICH. The meta-analyses demonstrated small, but statistically significant increases in the absolute risk of radiographic ICH and sICH, along with increased odds of sICH in patients with pre-existing antiplatelet use.

Meurer, William J.; Kwok, Heemun; Skolarus, Lesli E.; Adelman, Eric E.; Kade, Allison M.; Kalbfleisch, Jack; Frederiksen, Shirley M.; Scott, Phillip A.

2013-01-01

168

Pre-Existing Hypoxia Is Associated with Greater EEG Suppression and Early Onset of Evolving Seizure Activity during Brief Repeated Asphyxia in Near-Term Fetal Sheep  

PubMed Central

Spontaneous antenatal hypoxia is associated with high risk of adverse outcomes, however, there is little information on neural adaptation to labor-like insults. Chronically instrumented near-term sheep fetuses (125 ± 3 days, mean ± SEM) with baseline PaO2 < 17 mmHg (hypoxic group: n = 8) or > 17 mmHg (normoxic group: n = 8) received 1-minute umbilical cord occlusions repeated every 5 minutes for a total of 4 hours, or until mean arterial blood pressure (MAP) fell below 20 mmHg for two successive occlusions. 5/8 fetuses with pre-existing hypoxia were unable to complete the full series of occlusions (vs. 0/8 normoxic fetuses). Pre-existing hypoxia was associated with progressive metabolic acidosis (nadir: pH 7.08 ± 0.04 vs. 7.33 ± 0.02, p<0.01), hypotension during occlusions (nadir: 24.7 ± 1.8 vs. 51.4 ± 3.2 mmHg, p<0.01), lower carotid blood flow during occlusions (23.6 ± 6.1 vs. 63.0 ± 4.8 mL/min, p<0.01), greater suppression of EEG activity during, between, and after occlusions (p<0.01) and slower resolution of cortical impedance, an index of cytotoxic edema. No normoxic fetuses, but 4/8 hypoxic fetuses developed seizures 148 ± 45 minutes after the start of occlusions, with a seizure burden of 26 ± 6 sec during the inter-occlusion period, and 15.1 ± 3.4 min/h in the first 6 hours of recovery. In conclusion, in fetuses with pre-existing hypoxia, repeated brief asphyxia at a rate consistent with early labor is associated with hypotension, cephalic hypoperfusion, greater EEG suppression, inter-occlusion seizures, and more sustained cytotoxic edema, consistent with early onset of neural injury.

Wassink, Guido; Bennet, Laura; Davidson, Joanne O.; Westgate, Jenny A.; Gunn, Alistair J.

2013-01-01

169

Pre-existing Epithelial Diversity in Normal Human Livers: A Tissue-tethered Cytometric Analysis in Portal/Periportal Epithelial Cells  

PubMed Central

Routine light microscopy identifies two distinct epithelial cell populations in normal human livers: hepatocytes and biliary epithelial cells (BEC). Considerable epithelial diversity, however, arises during disease states when a variety of hepatocyte-BEC hybrid cells appear. This has been attributed to activation and differentiation of putative hepatic progenitor cells (HPC) residing in the Canals of Hering and/or metaplasia of pre-existing mature epithelial cells. A novel analytic approach consisting of multiplex labeling, high resolution whole slide imaging (WSI), and automated image analysis was used to determine if more complex epithelial cell phenotypes pre-existed in normal adult human livers, which might provide an alternative explanation for disease-induced epithelial diversity. “Virtually digested” WSI enabled quantitative cytometric analyses of individual cells displayed in a variety of formats (e.g. scatter plots) while still tethered to the WSI and tissue structure. We employed biomarkers specifically-associated with mature epithelial forms (HNF4? for hepatocytes, CK19 and HNF1? for BEC) and explored for the presence of cells with hybrid biomarker phenotypes. Results showed abundant hybrid cells in portal bile duct BEC, canals of Hering, and immediate periportal hepatocytes. These bi-potential cells likely serve as a reservoir for the epithelial diversity of ductular reactions, appearance of hepatocytes in bile ducts, and the rapid and fluid transition of BEC to hepatocytes, and vice versa. Conclusion Novel imaging and computational tools enable increased information extraction from tissue samples and quantify the considerable pre-existent hybrid epithelial diversity in normal human liver. This computationally-enabled tissue analysis approach offers much broader potential beyond the results presented here.

Isse, Kumiko; Lesniak, Andrew; Grama, Kedar; Maier, John; Specht, Susan; Castillo-Rama, Marcela; Lunz, John; Roysam, Badrinath; Michalopoulos, George; Demetris, Anthony J.

2012-01-01

170

Phenological asynchrony between herbivorous insects and their hosts: signal of climate change or pre-existing adaptive strategy?  

PubMed Central

Climate change alters phenological relations between interacting species. We might expect the historical baseline, or starting-point, for such effects to be precise synchrony between the season at which a consumer most requires food and the time when its resources are most available. We synthesize evidence that synchrony was not the historical condition in two insect–plant interactions involving Edith's checkerspot butterfly (Euphydryas editha), the winter moth (Operophtera brumata) and their host plants. Initial observations of phenological mismatch in both systems were made prior to the onset of anthropogenically driven climate change. Neither species can detect the phenology of its host plants with precision. In both species, evolution of life history has involved compromise between maximizing fecundity and minimizing mortality, with the outcome being superficially maladaptive strategies in which many, or even most, individuals die of starvation through poor synchrony with their host plants. Where phenological asynchrony or mismatch with resources forms the starting point for effects of anthropogenic global warming, consumers are particularly vulnerable to impacts that exacerbate the mismatch. This vulnerability likely contributed to extinction of a well-studied metapopulation of Edith's checkerspot, and to the skewed geographical pattern of population extinctions underlying a northward and upward range shift in this species.

Singer, Michael C.; Parmesan, Camille

2010-01-01

171

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

172

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

Code of Federal Regulations, 2013 CFR

...Basic conditions and limitations. 410.12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS...

2013-10-01

173

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

PubMed Central

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 issue, its usefulness should be judged using standardised criteria already proposed for screening for chronic disease. The aim of this paper is to propose standardised criteria suitable to assess the scientific validity of screening for unsafe driving due to medical conditions, and identify potential issues to be clarified before screening can be implemented and effective. Discussion Using criteria developed for screening for chronic diseases and published studies on driving with medical conditions, we specify six criteria to judge the opportunity of screening for unsafe driving due to medical conditions. This adaptation was needed because of the complexity of the natural history of medical conditions and their potential consequences on driving and road safety. We then illustrate that published studies pleading for or against screening for unsafe driving due to medical conditions fail to provide the needed documentation. Individual criteria were mentioned in 3 to 72% of 36 papers pleading for or against screening. Quantitative estimates of relevant indicators were provided in at most 42% of papers, and some data, such as the definition of an appropriate unsafe driving period were never provided. Summary The standardised framework described in this paper provides a template for assessing the effectiveness (or lack of effectiveness) of proposed measures for screening for unsafe driving due to medical conditions. Even if most criteria were mentioned in the published literature pleading for or against such a screening, the failure to find quantitative and evidence-based estimates of relevant indicators provides useful insight for further research.

Leproust, Sandy; Lagarde, Emmanuel; Salmi, L Rachid

2008-01-01

174

The impact of risk factors and pre-existing conditions on the mortality of burn patients and the precision of predictive admission-scoring systems  

Microsoft Academic Search

Clinical experience has shown that concomitant diseases and risk factors have a significant influence on the patient's outcome. Since none of the currently available score systems consider the impact of concomitant diseases or risk factors on burn trauma mortality, the present study was planned to further evaluate the role of these factors. Four hundred and ninety-eight patients could be included

G. Germann; U. Barthold; R. Lefering; T. Raff; B. Hartmann

1997-01-01

175

First-trimester abortion in women with medical conditions: release date October 2012 SFP guideline #20122.  

PubMed

Most women undergoing first-trimester abortion are healthy. However, abortion providers also encounter women with a wide variety of medical conditions, some of which are serious and complex. When such a condition exists, consultation with the woman's physician or a specialist can facilitate decision making regarding hospital referral and additional preparations that may be required. Medical conditions may determine the approach to abortion. Surgical abortion is preferred when mifepristone or methotrexate is contraindicated. Medication abortion may be preferred when lithotomy position is not possible or in patients with extreme obesity. Limited data suggest that women treated with anticoagulation therapy bleed more than other women during surgical abortion, although this additional bleeding may be clinically unimportant. The decision to temporarily discontinue anticoagulation therapy will depend on the agent used and the underlying risk of thrombosis. According to the American Heart Association, additional antibiotics are not recommended to prevent endocarditis in women with cardiac lesions during surgical abortion. We review specific recommendations for women with common medical conditions. In some women, highly effective postabortion contraception is essential to prevent pregnancy-related morbidity. The U.S. Medical Eligibility Criteria for Contraceptive Use, 2010, provides guidance for method selection for women with medical problems. PMID:23039921

Guiahi, M; Davis, A

2012-12-01

176

Early Colonoscopy Confers Survival Benefits on Colon Cancer Patients with Pre-Existing Iron Deficiency Anemia: A Nationwide Population-Based Study  

PubMed Central

This study aimed to examine the prognostic significance of pre-existing iron deficiency anemia (IDA) and the benefits of early colonoscopy in patients with colon cancer, since these have not been clearly established to date. Using the Taiwanese National Health Insurance Research Database, we retrieved and retrospectively reviewed the records of patients aged ?55 years who were diagnosed with colon cancer between 2000 and 2005. The patient cohort was divided into two groups: patients with (n?=?1,260) or without (n?=?15,912) an IDA diagnosis during ?18 months preceding the date of colon cancer diagnosis. We found that diabetes (27.9% vs. 20.3%, p<0.0001), cardiovascular disease (61.6% vs. 54.7%, p<0.001), and chronic kidney disease (4.6% vs. 2.2%, p<0.0001) were more common among patients with IDA than among those without IDA. The median overall survival times for patients with IDA and those without IDA were 4.6 and 5.7 years, respectively (p?=?0.002). Patients who underwent colonoscopy ?30 days, 31–90, and ?91 days after IDA diagnosis showed median overall survival times of 5.79, 4.43, and 4.04 years, respectively (p?=?0.003). Delayed colonoscopy was an independent factor associated with poor overall survival (adjusted hazard ratio, 1.28; 95% confidence interval, 1.07–1.53; p?=?0.01). In conclusion, colon cancer patients with IDA were more likely to experience comorbidities than were those without IDA. Pre-existing IDA was a poor prognostic factor in adult men and postmenopausal women who had colon cancer. Early colonoscopy could improve overall survival possibly by facilitating early diagnosis and treatment.

Teng, Chieh-Lin Jerry; Yu, Jui-Ting; Chen, Yi-Huei; Lin, Ching-Heng; Hwang, Wen-Li

2014-01-01

177

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

178

Medical and Obstetric Complications among Pregnant Women Aged 45 and Older  

PubMed Central

Objective The number of women aged 45 and older who become pregnant is increasing. The objective of this study was to estimate the risk of medical and obstetric complications among women aged 45 and older. Methods The Nationwide Inpatient Sample was used to identify pregnant woman during admission for delivery. Deliveries were identified using International Classification of Diseases, Ninth Revision (ICD-9-CM) codes. Using ICD-9-CM codes, pre-existing medical conditions and medical and obstetric complications were identified in women at the time of delivery and were compared for women aged 45 years and older to women under age 35. Outcomes among women aged 35–44 were also compared to women under age 35 to determine if women in this group demonstrated intermediate risk between the older and younger groups. Logistic regression analyses were used to calculate odds ratios with 95% confidence intervals for pre-existing medical conditions and medical and obstetric complications for both older groups relative to women under 35. Multivariable logistic regression analyses were also developed for outcomes at delivery among older women, while controlling for pre-existing medical conditions, multiple gestation, and insurance status, to determine the effect of age on the studied outcomes. Results Women aged 45 and older had higher adjusted odds for death, transfusion, myocardial infarction/ischemia, cardiac arrest, acute heart failure, pulmonary embolism, deep vein thrombosis, acute renal failure, cesarean delivery, gestational diabetes, fetal demise, fetal chromosomal anomaly, and placenta previa compared to women under 35. Conclusion Pregnant women aged 45 and older experience significantly more medical and obstetric complications and are more likely to die at the time of a delivery than women under age 35, though the absolute risks are low and these events are rare. Further research is needed to determine what associated factors among pregnant women aged 45 and older may contribute to these findings.

Grotegut, Chad A.; Chisholm, Christian A.; Johnson, Lauren N. C.; Brown, Haywood L.; Heine, R. Phillips; James, Andra H.

2014-01-01

179

Induced and pre-existing anti-polyethylene glycol antibody in a trial of every 3-week dosing of pegloticase for refractory gout, including in organ transplant recipients  

PubMed Central

Introduction Pegloticase, a PEGylated recombinant porcine uricase, is approved for treating refractory gout at a dose of 8 mg intravenous (IV) every 2 weeks. However, during phase 1 testing, pharmacokinetics supported less frequent dosing. Also, single doses of pegloticase unexpectedly induced antibodies (Ab) that bound to polyethylene glycol (PEG). We have conducted a phase 2 trial to evaluate every 3-week dosing, and to further define the Ab response to pegloticase. Organ transplant recipients were included, as they are prone to severe gout that is difficult to manage, and because treatment to prevent graft rejection might influence the immune response to pegloticase. Methods Plasma uricase activity (pUox), urate concentration (pUA), and clinical response were monitored during up to 5 infusions in 30 patients, including 7 organ transplant recipients. Depending on whether pUA <6 mg/dL was achieved and maintained, patients were classified as non (NR), persistent (PR), or transient (TR) responders. Ab to pegloticase and 10 kDa mPEG were monitored by enzyme linked immunosorbent assay and specificity was further defined. Results We observed 17 PR, 12 TR, and 1 NR; 21 patients (16 PR, 5 TR) received all 5 infusions. Over the 15-week trial, pUA in PR averaged 1.0?±?0.4 mg/dL; T½ for pUox was approximately 13 days, and area under the curve after dose 5 was approximately 30% higher than after dose 1. PR showed clinical benefit and in some, tophi resolved. In 11 of 12 TR, pUox fell rapidly and hyperuricemia recurred before dose 2. In all TR and NR, loss of response to pegloticase was accompanied by Ab to PEG, which was pre-existing in half of those who had no prior exposure to pegloticase. No PR, and 1 one out of 7 organ transplant recipients, had a sustained Ab response to pegloticase. Conclusions Every 3-week dosing is effective and may enhance the utility of pegloticase for treating refractory gout. Ab to PEG, which were pre-existing or induced by treatment, caused rapid loss of efficacy and increased the risk of infusion reactions. Organ transplant recipients can benefit from pegloticase, and may be less prone than non-recipients to developing anti-PEG Ab. Investigation of immunosuppressive strategies to minimize anti-PEG Ab is warranted. Trial registration ClincalTrials.gov identifier: NCT00111657

2014-01-01

180

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

181

Psychological Intervention Research With Pediatric Patients Having Neurologically Based Chronic Medical Conditions: Methodological and Conceptual Issues  

Microsoft Academic Search

Research has suggested that children and adolescents having a chronic medical condition (CMC), particularly those with a neurologically based CMC, are at risk for developing secondary psychological and psychosocial dysfunction. Currently, there is a paucity of psychological intervention research that has focused on these children and adolescents. Purpose: The present article addresses the methodological and conceptual issues that are salient

Melissa L. DeVries; Richard J. Morris

2008-01-01

182

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

183

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

184

An XML model of an enhanced data dictionary to facilitate the exchange of pre-existing clinical research data in international studies.  

PubMed

Pre-existing clinical research data sets exchanged in international epidemiology research often lack the elements needed to assess their suitability for use in multi-region meta-analyses or other clinical studies. While the missing information is generally known to local investigators, it is not contained in the files exchanged between sites. Instead, such content must be solicited by the study coordinating center though a series of lengthy phone and electronic communications: an informal process whose reproducibility and accuracy decays over time. This report describes a set of supplemental information needed to assess whether clinical research data from diverse research sites are truly comparable, and what metadata ("data about the data") should be preserved when a data set is archived for future use. We propose a structured Extensible Markup Language (XML) model that captures this information. The authors hope this model will be a first step towards preserving the metadata associated with clinical research data sets, thereby improving the quality of international data exchange, data archiving, and merged-data research using data collected in many different countries, languages and care settings. PMID:17911757

Duda, Stephany N; Cushman, Clint; Masys, Daniel R

2007-01-01

185

Effects of blending of desalinated and conventionally treated surface water on iron corrosion and its release from corroding surfaces and pre-existing scales.  

PubMed

This study examined effects of blending desalinated water with conventionally treated surface water on iron corrosion and release from corroding metal surfaces and pre-existing scales exposed to waters having varying fractions of desalinated water, alkalinities, pH values and orthophosphate levels. The presence of desalinated water resulted in markedly decreased 0.45 ?m-filtered soluble iron concentrations. However, higher fractions of desalinated water in the blends were also associated with more fragile corroding surfaces, lower retention of iron oxidation products and release of larger iron particles in the bulk water. SEM, XRD and XANES data showed that in surface water, a dense layer of amorphous ferrihydrite phase predominated in the corrosion products. More crystalline surface phases developed in the presence of desalinated water. These solid phases transformed from goethite to lepidocrocite with increased fraction of desalinated water. These effects are likely to result from a combination of chemical parameters, notably variations of the concentrations of natural organic matter, calcium, chloride and sulfate when desalinated and conventionally treated waters are blended. PMID:23651514

Liu, Haizhou; Schonberger, Kenneth D; Peng, Ching-Yu; Ferguson, John F; Desormeaux, Erik; Meyerhofer, Paul; Luckenbach, Heidi; Korshin, Gregory V

2013-07-01

186

Patient Perception Versus Medical Record Entry of Health-Related Conditions Among Patients With Heart Failure  

PubMed Central

A shared understanding of medical conditions between patients and their health care providers may improve self-care and outcomes. In this study, the concordance between responses to a medical history self-report (MHSR) form and the corresponding provider documentation in electronic health records (EHRs) of 19 select co-morbidities and habits in 230 patients with heart failure were evaluated. Overall concordance was assessed using the ? statistic, and crude, positive, and negative agreement were determined for each condition. Concordance between MHSR and EHR varied widely for cardiovascular conditions (? = 0.37 to 0.96), noncardiovascular conditions (? = 0.06 to 1.00), and habits (? = 0.26 to 0.69). Less than 80% crude agreement was seen for history of arrhythmias (72%), dyslipidemia (74%), and hypertension (79%) among cardiovascular conditions and lung disease (70%) and peripheral arterial disease (78%) for noncardiovascular conditions. Perfect agreement was observed for only 1 of the 19 conditions (human immunodeficiency virus status). Negative agreement >80% was more frequent than >80% positive agreement for a condition (15 of 19 [79%] vs 8 of 19 [42%], respectively, p = 0.02). Only 20% of patients had concordant MSHRs and EHRs for all 7 cardiovascular conditions; in 40% of patients, concordance was observed for ?5 conditions. For noncardiovascular conditions, only 28% of MSHR-EHR pairs agreed for all 9 conditions; 37% agreed for ?7 conditions. Cumulatively, 39% of the pairs matched for ?15 of 19 conditions. In conclusion, there is significant variation in the perceptions of patients with heart failure compared to providers’ records of co-morbidities and habits. The root causes of this variation and its impact on outcomes need further study.

Malik, Adnan S.; Giamouzis, Grigorios; Georgiopoulou, Vasiliki V.; Fike, Lucy V.; Kalogeropoulos, Andreas P.; Norton, Catherine R.; Sorescu, Dan; Azim, Sidra; Laskar, Sonjoy R.; Smith, Andrew L.; Dunbar, Sandra B.; Butler, Javed

2013-01-01

187

Novel application of stereotactic ablative radiotherapy using CyberKnife® for early-stage renal cell carcinoma in patients with pre-existing chronic kidney disease: Initial clinical experiences  

PubMed Central

The treatment of renal cell carcinoma (RCC) in patients diagnosed with chronic kidney disease (CKD) requires particular care in order to preserve the remaining renal function. The present study aimed to investigate the potential of a novel nephron-sparing treatment, which is capable of targeting tumors embedded deep within tissues. The present study analyzed three patients, with pre-existing CKD and multiple comorbidities, who were successfully treated for stage I RCC using the CyberKnife® stereotactic ablative radiotherapy (SABR) system. The total prescribed dose was 40 Gy in five fractions administered over five consecutive days. Treatment efficiency was determined using computed tomography scans of the tumors and periodic measurements of the glomerular filtration rate over a period of 12–40 months. Local control, defined as a radiologically stable condition, was achieved in all patients. Lung metastasis was observed in one patient nine months after SABR; however, the side-effects were generally mild and self-limiting. One patient developed renal failure 26 months after SABR, while the severity of CKD was only marginally altered in the other two patients and renal failure did not occur. In conclusion, in the present study, SABR with CyberKnife® was observed to be well tolerated in the patients, with an acceptable acute toxicity effect. Therefore, it may represent a potential therapeutic option for patients with early-stage RCC who have previously been diagnosed with CKD, but for whom other nephron-sparing treatments are contraindicated.

LO, CHENG-HSIANG; HUANG, WEN-YEN; CHAO, HSING-LUNG; LIN, KUEN-TZE; JEN, YEE-MIN

2014-01-01

188

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

189

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

Code of Federal Regulations, 2013 CFR

...establish a compensable medical condition and how will...Evidence of a compensable medical condition may include...laboratory reports, hospital records, death certificates...biopsy results and other medical records. A claimant is...

2013-04-01

190

The effect of pre-existing maternal obesity on the placental proteome: two-dimensional difference gel electrophoresis coupled with mass spectrometry.  

PubMed

Our aim was to study the protein expression profiles of placenta obtained from lean and obese pregnant women with normal glucose tolerance at the time of term Caesarean section. We used two-dimensional difference gel electrophoresis (2D-DIGE), utilising narrow-range immobilised pH gradient strips that encompassed the broad pH range of 4-5 and 5-6, followed by MALDI-TOF mass spectrometry of selected protein spots. Western blot and quantitative RT-PCR (qRT-PCR) analyses were performed to validate representative findings from the 2D-DIGE analysis. Eight proteins were altered (six down-regulated and two up-regulated on obese placentas). Annexin A5 (ANXA5), ATP synthase subunit beta, mitochondria (ATPB), brain acid soluble protein 1 (BASP1), ferritin light chain (FTL), heterogeneous nuclear ribonucleoprotein C (HNRPC) and vimentin (VIME) were all lower in obese patients. Alpha-1-antitrypsin (A1AT) and stress-70 protein, mitochondrial (GRP75) were higher in obese patients. Western blot analysis of ANXA5, ATPB, FTL, VIME, A1AT and GRP75 confirmed the findings from the 2D-DIGE analysis. For brain acid soluble protein 1 and HNRPC, qRT-PCR analysis also confirmed the findings from the 2D-DIGE analysis. Immunohistochemical analysis was also used to determine the localisation of the proteins in human placenta. In conclusion, proteomic analysis of placenta reveals differential expression of several proteins in patients with pre-existing obesity. These proteins are implicated in a variety of cellular functions such as regulation of growth, cytoskeletal structure, oxidative stress, inflammation, coagulation and apoptosis. These disturbances may have significant implications for fetal growth and development. PMID:22301947

Oliva, Karen; Barker, Gillian; Riley, Clyde; Bailey, Mark J; Permezel, Michael; Rice, Gregory E; Lappas, Martha

2012-04-01

191

Modeling pre-existing immunity to adenovirus in rodents: immunological requirements for successful development of a recombinant adenovirus serotype 5-based ebola vaccine.  

PubMed

Pre-existing immunity (PEI) to human adenovirus serotype 5 (Ad5) worldwide is the primary limitation to routine clinical use of Ad5-based vectors in immunization platforms. Using systemic and mucosal PEI induction models in rodents (mice and guinea pigs), we assessed the influence of PEI on the type of adaptive immune response elicited by an Ad5-based vaccine for Ebola with respect to immunization route. Splenocytes isolated from vaccinated animals revealed that immunization by the same route in which PEI was induced significantly compromised Ebola Zaire glycoprotein (ZGP)-specific IFN-?+ CD8+ T cells and ZGP-specific multifunctional CD8+ T cell populations. ZGP-specific IgG1 antibody levels were also significantly reduced and a sharp increase in serum anti-Ad5 neutralizing antibody (NAB) titers were noted following immunization. These immune parameters correlated with poor survival after lethal challenge with rodent-adapted Ebola Zaire virus (ZEBOV). Although the number of IFN-?+ CD8+ T cells was reduced in animals given the vaccine by a different route from that used for PEI induction, the multifunctional CD8+ T cell response was not compromised. Survival rates in these groups were higher than when PEI was induced by the same route as immunization. These results suggest that antigen-specific multifunctional CD8(+) T cell and Th2 type antibody responses compromised by PEI to Ad5 are required for protection from Ebola. They also illustrate that methods for induction of PEI used in preclinical studies must be carefully evaluated for successful development of novel Ad5-based vaccines. PMID:23915419

Choi, Jin Huk; Schafer, Stephen C; Zhang, Lihong; Juelich, Terry; Freiberg, Alexander N; Croyle, Maria A

2013-09-01

192

Decreased Pre-existing Ad5 Capsid and Ad35 Neutralizing Antibodies Increase HIV-1 Infection Risk in the Step Trial Independent of Vaccination  

PubMed Central

Background The Step trial raised the possibility that uncircumcised men with pre-existing Ad5 neutralizing antibodies carried an increased risk of HIV infection after vaccination. Thus, understanding Ad seropositivity in humans is important to the development of an AIDS vaccine. Here, we analyze the impact of different Ad5-specific neutralizing antibodies on immune function and clinical outcome. Methods and Findings Ad seropositivity in the Step trial volunteers was analyzed using chimeric rAd5/35 vectors to characterize their specificity for Ad5 fiber and non-fiber external (capsid) proteins. Immune responses and HIV seropositivity were correlated with the specificity of Ad5-neutralizing antibodies. Neutralizing antibodies induced by the vaccine in Ad5 seronegative subjects were directed preferentially to Ad5 capsid proteins, although some fiber-neutralizing antibodies could be detected. Pre-vaccination Ad5 serostatus did not affect the capsid-directed response after three vaccinations. In contrast, anti-fiber antibody titers were significantly higher in volunteers who were Ad5 seropositive prior to vaccination. Those Ad5 seropositive subjects who generated anti-capsid responses showed a marked reduction in vaccine-induced CD8 responses. Unexpectedly, anti-vector immunity differed qualitatively in Ad5 seropositive participants who became HIV-1 infected compared to uninfected case controls; Ad5 seropositive participants who later acquired HIV had lower neutralizing antibodies to capsid. Moreover, Ad35 seropositivity was decreased in HIV-infected subjects compared with uninfected case controls, while seroprevalence for other serotypes including Ad14, Ad28 and Ad41 was similar in both groups. Conclusions Together, these findings suggest that the case subjects were less immunologically responsive prior to infection. Subjects infected during the Step trial had qualitative differences in immunity that increased their risk of HIV-1 infection independent of vaccination.

Cheng, Cheng; Wang, LingShu; Gall, Jason G. D.; Nason, Martha; Schwartz, Richard M.; McElrath, M. Juliana; DeRosa, Steven C.; Hural, John; Corey, Lawrence; Buchbinder, Susan P.; Nabel, Gary J.

2012-01-01

193

Variations in Late Cenozoic Recent strike-slip and oblique-extensional geometries, within Indochina: The influence of pre-existing fabrics  

NASA Astrophysics Data System (ADS)

From Yunnan to Northern Thailand, Late Cenozoic-Recent faults strike predominantly NNE-SSW, N-S to NNE-SSW and NE-SW to ENE-WSW. Associated sedimentary basins are aligned NE-SW to N-S. The regional fault patterns are commonly interpreted as strike-slip dominated deformation throughout the area. Releasing bend and en echelon stepping patterns on faults bounding sedimentary basins indicate sinistral displacement on NE-SW to ENE-WSW trending faults. Yet, in the escape tectonics model left lateral displacement on the NE-SW to ENE-WSW faults is thought to have occurred late in the Miocene, whilst earlier motion was dextral. However, in Yunnan the NE-SW Shmax direction required for dextral motion on the N-S Sagaing, Nanting and Gaoligong fault zones is consistent with sinistral motion on ENE-WSW striking faults, which is still their sense of motion today. In Northern Thailand the dextral-sinistral switch model during the Miocene is not tenable because the Fang basin is of Late Oligocene-Pliocene age, and requires similar age sinistral motion on the ENE-WSW Mae Chan fault in order to have opened. In an alternative model, Northern Thailand is interpreted to have evolved predominantly by oblique extension. The Golden Triangle area marks a transition from transtensional deformation in the north to oblique extension in the south. The activation of pre-existing fabrics strongly affects both strike-slip and extensional faults and has given rise to the similar extensional and strike-slip fault patterns. Multiple episodes of basin inversion in Northern Thailand during the Miocene require short-term changes in stress pattern. To produce the inferred changes in stress pattern it is suggested that stresses radiating out from the Himalayan syntaxis exert a strong influence, but were not the only important forces acting on the region.

Morley, C. K.

2007-01-01

194

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

2012-08-01

195

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

196

Diabetes mellitus, other medical conditions and familial history of cancer as risk factors for pancreatic cancer  

Microsoft Academic Search

In a population-based case-control study of pancreatic cancer conducted in three areas of the USA, 484 cases and 2099 controls were interviewed to evaluate the aetiologic role of several medical conditions\\/interventions, including diabetes mellitus, cholecystectomy, ulcer\\/gastrectomy and allergic states. We also evaluated risk associated with family history of cancer. Our findings support previous studies indicating that diabetes is a risk

D T Silverman; M Schiffman; J Everhart; A Goldstein; K D Lillemoe; G M Swanson; A G Schwartz; L M Brown; R S Greenberg; J B Schoenberg; L M Pottern; R N Hoover; J F Fraumeni

1999-01-01

197

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

198

A retrospective cohort study of military deployment and postdeployment medical encounters for respiratory conditions.  

PubMed

Deployed military personnel are exposed to inhalational hazards that may increase their risk of chronic lung conditions. This evaluation assessed associations between Operation Iraqi Freedom (OIF) deployment and postdeployment medical encounters for respiratory symptoms and medical conditions. This retrospective cohort study was conducted among military personnel who, between January 2005 and June 2007, were deployed to either of two locations with burn pits in Iraq, or to either of two locations without burn pits in Kuwait. Incidence rate ratios (IRRs) were estimated using two nondeployed reference groups. Rates among personnel deployed to burn pit locations were also compared directly to those among personnel deployed to locations without burn pits. Significantly elevated rates of encounters for respiratory symptoms (IRR = 1.25; 95% confidence interval [CI]: 1.20-1.30) and asthma (IRR = 1.54; 95% CI: 1.33-1.78) were observed among the formerly deployed personnel relative to U.S.-stationed personnel. Personnel deployed to burn pit locations did not have significantly elevated rates for any of the outcomes relative to personnel deployed to locations without burn pits. These results are consistent with the hypothesis that OIF deployment is associated with subsequent risk of respiratory conditions. Elevated medical encounter rates were not uniquely associated with burn pits. PMID:24806499

Abraham, Joseph H; Eick-Cost, Angie; Clark, Leslie L; Hu, Zheng; Baird, Coleen P; DeFraites, Robert; Tobler, Steven K; Richards, Erin E; Sharkey, Jessica M; Lipnick, Robert J; Ludwig, Sharon L

2014-05-01

199

Medical costs and lost productivity from health conditions at volatile organic compound-contaminated Superfund sites  

SciTech Connect

This paper estimates the health costs at Superfund sites for conditions associated with volatile organic compounds (VOCs) in drinking water. Health conditions were identified from published literature and registry information as occurring at excess rates in VOC-exposed populations. These health conditions were: (1) some categories of birth defects, (2) urinary tract disorders, (3) diabetes, (4) eczema and skin conditions, (5) anemia, (6) speech and hearing impairments in children under 10 years of age, and (7) stroke. Excess rates were used to estimate the excess number of cases occurring among the total population living within one-half mile of 258 Superfund sites. These sites had evidence of completed human exposure pathways for VOCs in drinking water. For each type of medical condition, an individual`s expected medical costs, long-term care costs, and lost work time due to illness or premature mortality were estimated. Costs were calculated to be approximately $330 million per year, in the absence of any remediation or public health intervention programs. The results indicate the general magnitude of the economic burden associated with a limited number of contaminants at a portion of all Superfund sites, thus suggesting that the burden would be greater than that estimated in this study if all contaminants at all Superfund sites could be taken into account.

Lybarger, J.A.; Spengler, R.F.; Brown, D.R. [Agency for Toxic Substances and Disease Registry, Atlanta, GA (United States). Div. of Health Studies] [Agency for Toxic Substances and Disease Registry, Atlanta, GA (United States). Div. of Health Studies; Lee, R.; Vogt, D.P. [Oak Ridge National Lab., TN (United States)] [Oak Ridge National Lab., TN (United States); [Joint Inst. for Energy and Environment, Oak Ridge, TN (United States); Perhac, R.M. Jr. [Univ. of Tennessee, Knoxville, TN (United States)] [Univ. of Tennessee, Knoxville, TN (United States); [Joint Inst. for Energy and Environment, Oak Ridge, TN (United States)

1998-10-01

200

Cost effectiveness of lowering cholesterol concentration with statins in patients with and without pre-existing coronary heart disease: life table method applied to health authority population.  

PubMed Central

OBJECTIVES--To estimate the cost effectiveness of statins in lowering serum cholesterol concentration in people at varying risk of fatal cardiovascular disease and to explore the implications of changing the criteria for intervention on cost and cost effectiveness for a purchasing authority. DESIGN--A life table method was used to model the effect of treatment with a statin on survival over 10 years in men and women aged 45-64. The costs of intervention were estimated from the direct costs of treatment, offset by savings associated with a reduction in coronary angiographies, non-fatal myocardial infarctions, and revascularisation procedures. The robustness of the model to various assumptions was tested in a sensitivity analysis. SETTING--Population of a typical district health authority. MAIN OUTCOME MEASURE--Cost per life year saved. RESULTS--The average cost effectiveness of treating men aged 45-64 with no history of coronary heart disease and a cholesterol concentration > 6.5 mmol/l for 10 years with a statin was 136,000 pounds per life year saved. The average cost effectiveness for patients with pre-existing coronary heart disease and a cholesterol concentration > 5.4 mmol/l was 32,000 pounds. These averages hide enormous differences in cost effectiveness between groups at different risk, ranging from 6000 pounds per life year in men aged 55-64 who have had a myocardial infarction and whose cholesterol concentration is above 7.2 mmol/l to 361,000 pounds per life year saved in women aged 45-54 with angina and a cholesterol concentration of 5.5-6.0 mmol/l. CONCLUSIONS--Lowering serum cholesterol concentration in patients with and without preexisting coronary heart disease is effective and safe, but treatment for all those in whom treatment is likely to be effective is not sustainable within current NHS resources. Data on cost effectiveness data should be taken into account when assessing who should be eligible for treatment.

Pharoah, P. D.; Hollingworth, W.

1996-01-01

201

Selective Endothelin-1 Receptor type-A Inhibition in Cardiac Surgery Subjects with Pre-Existing LV Dysfunction: Influence on Early Post-Operative Hemodynamics  

PubMed Central

Background and Objective A robust release of endothelin-1-1 (ET) with subsequent ETA subtype receptor (ET-AR) activation occurs in patients following cardiac surgery requiring cardiopulmonary bypass (CPB). Increased ET-AR activation has been identified in patients with poor LV function (reduced ejection fraction; EF). Accordingly, this study tested the hypothesis that a selective ET-AR antagonist (ET-ARA) administered peri-operatively would favorably affect post-CPB hemodynamic profiles in patients with a pre-existing poor LVEF. Methods and Results Patients (n=29; 66±2 yrs) with a reduced LVEF (37±2%) were prospectively randomized, in a blinded fashion, at the time of elective coronary revascularization and/or valve replacement requiring CPB, to infusion of the highly-selective and potent ET-ARA, sitaxsentan at 1 or 2 mg/kg (IV bolus; n=9, 10 respectively) or vehicle (saline; n=10). Infusion of the ET-ARA/vehicle was performed immediately prior to separation from CPB and again at 12 hrs post-CPB. ET and hemodynamic measurements were performed at baseline, at separation from CPB (Time 0) and at 0.5, 6, 12, 24 hrs post-CPB. Baseline plasma ET (4.0±0.3 fmol/mL) was identical across all 3 groups, but when compared to pre-operative, baseline values obtained from age matched subjects with a normal LVEF (n=37;LVEF>50%), were significantly increased (2.9±0.2 fmol/mL, p<0.05) Baseline systemic (SVR; 1358±83 d·s·cm-5) and pulmonary (PVR; 180±23 d·s·cm-5) vascular resistance were equivalent in all 3 groups. As a function of Time 0, SVR changed in an equivalent fashion in the post-CPB period, but a significant ET-ARA effect was observed for PVR (ANOVA; p<0.05). For example at 24 hrs post-CPB, PVR increased by 40 d.scm-5 in the vehicle group, but directionally decreased by over 40 d·s·cm-5 in the 2 mg/kg ETARA group (p<0.05). Total adverse events were equivalently distributed across the ET-ARA/placebo groups. Conclusions These unique findings demonstrated that infusion of an ET-ARA in high risk cardiac surgery patients was not associated with significant hemodynamic compromise. Moreover, ET-ARA favorably affected PVR in the early post-operative period. Thus, the ET-AR serves as a potential pharmacological target for improving outcomes following cardiac surgery in patients with compromised LV function.

Toole, John M.; Ikonomidis, John S.; Szeto, Wilson Y.; Zellner, James L.; Mulcahy, John; Deardorff, Rachael L.; Spinale, Francis G.

2010-01-01

202

Discovering medical conditions associated with periodontitis using linked electronic health records  

PubMed Central

Aim To use linked electronic medical and dental records to discover associations between periodontitis and medical conditions independent of a priori hypotheses. Materials and Methods This case-control study included 2475 patients who underwent dental treatment at the College of Dental Medicine at Columbia University and medical treatment at NewYork-Presbyterian Hospital. Our cases are patients who received periodontal treatment and our controls are patients who received dental maintenance but no periodontal treatment. Chi-square analysis was performed for medical treatment codes and logistic regression was used to adjust for confounders. Results Our method replicated several important periodontitis associations in a largely Hispanic population, including diabetes mellitus type I (OR = 1.6, 95% CI 1.30–1.99, p < 0.001) and type II (OR = 1.4, 95% CI 1.22–1.67, p < 0.001), hypertension (OR = 1.2, 95% CI 1.10–1.37, p < 0.001), hypercholesterolaemia (OR = 1.2, 95% CI 1.07–1.38, p = 0.004), hyperlipidaemia (OR = 1.2, 95% CI 1.06–1.43, p = 0.008) and conditions pertaining to pregnancy and childbirth (OR = 2.9, 95% CI: 1.32–7.21, p = 0.014). We also found a previously unreported association with benign prostatic hyperplasia (OR = 1.5, 95% CI 1.05–2.10, p = 0.026) after adjusting for age, gender, ethnicity, hypertension, diabetes, obesity, lipid and circulatory system conditions, alcohol and tobacco abuse. Conclusions This study contributes a high-throughput method for associating periodontitis with systemic diseases using linked electronic records.

Boland, Mary Regina; Hripcsak, George; Albers, David J.; Wei, Ying; Wilcox, Adam B.; Wei, Jin; Li, Jianhua; Lin, Steven; Breene, Michael; Myers, Ronnie; Zimmerman, John; Papapanou, Panos N.; Weng, Chunhua

2013-01-01

203

Concurrent medical conditions and long-term outcome in dogs with nontraumatic intracranial hemorrhage.  

PubMed

Nontraumatic intracranial hemorrhage is bleeding originating from the brain or surrounding structures. It results from blood vessel rupture and may be primary or secondary in origin. The magnetic resonance imaging (MRI) characteristics of 75?dogs with nontraumatic intracranial hemorrhage were reviewed to determine signalment; intracranial compartment involved, size and number of lesions; type and prevalence of concurrent medical conditions; and long-term outcome. Hemorrhagic lesions were intraparenchymal (n = 72), subdural (n = 2) or intraventricular (n = 1). Thirty-three of 75?dogs had a concurrent medical condition. A concurrent condition was detected in 13 of 43?dogs with a single lesion ?5?mm and included Angiostrongylus vasorum infection, intracranial lymphoma and meningioma. Of the 20?dogs with multiple lesions ?5?mm, 7?had A. vasorum infection, 2?had hemangiosarcoma metastasis, 5?had suspected brain metastasis, and 1?was septicemic. Of the 12?dogs with multiple lesions, 2?had hyperadrenocorticism, 2?had chronic kidney disease, and 1 had hypothyroidism. Of these five dogs, all were hypertensive and four died within 12?months. No dog had a single lesion <5?mm. Long-term outcome was favorable in 26 of 43 dogs with single lesions ?5?mm, 6 of 20?dogs with multiple lesions ?5?mm, and 8 of 12?dogs with multiple lesions <5?mm. A. vasorum infection was the most common concurrent condition in dogs with nontraumatic intracranial hemorrhage (16/75), with an excellent outcome in 14 of 16 dogs. Prognosis in nontraumatic intracranial hemorrhage is reported in terms of concurrent medical conditions and the number and size of lesions. PMID:22537251

Lowrie, Mark; De Risio, Luisa; Dennis, Ruth; Llabrés-Díaz, Francisco; Garosi, Laurent

2012-01-01

204

Medical Treatment of Aortic Aneurysms in Marfan Syndrome and other Heritable Conditions  

PubMed Central

Thoracic aortic aneurysms can be triggered by genetic disorders such as Marfan syndrome (MFS) and related aortic diseases as well as by inflammatory disorders such as giant cell arteritis or atherosclerosis. In all these conditions, cardiovascular risk factors, such as systemic arterial hypertension, may contribute to faster rate of aneurysm progression. Optimal medical management to prevent progressive aortic dilatation and aortic dissection is unknown. ?-blockers have been the mainstay of medical treatment for many years despite limited evidence of beneficial effects. Recently, losartan, an angiotensin II type I receptor antagonist (ARB), has shown promising results in a mouse model of MFS and subsequently in humans with MFS and hence is increasingly used. Several ongoing trials comparing losartan to ?-blockers and/or placebo will better define the role of ARBs in the near future. In addition, other medications, such as statins and tetracyclines have demonstrated potential benefit in experimental aortic aneurysm studies. Given the advances in our understanding of molecular mechanisms triggering aortic dilatation and dissection, individualized management tailored to the underlying genetic defect may be on the horizon of individualized medicine. We anticipate that ongoing research will address the question whether such genotype/pathogenesis-driven treatments can replace current phenotype/syndrome-driven strategies and whether other forms of aortopathies should be treated similarly. In this work, we review currently used and promising medical treatment options for patients with heritable aortic aneurysmal disorders.

Jost, Christine H. Attenhofer; Greutmann, Matthias; Connolly, Heidi M.; Weber, Roland; Rohrbach, Marianne; Oxenius, Angela; Kretschmar, Oliver; Luscher, Thomas F.; Matyas, Gabor

2014-01-01

205

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

PubMed Central

Summary 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.

Kiwilsza, Malgorzata; Sporniak-Tutak, Katarzyna

2012-01-01

206

Origin of the Ciomadul Dacite, Carpathian-Pannonian Region, Eastern-Central Europe: Rejuvenation of a Pre-Existing Crystal Mush  

NASA Astrophysics Data System (ADS)

Dacitic composite volcanoes and calderas worldwide have many common specific characters. Notably, their activities are fairly unpredictable since the repose time between the active phases could be rather long, i.e. even several tens or hundreds ka. This nature might be related to the origin of such magmas. Petrological observations indicate that relatively old, cool, highly crystalline magma body (i.e., a crystal mush) could be present beneath the seemingly inactive dacitic volcanoes before reawakening. Reactivation of such locked magma chambers could occur due to the upwelling and intrusion of mafic magma and recent calculations suggest that this process takes place rather fast. Understanding the nature and time-scale of such remobilization events is crucial to explain the reason of the change in volcanic behaviour from dormant to active phase (i.e., the reawakening of the volcano). In this study, we show the role and the character of a pre-existing near-solidus granodioritic crystal mush to generate the eruptible dacitic magma in the Ciomadul volcano. The Ciomadul dacite is a crystal-rich rock with ubiquitous plagioclases and amphiboles. They form viscous lava domes and pumices generated by sub-plinian explosive eruptions. Combined, mineral-scale textural and geochemical investigations indicate a complex origin of these minerals, formed partly in a low temperature dioritic-granodioritic crystal mush body, partly in higher temperature hybrid magma. In addition, biotite, titanite, apatite, allanite, zircon, K-feldspar and quartz occur in various amounts and are interpreted also as antecrysts derived from the remobilized mushy body. High-Mg olivines and clinopyroxenes represent basaltic magma intruded into the mush. The nature of the crystal mush was closely investigated through the detailed analysis of the crystal clots found often in the Ciomadul dacites. Their texture resembles plutonic rocks, but they contain interstitial vesiculated glasses. The glass could represent evolved melt in a crystal mush body rather than melting product of the crystal phases. Thermobarometric calculations yield 2.68±0.47 kbar pressure and 735±26°C temperature, which is close to the granitic solidus. In certain crystal clots, plagioclases show strongly resorbed margin with sieved texture and an overgrowth zone with distinct composition, e.g., higher FeO content resembling the newly formed plagioclase microphenocrysts in the host rock. The amphiboles are strongly opacitized and often have coarse-grained clinopyroxene corona. All of these suggest interaction between the crystal mush and hot mafic magma. The amphibole-plagioclase thermometry in the host rock resulted in a minimum crystallization temperature of 840±11°C, significantly higher than the values got for the crystal clots. In summary, the Ciomadul dacite contains vast amount of low-temperature, disseminated crystal mush fragments (up to 50 vol% of the "phenocrysts"), which were remobilized by hot mafic magmas. This could lead to the rejuvenation of the magmatic system and an eruption phase, possibly after a long repose time.

Kiss, B.; Harangi, S.; Molnar, K.; Jankovics, E. M.; Lukacs, R.; Ntaflos, T.

2012-12-01

207

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

208

Influence of pre-existing fabrics on fault kinematics and rift geometry of interacting segments: Analogue models based on the Albertine Rift (Uganda), Western Branch-East African Rift System  

NASA Astrophysics Data System (ADS)

This study aims at showing how far pre-existing crustal weaknesses left behind by Proterozoic mobile belts, that pass around cratonic Archean shields (Tanzania Craton to the southeast and Congo Craton to the northwest), control the geometry of the Albertine Rift. Focus is laid on the development of the Lake Albert and Lake Edward/George sub-segments and between them the greatly uplifted Rwenzori Mountains, a horst block located within the rift and whose highest peak rises to >5000 m above mean sea level. In particular we study how the southward propagating Lake Albert sub-segment to the north interacts with the northward propagating Lake Edward/George sub-segment south of it, and how this interaction produces the structures and geometry observed in this section of the western branch of the East African Rift, especially within and around the Rwenzori horst. We simulate behaviour of the upper crust by conducting sandbox analogue experiments in which pre-cut rubber strips of varying overstep/overlap connected to a basal sheet and oriented oblique and/or orthogonal to the extension vector, are placed below the sand-pack. The points of connection present velocity discontinuities to localise deformation, while the rubber strips represent ductile domain affected by older mobile belts. From fault geometry of developing rift segments in plan view and section cuts, we study kinematics resulting from a given set of boundary conditions, and results are compared with the natural scenario. Three different basal model-configurations are used to simulate two parallel rifts that propagate towards each other and interact. Wider overstep (model SbR3) produces an oblique transfer zone with deep grabens (max. 7.0 km) in the adjoining segments. Smaller overlap (model SbR4) ends in offset rift segments without oblique transfer faults to join the two, and produces moderately deep grabens (max. 4.6 km). When overlap doubles the overstep (model SbR5), rifts propagate sub-orthogonal to the extension direction and form shallow valleys (max. 2.9 km). Relative ratios of overlap/overstep between rift segments dictate the kind of transition zone that develops and whether or not a block (like the Rwenzoris) is captured and rotates; hence determining the end-member geometry. Rotation direction is controlled by pre-existing fabrics. Fault orientation, fault kinematics, and block rotation (once in play) reinforce each other; and depending on the local kinematics, different parts of a captured block may rotate with variable velocities but in the same general direction. Mechanical strength anisotropy of pre-structured crust only initially centres fault nucleation and propagation parallel to the grain of weakness of the basement, but at later stages of a protracted period of crustal extension, such boundaries are locally defied.

Aanyu, K.; Koehn, D.

2011-02-01

209

Medical conditions among Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System  

PubMed Central

Abstract Objective To determine the range and burden of health services utilization among Iraqi refugees receiving health assistance in Jordan, a country of first asylum. Methods Medical conditions, diagnosed in accordance with the tenth revision of the International classification of diseases, were actively monitored from 1January to 31December 2010 using a pilot centralized database in Jordan called the Refugee Assistance Information System. Findings There were 27?166 medical visits by 7642 Iraqi refugees (mean age: 37.4 years; 49% male; 70% from Baghdad; 6% disabled; 3% with a history of torture). Chronic diseases were common, including essential hypertension (22% of refugees), visual disturbances (12%), joint disorders (11%) and type II diabetes mellitus (11%). The most common reasons for seeking acute care were upper respiratory tract infection (11%), supervision of normal pregnancy (4%) and urinary disorders (3%). The conditions requiring the highest number of visits per refugee were cerebrovascular disease (1.46 visits), senile cataract (1.46) and glaucoma (1.44). Sponsored care included 31?747 referrals or consultations to a specialty service, 18?432 drug dispensations, 2307 laboratory studies and 1090 X-rays. The specialties most commonly required were ophthalmology, dentistry, gynaecology and orthopaedic surgery. Conclusion Iraqi refugees in countries of first asylum and resettlement require targeted health services, health education and sustainable prevention and control strategies for predominantly chronic diseases.

Carone, Marco; Al-Saedy, Huda; Nyce, Sayre; Ghosn, Jad; Mutuerandu, Timothy; Black, Robert E

2012-01-01

210

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

211

Relationship Between Aerobic Activity Health Conditions and Medical Visits Among Men and Women Serving Aboard Navy Ships.  

National Technical Information Service (NTIS)

No recent studies on Navy personnel have examined the relationship between aerobic activity and adverse health conditions or medical care visits. This study examined these relationships to determine if aerobic activity was inversely related to self- repor...

L. M. Hughes C. F. Garland F. C. Garland E. D. Gorham

2002-01-01

212

Comorbidity in adults with hearing difficulties: Which chronic medical conditions are related to hearing impairment?  

PubMed

Abstract Objectives: To investigate the occurrence of 27 chronic medical conditions in a cohort of adults with and without hearing impairment, and to examine the association between these conditions and hearing ability. Design: The National Longitudinal Study on Hearing (NL-SH study) is a large prospective study among adults aged 18 to 70 years, conducted via the internet in the Netherlands. Hearing ability was measured with a digits-in-noise test and comorbidity was assessed through self-report. Study sample: Cross-sectional data of 890 hearing-impaired and 975 normally-hearing adults were analyzed. Both descriptive statistics and multinomial logistic regression analyses were conducted. Results: Of the NL-SH participants with insufficient or poor hearing ability, 78.5% reported to suffer from at least one additional chronic condition. This proportion was larger than in the normally-hearing group (68.6% with one or more chronic conditions and 37.7% with two or more). After adjustment for age and gender, 'dizziness causing falling', 'diabetes' and 'arthritis types other than osteoarthritis and rheumatic arthritis' were significantly associated with poor hearing ability. Conclusions: Our results show that some previously reported associations do not only occur in older age groups, but also in younger cohorts. Comorbidity is relevant in the rehabilitation (multi-disciplinary care) and the clinical encounter. PMID:24588528

Stam, Mariska; Kostense, Piet J; Lemke, Ulrike; Merkus, Paul; Smit, Jan H; Festen, Joost M; Kramer, Sophia E

2014-06-01

213

Effect of pre-existing anti-tick-borne encephalitis virus immunity on neutralising antibody response to the Vero cell-derived, inactivated Japanese encephalitis virus vaccine candidate IC51.  

PubMed

Japanese encephalitis virus (JEV) is the leading cause of viral encephalitis in Asia with a case fatality rate up to 35% and long-term sequelae up to 75%. This active-controlled, randomized, multi-centre, observer-blind, phase III trial investigated the neutralising antibody response to the new Japanese encephalitis (JE) vaccine IC51 in subjects with (N=81) and without (N=339) pre-existing tick-borne encephalitis (TBE) vaccine induced antibodies as determined by TBE enzyme-linked immunosorbent assay IgG (ELISA). Neutralising antibody response was statistically superior in TBE ELISA-positive subjects compared to TBE ELISA-negative subjects after the first (p<0.0001) but not after the second vaccination with IC51. Thus, pre-existing vaccine-induced TBE immunity enhances the neutralising JEV-specific antibody response after a single IC51 vaccination. PMID:18804132

Schuller, Elisabeth; Klade, Christoph S; Heinz, Franz X; Kollaritsch, Herwig; Rendi-Wagner, Pamela; Jilma, Bernd; Tauber, Erich

2008-11-11

214

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

215

Factors associated with geographic variation in cost per episode of care for three medical conditions  

PubMed Central

Objective To identify associations between market factors, especially relative reimbursement rates, and the probability of surgery and cost per episode for three medical conditions (cataract, benign prostatic neoplasm, and knee degeneration) with multiple treatment options. Methods We use 2004–2006 Medicare claims data for elderly beneficiaries from sixty nationally representative communities to estimate multivariate models for the probability of surgery and cost per episode of care as a function local market factors, including Medicare physician reimbursement for surgical versus non-surgical treatment and the availability of primary care and specialty physicians. We used Symmetry’s Episode Treatment Groups (ETG) software to group claims into episodes for the three conditions (n?=?540,874 episodes). Results Higher Medicare reimbursement for surgical episodes and greater availability of the relevant specialists are significantly associated with more surgery and higher cost per episode for all three conditions, while greater availability of primary care physicians is significantly associated with less frequent surgery and lower cost per episode. Conclusion Relative Medicare reimbursement rates for surgical vs. non-surgical treatments and the availability of both primary care physicians and relevant specialists are associated with the likelihood of surgery and cost per episode.

2014-01-01

216

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

2013-09-01

217

Medical conditions and depressive, anxiety, and somatic symptoms in older adults with and without generalized anxiety disorder  

PubMed Central

Objective The objective of this study was to examine medical illness and anxiety, depressive, and somatic symptoms in older medical patients with generalized anxiety disorder (GAD). Method A case-control study was designed and conducted in the University of California, San Diego (UCSD) Geriatrics Clinics. A total of fifty-four older medical patients with GAD and 54 matched controls participated. Measurements The measurements used for this study include: Brief Symptom Inventory – 18, Mini International Neuropsychiatric Interview, and the Anxiety Disorders Interview Schedule. Results Older medical patients with GAD reported higher levels of somatic symptoms, anxiety, and depression than other older adults, as well as higher rates of diabetes and gastrointestinal conditions. In a multivariate model that included somatic symptoms, medical conditions, and depressive and anxiety symptoms, anxiety symptoms were the only significant predictors of GAD. Conclusion These results suggest first, that older medical patients with GAD do not primarily express distress as somatic symptoms; second, that anxiety symptoms in geriatric patients should not be discounted as a byproduct of medical illness or depression; and third, that older adults with diabetes and gastrointestinal conditions may benefit from screening for anxiety.

Wetherell, Julie Loebach; Ayers, Catherine R.; Nuevo, Roberto; Stein, Murray B.; Ramsdell, Joe; Patterson, Thomas L.

2014-01-01

218

[About development of medical maintenance of military air forces in modern conditions].  

PubMed

The authors prove the necessity of transformation of medical service of Air Force of all levels within the framework of the realization of program "Development of medical supply of Armed Forces of Russian Federation 2008-2012". Goals, functions of different elements of medical service, responsibilities of performers are developed. These goals have fundamental differences from previous one. New organizational structure of medical service of Air Forces and criteria of the estimation of its effectiveness are suggested. Offers of further optimization of organizational medical structure and improvement of medical supply of Air Forces are developed. PMID:21254586

Radchenko, S N; Arsen'ev, Iu G

2010-10-01

219

Comparative Effectiveness of Medications To Reduce Risk of Primary Breast Cancer in Women. Appendixes.  

National Technical Information Service (NTIS)

Recent clinical trials have demonstrated the efficacy of three medications--tamoxifen citrate, raloxifene, and tibolone--to reduce the risk of invasive breast cancer in women without pre-existing cancer. This therapy is sometimes referred to as chemopreve...

2009-01-01

220

Which common clinical conditions should medical students be able to manage by graduation? A perspective from Australian interns  

Microsoft Academic Search

SUMMARY The objectives of the study were to report the devel- opment of a core curriculum that details the clinical conditions medical students should be able to manage upon graduation; and to canvass the opinion of interns (first-year postgraduate doctors) regarding their perceptions of the level of skill required to manage each condition. Literature relating to core curriculum development and

I. E. Rolfe; S.-A. Pearson; R. W. Sanson-Fisher; C. Ringland; S. Bayley; A. Hart; S. Kelly

2002-01-01

221

42 CFR 482.24 - Condition of participation: Medical record services.  

Code of Federal Regulations, 2013 CFR

...approved by the medical staff and the hospital's nursing and pharmacy leadership; (ii) Demonstrates that such orders and protocols...conducted by the medical staff and the hospital's nursing and pharmacy leadership to determine the continuing usefulness and...

2013-10-01

222

Do Race, Ethnicity, and Psychiatric Diagnoses Matter in the Prevalence of Multiple Chronic Medical Conditions?  

PubMed Central

Background The proportion of people in the United States with multiple chronic medical conditions (MCMC) is increasing. Yet, little is known about the relationship that race, ethnicity, and psychiatric disorders have on the prevalence of MCMCs in the general population. Methods This study used data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N= 33,107). Multinomial logistic regression models adjusting for socio-demographic variables, body mass index, and quality of life were used to examine differences in the 12-month prevalence of MCMC by race/ethnicity, psychiatric diagnosis, and the interactions between race/ethnicity and psychiatric diagnosis. Results Compared to non-Hispanic Whites, Hispanics reported lower odds of MCMC and African Americans reported higher odds of MCMC after adjusting for covariates. People with psychiatric disorders reported higher odds of MCMC compared to people without psychiatric disorders. There were significant interactions between race and psychiatric diagnosis associated with rates of MCMC. In the presence of certain psychiatric disorders, the odds of MCMC were higher among African Americans with psychiatric disorders compared to non-Hispanic Whites with similar psychiatric disorders. Conclusions Our study results indicate that race, ethnicity, and psychiatric disorders are associated with the prevalence of MCMC. As the rates of MCMC rise, it is critical to identify which populations are at increased risk and how to best direct services to address their health care needs.

Cabassa, Leopoldo J.; Humensky, Jennifer; Druss, Benjamin; Lewis-Fernandez, Roberto; Gomes, Arminda P.; Wang, Shuai; Blanco, Carlos

2013-01-01

223

The mechanism of Fe(2+)-initiated lipid peroxidation in liposomes: the dual function of ferrous ions, the roles of the pre-existing lipid peroxides and the lipid peroxyl radical.  

PubMed Central

The mechanism of Fe(2+)-initiated lipid peroxidation in a liposomal system was studied. It was found that a second addition of ferrous ions within the latent period lengthened the time lag before lipid peroxidation started. The apparent time lag depended on the total dose of Fe(2+) whenever the second dose of Fe(2+) was added, which indicates that Fe(2+) has a dual function: to initiate lipid peroxidation on one hand and suppress the species responsible for the initiation of the peroxidation on the other. When the pre-existing lipid peroxides (LOOH) were removed by incorporating triphenylphosphine into liposomes, Fe(2+) could no longer initiate lipid peroxidation and the acceleration of Fe(2+) oxidation by the liposomes disappeared. However, when extra LOOH were introduced into liposomes, both enhancement of the lipid peroxidation and shortening of the latent period were observed. When the scavenger of lipid peroxyl radicals (LOO(.)), N,N'-diphenyl-p-phenylene-diamine, was incorporated into liposomes, neither initiation of the lipid peroxidation nor acceleration of the Fe(2+) oxidation could be detected. The results may suggest that both the pre-existing LOOH and LOO(.) are necessary for the initiation of lipid peroxidation. The latter comes initially from the decomposition of the pre-existing LOOH by Fe(2+) and can be scavenged by its reaction with Fe(2+). Only when Fe(2+) is oxidized to such a degree that LOO(.) is no longer effectively suppressed does lipid peroxidation start. It seems that by taking the reactions of Fe(2+) with LOOH and LOO(.) into account, the basic chemistry in lipid peroxidation can explain fairly well the controversial phenomena observed in Fe(2+)-initiated lipid peroxidation, such as the existence of a latent period, the critical ratio of Fe(2+) to lipid and the required oxidation of Fe(2+).

Tang, L; Zhang, Y; Qian, Z; Shen, X

2000-01-01

224

The prevalence of the pre-existing hepatitis C viral variants and the evolution of drug resistance in patients treated with the NS3-4a serine protease inhibitor telaprevir  

SciTech Connect

Telaprevir (VX-950), a novel hepatitis C virus (HCV) NS3-4A serine protease inhibitor, has demonstrated substantial antiviral activity in patients infected with HCV genotype 1. Some patients experience viral breakthrough, which has been shown to be associated with emergence of telaprevir-resistant HCV variants during treatment. The exact mechanisms underlying the rapid selection of drug resistant viral variants during dosing are not fully understood. In this paper, we develop a two-strain model to study the pre-treatment prevalence of the mutant virus and derive an analytical solution of the mutant frequency after administration of the protease inhibitor. Our analysis suggests that the rapid increase of the mutant frequency during therapy is not due to mutant growth but rather due to the rapid and profound loss of wild-type virus, which uncovers the pre-existing mutant variants. We examine the effects of backward mutation and hepatocyte proliferation on the pre-existence of the mutant virus and the competition between wild-type and drug resistant virus during therapy. We then extend the simple model to a general model with multiple viral strains. Mutations during therapy do not play a significant role in the dynamics of various viral strains, although they are capable of generating low levels of HCV variants that would otherwise be completely suppressed because of fitness disadvantages. Hepatocyte proliferation may not affect the pretreatment frequency of mutant variants, but is able to influence the quasispecies dynamics during therapy. It is the relative fitness of each mutant strain compared with wild-type that determines which strain(s) will dominate the virus population. The study provides a theoretical framework for exploring the prevalence of pre-existing mutant variants and the evolution of drug resistance during treatment with other protease inhibitors or HCV polymerase inhibitors.

Rong, Libin [Los Alamos National Laboratory; Ribeiro, Ruy M [Los Alamos National Laboratory; Perelson, Alan S [Los Alamos National Laboratory

2008-01-01

225

Multiple Chronic Conditions Among US Adults Who Visited Physician Offices: Data From the National Ambulatory Medical Care Survey, 2009  

PubMed Central

Most research on adults with chronic conditions focuses on a single disease or condition, such as hypertension or diabetes, rather than on multiple chronic conditions (MCC). Our study’s objective was to compare physician office visits by adults with MCC with visits by adults without MCC, by selected patient demographic characteristics. We also identified the most prevalent dyads and triads of chronic conditions among these patients. We used the National Ambulatory Medical Care Survey, a nationally representative survey of office visits to nonfederal physicians and used 13 of the 20 conditions defined by the National Strategic Framework on Multiple Chronic Conditions. Descriptive estimates were generated and significant differences were tested. In 2009, an estimated 326 million physician office visits, were made by adults aged 18 years or older with MCC representing 37.6% of all medical office visits by adults. Hypertension was the most prevalent chronic condition that appeared in the top 5 MCC dyads and triads, by sex and age groups. The number of visits by patients with MCC increased with age and was greater for men than for women and for adults with public rather than private insurance. Physicians were more likely to prescribe medications at office visits made by patients with MCC. Physician office visits by adults with MCC were not evenly distributed by demographic characteristics.

Beresovsky, Vladislav

2013-01-01

226

Medication Treatments  

MedlinePLUS

... medications are used to treat certain symptoms of Fragile X syndrome, as shown in the chart below. The NICHD ... of these medications in treating the symptoms of Fragile X syndrome, or for other conditions for which the medications ...

227

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

PubMed Central

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.

Rizzo, Matthew

2012-01-01

228

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

229

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

Code of Federal Regulations, 2013 CFR

...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 qualified social worker, and in accordance with the plan of care. The...

2013-10-01

230

Diabetes mellitus, other medical conditions and familial history of cancer as risk factors for pancreatic cancer  

PubMed Central

In a population-based case-control study of pancreatic cancer conducted in three areas of the USA, 484 cases and 2099 controls were interviewed to evaluate the aetiologic role of several medical conditions/interventions, including diabetes mellitus, cholecystectomy, ulcer/gastrectomy and allergic states. We also evaluated risk associated with family history of cancer. Our findings support previous studies indicating that diabetes is a risk factor for pancreatic cancer, as well as a possible complication of the tumour. A significant positive trend in risk with increasing years prior to diagnosis of pancreatic cancer was apparent (P-value for test of trend = 0.016), with diabetics diagnosed at least 10 years prior to diagnosis having a significant 50% increased risk. Those treated with insulin had risks similar to those not treated with insulin (odds ratio (OR) = 1.6 and 1.5 respectively), and no trend in risk was associated with increasing duration of insulin treatment. Cholecystectomy also appeared to be a risk factor, as well as a consequence of the malignancy. Subjects with a cholecystectomy at least 20 years prior to the diagnosis of pancreatic cancer experienced a 70% increased risk, which was marginally significant. In contrast, subjects with a history of duodenal or gastric ulcer had little or no elevated risk (OR = 1.2; confidence interval = 0.9–1.6). Those treated by gastrectomy had the same risk as those not receiving surgery, providing little support for the hypothesis that gastrectomy is a risk factor for pancreatic cancer. A significant 40% reduced risk was associated with hay fever, a non-significant 50% decreased risk with allergies to animals, and a non-significant 40% reduced risk with allergies to dust/moulds. These associations, however, may be due to chance since no risk reductions were apparent for asthma or several other types of allergies. In addition, we observed significantly increased risks for subjects reporting a first-degree relative with cancers of the pancreas (OR = 3.2), colon (OR = 1.7) or ovary (OR = 5.3) and non-significantly increased risks for cancers of the endometrium (OR = 1.5) or breast (OR = 1.3). The pattern is consistent with the familial predisposition reported for pancreatic cancer and with the array of tumours associated with hereditary non-polyposis colon cancer. © 1999 Cancer Research Campaign

Silverman, D T; Schiffman, M; Everhart, J; Goldstein, A; Lillemoe, K D; Swanson, G M; Schwartz, A G; Brown, L M; Greenberg, R S; Schoenberg, J B; Pottern, L M; Hoover, R N; Fraumeni, J F

1999-01-01

231

Operational conditions: legal capacity of a patient soldier refusing medical treatment.  

PubMed

Using a three-dimensional ethical role-specific model, this article considers the dual loyalty conflict between following military orders and professional codes of practice in an operational military environment when a patient soldier refuses life-saving medical treatment and where their legal capacity is questionable. The article suggests that although every competent patient has the right to refuse medical treatment even though they may die as a consequence. Ordinarily, it is unethical to exert any undue influence on a patient to accept medical treatment, in a military operational environment where attack from the enemy is likely, it may be reasonable and understandable to exert undue influence over a patient when they lack legal capacity. PMID:21974941

Kelly, Janet C

2011-11-01

232

ROC study of four LCD displays under typical medical center lighting conditions.  

PubMed

Nine observers reviewed a previously assembled library of 320 chest computed radiography (CR) images. Observers participated in four sessions, reading a different 1/4 of the sample on each of four liquid crystal displays: a 2-megapixel (MP) consumer color display, a 2-MP business color display, a 2-MP medical-grade gray display, and a 3-MP gray display. Each display was calibrated according to the DICOM Part 14 standard. The viewing application required observer log-in, then randomized the order of the subsample seen on the display, and timed the responses of the observer to render a 1-5 judgment on the absence or presence of ILD on chest CRs. Selections of 1-2 were considered negative, 3 was indeterminate, and 4-5 were positive. The order of viewing sessions was also randomized for each observer. The experiment was conducted under controlled lighting, temperature, and sound conditions to mimic conditions typically found in a patient examination room. Lighting was indirect, and illuminance at the display face was 195 +/- 8% lux and was monitored over the course of the experiment. The average observer sensitivity for the 2 MP color consumer, 2 MP business color, 2 MP gray, and 3 MP gray displays were 83.7%, 84.1%, 85.5%, and 86.7%, respectively. The only pairwise significant difference was between the 2-MP consumer color and the 2-MP gray (P = 0.05). Effect of order within a session was not significant (P = 0.21): period 1 (84.3%), period 2 (86.2%), period 3 (85.4%), period 4 (84.1%). Observer specificity for the various displays was not statistically significant (P = 0.21). Finally, a timing analysis showed no significant difference between the displays for the user group (P = 0.13), ranging from 5.3 s (2 MP color business) to 5.9 s (3 MP Gray). There was, however, a reduction in time over the study that was significant (P < 0.001) for all users; the group average decreased from 6.5 to 4.7 s per image. Physical measurements of the resolution, contrast, and noise properties of the displays were acquired. Most notably, the noise of the displays varied by 3.5x between the lowest and highest noise displays. Differences in display noise were indicative of observer performance. However, the large difference in the magnitude of the noise was not predictive of the small difference (3%) in the observer sensitivity for various displays. This is likely because detection of interstitial lung disease is limited by "anatomical noise" rather than display or x-ray image noise. PMID:16249836

Langer, Steve; Fetterly, Ken; Mandrekar, Jay; Harmsen, Scott; Bartholmai, Brian; Patton, Charles; Bishop, Alan; McCannel, Colin

2006-03-01

233

Medical Costs and Lost Productivity from Health Conditions at Volatile Organic Compound-Contaminated Superfund Sites  

Microsoft Academic Search

This paper estimates the health costs at Superfund sites for conditions associated with volatile organic compounds (VOCs) in drinking water. Health conditions were identified from published literature and registry information as occurring at excess rates in VOC-exposed populations. These health conditions were: (1) some categories of birth defects, (2) urinary tract disorders, (3) diabetes, (4) eczema and skin conditions, (5)

Jeffrey A. Lybarger; Russell Lee; David P. Vogt; Ralph M. Perhac; Robert F. Spengler; David R. Brown

1998-01-01

234

The influence of basement structure on the evolution of the Bicorb-Quesa Diapir (eastern Betics, Iberian Peninsula): contractive thin-skinned deformation above a pre-existing extensional basement fault  

NASA Astrophysics Data System (ADS)

On the basis of an analysis of structural surface data in addition to previously available and new magnetotelluric data, it was possible to reconstruct the evolution of Bicorb-Quesa Diapir. This was initiated as a reactive diapir in relation to a basement fault. The reactive diapir was rejuvenated by a thin-skinned compression during the Paleogene and rose during an extensional early-middle Miocene phase. Later, in the middle Miocene, the diapir was squeezed and then, in the late Miocene, was extensionally reactivated. The current reconstruction allows us to analyse a diapir affected by a thin-skinned contractional deformation located on top of a pre-existing basement fault. Our study highlights the role played by the geometric relationship between the propagation direction of the cover deformation and the basement fault.

Rubinat, M.; Roca, E.; Escalas, M.; Queralt, P.; Ferrer, O.; Ledo, J. J.

2013-01-01

235

Does the correspondence between EQ-5D health state description and VAS score vary by medical condition?  

PubMed Central

Background The EQ-5D health-related quality of life instrument comprises a health state classification (health problems by severity in five domains), followed by an evaluation using a visual analogue scale (VAS). Despite the EQ-5D’s use in health technology assessment and as a patient-reported outcome measure (PROM), the correspondence between the two parts of the instrument remains ill-understood. In this paper, we consider whether the association between health state classification and VAS score might vary by medical condition. Methods EQ-5D data collected for studies of patients in four different clinical conditions or circumstances (stroke, low back pain, colposcopic investigation or cytological surveillance) were pooled to generate a sample of 3,851 patient records. VAS scores were regressed on reported problem severities, with the inclusion of intercept and slope dummy variables specific to condition. Results The regression model achieved a goodness-of-fit of 0.54. Given its structure and the significance of the coefficients, the proportion of VAS scores which differed by condition for the same health state varied between 33.3 and 88.5 per cent of possible states. Conclusions Many of the patients with different medical conditions or in receipt of different interventions recorded different VAS valuations, in spite of ostensibly being in the same EQ-5D-defined health states. By implication, it is probable that the same state-to-state change would by valued differently by patients experiencing different conditions.

2013-01-01

236

Mapping the river landscape "before and after": the utility of pre-existing digital data for floodplain definition and the documentation and analysis of human impacts along river corridors  

NASA Astrophysics Data System (ADS)

Critical to the analysis of the impacts of human activities on floodplain form and function are: 1) establishing the extent of the floodplain prior to human intervention, and 2) establishing the current extent of the functional floodplain surface as limited by human land use changes. In this study, I critically examine data, methods and concepts used in the definition and analysis of floodplain landscapes. I focus on data that are readily available, free of charge, and on techniques that may be quickly, easily, and inexpensively implemented. These topics are explored in a case study of the extent and ecological impact of floodplain disconnection caused by transportation infrastructure in three river corridors in Washington State. Specifically, I compare the utility of pre-existing digital data sets and different metrics for 1) floodplain delineation, and 2) analysis of the spatial extent and environmental impact of disconnection caused by transportation infrastructure across a variety of valley settings in the Chehalis and Upper and Lower Yakima basins. Pre-existing digital soil and geologic data, along with elevation data are useful for quickly delineating the extent of potential floodplain surface prior to human alteration, and have utility for many types of floodplain analysis. Valley confinement is likewise readily calculated from existing data, and provides a useful index for predicting channel and floodplain behavior, and its response to land use changes. Remotely sensed and GIS data are useful for mapping floodplain alteration at the river corridor scale, and assessing its ecological impact, particularly on the riparian zone. Lastly, the case study illustrates the utility of corridor-scale analysis as a methodological linkage between mapping and descriptive approaches used to assess basin-scale patterns and processes, and mechanistic and process-based approaches used to quantify reach scale impacts on channel and riparian habitat.

Blanton, P. M.

2009-12-01

237

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

238

Prevalence of Chronic Medical Conditions in Adults with Mental Retardation: Comparison with the General Population.  

ERIC Educational Resources Information Center

A study interviewed caregivers and reviewed medical records of 278 adults with mental retardation with and without Down syndrome. The adults with mental retardation had age-related disorders comparable to those in the general population, but there was an increased frequency of thyroid disorders, nonischemic heart disorders, and sensory impairment.…

Kapell, Deborah; Nightingale, Beryle; Rodriguez, Ana; Lee, Joseph H.; Zigman, Warren B.; Schupf, Nicole

1998-01-01

239

Meeting changing conditions at the Rhode Island Medical Center Cogeneration Plant  

Microsoft Academic Search

In 1902 the Central Power Plant (CPP) was established at the Rhode Island Medical Center (RIMC) to provide heat and electricity for the facility and to make the Center self-sufficient. The plant consisted of coal fired boilers and steam engine driven generators. In 1936 a new cogeneration plant was built and consisted of two General Electric Company steam turbine generators

D. P. Galamaga; P. T. Bowen

2009-01-01

240

Skin diseases and conditions among students of a medical college in southern India  

PubMed Central

Introduction: Skin diseases are a common problem among young adults. There is paucity of data about it among medical students. This study aimed to find out the pattern of skin disorders and to describe their association with various socio-demographic factors among medical students. Materials and Methods: This cross-sectional study was conducted in June 2011 in a medical college in Mangalore, Karnataka. Two-hundred and seventy eight medical students were chosen from the 4th, 6th and 8th semester through convenient sampling method. Data on hair and skin morbidities suffered over past 1 year and its associated factors were collected using a self-administered questionnaire. Results: Most of the participants 171 (61.5%) were of the age group 20-21 years and majority were females 148 (53.2%). The most common hair/skin morbidities suffered in the past one year were acne 185 (66.6%), hair loss 165 (59.3%), and sun tan 147 (52.9%). Fungal infection (P = 0.051) and severe type of acne (P = 0.041) were seen significantly more among males while hair morbidities like hair loss (P = 0.003), split ends of hairs (P < 0.0001) and dandruff (P =0.006) were seen significantly more among female students. Patterned baldness (P = 0.018) and sun tan (P < 0.0001) were significantly more among non-Mangalorean students than native Mangaloreans. Presence of dandruff was significantly associated with hair loss (P = 0.039) and usage of sunscreen was found to protect from developing sun tans (P = 0.049). Conclusion: Skin disorders, particularly the cosmetic problems are very common among medical students. Gender and place of origin were found to significantly influence the development of certain morbidities.

Joseph, Nitin; Kumar, Ganesh S; Nelliyanil, Maria

2014-01-01

241

Beliefs and Attitudes about Influenza Immunization among Parents of Children with Chronic Medical Conditions over a Two-Year Period  

PubMed Central

Influenza vaccination is recommended for children with chronic medical conditions yet is infrequently performed. The reasons for low influenza vaccination rates in this group have not been well studied. We assessed and compared parents of children with chronic medical conditions regarding their beliefs and attitudes about influenza vaccination in 2003 and 2004. Parents of 2- to 13-year-old children with chronic medical conditions from health centers in low-income urban neighborhoods completed a 19-question survey, mailed following the 2002–2003 and 2003–2004 influenza seasons. Parent-reported influenza vaccination rate declined from 2003 (44%) to 2004 (25%). The most important factors related to influenza vaccination status were perceived doctor's recommendation (odds ratio [OR] = 6.0, 95% confidence interval [CI] = 3.7–9.7), parents' belief that the child should be vaccinated (OR = 5.4, 95%CI = 3.3–8.8), relatives' belief that the child should be vaccinated (OR = 1.7, 95%CI = 1.1–2.7), easy access to the doctor's office for a flu shot (OR = 2.4, 95%CI = 1.4–4.2), and receipt of a reminder from the doctor's office (OR = 1.7, 95%CI = 1.1–2.6). In 2004 compared with 2003, fewer parents reported getting a reminder, and fewer believed that their child's doctor recommended flu vaccine. Doctors' recommendation that children with chronic medical conditions should receive an annual influenza vaccine and vaccine availability are important factors that resulted in a higher likelihood of influenza vaccination. Our findings that fewer parents reported receiving reminders and that fewer children were vaccinated in 2004 suggest that sustained improvements in vaccination rates may require continual changes in the format and delivery method of vaccination reminders from physicians.

Lin, Chyongchiou J.; Zimmerman, Richard K.; Ko, Feng-Shou; Zoffel, Lisa; Hoberman, Alejandro; Kearney, Diana H.

2006-01-01

242

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

243

Beliefs and attitudes about influenza immunization among parents of children with chronic medical conditions over a two-year period.  

PubMed

Influenza vaccination is recommended for children with chronic medical conditions yet is infrequently performed. The reasons for low influenza vaccination rates in this group have not been well studied. We assessed and compared parents of children with chronic medical conditions regarding their beliefs and attitudes about influenza vaccination in 2003 and 2004. Parents of 2- to 13-year-old children with chronic medical conditions from health centers in low-income urban neighborhoods completed a 19-question survey, mailed following the 2002-2003 and 2003-2004 influenza seasons. Parent-reported influenza vaccination rate declined from 2003 (44%) to 2004 (25%). The most important factors related to influenza vaccination status were perceived doctor's recommendation (odds ratio [OR] = 6.0, 95% confidence interval [CI] = 3.7-9.7), parents' belief that the child should be vaccinated (OR = 5.4, 95%CI = 3.3-8.8), relatives' belief that the child should be vaccinated (OR = 1.7, 95%CI = 1.1-2.7), easy access to the doctor's office for a flu shot (OR = 2.4, 95%CI = 1.4-4.2), and receipt of a reminder from the doctor's office (OR = 1.7, 95%CI = 1.1-2.6). In 2004 compared with 2003, fewer parents reported getting a reminder, and fewer believed that their child's doctor recommended flu vaccine. Doctors' recommendation that children with chronic medical conditions should receive an annual influenza vaccine and vaccine availability are important factors that resulted in a higher likelihood of influenza vaccination. Our findings that fewer parents reported receiving reminders and that fewer children were vaccinated in 2004 suggest that sustained improvements in vaccination rates may require continual changes in the format and delivery method of vaccination reminders from physicians. PMID:16770701

Lin, Chyongchiou J; Nowalk, Mary Patricia; Zimmerman, Richard K; Ko, Feng-Shou; Zoffel, Lisa; Hoberman, Alejandro; Kearney, Diana H

2006-09-01

244

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

245

Acute Lung Injury in the Medical ICU Comorbid Conditions, Age, Etiology, and Hospital Outcome  

Microsoft Academic Search

The independent effects of chronic disease, age, severity of illness, lung injury score (LIS) and etiol- ogy, and preceding nonpulmonary organ-system dysfunction (OSD) on the outcome of acute lung in- jury (ALI) have not been examined in an exclusively medical-intensive-care-unit (MICU) population. Therefore, 107 consecutive MICU patients with ALI (76% with acute respiratory distress syndrome (ARDS)) were prospectively investigated. The

MARYA D. ZILBERBERG; SCOTT K. EPSTEIN

246

An examination of co-occurring conditions and management of psychotropic medication use in soldiers with traumatic brain injury.  

PubMed

There are approximately 1.4 million cases of traumatic brain injury (TBI) per year in the United States, with about 23 000 survivors requiring hospitalization. The incidence of TBI has increased in the patient population of the Department of Defense and Veterans Healthcare Administration as a result of injuries suffered during recent military and combat operations. Within the past few years, TBI has emerged as a common form of injury in service members with a subset of patients experiencing postinjury symptoms that greatly affect their quality of life. Traumatic brain injury can occur when sudden trauma (ie, penetration blast or blunt) causes damage to the brain. Traumatic brain injury produces a cascade of potentially injurious processes that include focal contusions and cytotoxic damage. The results of TBI can include impaired physical, cognitive, emotional, and behavioral functioning, which may or may not require the initiation of pharmacological and nonpharmacological interventions when deemed appropriate. Associated outcomes of TBI include alterations in mental state at the time of injury (confusion, disorientation, slowed thinking, and alteration of consciousness). Neurological deficits include loss of balance, praxis, aphasia, change in vision that may or may not be transient. Individuals who sustain a TBI are more likely to have or developed co-occurring conditions (ie, sleep problems, headaches, depression, anxiety, and posttraumatic stress disorder) that may require the administration of multiple medications. It has been identified that veterans being discharged on central nervous system and muscular skeletal drug classes can develop addiction and experience medication misadventures. With the severity of TBI being highly variable but typically categorized as either mild, moderate, or severe, it can assist health care providers in determining which patients are more susceptible to medication misadventures compared with others. The unique development of cognitive and emotional symptoms of TBI can lead to significant impairments, so it is important for all health care providers, including pharmacists, to promote proper use of high-risk psychotropic medications among this patient population by providing effective medication education. PMID:25023837

Farinde, Abimbola

2014-01-01

247

Introduction: Chronic Medical Conditions and Depression: the View from Primary Care  

PubMed Central

Martin Hickman† maneuvered his way into the office and pulled up his sleeve as the medical assistant put the brake on his wheelchair and attached the blood pressure cuff around his oversized upper arm. A bulky 56-year-old man with a heavy shock of gray hair teetering on the edge of his forehead, his problem list included type 2 diabetes, chronic obstructive pulmonary disease, hypertension, obesity, and hyperlipidemia. For the past 15 years he has used a wheelchair due to T4 paraplegia from a gunshot wound. He has also suffers from bouts of major depression that respond to sertraline but never fully remit. As the medical assistant inflated the cuff, Mr. Hickman smiled weakly and maintained a cheerful façade even after she informed him that his blood pressure was 164/88 mm Hg and his glucose was 267 mg/dl (both well above goal). Later, on more careful questioning by his primary care physician, Hickman admitted that he was feeling “more down than usual” and that he sometimes neglected to take his diabetes medicine and blood pressure pills. Thinking back over the years he had cared for this patient, the physician recalled that December tended to be a particularly bad month. Social isolation, tolerable for most of the year, became painful around the holidays. December also happened to mark the anniversary of Hickman's spinal cord injury. The clock was running, the waiting room was full, and the physician realized he was already falling behind.

Kravitz, Richard L.; Ford, Daniel

2009-01-01

248

Photon doses at the entrance of 60Co and low-energy medical accelerator rooms under unusual irradiation conditions.  

PubMed

In this paper, the general-purpose Monte Carlo code MCNP5 was used to study the dose variance due to the position of medical linear accelerators, under unusual conditions, for shielding design of radiotherapy facilities. It was found that the computational methods generally used to estimate the scattered photon doses at the entrance of radiotherapy unit vaults provide conservative results when compared with the MCNP results, considering the standard condition. On the other hand, for the situations where the axis of gantry rotation is redirected at, for example, 45 degrees with respect to the walls of the room, the photon doses at the entrance can reach values up to seven times higher than those obtained under the standard condition, depending on the energy of the primary beam. PMID:19965909

Facure, A; Cardoso, S C; da Rosa, L A R; da Silva, A X

2010-03-01

249

Apparatus for detecting at least one predetermined condition and providing an informational signal in response thereto in a medication infusion system  

NASA Technical Reports Server (NTRS)

A medication infusion system provides redundant safety and includes condition detecting and informational alarm signal generating apparatus for indicating if (1) a fluid leak occurs in different portions of the system; (2) a programmable input from a patient or physician would result in exceeding a safe dosage limit; (3) the reservoir containing medication has been filled; (4) the intended medication pumping does not correlate with the pumping actually effected; (5) battery voltage is low; (6) the medication reserve is low; and (7) the system has been switched off. The apparatus may provide subcutaneous electrical, thermal, or audible stimulation to the patient and also provides a signal which a physician may monitor. The stimulation may be coded to separately identify each above-listed deviation in nominal system performance. In addition, the number of medication requests are correlated with actual medication dispensing to assure proper operation. An identification scheme is provided which matches the patient with his or her corresponding medication.

Fischell, Robert E. (Inventor)

1986-01-01

250

The effects of chronic medical conditions on work loss and work cutback.  

PubMed

Although work performance has become an important outcome in cost-of-illness studies, little is known about the comparative effects of different commonly occurring chronic conditions on work impairment in general population samples. Such data are presented here from a large-scale nationally representative general population survey. The data are from the MacArthur Foundation Midlife Development in the United States (MIDUS) survey, a nationally representative telephone-mail survey of 3032 respondents in the age range of 25 to 74 years. The 2074 survey respondents in the age range of 25 to 54 years are the focus of the current report. The data collection included a chronic-conditions checklist and questions about how many days out of the past 30 each respondent was either totally unable to work or perform normal activities because of health problems (work-loss days) or had to cut back on these activities because of health problems (work-cutback days). Regression analysis was used to estimate the effects of conditions on work impairments, controlling for sociodemographics. At least one illness-related work-loss or work-cutback day in the past 30 days was reported by 22.4% of respondents, with a monthly average of 6.7 such days among those with any work impairment. This is equivalent to an annualized national estimate of over 2.5 billion work-impairment days in the age range of the sample. Cancer is associated with by far the highest reported prevalence of any impairment (66.2%) and the highest conditional number of impairment days in the past 30 (16.4 days). Other conditions associated with high odds of any impairment include ulcers, major depression, and panic disorder, whereas other conditions associated with a large conditional number of impairment days include heart disease and high blood pressure. Comorbidities involving combinations of arthritis, ulcers, mental disorders, and substance dependence are associated with higher impairments than expected on the basis of an additive model. The effects of conditions do not differ systematically across subsamples defined on the basis of age, sex, education, or employment status. The enormous magnitude of the work impairment associated with chronic conditions and the economic advantages of interventions for ill workers that reduce work impairments should be factored into employer cost-benefit calculations of expanding health insurance coverage. Given the enormous work impairment associated with cancer and the fact that the vast majority of employed people who are diagnosed with cancer stay in the workforce through at least part of their course of treatment, interventions aimed at reducing the workplace costs of this illness should be a priority. PMID:11285869

Kessler, R C; Greenberg, P E; Mickelson, K D; Meneades, L M; Wang, P S

2001-03-01

251

One dose of an MF59-adjuvanted pandemic A/H1N1 vaccine recruits pre-existing immune memory and induces the rapid rise of neutralizing antibodies.  

PubMed

Protective antibody responses to a single dose of 2009 pandemic vaccines have been observed in the majority of healthy subjects aged more than 3 years. These findings suggest that immune memory lymphocytes primed by previous exposure to seasonal influenza antigens are recruited in the response to A/H1N1 pandemic vaccines and allow rapid seroconversion. However, a clear dissection of the immune memory components favoring a fast response to pandemic vaccination is still lacking. Here we report the results from a clinical study where antibody, CD4+ T cell, plasmablast and memory B cell responses to one dose of an MF59-adjuvanted A/H1N1 pandemic vaccine were analyzed in healthy adults. While confirming the rapid appearance of antibodies neutralizing the A/H1N1 pandemic virus, we show here that the response is dominated by IgG-switched antibodies already in the first week after vaccination. In addition, we found that vaccination induces the rapid expansion of pre-existing CD4+ T cells and IgG-memory B lymphocytes cross-reactive to seasonal and pandemic A/H1N1 antigens. These data shed light on the different components of the immune response to the 2009 H1N1 pandemic influenza vaccination and may have implications in the design of vaccination strategies against future influenza pandemics. PMID:22521851

Faenzi, Elisa; Zedda, Luisanna; Bardelli, Monia; Spensieri, Fabiana; Borgogni, Erica; Volpini, Gianfranco; Buricchi, Francesca; Pasini, Franco Laghi; Capecchi, Pier Leopoldo; Montanaro, Fabio; Belli, Riccardo; Lattanzi, Maria; Piccirella, Simona; Montomoli, Emanuele; Ahmed, Syed Sohail; Rappuoli, Rino; Del Giudice, Giuseppe; Finco, Oretta; Castellino, Flora; Galli, Grazia

2012-06-01

252

[Miranda de Ebro: Medical condition of the concentration camp in the autumn of 1943].  

PubMed

Georges Morin's thesis (Algiers January 4 1944) allows to understand the sanitary conditions of the refugee camp at Miranda De Ebro (Spain) in the fall 1943. To avoid the Nazi occupation and the Obligatory Work Service in Germany 18,000 French got in Spain in 1943 and 10,000 including 39 physicians came through Miranda. The French were the majority and they created a Health Service separate from the official Spanish Health Service. The general dirtiness, the lack of water, the rudimentary conditions of lodging, the inadequacy and imbalance of food provoked two diseases among the young men: scabies and the so-called "mirandite" that is to say all the diarrheic diseases in the camp. Despite hard conditions of living the death rate in the camp remained smaller than crossing the Pyrenees from France where the danger threatened the escaped men. PMID:19230323

Héraut, Louis-Armand

2008-01-01

253

PubMed search strategies for the identification of etiologic associations between hypothalamic-pituitary disorders and other medical conditions.  

PubMed

Biomedical literature has enormously grown in the last decades and become broadly available through online databases. Ad-hoc search methods, created on the basis of research field and goals, are required to enhance the quality of searching. Aim of this study was to formulate efficient, evidence-based PubMed search strategies to retrieve articles assessing etiologic associations between a condition of interest and hypothalamic-pituitary disorders (HPD). Based on expert knowledge, 17 MeSH (Medical Subjects Headings) and 79 free terms related to HPD were identified to search PubMed. Using random samples of abstracts retrieved by each term, we estimated the proportion of articles containing pertinent information and formulated two strings (one more specific, one more sensitive) for the detection of articles focusing on the etiology of HPD, that were then applied to retrieve articles identifying possible etiologic associations between HPD and three diseases (malaria, LHON and celiac disease) considered not associated to HPD, and define the number of abstracts needed to read (NNR) to find one potentially pertinent article. We propose two strings: one sensitive string derived from the combination of articles providing the largest literature coverage in the field and one specific including combined terms retrieving ?40% of potentially pertinent articles. NNR were 2.1 and 1.6 for malaria, 3.36 and 2.29 for celiac disease, 2.8 and 2.2 for LHON, respectively. For the first time, two reliable, readily applicable strings are proposed for the retrieval of medical literature assessing putative etiologic associations between HPD and other medical conditions of interest. PMID:23196809

Guaraldi, Federica; Grottoli, Silvia; Arvat, Emanuela; Mattioli, Stefano; Ghigo, Ezio; Gori, Davide

2013-12-01

254

Predictors of All-Cause Mortality in Patients with Stable COPD: Medical Co-morbid Conditions or High Depressive Symptoms.  

PubMed

Abstract Co-morbid conditions are frequently found in patients with COPD. We evaluate the association of co-morbidities with mortality, in stable COPD. 224 patients, mean age 61.2 (±10.00), 48.2% female, mean FEV1 1.1 (±0.5) liters, median follow-up time 4.2 years, participated. Medical co-morbidities were scored according to the Charlson Co-morbidity Index (CCI). Depressive symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS) and Symptom Checklist-90 (SCL-90). The Cox proportional hazard model was used for survival analyses. In our sample, 70% of all patients have a co-morbid medical condition or high depressive symptoms. During follow-up 51% of all patients died, and those with heart failure have the highest mortality rate (75%). Age, fat-free mass and exercise capacity were predictive factors, contrary to CCI-scores and high depressive symptoms. An unadjusted association between heart failure and survival was found. Although the presence of co-morbidities, using the CCI-score, is not related to survival, heart failure seems to have a detrimental effect on survival. Higher age and lower exercise capacity or fat-free mass predict mortality. PMID:24831411

Maters, Gemma A; de Voogd, Jacob N; Sanderman, Robbert; Wempe, Johan B

2014-08-01

255

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

256

Analysis of West Virginia medicaid claims data for the prevalence of medical conditions and use of drugs likely to cause QT prolongation in patients with schizophrenia?  

PubMed Central

Background An important concern with antipsychotic drugs used for the treatment of schizophrenia is the prolongation of the QT interval on the electrocardiogram. Concomitant use of other QT-prolonging drugs and the presence of certain medical conditions may lead to excessive QT prolongation and subsequent cardiac arrhythmias. Objective The aim of this study was to assess the utilization of QT-prolonging drugs and the prevalence of medical conditions causing QT prolongation in a large population of patients with schizophrenia in practice settings. Methods The study was conducted using West Virginia Medicaid claims data for patients aged 18 to 64 years with ?1 medical claim for schizophrenia between January 1, 1997, and December 31, 1999. A comprehensive list of drugs and medical conditions causing QT prolongation was obtained from the literature. The drugs were identified in the prescription claims data using their specific National Drug Classification codes. Codes from the International Classification of Diseases, Ninth Revision, Clinical Modification, were used to identify the medical conditions as described in the medical claims files. Descriptive statistics on utilization of drugs and prevalence of medical conditions were reported and demographic differences were examined. Results The final sample consisted of 1699 patients with schizophrenia. The mean (SD) age was 40.8 (11.35) years (range, 18–63 years); 55% of the patients were women. A total of 76.9% of patients utilized ?1 nonantipsychotic QT-prolonging drug in a year, with a mean (SD) of 2.1 (1.3) such drugs used per patient per year. A total of 15.9% of patients with schizophrenia had ?1 medical condition associated with QT prolongation. Patients with ?1 such medical condition had a mean (SD) of 1.2 (0.57) conditions potentially causing QT prolongation. The number of nonantipsychotic QT-prolonging prescriptions filled and the prevalence of medical conditions leading to QT prolongation were found to be significantly higher for women (both P<0.001) and patients aged 34 to 64 years (both P<0.001). Conclusions In this study, a high utilization of QT-prolonging drugs and the prevalence of medical conditions causing QT prolongation were found. These results merit assessment of predisposing risk factors, such as concurrent use of other QT-prolonging drugs and the presence of cardiovascular and other conditions associated with QT prolongation, before prescribing antipsychotics, especially in women and older patients with schizophrenia.

Kalsekar, Iftekhar D; Makela, Eugene H; Moeller, Karen E

2003-01-01

257

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

258

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

259

Leveraging a common representation for personalized search and summarization in a medical digital library  

Microsoft Academic Search

Despite the large amount of online medical literature, it can be difficult for clinicians to find relevant information at the point of patient care. In this paper, we present techniques to personalize the results of search, making use of the online patient record as a sophisticated, pre-existing user model. Our work in PERSIVAL, a medical digital library, includes methods for

Kathleen R. McKeown; Noemie Elhadad; Vasileios Hatzivassiloglou

2003-01-01

260

Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey-Replication (NCS-R)  

PubMed Central

The present study sought to extend prior research by using data from the National Comorbidity Survey Replication (NCS-R) to examine the relationship between number of lifetime traumas, PTSD and fifteen self-reported chronic medical conditions. The goal was to determine whether the commonly found relationship between PTSD symptomatology and physical health were better explained by the number of lifetime traumas experienced. The NCS-R is a representative U.S. household survey that assessed lifetime experience of a variety of traumas, lifetime diagnosis of PTSD and fifteen chronic medical conditions (e.g. pain conditions, cardiovascular disorders, etc.). Two major findings emerged: 1) there was a graded relationship between trauma exposure, PTSD, and the majority of chronic medical conditions where individuals with PTSD had the highest likelihood of chronic medical condition and non-traumatized individuals had the lowest risk and; 2) with the exception of headaches, the relationship between PTSD and chronic medical conditions was explained by the number of lifetime traumas experienced when analyses were subset to traumatized individuals. The present study supports prior research suggesting that multiple traumas have a cumulative effect on physical health. The impact of trauma on health may be independent of PTSD symptomatology.

Sledjeski, Eve M.; Speisman, Brittany; Dierker, Lisa C.

2009-01-01

261

Medical Devices and Equipment: Competitive Conditions Affecting U.S. Trade in Japan and Other Principal and Foreign Markets. Investigation No. 332-474.  

National Technical Information Service (NTIS)

This report examines competitive conditions affecting U.S. sales and trade of medical devices and equipment in Japan and other principal foreign markets, for 2001-5, with a focus on comparing the regulatory conditions in the Japanese market with those of ...

2007-01-01

262

Net Differences in Interview Data on Chronic Conditions and Information Derived from Medical Records. Vital and Health Statistics, Series 2, No. 57.  

ERIC Educational Resources Information Center

The California study, based on data from a national survey, compared accuracy and completeness of information on 7,182 chronic health conditions of persons, 17 years of age or older, given in household interviews with diagnostic information given by group medical plan physicians. Overreporting referred to conditions reported in the interview which…

Madow, William G.

263

Apparatus for detecting a condition of a medication infusion system and providing an informational signal in response thereto  

NASA Technical Reports Server (NTRS)

A medication infusion system having a means for providing an informational signal when (1) medication in the reservoir falls below a threshold level; (2) a fluid leak occurs in different portions of the system; and (3) the intended medication pumping does not correlate with the pumping actually affected.

Fischell, Robert E. (Inventor)

1988-01-01

264

Frontal White Matter Alterations in Short-Term Medicated Panic Disorder Patients without Comorbid Conditions: A Diffusion Tensor Imaging Study  

PubMed Central

The frontal cortex might play an important role in the fear network, and white matter (WM) integrity could be related to the pathophysiology of panic disorder (PD). A few studies have investigated alterations of WM integrity in PD. The aim of this study was to determine frontal WM integrity differences between patients with PD without comorbid conditions and healthy control (HC) subjects by using diffusion tensor imaging. Thirty-six patients with PD who had used medication within 1 week and 27 age- and sex-matched HC subjects participated in this study. Structural brain magnetic resonance imaging was performed on all participants. Panic Disorder Severity Scale and Beck Anxiety Inventory (BAI) scores were assessed. Tract-based spatial statistics (TBSS) was used for image analysis. TBSS analysis showed decreased fractional anisotropy (FA) in frontal WM and WM around the frontal lobe, including the corpus callosum of both hemispheres, in patients with PD compared to HC subjects. Moreover, voxel-wise correlation analysis revealed that the BAI scores for patients with PD were positively correlated with their FA values for regions showing group differences in the FA of frontal WM of both hemispheres. Altered integrity in frontal WM of patients with PD without comorbid conditions might represent the structural pathophysiology in these patients, and these changes could be related to clinical symptoms of PD.

Kim, Borah; Kim, Jeong Hoon; Kim, Min-Kyoung; Lee, Kang Soo; Kim, Youngki; Choi, Tai Kiu; Kim, Yun Tai; Lee, Sang-Hyuk

2014-01-01

265

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

266

[Experience of medical assistance in the hosital of Plesetsk Cosmodrome under conditions of large patient load after explosion of a launch vehicle].  

PubMed

Military hospital of Plesetsk Cosmodrome was founded on 20 December 1958. The aims of the hospital were always connected with medical support of the cosmodrome, including emergency situations. On 18 March 1980 a Vostok-2M rocket exploded on its launch pad during a fuelling operation. Experience of medical assistance under conditions of large patient load showed the necessity of constant readiness to medical assistance to patients with combined pathology (burn injury, orthopedic trauma and thermochemical injury of the upper respiratory tract), expediency of compact patient accommodation along with the modern anaesthetic machine and readiness to frequent suction bronchoscopy. PMID:24611312

Plekhanov, V N; Mel'nikov, O N; Shut', A D

2013-11-01

267

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

268

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

269

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

270

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

271

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.

272

The consequences of consanguinity on the rates of malformations and major medical conditions at birth and in early childhood in inbred populations.  

PubMed

The rate of malformations and major medical conditions in early childhood was analyzed in a single village according to the degree of relationship between the parents. In the village, 70-80% of the marriages are between descendants of the founders and therefore consanguineous. In the period 1992-2003, in 99 of 2,610 children, a major malformation was diagnosed at birth and seven additional fetuses were aborted because of a severe malformation. A significant medical condition was diagnosed in 38 additional children in early childhood. The total of 144 cases with malformations or a major medical condition represented 5.52% (95% CI: 4.64-6.4) of the live births. Three malformations/disorders were relatively frequent: Down syndrome, esophageal atresia, and profound deafness. The rate of malformations and significant medical conditions was 7.77% (95 CI: 5.68-9.86) when the parents were first cousins and 3.63% (95% CI: 2.11-5.15) when they were not related (P = 0.002, Fisher's exact test). Offspring of parents that were second cousins or closer but less than first cousin had a risk that was similar to the one of offspring of couples that were more distantly related. We propose therefore, that in inbred populations, all the couples that are not related as first cousins but in which the spouses are both descendants of the founders should be considered as related. The high prevalence of profound deafness in the village is due to mutations in the Connexin 26 gene, while the relatively high frequency of Down syndrome is not explained by maternal age only. PMID:20635393

Zlotogora, Joël; Shalev, Stavit A

2010-08-01

273

Familial and Personal Medical History of Cancer and Nervous System Conditions among Adults with Glioma and Controls  

Microsoft Academic Search

The causes of glioma, the most common type of primary malignant brain tumor, are poorly understood. This study compared the personal and first-degree familial medical histones of 462 adults newly diagnosed with glioma in the San Francisco Bay Area between August 1,1991, and March 31,1994, with those of 443 controls who were frequency-matched on age, sex, and ethnicity. Cases and

Margaret Wrensch; Marion Lee; Rei Mnke; Beth Newman; Geoffrey Barger; Richard Davis; John Wiencke; John Neuhaus

274

Trends in health services utilization, medication use, and health conditions among older adults: a 2-year retrospective chart review in a primary care practice  

PubMed Central

Background Population aging poses significant challenges to primary care providers and healthcare policy makers. Primary care reform can alleviate the pressures, but these initiatives require clinical benchmarks and evidence regarding utilization patterns. The objectives of this study is to measure older patients' use of health services, number of health conditions, and use of medications at the level of a primary care practice, and to investigate age- and gender-related utilization trends. Methods A cross-sectional chart audit over a 2-year study period was conducted in the academic family practice clinic of Sunnybrook Health Sciences Centre in Toronto, Ontario, Canada. All patients 65 years and older (n = 2450) were included. Main outcome measures included the number of family physician visits, specialist visits, emergency room visits, surgical admissions, diagnostic test days, inpatient hospital admissions, health conditions, and medications. Results Older patients (80-84 and 85+ age-group) had significantly more family physician visits (average of 4.4 visits per person per year), emergency room visits (average of 0.22 ER visits per year per patient), diagnostic days (average of 5.1 test days per person per year), health conditions (average of 7.7 per patient), and medications average of 8.2 medications per person). Gender differences were also observed: females had significantly more family physician visits and number of medications, while men had more specialist visits, emergency room visits, and surgical admissions. There were no gender differences for inpatient hospital admissions and number of health conditions. With the exception of the 85+ age group, we found greater intra-group variability with advancing age. Conclusion The data present a map of greater interaction with and dependency on the health care system with advancing age. The magnitudes are substantial and indicate high demands on patients and families, on professional health care providers, and on the health care system itself. There is the need to create and evaluate innovative models of care of multiple chronic conditions in the late life course.

2009-01-01

275

Chronic Medical Conditions and Major Depressive Disorder: Differential Role of Positive Religious Coping among African Americans, Caribbean Blacks and Non-Hispanic Whites  

PubMed Central

Background: This study was aimed to investigate the main and buffering effects of positive religious coping on the association between the number of chronic medical conditions and major depressive disorder (MDD) among African Americans, Caribbean Blacks and Non-Hispanic Whites. Methods: This cross-sectional study used data from the National Survey of American Life, 2001 and 2003. This study enrolled 3,570 African Americans, 1,438 Caribbean Blacks and 891 Non-Hispanic Whites. Number of chronic conditions and positive religious coping were independent variables, 12-month MDD was the outcome and socio-economic characteristics were controls. We fitted the following three ethnic-specific logistic regressions for data analysis. In Model I, we included the number of chronic conditions and controls. In Model II, we added the main effect of religious coping. In Model III, we included an interaction between religious coping and number of chronic conditions. Results: Based on Model I, number of chronic conditions was associated with higher odds of 12-month MDD among all race/ethnic groups. Model II showed a significant and negative association between religious coping and MDD among Caribbean Blacks (odds ratio [OR] =0.55, 95% confidence Interval [CI] =0.39-0.77), but not African Americans or Hispanic Whites. Model III suggested that, only among Caribbean Blacks, the effect of chronic medical conditions on MDD is smaller in the presence of high positive religious coping (OR for interaction = 0.73, 95% CI = 0.55-0.96). Conclusions: Although the association between multiple chronic conditions and MDD may exist regardless of race and ethnicity, race/ethnicity may shape how positive religious coping buffers this association. This finding sheds more light onto race and ethnic differences in protective effects of religiosity on mental health of populations.

Assari, Shervin

2014-01-01

276

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

277

Use of the synthetic superoxide dismutase/catalase mimetic EUK-134 to compensate for seasonal antioxidant deficiency by reducing pre-existing lipid peroxides at the human skin surface.  

PubMed

The generation of reactive oxygen species (ROS) in UV-exposed skin is believed to contribute to the photoaging process. The stratum corneum (SC) contains a variety of enzymatic and non-enzymatic antioxidants to protect against various environmental sources of free radicals. We have previously shown a seasonal variation in SC catalase activity with strong deactivation in sun-exposed skin in the summer, whereas SC superoxide dismutase (SOD) activity remained intact in those conditions. This potentially leads to the local overproduction of H(2)O(2). The oxidized lipid squalene hydroperoxide accumulates at the surface of sun-exposed skin in the summer and upon exposure to ultravoilet A (UVA) doses as low as 0.1 J cm(-2) and adequate protection against excessive lipid peroxidation at times of UV exposure should be aimed for. We have been using the induction of lipid hydroperoxides at the skin surface by a single dose of UVA (1 J cm(-2)) as a model system to evaluate the protective effect of antioxidants in vivo. Topical treatment with the synthetic SOD/catalase mimetic molecule (EUK-134) 1 h before UVA exposure reduced the level of lipid peroxides at the surface of UVA-exposed skin but also baseline peroxide levels on non-irradiated skin were reduced in a dose-dependent fashion. In contrast to alpha-tocopherol, EUK-134 even reduced the level of lipid peroxides at the surface of UVA-exposed skin when it was applied after irradiation. We confirmed that this salen-manganese complex was able to reduce squalene hydroperoxide levels in vitro, suggesting peroxidase-like activity towards organic peroxides. These data support the concept that the synthetic SOD/catalase mimetic EUK-134 might be able to compensate for seasonal deficiencies in antioxidant defense capacity at the skin surface, thereby contributing to an optimal protection of the skin against the accumulation of oxidative damage. PMID:18492138

Declercq, L; Sente, I; Hellemans, L; Corstjens, H; Maes, D

2004-10-01

278

Age and Medication Acceptance  

Microsoft Academic Search

Patients' willingness to take a newly prescribed medication is an important, but little studied, part of the medication process. The authors studied the impact of patient age on the perceived importance and interaction of three factors known to influence young people: severity of their medical condition, extent of possible medication side effects, and level of trust in their physician. A

Catherine Hervé; Etienne Mullet; Paul Clay Sorum

2004-01-01

279

Institutional conditions and individual experiences in the career-entry period of Swiss medical residents - a qualitative study  

Microsoft Academic Search

Background and objectives: The study investi- gated first-year residents' career entry experiences according to gender, clinical field and type of train- ing hospital. In addition to quantitatively assessed workplace experiences (1), this paper reports qual- itative data on institutional conditions as well as interpersonal and individual experiences encoun- tered by junior physicians during their first year of residency. Methods: The

Barbara Buddeberg-Fischer; Richard Klaghofer; Irena Zivanovic; Esther Vetsch; Claus Buddeberg

280

Medical care of overweight children under real-life conditions: the German BZgA observation study  

Microsoft Academic Search

Objective:Current care for overweight children is controversial, and only few data are available concerning the process of care, as well as the outcome under real-life conditions.Methods:A nationwide survey of treatment programs for overweight children and adolescents in Germany identified 480 treatment centers. From 135 institutions that had agreed to participate in this study of process of care and outcome, 48

T Reinehr; U Hoffmeister; R Mann; C Goldapp; J Westenhöfer; A Egmond-Froehlich; M Bullinger; U Ravens-Sieberer; R W Holl

2009-01-01

281

Effect of Hot-Attribute Aged Ginger Tea on Chinese Medical Pulse Condition of Healthy Young Humans  

PubMed Central

Young individuals typically have a dry-heat (?? zào rè) constitution and feel overly stimulated. This study observes specialties on the right-bar (?? yòu gu?n) section of the radial-arterial pulse of healthy young subjects, and investigates pulse variations induced by different attribute foods. Chinese medical doctors grouped thirty subjects into heat and non-heat constitutions. Each subject took water, aged ginger tea, and coconut water, well recognized as neutral, hot, and cold drinks, on different visits. The current study observed physiological signals induced by the samples using novel noninvasive sphygmography and a blood pressure monitor. As the baseline bigger percussion wave, dicrotic wave, and area in the sphygmogram of the non-heat constitution subjects, this work suggests that blood vessels of these subjects may be more relaxed than that of the heat constitution ones. Stroke volume increased and pulse pressure decreased in the non-heat constitution subjects after taking aged ginger tea, which may elevate arterial compliance corresponding to maintaining an estimated radial-arterial diameter in our study. However, the percussion wave widened and the valley increased in the heat constitution subjects after taking aged ginger tea. This corresponds to the markedly reduced radial-arterial diameter, indicating tighter blood vessels than the baseline status. Accordingly, this study confirms that selecting foods with attributes opposite to personal constitutions is important for reestablishing a healthy cold-heat balance within the human body. Moreover, novel noninvasive sphygmography may be a useful instrument to classify scientifically the heat personal constitution and the responses to different attribute foods.

Chao, Dan-Ping; Tyan, Chu-Chang; Chen, Jian-Jung; Hsieh, Ching-Liang; Sheen, Lee-Yan

2011-01-01

282

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

283

Myeloid sarcoma developing in pre-existing pyoderma gangrenosum.  

PubMed

We report here a case of pyoderma gangrenosum in a patient with myelodysplastic syndrome developing into myeloid sarcoma as a sign of transformation to acute leukaemia. The patient was treated successfully with intensive chemotherapy and achieved complete remission, and her otherwise expanding ulcers started to heal. This is the first reported case of secondary blastic infiltration in pyoderma gangrenosum, and it underlines the importance of performing re-biopsy of non-healing ulcers, especially in patients with an underlying haematological disease. PMID:19326005

Kristensen, Ida Bruun; Møller, Hanne; Kjaerskov, Mette Wanscher; Yderstraede, Knud; Møller, Michael Boe; Bergmann, Olav J

2009-01-01

284

Pre-existing brain states predict aesthetic judgments.  

PubMed

Intuition and an assumption of basic rationality would suggest that people evaluate a stimulus on the basis of its properties and their underlying utility. However, various findings suggest that evaluations often depend not only on what is being evaluated, but also on contextual factors. Here we demonstrate a further departure from normative decision making: Aesthetic evaluations of abstract fractal art by human subjects were predicted from pre-stimulus patterns of BOLD fMRI signals across a distributed network of frontal regions before the stimuli were presented. This predictive power was dissociated from motor biases in favor of pressing a particular button to indicate one's choice. Our findings suggest that endogenous neural signals present before stimulation can bias decisions at multiple levels of representation when evaluating stimuli. Hum Brain Mapp 35:2924-2934, 2014. © 2013 Wiley Periodicals, Inc. PMID:24038968

Colas, Jaron T; Hsieh, Po-Jang

2014-07-01

285

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

286

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

287

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

288

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

289

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

290

Treatment non-adherence in pediatric long-term medical conditions: systematic review and synthesis of qualitative studies of caregivers' views  

PubMed Central

Background Non-adherence to prescribed treatments is the primary cause of treatment failure in pediatric long-term conditions. Greater understanding of parents and caregivers’ reasons for non-adherence can help to address this problem and improve outcomes for children with long-term conditions. Methods We carried out a systematic review and thematic synthesis of qualitative studies. Medline, Embase, Cinahl and PsycInfo were searched for relevant studies published in English and German between 1996 and 2011. Papers were included if they contained qualitative data, for example from interviews or focus groups, reporting the views of parents and caregivers of children with a range of long-term conditions on their treatment adherence. Papers were quality assessed and analysed using thematic synthesis. Results Nineteen papers were included reporting 17 studies with caregivers from 423 households in five countries. Long-term conditions included; asthma, cystic fibrosis, HIV, diabetes and juvenile arthritis. Across all conditions caregivers were making on-going attempts to balance competing concerns about the treatment (such as perceived effectiveness or fear of side effects) with the condition itself (for instance perceived long-term threat to child). Although the barriers to implementing treatment regimens varied across the different conditions (including complexity and time-consuming nature of treatments, un-palatability and side-effects of medications), it was clear that caregivers worked hard to overcome these day-to-day challenges and to deal with child resistance to treatments. Yet, carers reported that strict treatment adherence, which is expected by health professionals, could threaten their priorities around preserving family relationships and providing a ‘normal life’ for their child and any siblings. Conclusions Treatment adherence in long-term pediatric conditions is a complex issue which needs to be seen in the context of caregivers balancing the everyday needs of the child within everyday family life. Health professionals may be able to help caregivers respond positively to the challenge of treatment adherence for long-term conditions by simplifying treatment regimens to minimise impact on family life and being aware of difficulties around child resistance and supportive of strategies to attempt to overcome this. Caregivers would also welcome help with communicating with children about treatment goals.

2014-01-01

291

Clinical implications and validity of nursing assessments: a longitudinal measure of patient condition from analysis of the Electronic Medical Record  

PubMed Central

Objectives This study investigates risk of mortality associated with nurses’ assessments of patients by physiological system. We hypothesise that nursing assessments of in-patients performed at entry correlate with in-hospital mortality, and those performed just before discharge correlate with postdischarge mortality. Design Cohort study of in-hospital and postdischarge mortality of patients over two 1-year periods. Setting An 805-bed community hospital in Sarasota, Florida, USA. Subjects 42?302 inpatients admitted for any reason, excluding obstetrics, paediatric and psychiatric patients. Outcome measures All-cause mortalities and mortality OR. Results Patients whose entry nursing assessments, other than pain, did not meet minimum standards had significantly higher in-hospital mortality than patients meeting minimums; and final nursing assessments before discharge had large OR for postdischarge mortality. In-hospital mortality OR were found to be: food, 7.0; neurological, 9.4; musculoskeletal, 6.9; safety, 5.6; psychosocial, 6.7; respiratory, 8.1; skin, 5.2; genitourinary, 3.0; gastrointestinal, 2.3; peripheral-vascular, 3.9; cardiac, 2.8; and pain, 1.1. CI at 95% are within ±20% of these values, with p<0.001 (except for pain). Similar results applied to postdischarge mortality. All results were comparable across the two 1-year periods, with 0.85 intraclass correlation coefficient. Conclusions Nursing assessments are strongly correlated with in-hospital and postdischarge mortality. No multivariate analysis has yet been performed, and will be the subject of a future study, thus there may be confounding factors. Nonetheless, we conclude that these assessments are clinically meaningful and valid. Nursing assessment data, which are currently unused, may allow physicians to improve patient care. The mortality OR and the dynamic nature of nursing assessments suggest that nursing assessments are sensitive indicators of a patient's condition. While these conclusions must remain qualified, pending future multivariate analyses, nursing assessment data ought to be incorporated in risk-related health research, and changes in record-keeping software are needed to make this information more accessible.

Rothman, Michael J; Solinger, Alan B; Rothman, Steven I; Finlay, G Duncan

2012-01-01

292

Medical marijuana.  

PubMed Central

Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana. The current regulatory system should be modified to remove barriers to clinical research with marijuana. The NIH panel has identified several conditions for which there may be therapeutic benefit from marijuana use and that merit further research. Marijuana should be held to the same evaluation standards of safety and efficacy as other drugs (a major flaw in Proposition 215) but should not have to be proved better than current medications for its use to be adopted. The therapeutic window for marijuana and THC between desired effect and unpleasant side effects is narrow and is a major reason for discontinuing use. Although the inhaled route of administration has the benefit of allowing patients to self-titrate the dose, the smoking of crude plant material is problematic. The NIH panel recommended that a high priority be given to the development of a controlled inhaled form of THC. The presence of a naturally occurring cannabinoid-receptor system in the brain suggests that research on selective analogues of THC may be useful to enhance its therapeutic effects and minimize adverse effects.

Marmor, J B

1998-01-01

293

Medical marijuana.  

PubMed

Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana. The current regulatory system should be modified to remove barriers to clinical research with marijuana. The NIH panel has identified several conditions for which there may be therapeutic benefit from marijuana use and that merit further research. Marijuana should be held to the same evaluation standards of safety and efficacy as other drugs (a major flaw in Proposition 215) but should not have to be proved better than current medications for its use to be adopted. The therapeutic window for marijuana and THC between desired effect and unpleasant side effects is narrow and is a major reason for discontinuing use. Although the inhaled route of administration has the benefit of allowing patients to self-titrate the dose, the smoking of crude plant material is problematic. The NIH panel recommended that a high priority be given to the development of a controlled inhaled form of THC. The presence of a naturally occurring cannabinoid-receptor system in the brain suggests that research on selective analogues of THC may be useful to enhance its therapeutic effects and minimize adverse effects. PMID:9656007

Marmor, J B

1998-06-01

294

Towards a clinically useful diagnosis for mild-to-moderate conditions of medically unexplained symptoms in general practice: a mixed methods study  

PubMed Central

Background Symptoms that cannot be attributed to any known conventionally defined disease are highly prevalent in general practice. Yet, only severe cases are captured by the current diagnostic classifications of medically unexplained symptoms (MUS). This study explores the clinical usefulness of a proposed new diagnostic category for mild-to-moderate conditions of MUS labelled ‘multiple symptoms’. Methods A mixed methods approach was used. For two weeks, 20 general practitioners (GPs) classified symptoms presented in consecutive consultations according to the International Classification of Primary Care (ICPC) supplemented with the new diagnostic category ‘multiple symptoms’. The GPs’ experiences were subsequently explored by focus group interviews. Interview data were analysed according to ethnographic principles. Results In 33% of patients, GPs classified symptoms as medically unexplained, but applied the category of ‘multiple symptoms’ only in 2.8%. The category was described as a useful tool for promoting communication and creating better awareness of patients with MUS; as such, the category was perceived to reduce the risk of unnecessary tests and referrals of these patients. Three main themes were found to affect the clinical usefulness of the diagnostic category of ‘multiple symptoms’: 1) lack of consensus on categorisation practices, 2) high complexity of patient cases and 3) relational continuity (i.e. continuity in the doctor-patient relationship over time). The first two were seen as barriers to usefulness, the latter as a prerequisite for application. The GPs’ diagnostic classifications were found to be informed by the GPs’ subjective pre-formed concepts of patients with MUS, which reflected more severe conditions than actually intended by the new category of ‘multiple symptoms’. Conclusions The study demonstrated possible clinical benefits of the category of ‘multiple symptoms’, such as GPs’ increased awareness and informational continuity in partnership practices. The use of the category was challenged by the GPs’ conceptual understanding of MUS and was applied only to a minority of patients. The study demonstrates a need for addressing these issues if sub-threshold categories for MUS are to be applied in routine care. The category of ‘multiple symptoms’ may profitably be used in the future as a risk indicator rather than a diagnostic category.

2014-01-01

295

Cyber-Physical Medical and Medication Systems  

Microsoft Academic Search

Medical and medication devices are real-time systems with safety and timing requirements. They range from hard-real-time, embedded, and reactive systems such as pacemakers to soft-real-time, stand-alone medication dispensers. Many of these devices are already connected to computer networks, especially in hospital intensive-care units, so that patients' conditions detected by sensors can be monitored in real-time at remote computer stations nearby

Albert M. K. Cheng

2008-01-01

296

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 ...

297

Medication Guide  

MedlinePLUS

... before starting any new medication. First-Line Medications: Nicotine Replacement Therapy (NRT) These medications are called "first- ... they might try a "second-line" medication instead. Nicotine replacement therapy (NRT) helps smokers quit by reducing ...

298

Beyond accreditation: excellence in medical education.  

PubMed

Medical school accreditation is a relatively new phenomenon in Korea. The development of an accreditation body and standards for a two-tiered "Must" and "Should" system in 1997 eventually led to the implementation of a third "Excellence" level of attainment. These standards were conceived out of a desire to be able to first recognize and promote outstanding performance of medical schools, second to provide role models in medical education, and furthermore to preview the third level as potential components of the pre-existing second level for the next accreditation cycle. It is a quality-assurance mechanism that, while not required for accreditation itself, pushes medical schools to go beyond the traditional requirements of mere pass-or-fail accreditation adequacy, and encourages schools to deliver an unprecedented level of medical education. The Association for Medical Education in Europe developed its own third-tier system of evaluation under the ASPIRE project, with many similar goals. Due to its advanced nature and global scope, the Korean accreditation body has decided to implement the ASPIRE system in Korea as well. PMID:24050749

Ahn, Eusang; Ahn, Ducksun

2014-01-01

299

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

300

Therapeutic antioxidant medical gas.  

PubMed

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. PMID:19177183

Nakao, Atsunori; Sugimoto, Ryujiro; Billiar, Timothy R; McCurry, Kenneth R

2009-01-01

301

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

302

Dangerous fatigue conditions: a study of police work and law enforcement administration  

Microsoft Academic Search

Sleep deprivation data from various nations have shown a lack of sleep contributing to a number of severe and destructive workplace accidents. Here, a triangulated research strategy focusing on pre?existing data, survey administration, and personal interviews from multiple law enforcement agencies (police, sheriff, and highway patrol) was implemented to study conditions which induce dangerous levels of fatigue in law enforcement

Scott R. Senjo

2011-01-01

303

[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

2006-01-01

304

Medical Assistants  

MedlinePLUS

... uses. Medical assistants should not be confused with physician assistants , who examine, diagnose, and treat patients under a ... learn their skills through on-the-job training. Physicians or other medical assistants may teach a new assistant medical terminology, the ...

305

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

2012-11-01

306

MEDICAL "DEPRIVATION."  

ERIC Educational Resources Information Center

THE SOCIAL AND MEDICAL PROBLEM TODAY HAS SHIFTED FROM PROVIDING FOR THE EMERGENCY MEDICAL NEEDS OF THE INDIGENT SICK TO RAISING THE LEVEL OF LOWER CLASS PARTICIPATION IN THE BENEFITS OF MODERN MEDICINE. GREATER ATTENTION IS BEING FOCUSED ON MEDICAL DEPRIVATION SUFFERED BY LARGE SEGMENTS OF THE POPULATION WHO DO NOT SHARE EQUALLY IN MEDICAL

SUCHMAN, EDWARD A.

307

Medical Matrix  

NSDL National Science Digital Library

Medical Matrix is a Web resource that offers a database of Internet clinical medicine resources. Medical Matrix categorizes resources by disease, specialty, and other interest areas. It is designed as a "home page" for a physician's or healthworker's computer. Medical Matrix is a project of the Internet Working Group of the American Medical Informatics Association.

308

Persons with Mental Retardation and Related Conditions in Mental Retardation Facilities: Selected Findings from the 1987 National Medical Expenditure Survey. Project Report 29.  

ERIC Educational Resources Information Center

This report presents statistics on residential facilities for the mentally retarded and on the residents themselves, derived from the Institutional Population Component of the 1987 National Medical Expenditure Survey (NMES). Part 1 presents an overview of the NMES and discusses previous efforts to survey persons residing in mental retardation…

Lakin, K. Charlie; And Others

309

Doctor–Patient Communication: Do people with spinal cord injury wish to receive written information about their medical condition from the physicians after an outpatient visit or after a readmission in the spinal unit?  

Microsoft Academic Search

Study design: A survey of spinal cord injury patients attending a follow-up clinic in a Regional Spinal Injuries Centre.Objectives: To investigate whether spinal cord injury patients wish to receive written information about any changes in their medical condition after an outpatient visit or, following readmission in a spinal unit.Setting: Regional Spinal Injuries Centre, Southport, United Kingdom.Methods: A questionnaire was developed

S Vaidyanathan; CA Glass; BM Soni; J Bingley; G Singh; JWH Watt; P Sett

2001-01-01

310

Exploration Medical Capability  

NASA Technical Reports Server (NTRS)

Exploration Medical Capability (ExMC) is an element of NASA's Human Research Program (HRP). ExMC's goal is to address the risk of the Inability to Adequately Recognize or Treat an Ill or Injured Crewmember. This poster highlights the approach ExMC has taken to address this goal and our current areas of interest. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to identify medical conditions of concern during exploration missions. The list was derived from space flight medical incidents, the shuttle medical checklist, the International Space Station medical checklist, and expert opinion. The conditions on the list were prioritized according to mission type by a panel comprised of flight surgeons, physician astronauts, engineers, and scientists. From the prioritized list, the ExMC element determined the capabilities needed to address the medical conditions of concern. Where such capabilities were not currently available, a gap was identified. The element s research plan outlines these gaps and the tasks identified to achieve the desired capabilities for exploration missions. This poster is being presented to inform the audience of the gaps and tasks being investigated by ExMC and to encourage discussions of shared interests and possible future collaborations.

Watkins, Sharmila; Baumann, David; Wu, Jimmy; Barsten, Kristina

2010-01-01

311

Weather conditions and visits to the medical wing of emergency rooms in a metropolitan area during the warm season in Israel: a predictive model  

Microsoft Academic Search

Global climate changes affect health and present new challenges to healthcare systems. The aim of the present study was to\\u000a analyze the pattern of visits to the medical wing of emergency rooms (ERs) in public hospitals during warm seasons, and to\\u000a develop a predictive model that will forecast the number of visits to ERs 2 days ahead. Data on daily visits

Ilya Novikov; Ofra Kalter-Leibovici; Angela Chetrit; Nir Stav; Yoram Epstein

2011-01-01

312

PHP95 MEDICAL FOODS AND FOODS FOR SPECIAL MEDICAL PURPOSES  

Microsoft Academic Search

OBJECTIVES: A medical food is formulated to be consumed or administered enterally under the supervision of a physician, and is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements are established by medical evaluation. In the US, medical foods are a special product category regulated by the FDA. In Europe, a similar category

Les L. Noe; N Neil; K Ogden; M Turini

2009-01-01

313

Medical Scenarios Relevant to Spaceflight  

NASA Technical Reports Server (NTRS)

The Medical Operational Support Team (MOST) was tasked by the JSC Space Medicine and Life Sciences Directorate (SLSD) to incorporate medical simulation into 1) medical training for astronaut-crew medical officers (CMO) and medical flight control teams and 2) evaluations of procedures and resources required for medical care aboard the International Space Station (ISS). Development of evidence-based medical scenarios that mimic the physiology observed during spaceflight will be needed for the MOST to complete these two tasks. The MOST used a human patient simulator, the ISS-like resources in the Medical Simulation Laboratory (MSL), and evidence from space operations, military operations and medical literature to develop space relevant medical scenarios. These scenarios include conditions concerning airway management, Advanced Cardiac Life Support (ACLS) and mitigating anaphylactic symptoms. The MOST has used these space relevant medical scenarios to develop a preliminary space medical training regimen for NASA flight surgeons, Biomedical Flight Controllers (Biomedical Engineers; BME) and CMO-analogs. This regimen is conducted by the MOST in the MSL. The MOST has the capability to develop evidence-based space-relevant medical scenarios that can help SLSD I) demonstrate the proficiency of medical flight control teams to mitigate space-relevant medical events and 2) validate nextgeneration medical equipment and procedures for space medicine applications.

Bacal, Kira; Hurs, Victor; Doerr, Harold

2004-01-01

314

Medical Illustration  

MedlinePLUS

... demanding and time-honored method of visual communication. Job description Through the medical graphics they create, medical illustrators ... in preparing prosthetics for patients or in preparing models for instructional purposes. In addition to the production ...

315

Medical Transcriptionists  

MedlinePLUS

... have an understanding of medical terminology, anatomy and physiology, grammar, and word-processing software. Pay The median ... must become familiar with medical terminology, anatomy and physiology, diagnostic procedures, pharmacology, and treatment assessments. Their ability ...

316

Medication Errors  

MedlinePLUS

... Design Control Reviewers - Medical Device Use-Safety: Incorporating Human Factors Engineering into Risk Management (PDF - 1.1MB) Draft ... Industry and Food and Drug Administration Staff - Applying Human Factors and Usability Engineering to Optimize Medical Device Design - ? - ...

317

42 CFR 410.132 - Medical nutrition therapy.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Medical nutrition therapy. 410.132 Section 410.132...MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for...

2013-10-01

318

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

319

Supporting Medical Decision Making with Argumentation Tools  

ERIC Educational Resources Information Center

This study investigated the collaborative decision-making and communicative discourse of groups of learners engaged in a simulated medical emergency in two conditions. In one condition subgroups used a traditional whiteboard (TW group) to document medical arguments on how to solve a medical emergency. In the other condition subgroups used…

Lu, Jingyan; Lajoie, Susanne P.

2008-01-01

320

Medical devices; pediatric uses of devices; requirement for submission of information on pediatric subpopulations that suffer from a disease or condition that a device is intended to treat, diagnose, or cure; direct final rule. Direct final rule.  

PubMed

The Food and Drug Administration (FDA) is amending the regulations on premarket approval of medical devices to include requirements relating to the submission of information on pediatric subpopulations that suffer from the disease or condition that a device is intended to treat, diagnose, or cure. Elsewhere in this issue of the Federal Register, we are publishing a companion proposed rule under FDA's usual procedure for notice and comment to provide a procedural framework to finalize the rule in the event we receive significant adverse comment and withdraw this direct final rule. PMID:20383921

2010-04-01

321

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

322

Medical tourism in India.  

PubMed

The term 'medical tourism' is under debate because health care is a serious business and rarely do patients combine the two. India is uniquely placed by virtue of its skilled manpower, common language, diverse medical conditions that doctors deal with, the volume of patients, and a large nonresident Indian population overseas. Medical tourism requires dedicated services to alleviate the anxiety of foreign patients. These include translation, currency conversion, travel, visa, posttreatment care system,and accommodation of patient relatives during and after treatment. PMID:22727009

Gupta, Vijay; Das, Poonam

2012-06-01

323

A Survey of the Methods Developed in the National Coal Board's Pneumoconiosis Field Research for Correlating Environmental Exposure with Medical Condition  

PubMed Central

The correlation of the medical and environmental data (i.e. the derivation of the dosage-response relationship) in a study such as the National Coal Board's Pneumoconiosis Field Research (P.F.R.) is subject to many complicating factors compared with the more conventional types of biological assay. Several methods have been developed within the Research to overcome these difficulties, and the new procedures are described. Each is concerned with the estimation of the direct relation between the radiological abnormality associated with simple pneumoconiosis and some single measure of the past hazard, but the basic techniques are sufficiently general to be applicable in other fields of study. The first development involves the definition of an underlying continuous scale of radiological abnormality. This prepares the way for the derivation of the “quantitative” relation between exposure and response, to replace the “semi-quantal” relation which is inherent in the use of a small number of discrete categories of radiological abnormality. The effect of errors of observation of dosage and response on the corresponding quantitative and quantal relationships is then determined. The second development concerns the use of a “multi-dimensional” representation of past hazard. Most of the men under observation had worked in a number of different mining occupations before their first chest radiograph was taken, but this exposure cannot be assessed in terms of dust concentrations, for which reliable data are not available. Nevertheless, it is shown that past hazard can usefully be represented by three “dimensions” corresponding to the periods spent in three main types of environment—(a) the coal-face (coal-getting shift), (b) the coal-face (preparation shift) and (c) elsewhere underground. Each man's past exposure up to the time of his first chest radiograph can be expressed in terms of these three dimensions and the effect of each environment separately can be determined. The third development extends the multi-dimensional approach to cover not only the working history before the first medical examination, but also the recorded exposure (in terms of measured dust concentrations), to which each man has been subject between the first and subsequent “follow-up” surveys. This measured exposure is regarded as one dimension of the man's total exposure up to the time of his second (or later) examination, and it is possible in this way to determine the direct relation between radiological abnormality and measured exposure, even when this component represents only part of the total hazard to which the man has been subject. The application of the methods is illustrated by the analysis of some of the data which have been obtained in the Pneumoconiosis Field Research.

Fay, J. W. J.; Ashford, J. R.

1961-01-01

324

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

325

The medical implications of space tourism.  

PubMed

Commercial space travel may soon be a reality. If so, microgravity, high acceleration, and radiation exposure, all known hazards, will be accessible to the general public. Therefore, space tourism has medical implications. Even though the first flights will feature space exposure times of only a few minutes, the potential may someday exist for exposure times long enough to warrant careful consideration of the potential hazards to the space-faring public. The effects of acceleration and microgravity exposure are well known on the corps of astronauts and cosmonauts. The effects of space radiation are partially known on astronauts, but much remains to be discovered. However, there are problems using astronaut data to make inferences about the general public. Astronauts are not necessarily representative of the general public, since they are highly fit, highly screened individuals. Astronaut data can tell us very little about the potential hazards of microgravity in pediatric, obstetric and geriatric populations, all of whom are potential space tourists. Key issues in standard setting will be determining acceptable limits of pre-existing disease and inferring medical standards from mission profiles. It will not be a trivial task drafting minimal medical standards for commercial space travel. It will require the collaboration of space medicine physicians, making the best guesses possible, based on limited amounts of data, with limited applicability. A helpful departure point may be the USAF Class 3 medical standard, applicable to NASA payload specialists. It is time to begin preliminary discussions toward defining those standards. Keywords: acceleration, aerospace medicine, medical standards, microgravity, radiation, space, space tourism, environmental hazards, environmental medicine. PMID:10870826

Tarzwell, R

2000-06-01

326

Taking Medication  

MedlinePLUS Videos and Cool Tools

... or labels with you when you go to health appointments. Ask a family member to go to an appointment with you adn take notes so your not confused when you get home. Also, ask them to remind you to take your medications or labels when you go for any medical appointment.

327

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

328

Medical malpractice  

PubMed Central

Objective To examine the causal effects of doctor-patient relations and the severity of a medical outcome on medical patient perceptions and malpractice intentions in the event of an adverse medical outcome. Design Randomized between-subjects experimental design. Patients were given scenarios depicting interactions between an obstetric patient and her physician throughout the patient's pregnancy, labor, and delivery. Participants One hundred twenty-eight postpartum obstetric patients were approached for participation, of whom 104 completed the study. Main outcome measures Patients' perceptions of physician competence and intentions to file a malpractice claim. Results Positive physician communication behaviors increased patients' perceptions of physician competence and decreased malpractice claim intentions toward both the physician and the hospital. A more severe outcome increased only patients' intentions to sue the hospital. Conclusion These results provide empiric evidence for a direct, causal effect of the doctor-patient relationship on medical patients' treatment perceptions and malpractice claim intentions in the event of an adverse medical outcome.

Moore, Philip J; Adler, Nancy E; Robertson, Patricia A

2000-01-01

329

Exploration Medical System Demonstration Project  

NASA Technical Reports Server (NTRS)

A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide better crew health via the reduction in crew errors, crew time, and ground time.

Chin, D. A.; McGrath, T. L.; Reyna, B.; Watkins, S. D.

2011-01-01

330

Exploration Medical System Demonstration  

NASA Technical Reports Server (NTRS)

BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that allows for scalability, extensibility, and interoperability of data sources and data users. f. Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management. g. Provide a better standard of healthcare for crew members through reductions in the time required by crew and ground personnel to provide medical treatment and the number of crew errors experienced during treatment.

Rubin, D. A.; Watkins, S. D.

2014-01-01

331

[The mandatory medical insurance through eyes of medical personnel].  

PubMed

The article considers the results of sociological survey carries out among medical personnel of the Moscowskaya oblast in August-September 2013. The purpose of the study was to examine opinions of medical personnel about system of mandatory insurance in conditions of implementation of the new law regulating system of mandatory medical insurance during last three years. The sampling included 932 respondents that corresponds approximately 1% of all medical personnel in the oblast. It is established that even 20 years later after the moment of organization of the system of mandatory medical insurance not all medical personnel is oriented in it. More than 70% of respondents consider this system too convoluted and over bureaucratized and only 22.2% of respondents assume that medical insurance organizations defense interests of patient and 25.8% feel no impact of mandatory medical insurance funds on functioning of medical organizations. Most of respondents consider functions of mandatory medical insurance organizations and mandatory medical insurance funds as controlling only. Only 31% of respondents support the actual system of mandatory medical insurance. PMID:24772652

Semenov, V Yu; Lakunin, K Yu; Livshits, S A

2014-01-01

332

Mycobacterial bone marrow infections at a medical centre in Taiwan, 2001-2009.  

PubMed

SUMMARY Mycobacterial bone marrow (BM) infection is the most common diagnosis established by BM examinations for fever of unknown origin. In this study, clinical features and outcomes of patients who fulfilled the criteria for BM infection due to Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacteria (NTM) at a medical centre in Taiwan from 2001 to 2009 were investigated. The BM histopathological findings were also analysed. A total of 24 patients (16 men, eight women) with mycobacterial BM infections were found. Of these, nine (38%) were positive for human immunodeficiency virus (HIV) and six (25%) had no pre-existing immunocompromised conditions. MTB isolates were obtained from 11 (46%) patients and NTM species were isolated from 10 (42%) patients, including M. avium complex (MAC, n = 7) and M. kansasii (n = 3). Patients with MTB infections were significantly older than those with NTM infections (60·5 vs. 47·7 years, P = 0·043) and were less likely to have a positive BM culture (45% vs. 100%, P = 0·012). The 90-day survival rates for MTB and NTM BM infections were 68% and 60%, respectively (P = 0·61). In addition, the presence of BM granulomas was significantly more common in patients with MTB BM infections than in those with NTM infections (82% vs. 30%, P = 0·030). In Taiwan, the importance of NTM was not inferior to MTB and besides MAC, M. kansasii might be an important pathogen in non-HIV-infected patients. The presence of BM granulomas and caseation provides valuable information regarding early treatment pending culture results. PMID:24168831

Lin, S-H; Lai, C-C; Huang, S-H; Hung, C-C; Hsueh, P-R

2014-07-01

333

Anxious patients in the medical setting  

Microsoft Academic Search

Within the setting of the general hospital, up to 60% of patients may present with psychological symptoms. Some of these are psychiatric presentations or complications of medical conditions, while others are medical presentations or complications of psychiatric conditions. A significant number have emotional reactions, commonly anxiety and depression (1,2) . Medical illness may mimic anxiety disorders and anxiety may mimic

Wilfred C G Peh; Lee Pheng Soon; Tham Tat Yean; L H Peh

334

Stability Analysis of ISS Medications  

NASA Technical Reports Server (NTRS)

It is known that medications degrade over time, and that extreme storage conditions will hasten their degradation. The temperature and humidity conditions of the ISS have been shown to be within the ideal ranges for medication storage, but the effects of other environmental factors, like elevated exposure to radiation, have not yet been evaluated. Current operational procedures ensure that ISS medications are re-stocked before expiration, but this may not be possible on long duration exploration missions. For this reason, medications that have experienced long duration storage on the ISS were returned to JSC for analysis to determine any unusual effects of aging in the low- Earth orbit environment. METHODS Medications were obtained by the JSC Pharmacy from commercial distributors and were re-packaged by JSC pharmacists to conserve up mass and volume. All medication doses were part of the ISS crew medical kit and were transported to the International Space Station (ISS) via NASA's Shuttle Transportation System (Space Shuttle). After 568 days of storage, the medications were removed from the supply chain and returned to Earth on a Dragon (SpaceX) capsule. Upon return to Earth, medications were transferred to temperature and humidity controlled environmental chambers until analysis. Nine medications were chosen on the basis of their availability for study. The medications included several of the most heavily used by US crewmembers: 2 sleep aids, 2 antihistamines/decongestants, 3 pain relievers, an antidiarrheal and an alertness medication. Each medication was available at a single time point; analysis of the same medication at multiple time points was not possible. Because the samples examined in this study were obtained opportunistically from medical supplies, there were no control samples available (i.e. samples aged for a similar period of time on the ground); a significant limitation of this study. Medications were analyzed using the HPLC/MS methods described in the United States Pharmacopeia (USP) to measure the amount of intact active ingredient, identify degradation products and measure their amounts. Some analyses were conducted by an independent analytical laboratory, but certain (Schedule) medications could not be shipped to their facility and were analyzed at JSC. RESULTS Nine medications were analyzed with respect to active pharmaceutical ingredient (API) and degradant amounts. Results were compared to the USP requirements for API and degradants/impurities content for every FDA-approved medication. One medication met USP requirements at 5 months after its expiration date. Four of the nine (44% of those tested) medications tested met USP requirements up to 8 months post-expiration. Another 3 medications (33% of those tested) met USP guidelines 2-3 months before expiration. One medication, a compound classed by the FDA as a dietary supplement and sometimes used as a sleep aid, failed to meet USP requirements at 11 months post-expiration. CONCLUSION Analysis of each medication at a single time point provides limited information on the stability of a medication stored in particular conditions; it is not possible to predict how long a medication may be safe and effective from these data. Notwithstanding, five of the nine medications tested (56%) met USP requirements for API and degradants/impurities at least 5 months past expiration dates. The single compound that failed to meet USP requirements is not regulated as strictly as prescription medications are during manufacture; it is unknown if this medication would have met the requirements prior to flight. Notably, it was the furthest beyond its expiration date. Only more comprehensive analysis of flight-aged samples compared to appropriate ground controls will permit determination of spaceflight effects on medication stability.

Wotring, V. E.

2014-01-01

335

Medical Scientists  

MedlinePLUS

... little supervision, forming their own hypotheses and developing experiments, accordingly. They often lead teams of technicians, and ... prospective medical scientists the opportunity to develop their experiments and, sometimes, to supervise undergraduates. Ph.D. programs ...

336

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

337

Medication Treatment  

MedlinePLUS

... behavior, such as to reduce self-injury or aggression. Once a symptom is no longer a problem, ... of repetitive behaviors; decrease anxiety, irritability, tantrums, and aggressive behavior; and improve eye contact. Tricyclics These medications ...

338

Medication Math  

NSDL National Science Digital Library

Medication calculation needs to be completed accurately for proper patient treatment. In this section you will need to review and improve your medication math. Understanding math: Math and Culture Refresher: Take the amount of fluid in the bottle and times that by the dose ordered. Then divide this number by the amount of drug in the bottle. This will give you the volume of the drug that you need to administer. Diagram of formulas Math Formulas Math ...

Joey

2008-10-16

339

Evaluation of the Reliability of Electronic Medical Record Data in Identifying Comorbid Conditions among Patients with Advanced Non-Small Cell Lung Cancer  

PubMed Central

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.

Muehlenbein, Catherine E.; Hoverman, J. Russell; Gruschkus, Stephen K.; Forsyth, Michael; Chen, Clara; Lopez, William; Lawson, Anthony; Hartnett, Heather J.; Pohl, Gerhardt

2011-01-01

340

10 CFR 712.14 - Medical assessment.  

...other substances, as identified by self-reporting or by medical or psychological evaluation or testing; (4) Threat of suicide, homicide, or physical harm; or (5) Medical conditions such as cardiovascular disease, endocrine disease,...

2014-01-01

341

10 CFR 712.14 - Medical assessment.  

Code of Federal Regulations, 2013 CFR

...other substances, as identified by self-reporting or by medical or psychological evaluation or testing; (4) Threat of suicide, homicide, or physical harm; or (5) Medical conditions such as cardiovascular disease, endocrine disease,...

2013-01-01

342

10 CFR 712.14 - Medical assessment.  

Code of Federal Regulations, 2011 CFR

...other substances, as identified by self-reporting or by medical or psychological evaluation or testing; (4) Threat of suicide, homicide, or physical harm; or (5) Medical conditions such as cardiovascular disease, endocrine disease,...

2011-01-01

343

10 CFR 712.14 - Medical assessment.  

Code of Federal Regulations, 2010 CFR

...other substances, as identified by self-reporting or by medical or psychological evaluation or testing; (4) Threat of suicide, homicide, or physical harm; or (5) Medical conditions such as cardiovascular disease, endocrine disease,...

2010-01-01

344

10 CFR 712.14 - Medical assessment.  

Code of Federal Regulations, 2012 CFR

...other substances, as identified by self-reporting or by medical or psychological evaluation or testing; (4) Threat of suicide, homicide, or physical harm; or (5) Medical conditions such as cardiovascular disease, endocrine disease,...

2012-01-01

345

The Association of Cardioprotective Medications with Pneumonia-Related Outcomes  

PubMed Central

Introduction Little research has examined whether cardiovascular medications, other than statins, are associated with improved outcomes after pneumonia. Our aim was to examine the association between the use of beta-blockers, statins, angiotensin converting enzyme (ACE) inhibitors, and angiotensin II receptor blockers (ARBs) with pneumonia-related outcomes. Materials and Methods We conducted a retrospective population-based study on male patients ?65 years of age hospitalized with pneumonia and who did not have pre-existing cardiac disease. Our primary analyses were multilevel regression models that examined the association between cardiovascular medication classes and either mortality or cardiovascular events. Results Our cohort included 21,985 patients: 22% died within 90 days of admission, and 22% had a cardiac event within 90 days. The cardiovascular medications studied that were associated with decreased 90-day mortality included: statins (OR 0.70, 95% CI 0.63–0.77), ACE inhibitors (OR 0.82, 95% CI 0.74–0.91), and ARBs (OR 0.58, 95% CI 0.44–0.77). However, none of the medications were significantly associated with decreased cardiovascular events. Discussion While statins, ACE inhibitors, and ARBs, were associated with decreased mortality, there was no significant association with decreased CV events. These results indicate that this decreased mortality is unlikely due to their potential cardioprotective effects.

Wu, Albert; Good, Chester; Downs, John R.; Fine, Michael J.; Pugh, Mary Jo V.; Anzueto, Antonio; Mortensen, Eric M.

2014-01-01

346

Medical Biofilms  

PubMed Central

For more than two decades, Biotechnology and Bioengineering has documented research focused on natural and engineered microbial biofilms within aquatic and subterranean ecosystems, wastewater and waste-gas treatment systems, marine vessels and structures, and industrial bioprocesses. Compared to suspended culture systems, intentionally engineered biofilms are heterogeneous reaction systems that can increase reactor productivity, system stability, and provide inherent cell: product separation. Unwanted biofilms can create enormous increases in fluid frictional resistances, unacceptable reductions in heat transfer efficiency, product contamination, enhanced material deterioration, and accelerated corrosion. Missing from B&B has been an equivalent research dialogue regarding the basic molecular microbiology, immunology, and biotechnological aspects of medical biofilms. Presented here are the current problems related to medical biofilms; current concepts of biofilm formation, persistence, and interactions with the host immune system; and emerging technologies for controlling medical biofilms.

2009-01-01

347

41 CFR 60-300.23 - Medical examinations and inquiries.  

Code of Federal Regulations, 2013 CFR

...obtained under this section regarding the medical condition or history of any applicant or...maintained on separate forms and in separate medical files and treated as a confidential medical record, except that: (i) Supervisors...

2013-07-01

348

41 CFR 60-741.23 - Medical examinations and inquiries.  

Code of Federal Regulations, 2013 CFR

...obtained under this section regarding the medical condition or history of any applicant or...maintained on separate forms and in separate medical files and treated as a confidential medical record, except that: (i) Supervisors...

2013-07-01

349

Medically Induced Coma vs. Sedation  

MedlinePLUS

... patient before, during and after surgery. LEARN MORE Anesthesia Topics Quick Links Choose a topic: Featured Video: ... to patient inquiries regarding specific medical conditions or anesthesia administration. Please direct any questions related to anesthetics, ...

350

Medical Tourism Q&A  

MedlinePLUS

... patient before, during and after surgery. LEARN MORE Anesthesia Topics Quick Links Choose a topic: Featured Video: ... to patient inquiries regarding specific medical conditions or anesthesia administration. Please direct any questions related to anesthetics, ...

351

Medical marijuana.  

PubMed

The Florida Supreme Court heard oral arguments in April regarding a glaucoma patient's request for a medical exception to the State prohibition on use of marijuana. [Name removed] was convicted on possession and cultivation charges, and a trial judge refused to allow a medical necessity defense. A State appeals court subsequently overturned [name removed]'s conviction. The case focuses on whether the legislature intended to prohibit such a defense when it declared in 1993 that the substance had no medicinal benefits. PMID:11366533

1999-04-30

352

Medical genetics  

SciTech Connect

This book on the subject of medical genetics is a textbook aimed at a very broad audience: principally, medical students, nursing students, graduate, and undergraduate students. The book is actually a primer of general genetics as applied to humans and provides a well-balanced introduction to the scientific and clinical basis of human genetics. The twelve chapters include: Introduction, Basic Cell Biology, Genetic Variation, Autosomal Dominant and Recessive Inheritance, Sex-linked and Mitochondrial Inheritance, Clinical Cytogenetics, Gene Mapping, Immunogenetics, Cancer Genetics, Multifactorial Inheritance and Common Disease, Genetic Screening, Genetic Diagnosis and Gene Therapy, and Clinical Genetics and Genetic Counseling.

Jorde, L.B.; Carey, J.C.; White, R.L.

1995-10-01

353

Gastro-intestinal problems and concomitant medication in NSAID users: additional findings from a questionnaire-based survey in Italy  

Microsoft Academic Search

Background  In a previous questionnaire-based survey, we found extensive use of nonsteroidal anti-inflammatory drugs (NSAIDs) in subjects\\u000a with risk factors for serious gastrointestinal complications.\\u000a \\u000a \\u000a \\u000a Aim  This study focused on the use of NSAIDs in subjects who reported either (a) pre-existing disorders which would have required\\u000a caution in using NSAIDs (e.g. dyspepsia\\/heartburn or peptic ulcer) or (b) co-medication with drugs having a high

Maria Chiara Silvani; Domenico Motola; Elisabetta Poluzzi; Ambrogio Bottoni; Fabrizio De Ponti; Alberto Vaccheri; Nicola Montanaro

2006-01-01

354

[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

355

Medical exceptionalism.  

PubMed

How should we assess the historical development of health care? Many historians are deeply reluctant to endorse ideas involving progress in human affairs, including the evolution of modern medicine. We tend to think either that our present situation is little better than in the past, or that most kinds of value judgments about history are subjective and inappropriate. A laudatory approach to medical history commonly adopted by "amateur" medical historians in the tradition of Sir William Osler has often been eschewed by "professionals" as faulty, feel-good history. But Osler was right in his belief that, on balance, the progress of medicine has been spectacular, that modern health care offers one of the finest examples of the possibility of "man's redemption of man." Written objectively, medical history is about progress and achievement, and can properly seen as inspiring. If we mordantly or relativistically dismiss the unprecedentedly high quality of modern health care, we lose the ability to understand why citizens value it so highly, and this distorts our understanding of current issues. We also lose our sense of the wonders of human and medical achievement. PMID:23179032

Bliss, Michael

2012-01-01

356

Medical tourism.  

PubMed

Medical tourism is becoming popular as an alternative to the high cost of health care in the United States and as an inexpensive resource for cosmetic surgery. The occupational health nurse is an excellent resource to assist in the pre-decision due diligence and post-decision travel health counseling. PMID:20102121

Tompkins, Olga S

2010-01-01

357

Travelers with Disabilities and Medical Conditions  

MedlinePLUS

... opportunity to coordinate checkpoint support with a TSA Customer Service Manager located at the airport when necessary. One ... to provide the highest level of security and customer service to all who pass through our screening checkpoints. ...

358

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

359

Chronic Medical Conditions Can Shorten Seniors' Lives  

MedlinePLUS

... 2014 Related MedlinePlus Pages Coping with Chronic Illness Seniors' Health MONDAY, July 28, 2014 (HealthDay News) -- The more ... HealthDay . All rights reserved. More Health News on: Seniors' Health Recent Health News Page last updated on 29 ...

360

Medical Conditions in Ashkenazi Schizophrenic Pedigrees  

Microsoft Academic Search

To limit the genetic heterogeneity of schizophrenia, this study focused on the widely extended pedigrees of Ashkenazi Jewish schizophrenia probands. The hypothesis posed is that the increased prevalence among the Ashkenazim of the rare lysosomal enzyme disorders, Tay Sachs disease (TDS), caused by low levels of hexosaminidase A, and Gaucher’s disease (GD), caused by low levels of glucocerebrosidase, might contribute

Ann B. Goodman

1994-01-01

361

Let's talk about medication: concordance in rating medication adherence among multimorbid patients and their general practitioners  

PubMed Central

Background Medication adherence can be essential for improving health outcomes. Patients with multiple chronic conditions, often receiving multiple medications, are at higher risk for medication nonadherence. Previous research has focused on concordance between patients and providers about which medication should be taken. However, the question of whether patients and providers are concordant in rating actual medication intake has not been answered as yet. This study aimed to explore the extent and predictors of patient – provider concordance in rating medication adherence in patients with multiple chronic conditions. Methods Overall medication adherence was measured by self-report (Medication Adherence Report Scale, MARS-D) in a sample of 92 patients with multiple chronic conditions. Twelve treating primary care physicians were asked to rate medication adherence in these patients using a mirrored version of the MARS-D. Concordance between external rating and self-reported medication adherence was analyzed descriptively. Predictors of concordance in rating medication adherence were explored in a multilevel analysis. Results Patients rate their medication adherence markedly higher than their general practitioner. Accordingly, the percentage of concordance ranges between 40% (forgot to take medication) and 61% (deliberately omitted a dose). In multilevel analysis, concordance in rating medication adherence was positively associated with being the single primary care provider (? 2.24, P < 0.0001) and frequent questioning about medication use (? 0.66, P = 0.0031). At the patient level, “not [being] married” (? ?0.81, P = 0.0064) and “number of prescribed medications” (? ?0.10, P = 0.0203) were negative predictors of patient – provider concordance in rating medication adherence. Conclusion Concordance for rating medication adherence between general practitioners and their patients was low. Talking about medication on a regular basis and better continuity of care may enhance patient – provider concordance in rating medication adherence as a prerequisite for shared decisions concerning medication in patients with multiple chronic conditions.

Ose, Dominik; Mahler, Cornelia; Vogel, Ines; Ludt, Sabine; Szecsenyi, Joachim; Freund, Tobias

2012-01-01

362

Medical imaging.  

PubMed Central

There is now a wide choice of medical imaging to show both focal and diffuse pathologies in various organs. Conventional radiology with plain films, fluoroscopy and contrast medium have many advantages, being readily available with low-cost apparatus and a familiarity that almost leads to contempt. The use of plain films in chest disease and in trauma does not need emphasizing, yet there are still too many occasions when the answer obtainable from a plain radiograph has not been available. The film may have been mislaid, or the examination was not requested, or the radiograph had been misinterpreted. The converse is also quite common. Examinations are performed that add nothing to patient management, such as skull films when CT will in any case be requested or views of the internal auditory meatus and heal pad thickness in acromegaly, to quote some examples. Other issues are more complicated. Should the patient who clinically has gall-bladder disease have more than a plain film that shows gall-stones? If the answer is yes, then why request a plain film if sonography will in any case be required to 'exclude' other pathologies especially of the liver or pancreas? But then should cholecystography, CT or scintigraphy be added for confirmation? Quite clearly there will be individual circumstances to indicate further imaging after sonography but in the vast majority of patients little or no extra information will be added. Statistics on accuracy and specificity will, in the case of gall-bladder pathology, vary widely if adenomyomatosis is considered by some to be a cause of symptoms or if sonographic examinations 'after fatty meals' are performed. The arguments for or against routine contrast urography rather than sonography are similar but the possibility of contrast reactions and the need to limit ionizing radiation must be borne in mind. These diagnostic strategies are also being influenced by their cost and availability; purely pragmatic considerations are not infrequently the overriding factor. Non-invasive methods will be preferred, particularly sonography as it is far more acceptable by not being claustrophobic and totally free of any known untoward effects. There is another quite different but unrelated aspect. The imaging methods, apart from limited exceptions, cannot characterize tissues as benign or malignant, granulomatous or neoplastic; cytology or histology usually provides the answer. Sonography is most commonly used to locate the needle tip correctly for percutaneous sampling of tissues. Frequently sonography with fine needle aspiration cytology or biopsy is the least expensive, safest and most direct route to a definitive diagnosis. Abscesses can be similarly diagnosed but with needles or catheters through which the pus can be drained. The versatility and mobility of sonography has spawned other uses, particularly for the very ill and immobile, for the intensive therapy units and for the operating theatre, as well in endosonography. The appointment of more skilled sonographers to the National Health Service could make a substantial contribution to cost-effective management of hospital services. Just when contrast agents and angiography have become safe and are performed rapidly, they are being supplanted by scanning methods. They are now mainly used for interventional procedures or of pre-operative 'road maps' and may be required even less in the future as MRI angiography and Doppler techniques progress. MRI will almost certainly extent its role beyond the central nervous system (CNS) should the equipment become more freely available, especially to orthopaedics. Until then plain films, sonography or CT will have to suffice. Even in the CNS there are conditions where CT is more diagnostic, as in showing calculations in cerebral cysticercosis. Then, too, in most cases CT produces results comparable to MRI apart from areas close to bone, structures at the base of the brain, in the posterior fossa and in the spinal cord. Scintigraphy for pulmonary infarcts and bone metastases and in renal disease in children plays

Kreel, L.

1991-01-01

363

Medical imaging.  

PubMed

There is now a wide choice of medical imaging to show both focal and diffuse pathologies in various organs. Conventional radiology with plain films, fluoroscopy and contrast medium have many advantages, being readily available with low-cost apparatus and a familiarity that almost leads to contempt. The use of plain films in chest disease and in trauma does not need emphasizing, yet there are still too many occasions when the answer obtainable from a plain radiograph has not been available. The film may have been mislaid, or the examination was not requested, or the radiograph had been misinterpreted. The converse is also quite common. Examinations are performed that add nothing to patient management, such as skull films when CT will in any case be requested or views of the internal auditory meatus and heal pad thickness in acromegaly, to quote some examples. Other issues are more complicated. Should the patient who clinically has gall-bladder disease have more than a plain film that shows gall-stones? If the answer is yes, then why request a plain film if sonography will in any case be required to 'exclude' other pathologies especially of the liver or pancreas? But then should cholecystography, CT or scintigraphy be added for confirmation? Quite clearly there will be individual circumstances to indicate further imaging after sonography but in the vast majority of patients little or no extra information will be added. Statistics on accuracy and specificity will, in the case of gall-bladder pathology, vary widely if adenomyomatosis is considered by some to be a cause of symptoms or if sonographic examinations 'after fatty meals' are performed. The arguments for or against routine contrast urography rather than sonography are similar but the possibility of contrast reactions and the need to limit ionizing radiation must be borne in mind. These diagnostic strategies are also being influenced by their cost and availability; purely pragmatic considerations are not infrequently the overriding factor. Non-invasive methods will be preferred, particularly sonography as it is far more acceptable by not being claustrophobic and totally free of any known untoward effects. There is another quite different but unrelated aspect. The imaging methods, apart from limited exceptions, cannot characterize tissues as benign or malignant, granulomatous or neoplastic; cytology or histology usually provides the answer. Sonography is most commonly used to locate the needle tip correctly for percutaneous sampling of tissues. Frequently sonography with fine needle aspiration cytology or biopsy is the least expensive, safest and most direct route to a definitive diagnosis. Abscesses can be similarly diagnosed but with needles or catheters through which the pus can be drained. The versatility and mobility of sonography has spawned other uses, particularly for the very ill and immobile, for the intensive therapy units and for the operating theatre, as well in endosonography. The appointment of more skilled sonographers to the National Health Service could make a substantial contribution to cost-effective management of hospital services. Just when contrast agents and angiography have become safe and are performed rapidly, they are being supplanted by scanning methods. They are now mainly used for interventional procedures or of pre-operative 'road maps' and may be required even less in the future as MRI angiography and Doppler techniques progress. MRI will almost certainly extent its role beyond the central nervous system (CNS) should the equipment become more freely available, especially to orthopaedics. Until then plain films, sonography or CT will have to suffice. Even in the CNS there are conditions where CT is more diagnostic, as in showing calculations in cerebral cysticercosis. Then, too, in most cases CT produces results comparable to MRI apart from areas close to bone, structures at the base of the brain, in the posterior fossa and in the spinal cord. Scintigraphy for pulmonary infarcts and bone metastases and in renal disease in children plays

Kreel, L

1991-04-01

364

Medical Tourism Abroad  

PubMed Central

Objectives: This study aimed to understand why people seek medical advice abroad given the trouble and expense this entails. The types of medical problems for which treatment abroad was sought, preferred destinations and satisfaction with the treatment were explored. A secondary aim was to give feedback to stakeholders in the health care system on how to handle this issue and meet the needs of the community. Methods: 45 patients who had recently travelled abroad for treatment were asked to complete a questionnaire or were interviewed by telephone. Results: 40 questionnaires were received. 68% of the respondents were male. Orthopaedic diseases were the most common conditions leading patients to seek treatment abroad. Thailand was the most popular destination followed by India (50% and 30% respectively). 85% of respondents went abroad for treatment only, 10% for treatment and tourism and 2.5% were healthy, but travelled abroad for a checkup. Interestingly, 15% of the participants went abroad without first seeking medical care locally. Out of those initially treated in Oman, 38.2% had no specific diagnosis and 38.2% had received treatment, but it was not effective. 73% of respondents obtained information on treatment abroad from a friend. The Internet and medical tourism offices were the least used sources of information. 15% of the patients experienced complications after their treatment abroad. Conclusion: Various facts about medical treatment abroad need to be disseminated to the public. This will necessitate greater effort in public health promotion and education.

Al-Hinai, Saleh S.; Al-Busaidi, Ahmed S.; Al-Busaidi, Ibrahim H.

2011-01-01

365

Medical treatment of benign prostatic hyperplasia  

PubMed Central

Pharmaceutical preparations are commonly used for benign prostate hyperplasia. This article reviews the current understanding of the natural history of the condition and the literature regarding medical treatment.

Connolly, Stephen S; Fitzpatrick, John M

2007-01-01

366

Medical Dictionary  

NSDL National Science Digital Library

For nurses and other health care professionals who seek to distinguish the habitus from the humerus, this online medical dictionary provided by MedicineNet will be a place to bookmark for repeat visits. The dictionary contains well-written explanations for over 16,000 medical terms, and users can go ahead and browse around, or enter keywords or phrases into the search engine that resides on the page. The site also features a âÂÂWord of the DayâÂÂ, and visitors can also look through recent news items that address different health issues and also look over the latest entries to the dictionary. The site is rounded out by a list of the âÂÂTop 10 MedtermsâÂÂ, which is also a good way to start exploring the materials here.

2007-03-31

367

Comparison of Pilot Medical History and Medications Found in Postmortem Specimens.  

National Technical Information Service (NTIS)

Pilots are required by Federal Aviation Administration (FAA) regulations to report all medications and medical conditions to the FAA Office of Aerospace Medicine for review and consideration as to the overall suitability of the pilot for flight activities...

D. V. Canfield G. J. Salazar J. E. Whinnery R. J. Lewis

2006-01-01

368

Special Operations individual medical equipment part 2 - the in-use and survival medical kits.  

PubMed

Special Operations Forces (SOF) Operators need a variety of individual medical items that can generally be broken down into three types of medical kits: a major trauma kit, to treat major traumatic wounds; an in-use medical kit, to prevent or treat anticipated common medical conditions during operations; and a survival medical kit, to treat minor injuries and ailments when in a survival/evasion situation. PMID:20306410

Geers, Dirk

2010-01-01

369

Medical Telemetry  

NASA Technical Reports Server (NTRS)

Telemetry is the process whereby physiological or other data is acquired by instruments, translated into radio signals and j sent to a receiving station where the signals are decoded and recorded. Extensively used in I space operations, it is finding new Earth applications, among them transmission of medical data between emergency vehicles and hospitals. For example, transmission of an electrocardiogram from an ambulance to a hospital enables a physician to read the telemetered EKG and advise ambulance attendants on emergency procedures. Central Medical Emergency Dispatch (CMED) operates as a regional emergency medical communications center for Cleveland, Ohio and Cuyahoga County. The CMED system includes radio and telephone communications from hospital-to-hospital and from ambulance-to-hospital, but for improved emergency life support CMED sought to add a county-wide telemetry capability. The problem was that there were only eight radio frequencies available for telemetry and there were more than 30 potential users in Cleveland alone. NASA's Lewis Research Center volunteered its expert assistance. The Center's engineers studied the systems of other telemetry using cities, surveyed area hospitals to assure compatibility of telemetry equipment, and advised what types of equipment would be needed in emergency vehicles and at the various hospitals. The Lewis plan suggested that CMED be designated the central coordinating agency for the Cuyahoga County system, monitoring all telemetry frequencies and, when requested, assigning one not in use or one to be used at a sufficient distance that it would create no interference problem.

1978-01-01

370

Medical Monitoring Applications for Wearable Computing  

Microsoft Academic Search

Medical monitors have benefited from technological advances in the field of wireless communication, processing, and power sources. These advances have made possible miniaturization and prolonged operating times of medical monitors, as well as their global integration into telemedical systems. This allows patients to have real-time feedback about medical conditions while going about their normal daily activities. System designers are facing

Dejan Raskovic; Thomas L. Martin; Emil Jovanov

2004-01-01

371

Fetal Conditions, Abnormalities and Diagnoses  

MedlinePLUS

... Services Clinical Studies Quick Links Continuing Medical Education Nursing Newsletters Conditions MyChart Neighborhood Locations Outcomes and Quality Family-Centered Rounds Clinical Laboratories Researchers ...

372

Medical clip  

NASA Technical Reports Server (NTRS)

An X-ray transparent and biological inert medical clip for treating aneurisms and the like is described. A graphite reinforced composite film is molded into a unitary structure having a pair of hourglass-like cavities hinged together with a pair of jaws for grasping the aneurism extending from the wall of one cavity. A silicone rubber pellet is disposed in the other cavity to exert a spring force through the hinge area to normally bias the jaws into contact with each other.

Baucom, R. M. (inventor)

1983-01-01

373

Medical Mystery  

NSDL National Science Digital Library

This activity (on pages 15-23) combines interactive role-playing and graphing to introduce learners to the health affects of pollen. In the first part, learners role-play a detective on a medical case and the main character in the case. Learners formulate a hypothesis about a patient's illness. In the second part, learners graph evidence based on pollen counts and create a "final report" about what caused the patient's health problem. This activity smoothly combines health education, environmental science, and math.

Museum, University O.; Nebraska Cooperative Extension 4-H Youth Development

2001-01-01

374

Medical Mysteries  

NSDL National Science Digital Library

Rice University presents Medical Mysteries (or MedMyst for short) "an Internet-based adventure...in which you are on a mission to discover the causes of diseases." Designed for middle and high school students, MedMyst offers an engaging, multimedia approach to learning about infectious diseases and the immune system, as well as pharmacology, chemistry, public health policy, and more. MedMyst also includes three downloadable mini-labs that expand on concepts covered in the multimedia adventure. The Web site also includes loads of useful links.

375

Radiation burden of assistant medical technicians at a medical accelerator  

PubMed Central

A survey of a CLINAC 2100 C medical accelerator showed residual short half-life radiation after switching off the accelerator. This led to a dose of radiation for the medical employees when the patient was handled. The dose rate was measured with a dose rate meter FH40G, and annual dose for an assistant medical technician (AMT) was estimated under conservative conditions. In the assumed situation of 1000 patient treatment fractions with high-energy photons, an AMT would get an annual dose of 960 ?Sv, while the monthly dosimeter records would show zero, if the dose received is below threshold of 100 ?Sv.

Grundel, M.; Guthoff, F.

2008-01-01

376

The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems  

NASA Technical Reports Server (NTRS)

The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.

Kerstman, Eric; Minard, Charles; Saile, Lynn; deCarvalho, Mary Freire; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David

2009-01-01

377

Medication-induced peripheral neuropathy  

Microsoft Academic Search

Although not very common, medication-induced neuropathy is a treatable condition and, therefore, is important to identify.\\u000a Medications continue to grow in number and expand in usage; consequently, toxic neuropathy continues to be relevant to neurologists.\\u000a Many agents have toxicities that are tolerated because the treatments are necessary, such as therapies for HIV and malignancy.\\u000a Additional agents to prevent or ameliorate

Louis H. Weimer

2003-01-01

378

Pre-existing central nervous system lesions negate cytokine requirements for regional experimental autoimmune encephalomyelitis development  

PubMed Central

Summary In region?specific forms of experimental autoimmune encephalomyelitis (EAE), lesion initiation is regulated by T?cell?produced interferon?? (IFN??) resulting in spinal cord disease in the presence of IFN?? and cerebellar disease in the absence of IFN??. Although this role for IFN?? in regional disease initiation is well defined, little is known about the consequences of previous tissue inflammation on subsequent regional disease, information vital to the development of therapeutics in established disease states. This study addressed the hypothesis that previous establishment of regional EAE would determine subsequent tissue localization of new T?cell invasion and associated symptoms regardless of the presence or absence of IFN?? production. Serial transfer of optimal or suboptimal doses of encephalitogenic IFN???sufficient or ?deficient T?cell lines was used to examine the development of new clinical responses associated with the spinal cord and cerebellum at various times after EAE initiation. Previous inflammation within either cerebellum or spinal cord allowed subsequent T?cell driven inflammation within that tissue regardless of IFN?? presence. Further, T?cell IFN?? production after initial lesion formation exacerbated disease within the cerebellum, suggesting that IFN?? plays different roles at different stages of cerebellar disease. For the spinal cord, IFN???deficient cells (that are ordinarily cerebellum disease initiators) were capable of driving new spinal?cord?associated clinical symptoms more than 60 days after the initial acute EAE resolution. These data suggest that previous inflammation modulates the molecular requirements for new neuroinflammation development.

Li, Xin; Lees, Jason R.

2013-01-01

379

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

380

Progression of pre-existing Chiari type I malformation secondary to cerebellar hemorrhage: case report.  

PubMed

A previously healthy 32-year-old man was surgically treated under a diagnosis of right subcortical hematoma. Magnetic resonance imaging incidentally demonstrated tonsillar herniation. Thirty-two months later, he was readmitted with complaints of occipital, neck, and shoulder pain as well as cerebellar ataxia. Subsequent magnetic resonance imaging demonstrated cerebellar hemorrhage and progression in the downward herniation of the tonsils. Conservative treatment resulted in spontaneous disappearance of the cerebellar hematoma, and the clinical signs and radiological findings improved. Patients with Chiari type I malformation require neuroimaging follow up because the downward herniation of the tonsils can progress in association with subsequent pathophysiological disorders. PMID:19246872

Kojima, Atsuhiro; Mayanagi, Keita; Okui, Shunichi

2009-02-01

381

Pre-existing autoimmunity determines type 1 diabetes outcome after Flt3-ligand treatment  

PubMed Central

Redirection of immune responses by manipulation of antigen-presenting cells is an emerging strategy for immunosuppressive treatment of autoimmune diseases. In vivo expansion of dendritic cells (DC) by Fms-like tyrosine kinase-3 (Flt3)-Ligand (FL) treatment was shown to delay diabetes onset in the NOD model of autoimmune diabetes. However, we show here that Flt3 stimulation actually accelerates autoimmunity when autoreactive CD8 T cells are detectable in blood prior to treatment. With autoreactive CD8 cells present, the capacity of FL to expand DCs and induce Treg remained intact, but both numbers and the functional response of islet-specific CD8s were boosted. Also, the inhibitory receptor PD-1 on (autoreactive) CD8 T cells and its ligand PD-L1 on Treg were no longer upregulated. These data highlight the need to prescreen for T cell autoreactivity prior to generalized DC expansion and illustrate how accelerated disease can occur when the intended initiation of regulatory mechanisms is impaired later in diabetogenesis.

Van Belle, Tom L.; Juntti, Therese; Liao, Jeanette; von Herrath, Matthias

2009-01-01

382

The Effects of Hurricane Katrina on Females with a Pre-Existing Fear of Storms  

Microsoft Academic Search

The purpose of this study was to determine the effects of Hurricane Katrina on those with preexisting storm fear. Participants\\u000a were divided into two groups, those with a fear of storms and control participants with no reported fears of any specific\\u000a stimuli. Differences were examined on measures of exposure to and distress from trauma, fear, coping self-efficacy, and demographic\\u000a variables.

Melissa S. Munson; Thompson E. Davis; Amie E. Grills-Taquechel; Kimberly R. Zlomke

2010-01-01

383

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

384

A Mohr circle construction for the opening of a pre-existing fracture  

Microsoft Academic Search

The opening of a fracture is dependent on the fluid pressure and the local stress regime around the fracture. For a fracture to open, the fluid pressure must exceed the normal stress acting on the fracture. The Mohr circle provides a useful tool allowing the visualization of these relationships. This construction determines the range of fracture orientations that are able

R. J. H. Jolly; D. J. Sanderson

1997-01-01

385

Pore Water Characteristics Following a Release of Neat Ethanol onto Pre-existing NAPL  

Microsoft Academic Search

Neat ethanol (75.7 L) was released into the upper capillary zone in a continuous-flow, sand-packed aquifer tank (8.2 m3) with an average seepage velocity of 0.75 m\\/day. This model aquifer system contained a residual nonaqueous phase liquid (NAPL) that extended from the capillary zone to 10 cm below the water table. Maximum aqueous concentrations of ethanol were 20% v\\/v in

Brent P. Stafford; Natalie L. Cápiro; Pedro J. J. Alvarez; William G. Rixey

2009-01-01

386

Impact of Pre-Existing Donor Hypertension and Diabetes Mellitus on Cadaveric Renal Transplant Outcomes  

Microsoft Academic Search

Hypertension (HTN) and diabetes mellitus (DM) predispose to systemic atherosclerosis with renal involvement. The prevalence of HTN and DM in cadaveric renal donors (affected donors) and the results of transplantation are unknown. We investigated these issues with national data from the US Renal Data System. A total of 4,035 transplants from affected donors were matched 1:1 with unaffected controls according

Akinlolu O. Ojo; Alan B. Leichtman; Jeffrey D. Punch; Julie A. Hanson; David M. Dickinson; Robert A. Wolfe; Friedrich K. Port; Lawrence Y. Agodoa

2000-01-01

387

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

388

Implantable medical devices MRI safe.  

PubMed

Pacemakers, ICDs, neurostimulators like deep brain stimulator electrodes, spiral cord stimulators, insulin pumps, cochlear implants, retinal implants, hearing aids, electro cardio gram (ECG) leads, or devices in interventional MRI such as vascular guide wires or catheters are affected by MRI magnetic and electromagnetic fields. Design of MRI Safe medical devices requires computer modeling, bench testing, phantom testing, and animal studies. Implanted medical devices can be MRI unsafe, MRI conditional or MRI safe (see glossary). In the following paragraphs we will investigate how to design implanted medical devices MRI safe. PMID:23739365

Dal Molin, Renzo; Hecker, Bertrand

2013-01-01

389

Medical marijuana.  

PubMed

Grassroots AIDS activist groups denounce the Clinton Administration's stance on banning medicinal use of marijuana due to the lack of clinical evidence supporting its benefits. The 1997 meeting of the San Francisco Medical Society and the New England Journal of Medicine both agreed, following a review of 75 scientific studies of the medicinal benefits of marijuana, that the benefits of smoked marijuana include relief from pain and the reduction of nausea caused by anti-cancer drugs. The Federal government is attempting to punish physicians for prescribing marijuana to their patients, a situation being opposed by the Bay Area Physicians for Human Rights who have initiated a suit against the government. A hearing to stop this prosecution was scheduled for March 21. PMID:11364533

Baker, R; Bowers, M

1997-03-01

390

Inflight Medical Events in the Shuttle Program  

NASA Technical Reports Server (NTRS)

Since the first launch of the Space Shuttle in 1981, the astronauts and their flight surgeons have dealt with a variety of inflight medical issues. A review will be provided of these issues as well as medications used in the treatment of these medical problems. Detailed medical debriefs are conducted by the flight ,surgeon with the individual crewmembers three days after landing. These debriefs were review for Shuttle flights from 1988 through 1999 to determine the frequency of inflight medical events. Medical events were grouped by ICD category and the frequency of medical events within those categories were reviewed. The ICD category of Symptoms, Signs and Ill-defined Conditions had the most medical events. Facial fullness and headache were the most common complaints within this category. The ICD category of Respiratory System had the next most common medical events with sinus congestion being the most common complaint. This was followed by Digestive System complaints and Nervous System/Sense Organ complaints. A variety of inflight medical events have occurred throughout the Shuttle program. Fortunately, the majority of these problems have been minor and have been well within the capability of the medical equipment flown and the skills of the Crew Medical Officers. Medical ,problems/procedures that are routine on the ground often present unique problems in the space flight environment. It is important that the flight surgeon understand the common medical problems encountered.

Baisden, Denise L.; Effenhauser, R. K.; Wear, Mary L.

1999-01-01

391

Business ethics, medical ethics and economic medicalization  

Microsoft Academic Search

This paper explores the ethical implications of economic medicalization: where non-medical problems are transformed into medical problems in order to achieve the objective of shareholder wealth maximization. After considering differences between business ethics and medical ethics, economic medicalization arising from corporate marketing strategies is detailed. Both direct-to-consumer and more traditional physician centred marketing methods are considered. In addition, the economic

Geoffrey Poitras

2009-01-01

392

International Space Station Medical Operations  

NASA Technical Reports Server (NTRS)

NASA is currently the leader, in conjunction with our Russian counterpart co-leads, of the Multilateral Medical Policy Board (MMPB), the Multilateral Medical Operations Panel (MMOP), which coordinates medical system support for International Space Station (ISS) crews, and the Multilateral Space Medicine Board (MSMB), which medically certifies all crewmembers for space flight on-board the ISS. These three organizations have representatives from NASA, RSA-IMBP (Russian Space Agency- Institute for Biomedical Problems), GCTC (Gagarin Cosmonaut Training Center), ESA (European Space Agency), JAXA (Japanese Space Agency), and CSA (Canadian Space Agency). The policy and strategic coordination of ISS medical operations occurs at this level, and includes interactions with MMOP working groups in Radiation Health, Countermeasures, Extra Vehicular Activity (EVA), Informatics, Environmental Health, Behavioral Health and Performance, Nutrition, Clinical Medicine, Standards, Post-flight Activities and Rehabilitation, and Training. Each ISS Expedition has a lead Crew Surgeon from NASA and a Russian Crew Surgeon from GCTC assigned to the mission. Day-to-day issues are worked real-time by the flight surgeons and biomedical engineers (also called the Integrated Medical Group) on consoles at the MCC (Mission Control Center) in Houston and the TsUP (Center for Flight Control) in Moscow/Korolev. In the future, this may also include mission control centers in Europe and Japan, when their modules are added onto the ISS. Private medical conferences (PMCs) are conducted regularly and upon crew request with the ISS crew via private audio and video communication links from the biomedical MPSR (multipurpose support room) at MCC Houston. When issues arise in the day-to-day medical support of ISS crews, they are discussed and resolved at the SMOT (space medical operations team) meetings, which occur weekly among the International Partners. Any medical or life science issue that is not resolved at the SMOT can be taken to the Mission Management Team meeting, which occurs biweekly from MCC-Houston. This meeting includes the other International Partners and all flight support and console position representatives via teleconference. ISS Crew Surgeons have handled many medical conditions on orbit; including skin rashes, dental abscesses, lacerations, and STT segment EKG changes. Fortunately to date, there have not been any forced medical evacuations from the ISS. This speaks well for the implementation of the primary, secondary and even tertiary prevention strategies invoked by the Integrated Medical Group, as there were several medical evacuations during the previous Russian space stations.

Jones, Jeffrey A.

2008-01-01

393

Medical expertise, existential suffering and ending life.  

PubMed

In this article, I assess the position that voluntary euthanasia (VE) and physician-assisted suicide (PAS) ought not to be accepted in the cases of persons who suffer existentially but who have no medical condition, because existential questions do not fall within the domain of physicians' professional expertise. I maintain that VE and PAS based on suffering arising from medical conditions involves existential issues relevantly similar to those confronted in connection with existential suffering. On that basis I conclude that if VE and PAS based on suffering arising from medical conditions is taken to fall within the domain of medical expertise, it is not consistent to use the view that physicians' professional expertise does not extend to existential questions as a reason for denying requests for VE and PAS from persons who suffer existentially but have no medical condition. PMID:23869046

Varelius, Jukka

2014-02-01

394

41 CFR 60-250.23 - Medical examinations and inquiries.  

Code of Federal Regulations, 2013 CFR

...VETERANS, VETERANS OF THE VIETNAM ERA, RECENTLY SEPARATED VETERANS...including voluntary medical histories, which are part of an employee...regarding the medical condition or history of any applicant or employee...regarding the medical condition or history of any applicant or...

2013-07-01

395

41 CFR 60-250.23 - Medical examinations and inquiries.  

Code of Federal Regulations, 2010 CFR

...VETERANS, VETERANS OF THE VIETNAM ERA, RECENTLY SEPARATED VETERANS...including voluntary medical histories, which are part of an employee...regarding the medical condition or history of any applicant or employee...regarding the medical condition or history of any applicant or...

2010-07-01

396

41 CFR 60-250.23 - Medical examinations and inquiries.  

Code of Federal Regulations, 2010 CFR

...VETERANS, VETERANS OF THE VIETNAM ERA, RECENTLY SEPARATED VETERANS...including voluntary medical histories, which are part of an employee...regarding the medical condition or history of any applicant or employee...regarding the medical condition or history of any applicant or...

2009-07-01

397

76 FR 8637 - Medical Devices; Medical Device Data Systems  

Federal Register 2010, 2011, 2012, 2013

...basis of irreversible data compression. FDA has...sufficient to ensure that any data compression features will...conditions, including high-priority, real-time...whether displaying the content and timing of an alarm...display medical device data without controlling...

2011-02-15

398

Medical narratives in electronic medical records  

Microsoft Academic Search

In this article, we describe the state of the art and directions of current development and research with respect to the inclusion of medical narratives in electronic medical-record systems. We used information about 20 electronic medical-record systems as presented in the literature. We divided these systems into `classical' systems that matured before 1990 and are now used in a broad

Huibert J Tange; Arie Hasman; Pieter F de Vries Robbé; Harry C Schouten

1997-01-01

399

42 CFR 124.10 - Additional conditions.  

Code of Federal Regulations, 2012 CFR

...OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT MEDICAL FACILITY CONSTRUCTION AND MODERNIZATION Project Grants for Public Medical Facility Construction and Modernization § 124.10 Additional conditions. The Secretary...

2012-10-01

400

Medical Entomology Project.  

National Technical Information Service (NTIS)

The Medical Entomology Project (MEP), a cooperative venture between the Smithsonian Institution and the U.S. Army Medical Research and Development Command, conducts biosystematic research on arthropods of medical importance to the Army. MEP fulfills this ...

O. S. Flint

1977-01-01

401

Mental Health Medications  

MedlinePLUS

... information about any medication. Medications Organized by Trade Name Trade Name Generic Name FDA Approved Age Combination ... dimesylate 6 and older Medications Organized by Generic Name Generic Name Trade Name FDA Approved Age Combination ...

402

Federal Medication Terminologies  

Cancer.gov

The Federal Medication (FedMed) interagency collaboration is organizing an agreed set of standard, comprehensive, freely and easily accessible Federal Medication Terminologies (FMT) to improve the exchange and public availability of medication information.

403

Medical Entomology Project.  

National Technical Information Service (NTIS)

The Medical Entomology Project (MEP), a cooperative venture between the Smithsonian Institution and the U.S. Army Medical Research and Development Command, conducts biosystematic research on arthropods of medical importance to the Army. MEP fulfills this ...

O. S. Flint

1981-01-01

404

Medical confidentiality and patient safety: reporting procedures.  

PubMed

Medical confidentiality is of individual and of general interest. Medical confidentiality is not absolute. European countries differ in their legislative approaches of consent for data-sharing and lawful breaches of medical confidentiality. An increase of interference by the legislator with medical confidentiality is noticeable. In The Netherlands for instance this takes the form of new mandatory duties to report resp. of legislation providing for a release of medical confidentiality in specific situations, often under the condition that reporting takes place on the basis of a professional code that includes elements imposed by the legislator (e.g. (suspicion of) child abuse, domestic violence). Legislative interference must not result in the patient loosing trust in healthcare. To avoid erosion of medical confidentiality, (comparative) effectiveness studies and privacy impact assessments are necessary (European and national level). Medical confidentiality should be a subject of permanent education of health personnel. PMID:25065032

Abbing, Henriette Roscam

2014-06-01

405

Developmental Dyscalculia and Medical Assessment.  

ERIC Educational Resources Information Center

Medical evaluation of seven third-grade children with developmental dyscalculia in a mainstream setting identified neurological conditions (including petit mal seizures, Gerstmann syndrome, and attention deficit disorder without hyperactivity) in all the children. Findings suggest that children who are not improving academically should undergo…

Shalev, Ruth S.; Gross-Tsur, Varda

1993-01-01

406

Tactical Medical Coordination System (TacMedCS).  

National Technical Information Service (NTIS)

The Tactical Medical Coordination System (TacMedCS) provides rapid casualty identification under adverse conditions, enables visibility of casualty status from the point of injury through medical treatment in higher echelons of care, maintains an electron...

D. Williams

2007-01-01

407

Athletes with Disabilities. Removing Medical Barriers.  

ERIC Educational Resources Information Center

Disability-related conditions such as bladder problems or pressure sores need not keep people from activity. Although active individuals with disabilities require some specialized management, they mainly need medical care for sports-related cuts, sprains, and strains. Physicians can help remove medical barriers to participation for active…

Peck, David M.; McKeag, Douglas B.

1994-01-01

408

World Directory of Medical Schools. Seventh Edition.  

ERIC Educational Resources Information Center

This 7th edition of the World Directory of Medical Schools is a country-by-country listing of 1,642 institutions of basic medical education approved by the competent national authorities in 157 countries or areas; the information reflects academic year 1995-96. The directory also provides information on the conditions for obtaining the license to…

World Health Organization, Geneva (Switzerland).

409