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1

Travellers with pre-existing medical conditions.  

PubMed

Medical conditions that influence travel include those that compromise the immunity of the traveller and chronic underlying diseases or infirmities. The former includes HIV, transplantation, malignancy and its treatment, IgA deficiency, asplenia and use of immunocompromising drugs like corticosteroids. Chronic conditions include diabetes mellitus, end stage renal disease, diseases associated with compromised cardiac or pulmonary function and certain gastrointestinal diseases including cirrhosis. This review includes practical approaches to each of these conditions with attention to risk assessment and avoidance, vaccination when appropriate and not a risk to the compromised host, and arming the traveller with self-therapy and chemoprophylaxis. Since travellers with underlying conditions are often taking various medications the travel health practitioner must be alert for possible drug/drug interactions and must adjust dosages depending on the level of compromised renal or hepatic function. Finally, education of such travellers is paramount; they must understand that risk avoidance is critical and preventative modalities such as vaccination and chemoprophylaxis are never 100% efficacious. PMID:12615384

Ericsson, Charles D

2003-02-01

2

78 FR 30218 - Pre-Existing Condition Insurance Plan Program  

Federal Register 2010, 2011, 2012, 2013, 2014

...prescription drug, organ/tissue transplant, dialysis and...medical equipment benefits, covered services...furnished under the organ/tissue transplant benefit to ensure that...furnished under the organ/tissue transplant benefit will remain...

2013-05-22

3

45 CFR 155.345 - Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition...  

Code of Federal Regulations, 2012 CFR

...CHIP, the Basic Health Program, and...Pre-existing Condition Insurance Plan. 155...Participation and Insurance Affordability Programs...CHIP, the Basic Health Program, and the...Pre-existing Condition Insurance Plan....

2012-10-01

4

45 CFR 155.345 - Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition...  

Code of Federal Regulations, 2014 CFR

...CHIP, the Basic Health Program, and...Pre-existing Condition Insurance Plan. 155...Participation and Insurance Affordability Programs...CHIP, the Basic Health Program, and the...Pre-existing Condition Insurance Plan....

2014-10-01

5

45 CFR 155.345 - Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition...  

Code of Federal Regulations, 2013 CFR

...CHIP, the Basic Health Program, and...Pre-existing Condition Insurance Plan. 155...Participation and Insurance Affordability Programs...CHIP, the Basic Health Program, and the...Pre-existing Condition Insurance Plan....

2013-10-01

6

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

Code of Federal Regulations, 2010 CFR

...If I have a pre-existing dental or vision condition, may I join FEDVIP? 894.102 Section 894.102 Administrative Personnel...If I have a pre-existing dental or vision condition, may I join FEDVIP? Yes. Pre-existing conditions do not exclude...

2010-01-01

7

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

Code of Federal Regulations, 2012 CFR

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

2012-01-01

8

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

Code of Federal Regulations, 2014 CFR

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

2014-01-01

9

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

Code of Federal Regulations, 2013 CFR

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

2013-01-01

10

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

Code of Federal Regulations, 2011 CFR

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

2011-01-01

11

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. PMID:23496890

2013-01-01

12

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

13

Realizing Health Reform’s Potential Early Implementation of Pre-Existing Condition Insurance Plans: Providing an Interim Safety Net for the Uninsurable  

E-print Network

Realizing Health Reform’s Potential Early Implementation of Pre-Existing Condition Insurance Plans: Providing an Interim Safety Net for the Uninsurable JUNE 2011 For more information about this study, please contact: Jean P. Hall, Ph...-Existing Condition Insurance Plan (PCIP) is a temporary program implemented under the Patient Protection and Affordable Care Act to make health insur- ance coverage available to uninsured individuals with preexisting conditions until 2014, when exchange...

Hall, Jean P.; Moore, Janice M.

2011-06-01

14

Roots of Mold Problems and Humidity Control Measures in Institutional Buildings with Pre-Existing Mold Condition  

E-print Network

. Mold in buildings is a serious problem since previous studies indicate that it can lead to or aggravate health problems including headaches, breathing difficulties, allergic reactions, and aggravation of asthma systems (United States Environmental... conditions as indicated by a room thermostat. No reheat coil was designed for this system, so dehumidified primary air or recirculated room air could not be reheated if the cooling coil was opened for humidity control. 0 10 20 30 40 50 60 70 80 90...

Chen, H.; Deng, S.; Bruner, H.; Garcia, J.

2004-01-01

15

Realizing Health Reform’s Potential The Affordable Care Act’s Pre-Existing Condition Insurance Plan: Enrollment, Costs, and Lessons for Reform  

E-print Network

, 2012 (Washington, D.C.: Center for Consumer Information and Insurance Oversight, Centers for Medicare and Medicaid Services, May 2012), avail- able at http://cciio.cms.gov/resources/files/pcip- expenditures-03-31-2012.pdf. 12 S. L. Decker, J. A. Doshi... of 10 States’ PCIP Enrollees a Condition (ICD-9 Codes) N b Percent of sample Immune disorders (042, V08, 279, 695.4) 48 3.2 HIV (042, V08) 44 3.0 Cancers (140–65, 170–72, 174–76, 179–208, 209.0–209.3, 230–34, 237.7, 237.8, 511.81, 789.51, V58.0–.12, V...

Hall, Jean P.; Moore, Janice M.

2012-09-01

16

17 CFR 151.9 - Pre-existing positions.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 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...

2012-04-01

17

17 CFR 151.9 - Pre-existing positions.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 false Pre-existing positions. 151.9 Section 151.9 Commodity...FUTURES TRADING COMMISSION (CONTINUED) POSITION LIMITS FOR FUTURES AND SWAPS § 151.9 Pre-existing positions. (a) Non-spot-month...

2014-04-01

18

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

19

Pre-existing diabetes significantly increases the risk of graft failure and mortality following renal transplantation.  

PubMed

The aim of this study was to examine the impact of pre-existing diabetes mellitus (DM) on acute rejection, graft loss, and mortality following kidney transplant and whether glycemic control or cardiovascular disease (CVD) risk control with medications influenced outcomes. This was a cohort study of 1002 renal transplants conducted between 2000 and 2008. Patients were included if they received a kidney transplant within the allotted time and were at least 18 yr of age. Cox regression was used to assess acute rejection, graft failure, or death controlling for relevant sociodemographic, clinical, and post-transplant variables. Five-yr patient survival (83% vs. 93%, p < 0.001) and graft survival (74% vs. 79%, p = 0.005) were significantly lower in patients with pre-existing DM. Sequential Cox regression models demonstrated that pre-existing DM was consistently associated with a higher risk of death (HR 2.3-3.0, p < 0.01) and graft failure (HR 1.5-1.8, p < 0.04) in all models except after adjusting for CVD medication use (HR 1.9, p = 0.174 and HR 1.5, p = 0.210, respectively). These data suggest pre-existing DM is a significant risk factor for graft failure and death following renal transplantation and aggressive CVD risk reduction with medications may be an important strategy to reduce mortality and graft failure. PMID:23383719

Taber, David J; Meadows, Holly B; Pilch, Nicole A; Chavin, Kenneth D; Baliga, Prabhakar K; Egede, Leonard E

2013-01-01

20

A Double Whammy: Health Promotion Among Cancer Survivors with Pre-Existing Functional Limitations  

PubMed Central

Purpose/Objectives To explore the experience of living with a cancer diagnosis within the context of a pre-existing functional disability and to identify strategies to promote health in this growing population of cancer survivors. Research Approach Qualitative descriptive Setting Four sites in the United States Participants 19 female cancer survivors with pre-existing disabling conditions Methodologic Approach Four focus groups were conducted. The audiotapes were transcribed and analyzed using content analysis techniques. Main Research Variables cancer survivor, disability, health promotion Findings Analytic categories included living with a cancer diagnosis, health promotion strategies, and wellness program development for survivors with pre-existing functional limitations. Participants described many challenges associated with managing a cancer diagnosis on top of living with a chronic disabling functional limitation. They identified strategies they used to maintain their health and topics to be included in health promotion programs tailored for this unique group of cancer survivors. Conclusions The “double whammy” of a cancer diagnosis for persons with pre-existing functional limitations requires modification of health promotion strategies and programs to promote wellness in this group of cancer survivors. Interpretation Nurses and other health care providers must attend to patients’ pre-existing conditions as well as the challenges of the physical, emotional, social, and economic sequelae of a cancer diagnosis. PMID:23269771

Volker, Deborah L.; Becker, Heather; Kang, Sook Jung; Kullberg, Vicki

2012-01-01

21

The Origin of Allosteric Functional Modulation: Multiple Pre-existing Pathways  

PubMed Central

While allostery draws increasing attention, not much is known about allosteric mechanisms. Here we argue that in all proteins, allosteric signals transmit through multiple, pre-existing pathways; which pathways dominate depend on protein topologies, specific binding events, covalent modifications and cellular (environmental) conditions. Further, perturbation events at any site on the protein surface (or in the interior) will not create new pathways but only shift the pre-existing ensemble of pathways. Drugs binding at different sites or mutational events in disease shift the ensemble toward the same conformations; however, the relative populations of the different states will change. Consequently the observed functional, conformational, and dynamic effects will be different. This is the origin of allosteric functional modulation in dynamic proteins: allostery does not necessarily need to invoke conformational rearrangements to control protein activity and pre-existing pathways are always defaulted to during allostery regardless of the stimulant and perturbation site in the protein. PMID:19679084

del Sol, Antonio; Tsai, Chung-Jung; Ma, Buyong; Nussinov, Ruth

2009-01-01

22

77 FR 52614 - Pre-Existing Condition Insurance Plan Program  

Federal Register 2010, 2011, 2012, 2013, 2014

...cost sharing. This is consistent with the policy under S. 3992, the Development, Relief, and Education for Alien Minors (DREAM) Act of 2010.'' See Consideration of Deferred Action for Childhood Arrivals,...

2012-08-30

23

75 FR 45013 - Pre-Existing Condition Insurance Plan Program  

Federal Register 2010, 2011, 2012, 2013, 2014

...health problems, economic statuses, and demands...care and health insurance than the insured...Comprehensive Health Insurance for High-Risk...Uninsurable: The Growth in High-Risk Pools...by the Council of Economic Advisers found that...access to health insurance coverage...

2010-07-30

24

Medical conditions with neuropsychiatric manifestations.  

PubMed

Medical disease sometimes affects patients through neuropsychiatric manifestations. When neuropsychiatric symptoms are predominant, identifying medical disease early in the illness course is imperative because many of these conditions are reversible with appropriate treatment. A high index of suspicion is required on the part of clinicians, particularly when patients also present with physical signs or unexplained symptoms that might suggest a broader, systemic process. The processes that most commonly cause neuropsychiatric symptoms include infectious, autoimmune, endocrinologic, metabolic, and neoplastic diseases. This article focuses on the most common of these conditions, and conditions for which early diagnosis and treatment are particularly important. PMID:25134879

Isaac, Margaret L; Larson, Eric B

2014-09-01

25

Diagnosis: medical and psychosocial conditions  

E-print Network

Disorders (FASD) What you can do to help your child www.beinthekNOwnj.org How We Can Help Through a grant Diagnosis: medical and psychosocial conditions Case Management: referrals to community resources pregnancy. Babies with identifiable facial characteristics, stunted growth and possible brain damage

Garfunkel, Eric

26

Gate dielectric degradation: Pre-existing vs. generated defects  

SciTech Connect

We consider the possibility that degradation of the electrical characteristics of high-k gate stacks under low voltage stresses of practical interest is caused primarily by activation of pre-existing defects rather than generation of new ones. In nFETs in inversion, in particular, defect activation is suggested to be associated with the capture of an injected electron: in this charged state, defects can participate in a fast exchange of charge carriers with the carrier reservoir (substrate or gate electrode) that constitutes the physical process underlying a variety of electrical measurements. The degradation caused by the activation of pre-existing defects, as opposed to that of new defect generation, is both reversible and exhibits a tendency to saturate through the duration of stress. By using the multi-phonon assisted charge transport description, it is demonstrated that the trap activation concept allows reproducing a variety of experimental results including stress time dependency of the threshold voltage, leakage current, charge pumping current, and low frequency noise. Continuous, long-term degradation described by the power law time dependency is shown to be determined by the activation of defects located in the interfacial SiO{sub 2} layer of the high-k gate stacks. The findings of this study can direct process optimization efforts towards reduction of as-grown precursors of the charge trapping defects as the major factor affecting reliability.

Veksler, Dmitry, E-mail: Dmitry.Veksler@sematech.org, E-mail: gennadi.bersuker@sematech.org; Bersuker, Gennadi, E-mail: Dmitry.Veksler@sematech.org, E-mail: gennadi.bersuker@sematech.org [SEMATECH Inc., 257 Fuller Rd., Albany, New York 12203 (United States)

2014-01-21

27

PRESENCE OF PRE-EXISTING ANTIBODIES MEDIATE SURVIVAL IN SEPSIS  

PubMed Central

Sepsis is one of the leading causes of death in hospitals worldwide. Even with optimal therapy, severe sepsis results in 50% mortality, indicating variability in the response of individuals towards treatment. We hypothesize that the presence of pre-existing antibodies present in the blood before the onset of sepsis induced by cecal ligation and puncture (CLP) in mice, accounts for the differences in their survival. A Plasma Enhanced Killing (PEK) assay was performed to calculate the PEK capacity of plasma i.e. the ability of plasma to augment PMN killing of bacteria. PEK was calculated as PEK= (1/log (N)) × 100; where N= number of surviving bacteria; a higher PEK indicated better bacterial killing. A range of PEK in plasma collected from mice prior to CLP was observed, documenting individual differences in bacterial killing capacity. Mortality was predicted based on plasma IL-6 levels at 24 hr post CLP. Mice predicted to die (Die-P) had a lower PEK (<14) and higher peritoneal bacterial counts 24 hr post sepsis compared to those predicted to live (Live-P) with a PEK>16. Mice with PEK<14 were 3.1 times more likely to die compared to the PEK>16 group. To understand the mechanism of defense conferred by the pre-existing antibodies, binding of IgM or IgG to enteric bacteria was documented by flow cytometry. To determine the relative contribution of IgM or IgG, the immunoglobulins were specifically immuno-depleted from the naďve plasma samples and the PEK of the depleted plasma measured. Compared to naďve plasma, depletion of IgM had no effect on the PEK. However, depletion of IgG increased PEK suggesting that an inhibitory IgG binds to antigenic sites on bacteria preventing optimal opsonization of the bacteria. These data demonstrate that prior to CLP; circulating inhibitory IgG antibodies exist that prevent bacterial killing by PMNs in a CLP model of sepsis. PMID:21921828

Moitra, Rituparna; Beal, Dominic R.; Belikoff, Bryan G.; Remick, Daniel G.

2011-01-01

28

13 CFR 120.922 - Pre-existing debt on the Project Property.  

Code of Federal Regulations, 2010 CFR

13 Business Credit and Assistance...Pre-existing debt on the Project Property. 120...Section 120.922 Business Credit and Assistance...ADMINISTRATION BUSINESS LOANS Development...Pre-existing debt on the Project Property....

2010-01-01

29

Do Transient Working Conditions Trigger Medical Errors?  

Microsoft Academic Search

Objective: Organizational factors affecting working conditions for health care workers have received significant attention as latent causes of medical errors. Little is known, however, about the risks associated with transient or changing working conditions. The purpose of this study was to identify specific transient, modifiable working conditions in the hospital environment that serve as triggers for medical errors. Methods: A

Deborah Grayson; Stuart Boxerman; Patricia Potter; Laurie Wolf; Clay Dunagan; Gary Sorock; Bradley Evanoff

30

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

31

Surrogate-based optimization of hydraulic fracturing in pre-existing fracture networks  

NASA Astrophysics Data System (ADS)

Hydraulic fracturing has been used widely to stimulate production of oil, natural gas, and geothermal energy in formations with low natural permeability. Numerical optimization of fracture stimulation often requires a large number of evaluations of objective functions and constraints from forward hydraulic fracturing models, which are computationally expensive and even prohibitive in some situations. Moreover, there are a variety of uncertainties associated with the pre-existing fracture distributions and rock mechanical properties, which affect the optimized decisions for hydraulic fracturing. In this study, a surrogate-based approach is developed for efficient optimization of hydraulic fracturing well design in the presence of natural-system uncertainties. The fractal dimension is derived from the simulated fracturing network as the objective for maximizing energy recovery sweep efficiency. The surrogate model, which is constructed using training data from high-fidelity fracturing models for mapping the relationship between uncertain input parameters and the fractal dimension, provides fast approximation of the objective functions and constraints. A suite of surrogate models constructed using different fitting methods is evaluated and validated for fast predictions. Global sensitivity analysis is conducted to gain insights into the impact of the input variables on the output of interest, and further used for parameter screening. The high efficiency of the surrogate-based approach is demonstrated for three optimization scenarios with different and uncertain ambient conditions. Our results suggest the critical importance of considering uncertain pre-existing fracture networks in optimization studies of hydraulic fracturing.

Chen, Mingjie; Sun, Yunwei; Fu, Pengcheng; Carrigan, Charles R.; Lu, Zhiming; Tong, Charles H.; Buscheck, Thomas A.

2013-08-01

32

A framework for the merging of pre-existing and correspondenceless 3D statistical shape models.  

PubMed

The construction of statistical shape models (SSMs) that are rich, i.e., that represent well the natural and complex variability of anatomical structures, is an important research topic in medical imaging. To this end, existing works have addressed the limited availability of training data by decomposing the shape variability hierarchically or by combining statistical and synthetic models built using artificially created modes of variation. In this paper, we present instead a method that merges multiple statistical models of 3D shapes into a single integrated model, thus effectively encoding extra variability that is anatomically meaningful, without the need for the original or new real datasets. The proposed framework has great flexibility due to its ability to merge multiple statistical models with unknown point correspondences. The approach is beneficial in order to re-use and complement pre-existing SSMs when the original raw data cannot be exchanged due to ethical, legal, or practical reasons. To this end, this paper describes two main stages, i.e., (1) statistical model normalization and (2) statistical model integration. The normalization algorithm uses surface-based registration to bring the input models into a common shape parameterization with point correspondence established across eigenspaces. This allows the model fusion algorithm to be applied in a coherent manner across models, with the aim to obtain a single unified statistical model of shape with improved generalization ability. The framework is validated with statistical models of the left and right cardiac ventricles, the L1 vertebra, and the caudate nucleus, constructed at distinct research centers based on different imaging modalities (CT and MRI) and point correspondences. The results demonstrate that the model integration is statistically and anatomically meaningful, with potential value for merging pre-existing multi-modality statistical models of 3D shapes. PMID:24983233

Pereańez, Marco; Lekadir, Karim; Butakoff, Constantine; Hoogendoorn, Corné; Frangi, Alejandro F

2014-10-01

33

MEDICAL INSURANCE ConditionCare  

E-print Network

artery disease (CAD), heart failure (HF), chronic obstructive pulmonary disease (COPD) or asthma, ask and education on how to better manage your condition Specially designed condition-specific care diaries, self pre- and post-natal, confidential support and education any time of the day or night! Even

34

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

35

Pre-existing Cardiovascular Disease and Periodontitis: A Follow-up Study  

Microsoft Academic Search

Periodontal infections in individuals with pre-existing heart disease are believed to increase the risk for future coronary heart disease (CHD) events. The goal of this study was to search for an association between periodontitis and CHD events among individuals with pre-existing heart disease, reported in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Dentate adults (n =

P. P. Hujoel; M. Drangsholt; C. Spiekerman; T. A. DeRouen

2002-01-01

36

Asperger Syndrome: Associated Psychiatric and Medical Conditions.  

ERIC Educational Resources Information Center

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

Ghaziuddin, Mohammad

2002-01-01

37

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 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...

2010-10-01

38

42 CFR 482.22 - Condition of participation: Medical staff.  

Code of Federal Regulations, 2010 CFR

...false Condition of participation: Medical staff. 482.22 Section 482.22 Public Health...22 Condition of participation: Medical staff. The hospital must have an organized medical staff that operates under bylaws approved by...

2010-10-01

39

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2014 CFR

...2014-10-01 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...

2014-10-01

40

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2011 CFR

...2011-10-01 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...

2011-10-01

41

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2012 CFR

...2012-10-01 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...

2012-10-01

42

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

43

Solid particle impingement erosion characteristics of cylindrical surfaces, pre-existing holes and slits  

NASA Technical Reports Server (NTRS)

The erosion characteristics of aluminum cylinders sand-blasted with both spherical and angular erodent particles were studied and compared with results from previously studied flat surfaces. The cylindrical results are discussed with respect to impact conditions. The relationship between erosion rate and pit morphology (width, depth, and width to depth ratio) is established. The aspects of (1) erosion rate versus time curves on cylindrical surfaces; (2) long-term exposures; and (3) erosion rate versus time curves with spherical and angular particles are presented. The erosion morphology and characteristics of aluminum surfaces with pre-existing circular cylindrical and conical holes of different sizes were examined using weight loss measurements, scanning electron microscopy, a profilometer, and a depth gage. The morphological features (radial and concentric rings) are discussed with reference to flat surfaces, and the erosion features with spherical microglass beads. The similarities and differences of erosion and morphological features are highlighted. The erosion versus time curves of various shapes of holes are discussed and are compared with those of a flat surface. The erosion process at slits is considered.

Rao, P. V.; Buckley, D. H.

1983-01-01

44

Dyke intrusion into a pre-existing joint network: The Aiguablava lamprophyre dyke swarm (Catalan Coastal Ranges)  

NASA Astrophysics Data System (ADS)

A structural analysis has been performed in the Upper Permian lamprophyric dyke swarm of Aiguablava (Costa Brava, NE Iberia). Emplacement of sub-vertical dykes is related to the presence of a widespread joint network, mostly developed during the cooling and decompression of the late Variscan leucogranitic host rocks. The joint pattern consists on multiple sub-vertical joint sets among which two orthogonal sets at ? N23° and ? N113° are predominant. A sub-horizontal set is also prominent. The sub-vertical dykes have a mean N100°-N125° trend, which corresponds to the trend of one of the main joint sets. However, dyke segmentation is noticeable at the Dm- to cm-scale, and this is inferred to be related to dyke propagation and emplacement along the variably oriented pre-existing joints. A mean robust sub-horizontal NNE-SSW net dilation direction was measured from matching dyke jogs, markers in the host rock and analysis of maximum dyke thicknesses, and this is in line with the minimum principal stress axis (3) derived from a three-dimensional paleostress analysis from dyke orientations. The inferred maximum principal stress axis (1) is sub-vertical, indicating that dykes intruded under conditions of tectonic extension. Furthermore, a Mohr construction allowed calculation of the stress ratio ? = 0.29 (close to a prolate stress ellipsoid) and a driving pressure ratio R? = 0.27, which corresponds to a magmatic pressure almost equal to the intermediate principal stress axis, ?2. It is inferred that many of the pre-existing joint sets were exploited by the magma, the WNW-ESE joint set (normal to ?3) being the most favorable for dyke emplacement. The present study highlights the structural control of a pre-existing fracture network on emplacement of the Aiguablava lamprophyres in the upper crust during late Permian NNE-SSW brittle extension.

Martínez-Poza, A. I.; Druguet, E.; Castańo, L. M.; Carreras, J.

2014-09-01

45

Influence of Pre-existing LPO on Texture Development in Ultramafic Shear Zones  

NASA Astrophysics Data System (ADS)

The Red Hills ultramafic massif, the South Island, New Zealand, contains a suite of cm-scale shear zones composed of dunite, pyroxenite, and olivine websterite. The shear zones cross-cut banded dunite and harzburgite host rock. Offset along the shear zones was measured using displacement of distinct compositional layers in the host rock, and is interpreted to occur by dominantly simple shear. While these zones contain a different mineralogy that the host rocks, they contain microstructures that are similar to the host rock, including coarse grain sizes (>1 mm) and dominantly polygonal grains. The olivine lattice preferred orientation (LPO) in the host rocks is consistent with the (010)[100] slip system, known to be active at high-temperature, upper mantle conditions. Within the shear zones, the olivine LPO, when plotted relative to the shear zone foliation and lineation, suggests (010)[001] slip. The shear zone LPO is typically more poorly clustered than in host rock samples, and double maxima are observed in some samples, with the second maxima suggesting (010)[100] slip. Fourier transform infra-red spectroscopy analysis of the shear zone olivines indicates that they are not fluid-rich relative to the host rock. When olivine LPO from both host rocks and shear zone samples is plotted within the same (geographic) reference frame, it is apparent that the shear zone LPO retains evidence for the dominant LPO of the host rocks. We suggest that the LPO in the shear zone rocks developed as a result of reactivation of a pre-exiting fabric; the poorly clustered data and double maxima reflect the change during deformation along the shear zone. These rocks demonstrate the influence of pre-existing LPO on texture development during deformation and the need to consider the LPO of deformed rocks within different reference frames.

Newman, J.; Webber, C.; Holyoke, C.; Little, T.; Tikoff, B.

2007-12-01

46

Contributions Made by a Strengths-Oriented Intervention to Trusting Relationships within Pre-Existing Teams  

ERIC Educational Resources Information Center

This qualitative study spotlighted a grounded theory regarding contributions to affect- and cognition-based trust by a strengths-oriented intervention in pre-existing teams. Using purposeful and convenience sampling, 18 participants in a strengths-oriented intervention from 2 different regions of the Pacific Northwest were selected. A…

King, W. Bernt

2012-01-01

47

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

48

Surrogate-based optimization of hydraulic fracturing in pre-existing fracture networks  

E-print Network

Surrogate-based optimization of hydraulic fracturing in pre-existing fracture networks Mingjie Chen Keywords: Hydraulic fracturing Fractal dimension Surrogate model Optimization Global sensitivity a b s t r a c t Hydraulic fracturing has been used widely to stimulate production of oil, natural gas

Lu, Zhiming

49

Opposite clear corneal incisions to correct pre-existing astigmatism in cataract surgery  

Microsoft Academic Search

In cataract surgery, the clear corneal incision (CCI) has a small flattening effect on corneal curvature, which can be used to reduce pre-existing astigmatism (PEA). Adding an identical, penetrating CCI opposite the first one can enhance the flattening effect. The paired opposite CCIs (OCCIs) are placed on the steepest meridian axis to flatten it. One CCI is used to perform

Jeffrey Lever; Elie Dahan

2000-01-01

50

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

51

Interaction of ascending magma with pre-existing crustal structures: Insights from analogue modeling  

NASA Astrophysics Data System (ADS)

Magma transport through dikes is a major component of the development of basaltic volcanic fields. Basaltic volcanic fields occur in many different tectonic setting, from tensile (e.g., Camargo Volcanic Field, Mexico) to compressive (e.g., Abu Monogenetic Volcano Group, Japan). However, an important observation is that, independently of their tectonic setting, volcanic fields are characterized by numerous volcanic centers showing clustering and lineaments, each volcanic center typically resulting from a single main eruption. Analyses from Auckland Volcanic Field reveal that, for each eruption, magma was transported from its source and reached the surface at different places within the same field, which raises the important question of the relative importance of 1) the self-propagation of magma through pristine rock, as opposed to 2) the control exerted by pre-existing structures. These two mechanisms have different implications for the alignment of volcanic centers in a field as these may reflect either 1) the state of crustal stress dikes would have experienced (with a tendency to propagate perpendicular to the least compressive stress) or 2) the interaction of propagating dikes with pre-existing crustal faults. In the latter case, lineaments might not be related to the syn-emplacement state of stress of the crust. To address this issue, we have carried out a series of analogue experiments in order to constrain the interaction of a propagating magma-filled dike with superficial pre-existing structures (e.g., fracture, fault, joint system). The experiments involved the injection of air (a buoyant magma analogue) into elastic gelatine solids (crustal rock analogues). Cracks were cut into the upper part of the gelatine solids prior to the injection of air to simulate the presence of pre-existing fractures. The volume of the propagating dikes, their distance from pre-existing fractures and the ambient stress field were systematically varied to assess their influence on the propagating dikes and their potential interaction with pre-existing fractures. The experimental results will be presented and discussed in the context of basaltic field volcanism before relating them to Auckland Volcanic Field.

Le Corvec, N.; Menand, T.; Rowland, J. V.

2010-12-01

52

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

53

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

ERIC Educational Resources Information Center

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

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

2008-01-01

54

Pre-existing atrial fibrillation and risk of arterial thromboembolism and death following pneumonia: a population-based cohort study  

PubMed Central

Objectives To examine the effect of pre-existing atrial fibrillation (AF) and associated therapy on the risk of arterial thromboembolism (ATE) and death following pneumonia. Design, setting and participants Population-based cohort study (1997–2012) of 88?315 patients with first-time hospitalisation with pneumonia in Northern Denmark. Results Of the included patients (median age 73.4?years), 8880 (10.1%) had pre-existing AF. The risk of ATE within 30?days of admission was 5.2% in patients with AF and 3.6% in patients without AF. After adjustment for higher age and comorbidity, the adjusted HR (aHR) with AF was 1.06 (95% CI 0.96 to 1.18). Among patients with AF, reduced risk of ATE was observed in vitamin-K antagonist users compared with non-users (aHR 0.74 (95% CI 0.61 to 0.91)). Thirty-day mortality was 20.1% in patients with AF and 13.9% in patients without AF. Corresponding 1-year mortalities were 43.7% and 30.3%. The aHRs for 30-day and 1-year mortality with AF were 1.00 (95% CI 0.94 to 1.05) and 1.01 (95% CI 0.98 to 1.05). In patients with AF, reduced mortality risk was observed in users of vitamin-K antagonists (aHR 0.70 (95% CI 0.63 to 0.77)) and ?-blockers (aHR 0.77 (95% CI 0.70 to 0.85). Increased mortality was found in digoxin users (aHR 1.16 (95% CI 1.06 to 1.28)). Conclusions Pre-existing AF is frequent in patients hospitalised with pneumonia and a marker of increased risk of ATE and death, explained by higher patient age and comorbidity. Prognosis is closely related to preadmission medical treatment for AF. PMID:25398678

Gamst, Jacob; Christiansen, Christian Fynbo; Rasmussen, Bodil Steen; Rasmussen, Lars Hvilsted; Thomsen, Reimar Wernich

2014-01-01

55

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

Microsoft Academic Search

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

ALEXANDRA L. BASOLO

1995-01-01

56

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

Microsoft Academic Search

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

Ludwig Bstieler; Martin Hemmert

2010-01-01

57

Interaction of Martian Flow Ejecta Blankets with Pre-existing Impact Craters: Morphological Observations  

NASA Technical Reports Server (NTRS)

The evidence of interaction between impact flow ejecta blankets and pre-existing landforms such as craters, scarps, and wrinkle ridges may yield important clues as to the nature of the ejecta emplacement process. The morphology of flow ejecta blankets and the interactions of these blankets with pre-emplacement impact craters were characterized. About 80 small satellite craters on or in 3 well-expressed low ejecta parent impact craters were recognized. Interaction of the blanket with pre-existing structures was studied, and several types were described. These are: (1) infilling; (2) encroachment; (3) overflow; and (4) breaching. Examination of the overall morphology of three ejecta blankets reveals a range of thickness, from depths sufficient to completely bury craters in the 5 km diameter range in distal areas of the blankets, to very thin blankets which allow subtle pre-existing topography to be visible within a half the diameter of the parent crater. Radial and azimuthal symmetries appear to exist within the blankets over a range of morphologies. It also appears that there is a weak linear correlation between the diameter of craters with nearly 100% infilling and distance from the center of the parent crater.

Pieri, D. C.; Hurick, M.; Baloga, S. M.

1985-01-01

58

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

59

Pre-existing Conditions Genetic Testing, Causation, and the Justice of  

E-print Network

public debate. Cloning or somatic cell nuclear transfer (even the terminol- ogy is controversial will require close collaboration of both scientists and ethicists. Progress on the controversy about human cloning, for instance, may be possible when scientists, ethicists, and phil- osophers of science use

Pennock, Robert T.

60

Medication errors in the homes of children with chronic conditions  

Microsoft Academic Search

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

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

2011-01-01

61

The evolution of floral scent and olfactory preferences in pollinators: coevolution or pre-existing bias?  

PubMed

Coevolution is thought to be a major factor in shaping plant-pollinator interactions. Alternatively, plants may have evolved traits that fitted pre-existing preferences or morphologies in the pollinators. Here, we test these two scenarios in the plant family of Araceae and scarab beetles (Coleoptera, Scarabaeidae) as pollinators. We focused on floral volatile organic compounds (VOCs) and production/detection of VOCs by scarab beetles. We found phylogenetic structure in the production/detection of methoxylated aromatics in scarabs, but not plants. Within the plants, most of the compounds showed a well-supported pattern of correlated evolution with scarab-beetle pollination. In contrast, the scarabs showed no correlation between VOC production/detection and visitation to Araceae flowers, with the exception of the VOC skatole. Moreover, many VOCs were found in nonpollinating beetle groups (e.g., Melolonthinae) that are ancestors of pollinating scarabs. Importantly, none of the tested VOCs were found to have originated in pollinating taxa. Our analysis indicates a Jurassic origin of VOC production/detection in scarabs, but a Cretaceous/Paleocene origin of floral VOCs in plants. Therefore, we argue against coevolution, instead supporting the scenario of sequential evolution of floral VOCs in Araceae driven by pre-existing bias of pollinators. PMID:22759283

Schiestl, Florian P; Dötterl, Stefan

2012-07-01

62

Absence Memo Office Verification of Chronic Medical Condition  

E-print Network

Absence Memo Office Verification of Chronic Medical Condition Student's Name medical condition? Yes No If yes, how many days do you anticipate the patient/student might realistically miss during an academic term indicated below? Express Course/6 weeks: Days realistically missed

Przeworski, Andrew

63

Impact of infection or vaccination on pre-existing serological memory.  

PubMed

Once established, serum antibody responses against a specific pathogen may last a lifetime. We describe a cohort of four subjects who received smallpox vaccination, and a single subject who received multiple vaccinations, with antibody levels to unrelated antigens monitored for 1-3 years. These immunizations provided the opportunity to determine if infection/vaccination and the resulting toll-like receptor stimulation would alter antigen-specific serological memory to other antigens, including bacterial toxins (tetanus, diphtheria, and pertussis) and viruses (yellow fever virus, measles, mumps, rubella, Epstein-Barr virus, and varicella-zoster virus). Our results indicate that serum IgG levels are remarkably stable and infection or vaccination are unlikely to increase or decrease pre-existing antigen-specific antibody responses. PMID:22902392

Amanna, Ian J; Hammarlund, Erika; Lewis, Mathew W; Slifka, Mark K

2012-11-01

64

Numerical Study on Coalescence of Pre-Existing Flaw Pairs in Rock-Like Material  

NASA Astrophysics Data System (ADS)

The present numerical study, which is an extension of our previous numerical analysis on cracking processes of a single pre-existing flaw, focuses on the coalescence of two pre-existing parallel open flaws in rock subjected to a uniaxial compressive loading. To facilitate a systematic investigation, the arrangements of the flaw pair are classified into 11 categories. Simulations engaging AUTODYN are conducted on each category. The numerical results are compared with some published physical experimental test results. Eleven typical coalescence patterns are obtained, which are in good agreement with the experimental results, which include two coalescence patterns obtained in flaw pair arrangements (II) and (VIII?) not being reported in previous studies. The information gathered in the simulations helps identify the type (tensile/shear) of each crack segment involved in the coalescence. Most of the coalescence cracks initiate at or around the flaw tips, except those in flaw pair arrangements (II) and (IX') with a very short ligament length, in which the coalescence cracks initiate on the flaw surfaces away from the flaw tip regions. Based on the numerical simulation results, the properties of the 11 coalescence patterns are obtained. Except those in flaw pair arrangements (II) and (IX'), the other coalescence patterns can be interpreted with respect to the basic crack types—tensile wing crack, horsetail crack and anti-wing crack. In addition, based on the type of crack segments involved in coalescence, namely tensile and shear, the coalescence can be classified into T mode (tensile mode), S mode (shear mode) and TS mode (mixed tensile-shear mode).

Li, Huan-Qiang; Wong, Louis Ngai Yuen

2014-11-01

65

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

66

MEDICAL PHYSICS PERSONNEL FOR MEDICAL IMAGING: REQUIREMENTS, CONDITIONS OF INVOLVEMENT AND STAFFING LEVELS-FRENCH RECOMMENDATIONS.  

PubMed

The French regulations concerning the involvement of medical physicists in medical imaging procedures are relatively vague. In May 2013, the ASN and the SFPM issued recommendations regarding Medical Physics Personnel for Medical Imaging: Requirements, Conditions of Involvement and Staffing Levels. In these recommendations, the various areas of activity of medical physicists in radiology and nuclear medicine have been identified and described, and the time required to perform each task has been evaluated. Criteria for defining medical physics staffing levels are thus proposed. These criteria are defined according to the technical platform, the procedures and techniques practised on it, the number of patients treated and the number of persons in the medical and paramedical teams requiring periodic training. The result of this work is an aid available to each medical establishment to determine their own needs in terms of medical physics. PMID:25323441

Isambert, Aurélie; Le Du, Dominique; Valéro, Marc; Guilhem, Marie-Thérčse; Rousse, Carole; Dieudonné, Arnaud; Blanchard, Vincent; Pierrat, Noëlle; Salvat, Cécile

2014-10-16

67

Gene Therapy for Mucopolysaccharidosis Type VI Is Effective in Cats Without Pre-Existing Immunity to AAV8  

PubMed Central

Abstract Liver gene transfer with adeno-associated viral (AAV) 2/8 vectors is being considered for therapy of systemic diseases like mucopolysaccharidosis type VI (MPS VI), a lysosomal storage disease due to deficiency of arylsulfatase B (ARSB). We have previously reported that liver gene transfer with AAV2/8 results in sustained yet variable expression of ARSB. We hypothesized that the variability we observed could be due to pre-existing immunity to wild-type AAV8. To test this, we compared the levels of AAV2/8-mediated transduction in MPS VI cats with and without pre-existing immunity to AAV8. In addition, since levels of lysosomal enzymes as low as 5% of normal are expected to be therapeutic, we evaluated the impact of pre-existing immunity on MPS VI phenotypic rescue. AAV2/8 administration to MPS VI cats without pre-existing neutralizing antibodies to AAV8 resulted in consistent and dose-dependent expression of ARSB, urinary glycosaminoglycan (GAG) reduction, and femur length amelioration. Conversely, animals with pre-existing immunity to AAV8 showed low levels of ARSB expression and limited phenotypic improvement. Our data support the use of AAV2/8-mediated gene transfer for MPS VI and other systemic diseases, and highlight that pre-existing immunity to AAV8 should be considered in determining subject eligibility for therapy. PMID:23194248

Ferla, Rita; O'Malley, Thomas; Calcedo, Roberto; O'Donnell, Patricia; Wang, Ping; Cotugno, Gabriella; Claudiani, Pamela; Wilson, James M.; Haskins, Mark

2013-01-01

68

Gene therapy for mucopolysaccharidosis type VI is effective in cats without pre-existing immunity to AAV8.  

PubMed

Liver gene transfer with adeno-associated viral (AAV) 2/8 vectors is being considered for therapy of systemic diseases like mucopolysaccharidosis type VI (MPS VI), a lysosomal storage disease due to deficiency of arylsulfatase B (ARSB). We have previously reported that liver gene transfer with AAV2/8 results in sustained yet variable expression of ARSB. We hypothesized that the variability we observed could be due to pre-existing immunity to wild-type AAV8. To test this, we compared the levels of AAV2/8-mediated transduction in MPS VI cats with and without pre-existing immunity to AAV8. In addition, since levels of lysosomal enzymes as low as 5% of normal are expected to be therapeutic, we evaluated the impact of pre-existing immunity on MPS VI phenotypic rescue. AAV2/8 administration to MPS VI cats without pre-existing neutralizing antibodies to AAV8 resulted in consistent and dose-dependent expression of ARSB, urinary glycosaminoglycan (GAG) reduction, and femur length amelioration. Conversely, animals with pre-existing immunity to AAV8 showed low levels of ARSB expression and limited phenotypic improvement. Our data support the use of AAV2/8-mediated gene transfer for MPS VI and other systemic diseases, and highlight that pre-existing immunity to AAV8 should be considered in determining subject eligibility for therapy. PMID:23194248

Ferla, Rita; O'Malley, Thomas; Calcedo, Roberto; O'Donnell, Patricia; Wang, Ping; Cotugno, Gabriella; Claudiani, Pamela; Wilson, James M; Haskins, Mark; Auricchio, Alberto

2013-02-01

69

Travelers with Disabilities and Medical Conditions  

MedlinePLUS

... Conditions Download / Print Traveler Information TSA Cares Help Line TSA Cares is a help line to assist ... coordinate checkpoint support with a TSA Customer Service Manager located at the airport when necessary. One of ...

70

28 CFR 79.16 - Proof of medical condition.  

Code of Federal Regulations, 2012 CFR

...Eligibility Criteria for Claims Relating to Leukemia § 79.16 Proof of medical condition...the claimant suffered from or suffers from leukemia. Proof that the claimant contracted leukemia must be made either by using the...

2012-07-01

71

28 CFR 79.16 - Proof of medical condition.  

Code of Federal Regulations, 2011 CFR

...Eligibility Criteria for Claims Relating to Leukemia § 79.16 Proof of medical condition...the claimant suffered from or suffers from leukemia. Proof that the claimant contracted leukemia must be made either by using the...

2011-07-01

72

28 CFR 79.16 - Proof of medical condition.  

Code of Federal Regulations, 2013 CFR

...Eligibility Criteria for Claims Relating to Leukemia § 79.16 Proof of medical condition...the claimant suffered from or suffers from leukemia. Proof that the claimant contracted leukemia must be made either by using the...

2013-07-01

73

28 CFR 79.16 - Proof of medical condition.  

Code of Federal Regulations, 2010 CFR

...Eligibility Criteria for Claims Relating to Leukemia § 79.16 Proof of medical condition...the claimant suffered from or suffers from leukemia. Proof that the claimant contracted leukemia must be made either by using the...

2010-07-01

74

28 CFR 79.16 - Proof of medical condition.  

Code of Federal Regulations, 2014 CFR

...Eligibility Criteria for Claims Relating to Leukemia § 79.16 Proof of medical condition...the claimant suffered from or suffers from leukemia. Proof that the claimant contracted leukemia must be made either by using the...

2014-07-01

75

The Influence of Pre-existing Deformation on GMA Welding Distortion in Thin Steel Plates  

NASA Astrophysics Data System (ADS)

Weld distortion is particularly problematic for large thin structures that are used in the assembly of ships. The drive toward lighter ships and thinner plate is restricted by the significant increase in distortion as the plate thickness decreases. The influence of pre-existing deformation in the plates to be joined on the resultant distortion in gas metal arc welded structure has been studied. DH-36 steel plate surface profiles were measured before and after the butt welding of two plates 1000 × 500 × 4 mm in size. Three dimensional finite element models that incorporate the initial plate profile have been created to simulate the welding process and to examine the relationship between the final welded plate profiles and the initial deformation present in the plates. Both symmetric and asymmetric models were considered. A significant variation in the unwelded base plates' initial distortion was observed. Generally, it has been found that if an out-of-plane deformation exists in a plate prior to welding, the level of distortion further increases in the same direction following welding. The final distortions are strongly related to the initial plate profiles. The residual stress distributions in the plates are also to some extent affected by the level of distortion initially present.

Davies, C. M.; Ahn, J.; Tsunori, M.; Dye, D.; Nikbin, K. M.

2015-01-01

76

Phenolic acids in neem (Azadirachta indica): a major pre-existing secondary metabolites.  

PubMed

High Performance Liquid Chromatographic (HPLC) analyses of various parts (fresh and dry bark of stem, mature and tender leaves, flower and different parts of fruit, i.e., raw and ripe fruit epicarp, mesocarp and seed) of neem (Azadirachta indica), which occupies an important place in socio-cultural-religious life in Indian communities, indicate that neem is rich in pre-existing secondary metabolites (phenolic acids). Dry bark showed only tannic acid but in fresh bark three phenolic acids were observed, i.e., gallic, tannic, and ferulic acids. In tender leaves only gallic and ferulic acids were detected, but the levels of these phenolic acids in mature leaves were about three times and fifty times greater, respectively. Flowers had only two phenolic acids in which gallic acid was maximum followed by chlorogenic acid. The level of phenolic acid was maximum in seeds followed by epicarp and pulp. In raw and ripe fruit seeds four phenolic acids were detected. Raw fruit seeds were rich in phenolic acids than ripe fruit seeds. Fruit epicarp was relatively richer than seed, seed pulp and flowers of the plants. Neem flowers were also rich in gallic and chlorogenic acids. PMID:16093234

Singh, U P; Maurya, S; Singh, D P

2005-01-01

77

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

78

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

Microsoft Academic Search

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

Paolo Gamberini

2008-01-01

79

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

Code of Federal Regulations, 2010 CFR

...medical condition and determining the medical necessity for the PMD as part of...pertinent parts of the beneficiary's medical record (for example, history, physical...appropriate) that supports the medical necessity for the power...

2010-10-01

80

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

Code of Federal Regulations, 2011 CFR

...medical condition and determining the medical necessity for the PMD as part of...pertinent parts of the beneficiary's medical record (for example, history, physical...appropriate) that supports the medical necessity for the power...

2011-10-01

81

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

82

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

Code of Federal Regulations, 2012 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...

2012-10-01

83

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

Code of Federal Regulations, 2014 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...

2014-10-01

84

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

Code of Federal Regulations, 2011 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...

2011-10-01

85

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

86

42 CFR 416.47 - Condition for coverage-Medical records.  

Code of Federal Regulations, 2010 CFR

...false Condition for coverage-Medical records. 416.47 Section 416...47 Condition for coverage—Medical records. The ASC must maintain complete, comprehensive, and accurate medical records to ensure adequate patient...

2010-10-01

87

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

Code of Federal Regulations, 2010 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...

2010-07-01

88

42 CFR 416.47 - Condition for coverage-Medical records.  

Code of Federal Regulations, 2012 CFR

...false Condition for coverage-Medical records. 416.47 Section 416...47 Condition for coverage—Medical records. The ASC must maintain complete, comprehensive, and accurate medical records to ensure adequate patient...

2012-10-01

89

42 CFR 416.47 - Condition for coverage-Medical records.  

Code of Federal Regulations, 2014 CFR

...false Condition for coverage-Medical records. 416.47 Section 416...47 Condition for coverage—Medical records. The ASC must maintain complete, comprehensive, and accurate medical records to ensure adequate patient...

2014-10-01

90

42 CFR 416.47 - Condition for coverage-Medical records.  

Code of Federal Regulations, 2011 CFR

...false Condition for coverage-Medical records. 416.47 Section 416...47 Condition for coverage—Medical records. The ASC must maintain complete, comprehensive, and accurate medical records to ensure adequate patient...

2011-10-01

91

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

Code of Federal Regulations, 2012 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...

2012-01-01

92

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

Code of Federal Regulations, 2011 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...

2011-01-01

93

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

Code of Federal Regulations, 2014 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...

2014-01-01

94

42 CFR 416.47 - Condition for coverage-Medical records.  

Code of Federal Regulations, 2013 CFR

...false Condition for coverage-Medical records. 416.47 Section 416...47 Condition for coverage—Medical records. The ASC must maintain complete, comprehensive, and accurate medical records to ensure adequate patient...

2013-10-01

95

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

96

Medical students' self-report of mental health conditions  

PubMed Central

Objectives To investigate the subjective presenceof a range of subsyndromal and syndromal mental health conditions in medical students, and to compare the presence of these conditions between preclinical and clinical training. Methods A cross sectional study was used among first-and fifth-year medical students. Student reported their mental health conditions using the Diagnostic and Statistical Manual of Mental Disorders criteria, the fourth version (DSM-IV). Data analysis was based on 110 questionnaires. Results A total of 61 students (55.5%) reported that they experienced symptoms of mental illness, albeit many with minimum severity. More than 50% of the students reported that they experienced Axis I and Axis II disorders, which mostly were mood disorders (38% in year 1 and 35% in year 5) and obsessive-compulsive traits (41% in year 1 and 46% in year 5), respectively. The least common disorders reported were psychotic disorders (5% in year 1 and 0% in year 5) and schizotypal traits (7% in year 1 and 2% in year 5). Fifth-year students reported more Axis I disorders than first-year students. Female students reported more Axis I disorders than their male peers. A further analysis indicated that there was no significant association between age and Axis disorders. Several conditions were comorbid with other mental illnesses. Conclusions A great number of students reported that they experience mental health conditions with minimal severity. This implies a need for indispensable ongoing support programs for the special needs of medical students.

Shoenfeld, Netta; Lehman, Avi; Wolf, Aharon; Snyder, Leah; Barzilai, Ori

2012-01-01

97

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

98

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. PMID:24796533

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

2014-01-01

99

Psychological adjustment in young children with chronic medical conditions.  

PubMed

Children with chronic medical conditions are at higher risk for behavioral and emotional problems compared to physically healthy children. This study used a conceptual model to examine factors associated with psychological adjustment in children aged 7-11 years old with any of four chronic illnesses. The variables most closely associated with child adjustment included the following: mothers' evaluation of the impact of the child's illness on the family; child's perceptions of parental acceptance; and child's self-perceptions of physical appearance, social acceptance, and athletic competence. These findings confirm the importance of maternal and child perceptions in understanding the psychological adjustment of children with chronic conditions. PMID:16980136

Immelt, Susan

2006-10-01

100

Competition between newly recruited and pre-existing visual cues during the construction of visual appearance  

Microsoft Academic Search

During perception, conXicting visual cues often trade against each other. Recent cue recruitment experiments show that the visual sys- tem can be conditioned to use artiWcial visual cues during the perception of a bistable stimulus. Does the visual system treat the new cue as an independent source of information, separate from the long-trusted cues that were used to train it?

Benjamin T. Backus; Qi Haijiang

2007-01-01

101

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, Genevičve; Sahle, Mesfin; Diallo, Adama; Albina, Emmanuel

2014-06-24

102

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

103

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

PubMed

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

Kato, Shogo; Tsuru, Satoko; Iizuka, Yoshinori

2009-01-01

104

Effect of pre-existing crystallographic preferred orientation on the rheology of Carrara marble  

NASA Astrophysics Data System (ADS)

Localized deformation during high temperature plastic flow is frequently attributed to mechanical weakening caused by grain size reduction and, in some cases, by the development of a crystallographic preferred orientation (CPO). This study aims to investigate experimentally the contribution of CPO development to the strain weakening seen in Carrara marble samples during large strain torsion experiments at temperatures in the range 600-800 °C at constant strain rate and confining pressure. The starting material shows little or no CPO. Samples were treated in three steps. First, they were deformed to achieve a well-developed CPO and recrystallized to a finer grain size. Second, the samples were annealed at 727 °C for 5 h to grow the grains to approximately their original size and shape while maintaining a reasonably strong CPO. Finally, the samples were deformed again, under the same conditions as the first step. Re-deformed samples showed a strain weakening lower than during the first step. We infer that this strength difference is caused primarily by the CPO developed during the first deformation event. This implies that CPO development is an important process that contributes to strain weakening during flow of Carrara marble and likely of other rock types as well.

de Raadt, Wilhelmina S.; Burlini, Luigi; Kunze, Karsten; Spiers, Christopher J.

2014-11-01

105

Condensational uptake of semivolatile organic compounds in gasoline engine exhaust onto pre-existing inorganic particles  

NASA Astrophysics Data System (ADS)

This paper presents the results of laboratory studies on the condensational uptake of gaseous organic compounds in the exhaust of a light-duty gasoline engine onto preexisting sulfate and nitrate seed particles. Significant condensation of the gaseous organic compounds in the exhaust occurs onto these inorganic particles on a time scale of 2-5 min. The amount of condensed organic mass (COM) is proportional to the seed particle mass, suggesting that the uptake is due to dissolution determined by the equilibrium partitioning between gas phase and particles, not adsorption. The amount of dissolution in unit seed mass, S, decreases as a power function with increased dilution of the exhaust, ranging from 0.23 g g-1 at a dilution ratio of 81, to 0.025 g g-1 at a dilution ratio of 2230. It increases nonlinearly with increasing concentration of the total hydrocarbons in the gas phase (THC), rising from 0.12 g g-1 to 0.26 g g-1 for a CTHC increase of 1 to 18 ?g m-3, suggesting that more organics are partitioned into the particles at higher gas phase concentrations. In terms of gas-particle partitioning, the condensational uptake of THC gases in gasoline engine exhaust can account for up to 30% of the total gas + particle THC. The organic mass spectrum of COM has the largest fragment at m/z 44, with mass ratios of mass fragments 43/44 and 57/44 at 0.59 and 2.91, much lower than those reported for gasoline engine primary organic aerosols. The mass fragment 44/total organic mass ratio of 0.097 indicates that COM contains large oxygenated components. By incorporating the present findings, regional air quality modelling results suggest that the condensational uptake of THC onto sulfate particles alone can be comparable to the primary particle mass under moderately polluted ambient conditions. These findings are important for modelling and regulating the air quality impacts of gasoline vehicular emissions.

Li, S.-M.; Liggio, J.; Graham, L.; Lu, G.; Brook, J.; Stroud, C.; Zhang, J.; Makar, P.; Moran, M. D.

2011-10-01

106

The prevalence and incidence of medical conditions in healthy pharmaceutical company employees who volunteer to participate in medical research  

PubMed Central

Aims Although clinical research in healthy volunteers is commonly performed there have been few studies of the value of the medical screening of subjects. The aim of this study was to investigate the prevalence and incidence of medical conditions found during the medical screening of ‘healthy’ subjects employed in a pharmaceutical company who volunteered to participate in medical research. Methods This was a retrospective study of the medical notes of all the subjects who volunteered for membership of the Zeneca Clinical Pharmacology Unit’s healthy volunteer panel over a 4 year period from 1990 to 1994. The prevalence of medical conditions found at presentation was determined. The incidence of medical conditions during the 4 year observation period was also ascertained. Medical screening included a full medical history and examination, clinical chemistry, haematology and urinalysis screens, pulmonary function tests, ECGs, 24 h ambulatory cardiac monitoring and a request for information from the volunteer’s General Practitioner. Results Prevalence-1293 subjects volunteered to join the panel of which 156 subjects (12%) were not accepted at presentation including 141 (10.9%) for medical reasons. The most medical common reasons were; previously diagnosed medical conditions (3.3%), cardiovascular abnormalities (1.9%), abnormal liver function tests (1.9%), anaemia (1.2%), hyperlipidaemia (1.1%), excess alcohol intake (0.6%) and thyroid disease (0.5%). Incidence—36 of the 1137 volunteers (0.8% per year) accepted onto the panel subsequently developed medical conditions of which the most common were; anaemia (0.29% per year), cardiovascular abnormalities (0.13% per year) and vasovagal syncope (0.13% per year). Conclusions This study demonstrates the importance of medical screening before healthy volunteers participate in clinical research. PMID:10383556

Singh, S D; Williams, A J

1999-01-01

107

Medical Signal-Conditioning and Data-Interface System  

NASA Technical Reports Server (NTRS)

A general-purpose portable, wearable electronic signal-conditioning and data-interface system is being developed for medical applications. The system can acquire multiple physiological signals (e.g., electrocardiographic, electroencephalographic, and electromyographic signals) from sensors on the wearer s body, digitize those signals that are received in analog form, preprocess the resulting data, and transmit the data to one or more remote location(s) via a radiocommunication link and/or the Internet. The system includes a computer running data-object-oriented software that can be programmed to configure the system to accept almost any analog or digital input signals from medical devices. The computing hardware and software implement a general-purpose data-routing-and-encapsulation architecture that supports tagging of input data and routing the data in a standardized way through the Internet and other modern packet-switching networks to one or more computer(s) for review by physicians. The architecture supports multiple-site buffering of data for redundancy and reliability, and supports both real-time and slower-than-real-time collection, routing, and viewing of signal data. Routing and viewing stations support insertion of automated analysis routines to aid in encoding, analysis, viewing, and diagnosis.

Braun, Jeffrey; Jacobus, charles; Booth, Scott; Suarez, Michael; Smith, Derek; Hartnagle, Jeffrey; LePrell, Glenn

2006-01-01

108

Is the fault core-damage zone model representative of seismogenic faults? Pre-existing anisotropies and fault zone complexity  

NASA Astrophysics Data System (ADS)

Seismogenic fault zones are often described in terms of a "fault core" surrounded by an intensely fractured "damage zone". This useful framework has found broad application in many fault zone studies (hydraulic potential, etc.). However, we found it difficult to apply this model in the case of several seismogenic faults zones hosted in the continental crust of the Italian Southern Alps. As an example, we present quantitative field data (e.g. roughness analysis, fracture density profiles) derived from various digital mapping methods (LiDAR, RTK-GPS, high resolution photogrammetry) to illustrate two case studies of seismogenic strike-slip faults: 1) The Gole Larghe Fault Zone (GLFZ) hosted in granitoids and exhumed from 8-10 km depth, and, 2) The Borcola Pass Fault Zone (BPFZ) hosted in dolostones and exhumed from 1.5-2 km depth. Ancient seismicity is corroborated by the occurrence of pseudotachylytes (GLFZ) and fluidized cataclasites (BPFZ). Both of the studied fault zones accommodated < 2 km of displacement. Despite the large differences in exhumation depth and host rock lithology, both fault zones: 1) are up to several hundreds of meters thick; 2) consist of tens to hundreds of sub-parallel fault strands, connected by a network of minor faults and fractures; 3) most significantly, lack a well-defined fault core that accommodated a majority of fault displacement. Instead, displacement was distributed amongst the networks of minor faults and fractures. The above similarities can be explained by the fact that both fault zones developed in rock volumes containing strong pre-existing anisotropies: magmatic cooling joints sets spaced 2-5 m apart for the GLFZ, regional joint sets spaced < 1 m apart for the BPFZ. During initial development of both fault zones, the pre-existing anisotropies were diffusely reactivated over wide volumes. This was associated in both cases with extensive fluid flow, and sealing/hardening of the pre-existing anisotropies by syn-deformation mineral precipitation. Pre-existing anisotropies are a common occurrence in the continental crust (e.g. joints, bedding surfaces, old fault zones, cleavage surfaces): fault zones developing in such areas will be highly segmented and discontinuous, particularly during the early stages of fault evolution (first few kilometers of displacement?). We speculate that the absence of a leading fault may result in long duration earthquake sequences with several main shocks, especially if accompanied by fluid migration. This is the case for the L'Aquila 2008-2009 seismic sequence (mainshock Mw 6.3) occurring within a fault zone with ~1.5 km total displacement cutting limestones and dolostones (Chiaraluce et al. 2011). High-resolution aftershock locations suggest the re-activation of both optimally and non-optimally oriented small fault segments over a total fault zone width of ~1 km. The magnitude of aftershocks is consistent with activation of fault strands tens to hundreds of meters in length for a period of several months following the mainshocks.

Di Toro, G.; Smith, S. A.; Fondriest, M.; Bistacchi, A.; Nielsen, S. B.; Mitchell, T. M.; Mittempergher, S.; Griffith, W. A.

2012-12-01

109

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

110

Cytomegalovirus infection after orthotopic liver transplantation is restricted by a pre-existing antiviral immune response of the recipient.  

PubMed

Infection of the liver by the human cytomegalovirus (HCMV) frequently occurs after orthotopic liver transplantation (OLT). However, the role of viral replication and the inflammatory reaction in the development of HCMV-associated liver dysfunction is unclear. To address this question in vivo, 84 liver biopsy specimens from 74 patients who received an orthotopic liver transplant were investigated by immunohistochemical detection of viral antigens and cell type specific marker proteins. The extent of viral replication was correlated with the HCMV antibody status of donor and recipient. HCMV immediate early antigens were found in 25 of 84 liver tissue sections investigated, hepatocytes being the predominant target cells. Bile duct epithelial cells, endothelial cells, mesenchymal cells and sinusoidal lining cells were also found susceptible to HCMV infection. The detection of viral capsid antigens, nuclear inclusions in infected cells and foci of infected cells were suggestive of permissive infection in these cells. In 25 HCMV-positive liver biopsy specimens, the median extent of HCMV infection was 0.33 (0.02-5.67) infected cells/mm(2) liver tissue. Primary infection of liver transplant recipients (D+/R-) was associated with a significantly higher extent of organ involvement as compared to reinfection or reactivation (D+/R+). In contrast, the extent of inflammatory infiltrates in areas of infected liver cells was higher in tissues of patients with pre-existing immunoreactivity (R+) compared to patients without pre-existing immunoreactivity (R-). In conclusion, these results favour the assumption that the immune response to HCMV is effective in restricting viral spread in the liver. PMID:15042647

Bissinger, A L; Oettle, H; Jahn, G; Neuhaus, P; Sinzger, C

2004-05-01

111

Medical Conditions Associated with Out-of-Hospital Endotracheal Intubation  

PubMed Central

OBJECTIVE While prior studies describe the clinical presentation of patients requiring paramedic out-of-hospital endotracheal intubation (ETI), limited data characterize the underlying medical conditions or comorbidities. We sought to characterize the medical conditions and comorbidities of patients receiving successful paramedic out-of-hospital ETI. METHODS We used Pennsylvania statewide EMS clinical data, including all successful ETIs performed during 2003–2005. Using multiple imputation triple-match algorithms, we probabilistically linked EMS ETI to statewide death and hospital admission data. Each hospitalization record contained one primary and up to eight secondary diagnoses, classified according to the International Classification of Diseases, Clinical Modification, ninth edition (ICD-9-CM). We determined the proportion of patients in each major ICD-9-CM diagnostic group and subgroup. We calculated the Charlson Comorbidity Index for each patient. Using binomial proportions with confidence intervals, we analyzed the data and combined imputed results using Rubin's method. RESULTS Across the imputed sets, we linked 25,733 (77.7% linkage) successful ETI to death or hospital records; 56.3% died before and 43.7% survived to hospital admission. Of the 14,479 deaths before hospital admission, most (92.7%, 95% CI: 92.5–93.3%) presented to EMS in cardiac arrest. Of the 11,255 hospitalized patents, the leading primary diagnoses were circulatory diseases (32.0%, 30.2–33.7%), respiratory diseases (22.8%, 21.9–23.7%), and injury or poisoning (25.2%; 22.7–27.8%). Prominent primary diagnosis subgroups included: asphyxia and respiratory failure (15.2%), traumatic brain injury and skull fractures (11.3%), acute myocardial infarction and ischemic heart disease (10.9%), poisoning, drug and alcohol disorders (6.7%), dysrhythmias (6.7%), hemorrhagic and non-hemorrhagic stroke (5.9%), acute heart failure and cardiomyopathies (5.6%), pneumonia and aspiration (4.9%), and sepsis, septicemia and septic shock (3.2%). Most of the admitted ETI patients had a secondary circulatory (70.8%), respiratory (61.4%), or endocrine, nutritional or metabolic secondary diagnosis (51.4%). The mean Charlson Index score was 1.6 (95% CI: 1.5–1.7). CONCLUSIONS The majority of successful paramedic ETI occur on patients with cardiac arrest, circulatory and respiratory conditions. Injury, poisoning and other conditions compromise smaller but important portions. ETI patients have multiple comorbidities. These findings may guide the systemic planning of paramedic airway management care and education. PMID:21612386

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

2011-01-01

112

14 CFR 67.113 - General medical condition.  

Code of Federal Regulations, 2010 CFR

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

2010-01-01

113

14 CFR 67.113 - General medical condition.  

Code of Federal Regulations, 2012 CFR

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

2012-01-01

114

14 CFR 67.313 - General medical condition.  

Code of Federal Regulations, 2013 CFR

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

2013-01-01

115

14 CFR 67.113 - General medical condition.  

Code of Federal Regulations, 2013 CFR

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

2013-01-01

116

42 CFR 482.22 - Condition of participation: Medical staff.  

Code of Federal Regulations, 2013 CFR

...registration, but prior to surgery or a procedure requiring anesthesia services. The medical history and physical examination must...registration, but prior to surgery or a procedure requiring anesthesia services, when the medical history and physical...

2013-10-01

117

42 CFR 482.22 - Condition of participation: Medical staff.  

Code of Federal Regulations, 2014 CFR

...registration, but prior to surgery or a procedure requiring anesthesia services. The medical history and physical examination must...registration, but prior to surgery or a procedure requiring anesthesia services, when the medical history and physical...

2014-10-01

118

42 CFR 482.22 - Condition of participation: Medical staff.  

Code of Federal Regulations, 2012 CFR

...registration, but prior to surgery or a procedure requiring anesthesia services. The medical history and physical examination must...registration, but prior to surgery or a procedure requiring anesthesia services, when the medical history and physical...

2012-10-01

119

42 CFR 482.22 - Condition of participation: Medical staff.  

Code of Federal Regulations, 2011 CFR

...registration, but prior to surgery or a procedure requiring anesthesia services. The medical history and physical examination must...registration, but prior to surgery or a procedure requiring anesthesia services, when the medical history and physical...

2011-10-01

120

14 CFR 67.213 - General medical condition.  

Code of Federal Regulations, 2010 CFR

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

2010-01-01

121

14 CFR 67.313 - General medical condition.  

Code of Federal Regulations, 2010 CFR

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

2010-01-01

122

42 CFR 416.45 - Condition for coverage-Medical staff.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 false Condition for coverage-Medical staff. 416.45 Section 416.45 Public Health ...Coverage § 416.45 Condition for coverage—Medical staff. The medical staff of the ASC must be accountable to the governing...

2010-10-01

123

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

Code of Federal Regulations, 2014 CFR

...END-STAGE RENAL DISEASE FACILITIES Administration § 494.150 Condition: Responsibilities of the medical director. The dialysis facility must have a medical director who meets the qualifications of § 494.140(a) to be responsible for the...

2014-10-01

124

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

125

The role of pre-existing tectonic structures and magma chamber shape on the geometry of resurgent blocks: Analogue models  

NASA Astrophysics Data System (ADS)

A set of analogue models has been carried out to understand the role of an asymmetric magma chamber on the resurgence-related deformation of a previously deformed crustal sector. The results are then compared with those of similar experiments, previously performed using a symmetric magma chamber. Two lines of experiments were performed to simulate resurgence in an area with a simple graben-like structure and resurgence in a caldera that collapsed within the previously generated graben-like structure. On the basis of commonly accepted scaling laws, we used dry-quartz sand to simulate the brittle behaviour of the crust and Newtonian silicone to simulate the ductile behaviour of the intruding magma. An asymmetric shape of the magma chamber was simulated by moulding the upper surface of the silicone. The resulting empty space was then filled with sand. The results of the asymmetric-resurgence experiments are similar to those obtained with symmetrically shaped silicone. In the sample with a simple graben-like structure, resurgence occurs through the formation of a discrete number of differentially displaced blocks. The most uplifted portion of the deformed depression floor is affected by newly formed, high-angle, inward-dipping reverse ring-faults. The least uplifted portion of the caldera is affected by normal faults with similar orientation, either newly formed or resulting from reactivation of the pre-existing graben faults. This asymmetric block resurgence is also observed in experiments performed with a previous caldera collapse. In this case, the caldera-collapse-related reverse ring-fault is completely erased along the shortened side, and enhances the effect of the extensional faults on the opposite side, so facilitating the intrusion of the silicone. The most uplifted sector, due to an asymmetrically shaped intrusion, is always in correspondence of the thickest overburden. These results suggest that the stress field induced by resurgence is likely dictated by the geometry of the intruding magma body, and the related deformation is partially controlled by pre-existing tectonic and/or volcano-tectonic structures.

Marotta, Enrica; de Vita, Sandro

2014-02-01

126

28 CFR 79.26 - Proof of medical condition.  

Code of Federal Regulations, 2011 CFR

... (A) Computerized tomography (CT) scan; (B) Magnetic resonance imaging (MRI); or (C) Ultrasonography (ultrasound); (iv) One of the following summary medical reports: (A) Physician summary report; (B) Hospital...

2011-07-01

127

28 CFR 79.26 - Proof of medical condition.  

Code of Federal Regulations, 2012 CFR

... (A) Computerized tomography (CT) scan; (B) Magnetic resonance imaging (MRI); or (C) Ultrasonography (ultrasound); (iv) One of the following summary medical reports: (A) Physician summary report; (B) Hospital...

2012-07-01

128

28 CFR 79.26 - Proof of medical condition.  

Code of Federal Regulations, 2013 CFR

... (A) Computerized tomography (CT) scan; (B) Magnetic resonance imaging (MRI); or (C) Ultrasonography (ultrasound); (iv) One of the following summary medical reports: (A) Physician summary report; (B) Hospital...

2013-07-01

129

28 CFR 79.26 - Proof of medical condition.  

Code of Federal Regulations, 2014 CFR

... (A) Computerized tomography (CT) scan; (B) Magnetic resonance imaging (MRI); or (C) Ultrasonography (ultrasound); (iv) One of the following summary medical reports: (A) Physician summary report; (B) Hospital...

2014-07-01

130

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. PMID:23593432

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

2013-01-01

131

Characteristics of Memory B Cells Elicited by a Highly Efficacious HPV Vaccine in Subjects with No Pre-existing Immunity  

PubMed Central

Licensed human papillomavirus (HPV) vaccines provide near complete protection against the types of HPV that most commonly cause anogenital and oropharyngeal cancers (HPV 16 and 18) when administered to individuals naive to these types. These vaccines, like most other prophylactic vaccines, appear to protect by generating antibodies. However, almost nothing is known about the immunological memory that forms following HPV vaccination, which is required for long-term immunity. Here, we have identified and isolated HPV 16-specific memory B cells from female adolescents and young women who received the quadrivalent HPV vaccine in the absence of pre-existing immunity, using fluorescently conjugated HPV 16 pseudoviruses to label antigen receptors on the surface of memory B cells. Antibodies cloned and expressed from these singly sorted HPV 16-pseudovirus labeled memory B cells were predominantly IgG (>IgA>IgM), utilized diverse variable genes, and potently neutralized HPV 16 pseudoviruses in vitro despite possessing only average levels of somatic mutation. These findings suggest that the quadrivalent HPV vaccine provides an excellent model for studying the development of B cell memory; and, in the context of what is known about memory B cells elicited by influenza vaccination/infection, HIV-1 infection, or tetanus toxoid vaccination, indicates that extensive somatic hypermutation is not required to achieve potent vaccine-specific neutralizing antibody responses. PMID:25330199

Scherer, Erin M.; Smith, Robin A.; Simonich, Cassandra A.; Niyonzima, Nixon; Carter, Joseph J.; Galloway, Denise A.

2014-01-01

132

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

133

IAPT and Long Term Medical Conditions: What Can We Offer?  

PubMed

Background: The proposal of a 4-year plan to integrate treatment of people with long term medical conditions (LTCs) into the IAPT service (Department of Health, 2011) seeks for research to understand the effectiveness of IAPT interventions for this patient group. Aim: The aim of this service development pilot work was to develop an intervention that is effective for people with Type 2 Diabetes Mellitus (T2DM). It was hypothesized that the standard IAPT intervention would not be effective, but that it can be adapted so that it is effective both in terms of mood and self-management of T2DM. Method: Clients (n = 95) who experienced mild to moderate depression and/or anxiety and had a diagnosis of T2DM opted to attend. The intervention was adapted over a series of cohorts from a standard Step 2 intervention. A team of Psychological Wellbeing Practitioners (PWPs), a Clinical Health Psychologist and a General Practitioner worked in collaboration, using outcomes measures and feedback from service users and facilitators. Results: The standard IAPT Step 2 intervention met with challenges when specifically targeting this client group. Using paired t-tests, the modified Step 2 intervention demonstrated significant improvements from pre- to postintervention measures both in terms of psychological (n = 17) and physical (n = 9) outcomes. Conclusion: It is concluded that it may be possible to modify a generic Step 2 IAPT intervention to demonstrate improvements both in terms of psychological wellbeing and self-management of T2DM. The main adaptations were related to more targeted recruitment and linking of diabetes specifically into the CBT model. PMID:24618414

Wroe, Abigail L; Rennie, Edward W; Gibbons, Sarah; Hassy, Arek; Chapman, Judith E

2014-03-11

134

Graduate Studies Office, California Institute of Technology CONDITIONS FOR STUDENTS ON MEDICAL LEAVE  

E-print Network

Graduate Studies Office, California Institute of Technology CONDITIONS FOR STUDENTS ON MEDICAL LEAVE 1) A student on medical leave is expected to be in treatment and focus on getting healthy students on medical leave are eligible for coverage on Caltech's Health Care Benefit plan for up to one

Greer, Julia R.

135

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

Code of Federal Regulations, 2010 CFR

...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE FOR END-STAGE RENAL DISEASE FACILITIES Administration § 494.150 Condition: Responsibilities of the medical director. The...

2010-10-01

136

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

Microsoft Academic Search

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

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

1996-01-01

137

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

138

The role of pre-existing Precambrian structures in rift evolution: The Albertine and Rhino grabens, Uganda  

NASA Astrophysics Data System (ADS)

We integrated Shuttle Radar Topography Mission (SRTM) Digital Elevation Models (DEM), airborne magnetic, radiometric and three-dimensional Full Tensor Gravity Gradiometry (3D-FTG) data to investigate the role of Precambrian structures in the evolution of the largely amagmatic Miocene-Recent aged Albertine and Rhino grabens in Uganda. These grabens represent the northern segment of the Western Branch of the East African Rift System (EARS). The two NE-trending grabens are connected by a right-stepping transfer zone and they extend within the Archean-Paleoproterozoic Northeast Congo block which represents the northeastern extension of the Congo craton. Our results show the following and highlight the importance of pre-existing structures in the evolution of continental rift systems: (1) The NE-extent of the Albertine full-graben is controlled by NE-trending Precambrian fabric and the graben terminates at its northeastern end when it encounters a multiply folded Precambrian basement terrain with poorly-developed NW-trending structural grain. Additionally, the northeastern termination of the Albertine graben coincides with the presence of NW-trending right-stepping high-density bodies within the Precambrian terrain. (2) The transfer zone between the Albertine and Rhino grabens is controlled by NE-trending Precambrian structures which might have facilitated the development of relay ramp faults. (3) Strain localization within the better-developed southeastern border fault of the Rhino half-graben is facilitated by the presence of Precambrian structures better aligned in a NE-direction in the southeastern part of the basin compared to its northwestern part. (4) Further to the northeast, the Rhino graben is segmented and transitions into a narrower ENE-trending half-graben with a better-developed border fault on its northwestern side. This segmentation coincides with the presence of N-trending Precambrian structures. (5) The Rhino graben terminates farther northeast against the NW-trending Precambrian Aswa shear zone; a prominent structure with complex, but generally NW-trending fabric.

Katumwehe, Andrew B.; Abdelsalam, Mohamed G.; Atekwana, Estella A.

2015-04-01

139

Schoolchildren with Dysphagia Associated with Medically Complex Conditions  

ERIC Educational Resources Information Center

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

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

2008-01-01

140

A dairy-based high calcium diet improves glucose homeostasis and reduces steatosis in the context of pre-existing obesity  

Technology Transfer Automated Retrieval System (TEKTRAN)

High dietary calcium (Ca) in the context of a dairy food matrix has been shown to reduce obesity development and associated inflammation in diet-induced obese (DIO) rodents. The influence of Ca and dairy on these phenotypes in the context of pre-existing obesity is not known. Furthermore, interpre...

141

A dairy-based high calcium diet improves glucose homeostasis and reduces further weight gain in high fat fed mice in the context of pre-existing obesity  

Technology Transfer Automated Retrieval System (TEKTRAN)

Background: High dietary calcium (Ca) in the context of a dairy food matrix has been shown to reduce obesity development and associated inflammation in diet-induced obese (DIO) mice. However, the influence of Ca and dairy on these phenotypes in the context of pre-existing obesity is not known. Met...

142

Pre-Existing Mutations in Reverse Transcriptase of Hepatitis B Virus in Treatment-Naive Chinese Patients with Chronic Hepatitis B  

PubMed Central

High rate of viral replication and lacking of proofreading activity in hepatitis B virus (HBV) polymerase lead to the generation of mutations in HBV virus. Mutations in the reverse transcriptase (RT) region of HBV polymerase are demonstrated to be strongly associated with drug resistance during antiviral treatment. However, the presence of mutations as well as its clinical significance in treatment-naďve hepatitis patients (defined as pre-existing mutations) need to be further investigated. In the present study, a total of 168 serum samples from treatment-naive chronic hepatitis B (CHB) patients were collected, and the RT region of HBV polymerase was sequenced. The results showed that pre-existing mutations in the RT region of HBV polymerase were detected in 43 of 168 (25.6%) treatment-naive CHB patients within which there were no well-characterized primary nucleotide analogs (NAs) resistance sites. Three dominant sites at rt191, rt207 and rt226 were found mutant in 7(16.28%), 8(18.60%), and 14(32.56%) samples respectively among these 43 patients. No significant correlation was found between pre-existing mutations and gender, age, HBV genotype, ALT, HBeAg or HBV DNA loads. However, patients with pre-existing RT mutations under HBeAg sero-negative status exhibited decreased HBV DNA loads, which contributed to the decreased HBV DNA loads in the total HBeAg sero-negative patients. The above investigation indicated that there was a prevalence of pre-existing mutations in RT region of HBV polymerase which might affect the serum HBV DNA level in treatment-naive CHB patients. Its effects on the occurrence of NAs resistance and the prognosis after treatment need to be further investigated. PMID:25821965

Wang, Jing-Hui; Huang, Ling; Wang, Deng-yu; Zhao, Ling; Zhao, Guo-ping; Wang, Ying

2015-01-01

143

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

144

Advancing medical-surgical nursing practice: improving management of the changing patient condition.  

PubMed

Higher patient acuities and more novice nurses on medical-surgical units have Educators focused on achieving positive outcomes with changes in patient condition. An educational program was developed to enhance nurses' knowledge, skill, and confidence in assessing hemodynamics, recognizing early signs of instability, and administering vasoactive medications. The program was successful with significant knowledge improvement as well as an increased use of the Medical Emergency Team while maintaining a low number of code calls. PMID:25407973

Monroe, Heidi; Plylar, Peggy; Krugman, Mary

2014-01-01

145

High prevalence of cardiovascular diseases among other medically compromised conditions in dental patients: A retrospective study  

PubMed Central

Background: Over the last few decades, oral health care has become a greater priority as people live longer with serious medical conditions and disabilities. As a result, they require more comprehensive dental treatment. We are now, more than ever, at a turning point in history where dental care, or more broadly oral health care, is an integral part of medical care. Therefore, a need was felt to study the prevalence of medically compromised patients seeking dental treatments. Materials and Methods: The present study was a retrospective study conducted by reviewing the patient records starting from 1st January 2009 to 31st December 2010 for the presence of medically compromised conditions. Demographic data of the patients was also collected. Results: The prevalence of medically compromised conditions in dental patients of our hospital in the present study was 1.02%. The Cardiovascular diseases accounted to be the most prevalent condition (57.87%) followed by Endocrine disorders (35.73%). Conclusion: Even though the prevalence of medically compromised conditions in dental patients is not high, dentists should bear in mind that some of the patients may harbor such conditions, which are contraindicated for certain dental procedures or medication or require special attention when treating these patients. PMID:22629028

Bhateja, Sumit

2012-01-01

146

Quantifying remobilization of pre-existing nitrogen from cuttings to new growth of woody plants using 15N at natural abundance  

PubMed Central

Background For measurements of nitrogen isotope composition at natural abundance, carry-over of pre-existing nitrogen remobilized to new plant growth can cause deviation of measured isotope composition (?15N) from the ?15Nof newly acquired nitrogen. To account for this problem, a two-step approach was proposed to quantify and correct for remobilized nitrogen from vegetative cuttings of Populus balsamifera L. grown with either nitrate (?15N?=?58.5‰) or ammonium (?15N?=??0.96‰). First, the fraction of carry-over nitrogen remaining in the cutting was estimated by isotope mass balance. Then measured ?15N values were adjusted for the fraction of pre-existing nitrogen remobilized to the plant. Results Mean plant ?15N prior to correction was 49‰ and ?5.8‰ under nitrate and ammonium, respectively. Plant ?15N was non-linearly correlated to biomass (r2?=?0.331 and 0.249 for nitrate and ammonium, respectively; P?pre-existing nitrogen. Approximately 50% of cutting nitrogen was not remobilized, irrespective of size. The proportion of carry-over nitrogen in new growth was not different between sources but ranged from less than 1% to 21% and was dependent on plant biomass and, to a lesser degree, the size of the cutting. The ?15N of newly acquired nitrogen averaged 52.7‰ and ?6.4‰ for nitrate and ammonium-grown plants, respectively; both lower than their source values, as expected. Since there was a greater difference in ?15N between the carried-over pre-existing and newly assimilated nitrogen where nitrate was the source, the difference between measured ?15N and adjusted ?15N was also greater. There was no significant relationship between biomass and plant ?15N with either ammonium or nitrate after adjusting for carry-over nitrogen. Conclusion Here, we provide evidence of remobilized pre-existing nitrogen influencing ?15N of new growth of P. balsamifera L. A simple, though approximate, correction is proposed that can account for the remobilized fraction in the plant. With careful sampling to quantify pre-existing nitrogen, this method can more accurately determine changes in nitrogen isotope discrimination in plants. PMID:23849546

2013-01-01

147

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

Microsoft Academic Search

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

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

2003-01-01

148

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

ERIC Educational Resources Information Center

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

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

2011-01-01

149

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

Microsoft Academic Search

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

Philip G. Gasquoine

2011-01-01

150

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

Code of Federal Regulations, 2010 CFR

...Condition of participation: Acceptance of patients, plan of care, and medical supervision...Condition of participation: Acceptance of patients, plan of care, and medical supervision. Patients are accepted for treatment on the...

2010-10-01

151

Decreased Pre-existing Ad5 Capsid and Ad35 Neutralizing Antibodies Increase HIV1 Infection Risk in the Step Trial Independent of Vaccination  

Microsoft Academic Search

BackgroundThe 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 FindingsAd seropositivity in the Step

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

2012-01-01

152

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

Microsoft Academic Search

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

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

153

28 CFR 79.26 - Proof of medical condition.  

Code of Federal Regulations, 2010 CFR

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

2010-07-01

154

Tests and Medical Conditions Associated with Dementia Diagnosis  

ERIC Educational Resources Information Center

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

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

2005-01-01

155

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. PMID:23349712

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

2013-01-01

156

Parental perspectives on influenza vaccination of children with chronic medical conditions.  

PubMed Central

BACKGROUND: Minorities and those living in the inner city have a higher respiratory disease burden than other groups. Yet, influenza vaccination rates among all children with chronic medical conditions remain low. METHODS: Parents of 2-13-year-old children with high-risk medical conditions from health centers in low-income urban neighborhoods completed a mailed survey. Immunization status from medical records was used to calculate validity measures. Survey data are presented for those whose vaccination status was concordant between parental report and the medical record (n=183). RESULTS: Parent-reported influenza vaccination versus medical record review showed 84.9% sensitivity, 68.7% specificity, 49.1% positive predictive value and 92.7% negative predictive value, with a kappa of 0.43. Vaccination rate was 30.6%. Medical record-verified influenza vaccination was associated with parental beliefs that the doctor recommends a flu shot (OR, 40.9; 95% Cl, 9.0-184.9) and that relatives recommend a flu shot (OR, 4.3; 95% Cl, 1.7-10.5), and was less likely if the parent believed that the child will get the flu if a household member is infected (OR, 0.2; 95% Cl, 0.1-0.6). CONCLUSIONS: The message that influenza vaccination is important to protect children with chronic medical conditions may be relayed through physician recommendation or a relative's suggestion and may be more effective if it addresses vaccine efficacy issues. PMID:16708499

Lin, Chyongchiou J.; Zimmerman, Richard K.; Nowalk, Mary Patricia; Ko, Feng-Shou; Raymund, Mahlon; Hoberman, Alejandro; Kearney, Diana H.; Block, Bruce

2006-01-01

157

Medication Adherence of Patients with Selected Rheumatic Conditions: A Systematic Review of the Literature  

PubMed Central

Objective Nonadherence with medication treatment has been found to occur in large proportions of patients with a broad range of chronic conditions. Our aim was to perform a systematic review of the literature examining adherence with treatments for inflammatory rheumatic conditions to assess the magnitude of the problem in this patient population. Methods A MEDLINE search of English language literature was performed to identify studies published between January 1, 1985 and November 30, 2007 that evaluated adherence with chronic medications needed in the treatment of rheumatic conditions. Results A total of 20 articles met the criteria for evaluation, the majority of which focused on the treatment of rheumatoid arthritis. Most of the studies examined the use of nonsteroidal anti-inflammatory medications and disease modifying anti-rheumatic drugs. Adherence was assessed based on self-report, pill counts, pharmacy dispensings, openings of pill containers using electronic devices, laboratory assays, and physician assessment. Adherence varied greatly based on the adherence measure used, arthritic condition evaluated and medication under study. Overall, the highest rates of adherence were based on self-reports for a wide variety of medications and conditions (range of persons reporting adherence was 30 to 99%), while the lowest adherence rates were for allopurinol based on pharmacy dispensings (18–26%). Conclusions Adherence has not been widely examined for most chronic inflammatory rheumatic conditions and the few studies that exist used different definitions and populations, thus limiting any conclusions. However, the current literature does suggest that nonadherence is a substantial problem. PMID:18336875

Harrold, Leslie R.; Andrade, Susan E.

2009-01-01

158

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

Microsoft Academic Search

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

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

2010-01-01

159

Reprinted from: TECTONICS, VOL. 29, TC6004, doi:10.1029/2010TC002744, 2010 Influence of pre-existing fault fabric on inversion-related deformation: A case study  

E-print Network

-existing fault fabric on inversion-related deformation: A case study of the inverted Fundy rift basin. The pre-existing fabric, con- sisting of NE-striking faults with gentle dips and E-striking faults orogenic activity. During Mesozoic rifting, the pre-existing fabric was reactivated, creating a border

160

University of Central Florida Certification of Health Care Provider Form for Employee's Serious Health Condition (Family and Medical Leave Act)  

E-print Network

must generally maintain records and documents relating to medical certifications, recertifications, or medical histories of employees created for FMLA purposes as confidential medical records in separate files/records Health Condition (Family and Medical Leave Act) Page 1 of 2 University of Central Florida, Human

Wu, Shin-Tson

161

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. PMID:24769856

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

2014-01-01

162

[The main ways of improvement of medical support of the Air Forces in modern conditions].  

PubMed

Blaginin A.A., Grebenyuk A.N., Lizogub LN. - The main ways of improvement of medical support of the Air Forces in modern conditions. Aircrew conducting active hostilities suffers from the whole spectrum of factors and conditions of the combat situation. The main task for the medical service of the Air Force is to carry out preventive and curative action for aviation specialists who are responsible for the combat capability of aircraft formations. The medical service of the Air Force must have forces and facilities for planning, organization and implementation of the treatment of lightly wounded and sick aviation professionals with short periods of recovery, medical rehabilitation of aircrew qfter suffering injuries, diseases, sanatorium therapy of aircrew with partial failure of health, outpatient and inpatient medical examination aircrew - flight commissions, preventive rest of aviation specialists with symptoms of chronic fatigue. Should be trained aviation physicians, including both basic military medical education and in-depth study of the medical aspects of various fields of personnel of the Air Force. PMID:25046924

Blaginin, A A; Grebeniuk, A N; Lizogub, I N

2014-02-01

163

Insight of first-year medical students into their future working conditions.  

PubMed

In the light of recent publicity in the media, and a Private Members Bill in the Houses of Parliament, a multiple choice questionnaire was designed to ascertain the insight of first-year medical students at Leicester Medical School into their career structure and future working conditions. The results obtained were surprising in that they indicated an almost total lack of knowledge among the medical students about the profession into which they had just entered, and to which they had made a lifelong commitment. PMID:2355862

Underwood, M J; Thompson, M; McCaskie, A

1990-05-01

164

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. PMID:23991209

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

2013-01-01

165

Pre-existing hyperlipidaemia increased the risk of new-onset anxiety disorders after traumatic brain injury: a 14-year population-based study  

PubMed Central

Objectives Anxiety disorders (ADs) are common after traumatic brain injury (TBI). However, the risk factors of new-onset ADs remain unclear. This study was aimed at evaluating the incidence and risk factors for new-onset ADs, including pre-existing hyperlipidaemia and three major comorbidities (diabetes mellitus, hypertension and cardiovascular disease), in patients with TBI. Setting A matched cohort study was conducted using the Taiwan Longitudinal Health Insurance Database between January 1997 and December 2010. Participants A total of 3822 participants (1274 patients with TBI with hyperlipidaemia and 2548 age-matched and gender-matched patients with TBI without hyperlipidaemia). Outcome measures The incidence and HRs for the development of new-onset ADs after TBI were compared between the two groups. Results The overall incidence rate of new-onset ADs for patients with TBI with hyperlipidaemia is 142.03/10?000 person-years (PYs). Patients with TBI with hyperlipidaemia have a 1.60-fold incidence rate ratio (p<0.0001) and increased HR of ADs (1.58, 95% CI 1.24 to 2.02) compared with those without hyperlipidaemia. The incidence rates of ADs for males and females with hyperlipidaemia, respectively, were 142.12 and 292.32/10?000 PYs, which were higher than those without hyperlipidaemia (93.03 and 171.68/10?000 PYs, respectively). Stratified by age group, hyperlipidaemia is a risk factor of ADs for patients with TBI aged 65?years or younger. Conclusions Pre-existing hyperlipidaemia is an independent predictor of new-onset ADs in patients with TBI, even when controlling for other demographic and clinical variables. Female patients with pre-existing hyperlipidaemia had significantly higher risk of new-onset ADs than males, especially between the ages of 35 and 65?years. PMID:25034630

Ho, Chung-Han; Hsieh, Kuang-Yang; Liang, Fu-Wen; Li, Chia-Jung; Wang, Jhi-Joung; Chio, Chung-Ching; Chang, Chin-Hung; Kuo, Jinn-Rung

2014-01-01

166

Effects of pre-existing ice crystals on cirrus clouds and comparison between different ice nucleation parameterizations with the Community Atmosphere Model (CAM5)  

NASA Astrophysics Data System (ADS)

In order to improve the treatment of ice nucleation in a more realistic manner in the Community Atmosphere Model version 5.3 (CAM5.3), the effects of pre-existing ice crystals on ice nucleation in cirrus clouds are considered. In addition, by considering the in-cloud variability in ice saturation ratio, homogeneous nucleation takes place spatially only in a portion of the cirrus cloud rather than in the whole area of the cirrus cloud. Compared to observations, the ice number concentrations and the probability distributions of ice number concentration are both improved with the updated treatment. The pre-existing ice crystals significantly reduce ice number concentrations in cirrus clouds, especially at mid- to high latitudes in the upper troposphere (by a factor of ~10). Furthermore, the contribution of heterogeneous ice nucleation to cirrus ice crystal number increases considerably. Besides the default ice nucleation parameterization of Liu and Penner (2005, hereafter LP) in CAM5.3, two other ice nucleation parameterizations of Barahona and Nenes (2009, hereafter BN) and Kärcher et al. (2006, hereafter KL) are implemented in CAM5.3 for the comparison. In-cloud ice crystal number concentration, percentage contribution from heterogeneous ice nucleation to total ice crystal number, and pre-existing ice effects simulated by the three ice nucleation parameterizations have similar patterns in the simulations with present-day aerosol emissions. However, the change (present-day minus pre-industrial times) in global annual mean column ice number concentration from the KL parameterization (3.24 × 106 m-2) is less than that from the LP (8.46 × 106 m-2) and BN (5.62 × 106 m-2) parameterizations. As a result, the experiment using the KL parameterization predicts a much smaller anthropogenic aerosol long-wave indirect forcing (0.24 W m-2) than that using the LP (0.46 W m-2) and BN (0.39 W m-2) parameterizations.

Shi, X.; Liu, X.; Zhang, K.

2015-02-01

167

Assessing health conditions and medication use among the homeless community in Long Beach, California  

PubMed Central

Objective: Persons experiencing homelessness are a vulnerable population and are at increased risk for morbidity and all-cause mortality compared to the general population. This study sought to evaluate medication use, regular physician visits, and identify health conditions among the homeless population of Long Beach, California. Methods: Two “brown bag” medication review events were held at homeless shelters in the Long Beach area. Demographic information, medication use, and comorbid disease states were obtained through surveys. Findings: Three-fourths of the cohort (95 participants) consisted of males, and the average age of participants was 48 years. Psychiatric disorders and cardiovascular disease were the most common disease states reported at 32% and 46%, respectively and so were medications used in treating these chronic diseases. Medication adherence was found to be a significant problem in this population, where more than 30% of patients were nonadherent to medications for chronic diseases. Furthermore, foot problems, hearing and vision difficulties constitute the most commonly overlooked health problems within the homeless population. Conclusion: Based on this and other similar finding, we must accept that the homeless represent a vulnerable population, and that because of this fact, more programs should be focused at improving availability and access to health care among the homeless. Regarding the high number of reported health problems in the study, more studies are needed and more studies should incorporate screening for foot, hearing, and vision issues, both to increase awareness and to provide an opportunity for devising possible solutions to these highly preventable conditions. PMID:25114938

Chong, Mok Thoong; Yamaki, Jason; Harwood, Megan; d'Assalenaux, Richard; Rosenberg, Ettie; Aruoma, Okezie; Bishayee, Anupam

2014-01-01

168

Reduction in Noise-Induced Functional Loss of the Cochleae in Mice with Pre-Existing Cochlear Dysfunction Due to Genetic Interference of Prestin  

PubMed Central

Various cochlear pathologies, such as acoustic trauma, ototoxicity and age-related degeneration, cause hearing loss. These pre-existing hearing losses can alter cochlear responses to subsequent acoustic overstimulation. So far, the knowledge on the impacts of pre-existing hearing loss caused by genetic alteration of cochlear genes is limited. Prestin is the motor protein expressed exclusively in outer hair cells in the mammalian cochlea. This motor protein contributes to outer hair cell motility. At present, it is not clear how the interference of prestin function affects cochlear responses to acoustic overstimulation. To address this question, a genetic model of prestin dysfunction in mice was created by inserting an internal ribosome entry site (IRES)-CreERT2-FRT-Neo-FRT cassette into the prestin locus after the stop codon. Homozygous mice exhibit a threshold elevation of auditory brainstem responses with large individual variation. These mice also display a threshold elevation and a shift of the input/output function of the distortion product otoacoustic emission, suggesting a reduction in outer hair cell function. The disruption of prestin function reduces the threshold shifts caused by exposure to a loud noise at 120 dB (sound pressure level) for 1 h. This reduction is positively correlated with the level of pre-noise cochlear dysfunction and is accompanied by a reduced change in Cdh1 expression, suggesting a reduction in molecular responses to the acoustic overstimulation. Together, these results suggest that prestin interference reduces cochlear stress responses to acoustic overstimulation. PMID:25486270

Cai, Qunfeng; Wang, Bo; Coling, Donald; Zuo, Jian; Fang, Jie; Yang, Shiming; Vera, Krystal; Hu, Bo Hua

2014-01-01

169

Pre-existing oblique transfer zones and transfer/transform relationships in continental margins: New insights from the southeastern Gulf of Aden, Socotra Island, Yemen  

NASA Astrophysics Data System (ADS)

Transfer zones are ubiquitous features in continental rifts and margins, as are transform faults in oceanic lithosphere. Here, we present a structural study of the Hadibo Transfer Zone (HTZ), located in Socotra Island (Yemen) in the southeastern Gulf of Aden. There, we interpret this continental transfer fault zone to represent a reactivated pre-existing structure. Its trend is oblique to the direction of divergence and it has been active from the early up to the latest stages of rifting. One of the main oceanic fracture zones (FZ), the Hadibo-Sharbithat FZ, is aligned with and appears to be an extension of the HTZ and is probably genetically linked to it. Comparing this setting with observations from other Afro-Arabian rifts as well as with passive margins worldwide, it appears that many continental transfer zones are reactivated pre-existing structures, oblique to divergence. We therefore establish a classification system for oceanic FZ based upon their relationship with syn-rift structures. Type 1 FZ form at syn-rift structures and are late syn-rift to early syn-OCT. Type 2 FZ form during the OCT formation and Type 3 FZ form within the oceanic domain, after the oceanic spreading onset. The latter are controlled by far-field forces, magmatic processes, spreading rates, and oceanic crust rheology.

Bellahsen, N.; Leroy, S.; Autin, J.; Razin, P.; d'Acremont, E.; Sloan, H.; Pik, R.; Ahmed, A.; Khanbari, K.

2013-11-01

170

Efficient control of Plasmodium yoelii infection in BALB/c and C57BL/6 mice with pre-existing Strongyloides ratti infection.  

PubMed

About 225 million malaria cases have been reported worldwide in 2009, and one-third of the world's population is infected with parasitic helminths. As helminths and Plasmodium are co-endemic, concurrent infections frequently occur. Helminths have been shown to modulate the host's immune response; therefore, pre-existing helminth infections may interfere with the efficient immune response to Plasmodium. To study the interaction between helminths and Plasmodium, we established a murine model of co-infection using the gastrointestinal nematode Strongyloides ratti and Plasmodium yoelii. We show that a pre-existing Strongyloides infection slightly enhanced peak parasitemia and weight loss in P. yoelii-infected BALB/c mice, while disease progression was not altered in co-infected C57BL/6 mice. The Plasmodium-induced IFN-? production and final clearance of Plasmodium infection were not affected by S. ratti co-infection in both C57BL/6 and BALB/c mice. Interestingly, the T helper cell (Th) 2 response induced by S. ratti was significantly suppressed upon P. yoelii co-infection. This suppressed Th2 response, however, was still sufficient to allow expulsion of S. ratti parasitic adults. Taken together, we provide evidence that simultaneous presence of helminth and protist parasites does not interfere with efficient host defence in our co-infection model although changes in Th responses were observed. PMID:22554071

Kolbaum, J; Eschbach, M-L; Steeg, C; Jacobs, T; Fleischer, B; Breloer, M

2012-07-01

171

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

PubMed

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. PMID:20819810

Singer, Michael C; Parmesan, Camille

2010-10-12

172

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. PMID:20819810

Singer, Michael C.; Parmesan, Camille

2010-01-01

173

DNase I and proteinase K impair Listeria monocytogenes biofilm formation and induce dispersal of pre-existing biofilms.  

PubMed

Current sanitation methods in the food industry are not always sufficient for prevention or dispersal of Listeria monocytogenes biofilms. Here, we determined if prevention of adherence or dispersal of existing biofilms could occur if biofilm matrix components were disrupted enzymatically. Addition of DNase during biofilm formation reduced attachment (<50% of control) to polystyrene. Treatment of established 72h biofilms with 100?g/ml of DNase for 24h induced incomplete biofilm dispersal, with <25% biofilm remaining compared to control. In contrast, addition of proteinase K completely inhibited biofilm formation, and 72h biofilms-including those grown under stimulatory conditions-were completely dispersed with 100?g/ml proteinase K. Generally-regarded-as-safe proteases bromelain and papain were less effective dispersants than proteinase K. In a time course assay, complete dispersal of L. monocytogenes biofilms from both polystyrene and type 304H food-grade stainless steel occurred within 5min at proteinase K concentrations above 25?g/ml. These data confirm that both DNA and proteins are required for L. monocytogenes biofilm development and maintenance, and that these components of the biofilm matrix can be targeted for effective prevention and removal of biofilms. PMID:25043896

Nguyen, Uyen T; Burrows, Lori L

2014-09-18

174

An evaluation of exclusionary medical/psychiatric conditions in the definition of chronic fatigue syndrome  

PubMed Central

Background The diagnosis of chronic fatigue syndrome (CFS) in research studies requires the exclusion of subjects with medical and psychiatric conditions that could confound the analysis and interpretation of results. This study compares illness parameters between individuals with CFS who have and those who do not have exclusionary conditions. Methods We used a population-based telephone survey of randomly selected individuals, followed by a clinical evaluation in the study metropolitan, urban, and rural counties of Georgia, USA. The medical and psychiatric histories of the subjects were examined and they underwent physical and psychiatric examinations and laboratory screening. We also employed the multidimensional fatigue inventory (MFI), the medical outcomes survey short form-36 (SF-36) and the US Centres for Disease Control and Prevention symptom inventory (SI). Results Twenty-nine percent (1,609) of the 5623 subjects who completed the detailed telephone interview reported exclusionary diagnoses and we diagnosed an exclusionary condition in 36% of 781 clinically evaluated subjects. Both medical and psychiatric exclusionary conditions were more common in women, blacks and participants from rural areas. Subjects with and without exclusions had similar levels of fatigue and impairment as measured by the MFI and SF-36; those with CFS-like illness (not meeting the formal CFS definition) were more likely to have an exclusionary diagnosis. After adjusting for demographics, body mass index, fatigue subscales, SF-36 subscales and CFS symptoms, CFS-like illness did not remain significantly associated with having an exclusionary diagnosis. Conclusion Medical and psychiatric illnesses associated with fatigue are common among the unwell. Those who fulfill CFS-like criteria need to be evaluated for potentially treatable conditions. Those with exclusionary conditions are equally impaired as those without exclusions. PMID:19818157

Jones, James F; Lin, Jin-Mann S; Maloney, Elizabeth M; Boneva, Roumiana S; Nater, Urs M; Unger, Elizabeth R; Reeves, William C

2009-01-01

175

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

Code of Federal Regulations, 2014 CFR

...a patient's response to medication therapy, identification...facility may only be administered medications by the following individuals...State-approved training program in medication administration; and (iii...of the Comprehensive Drug Abuse Prevention and Control...

2014-10-01

176

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

Code of Federal Regulations, 2013 CFR

...a patient's response to medication therapy, identification...facility may only be administered medications by the following individuals...State-approved training program in medication administration; and (iii...of the Comprehensive Drug Abuse Prevention and Control...

2013-10-01

177

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

Code of Federal Regulations, 2012 CFR

...a patient's response to medication therapy, identification...facility may only be administered medications by the following individuals...State-approved training program in medication administration; and (iii...of the Comprehensive Drug Abuse Prevention and Control...

2012-10-01

178

Children With Complex Chronic Medical Conditions and Special Needs Privately Insured Through an HMO  

Microsoft Academic Search

The objective of this study was to determine for children with selected complex chronic medical conditions and special needs, who are insured privately by a managed care organization, those services received in and out of plan; who provides and pays for services; family assessments of care; and managed care expenditures. The data came from two sources. Expenditures and service utilization

Anne Kelly; Kathleen Thiede Call; Barbara Staub; Brooks Donald; Catherine L. Wisner; Andrew F. Nelson; Robert W. Blum

2002-01-01

179

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

ERIC Educational Resources Information Center

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

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

2007-01-01

180

Evaluation of treatment effects in obese children with co-morbid medical or psychiatric conditions  

Technology Transfer Automated Retrieval System (TEKTRAN)

The need for effective treatments for pediatric overweight is well known. We evaluated the applicability of an evidence-based treatment in an applied clinic setting that includes children with severe obesity and comorbid medical or psychiatric conditions. Forty-eight overweight children and their fa...

181

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

182

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

E-print Network

, in advance of need, the large number of different editions of each publication that is entailed by individualHealthDoc: Customizing patient information and health education by medical condition and personal Science University of Waterloo Waterloo, Ontario Canada N2L 3G1 **Department of Computer Science

DiMarco, Chrysanne

183

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

184

Medical conditions, risk exposure, and truck drivers' accidents: An analysis with count data regression models  

Microsoft Academic Search

Recent studies do not agree on the possible relationship between medical conditions and traffic safety; most of them do not control for exposure factors. This problem has become more pertinent for scientific studies because of litigation that showed that present regulations about access to driver permits might contravene human rights legislation. In our study, we estimate the effect of different

Georges Dionne; Denise Desjardins; Claire Laberge-Nadeau; Urs Maag

1995-01-01

185

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

ERIC Educational Resources Information Center

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

Kraaij, Vivian; Garnefski, Nadia

2012-01-01

186

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

Federal Register 2010, 2011, 2012, 2013, 2014

...conditions would apply to that model as well. Conclusion This action...unusual design features on one model of airplanes. It is not a...TAXI, TAKEOFF, LANDING, OR TURBULENCE. c. AN APPROVED MEDICAL STRETCHER...non-operation such as during TTL and turbulence. d. Operate the...

2010-05-18

187

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

PubMed Central

Purpose/Background: Some physical therapists (PTs) provide services at sporting events, but there are limited studies investigating whether PTs are properly prepared to provide such services. The purpose of this study was to assess acute sports injury and medical condition management decision-making skills of PTs. Methods: A Web-based survey presented 17 case scenarios related to acute medical conditions and sport injuries. PTs from the Sports Physical Therapy Section of The American Physical Therapy Association were e-mailed a cover letter/Web link to the survey and invited to participate over a 30-day period. Data were analyzed using SPSS 18.0. Results: A total of 411 of 5158 PTs who were members of the Sports Physical Therapy Association in 2009 and had valid e-mail addresses completed the survey, of which 389 (7.5%) were appropriate for analysis. Over 75.0% of respondents felt “prepared” or “somewhat prepared” to provide immediate care for 13 out of 16 medical conditions, with seizures, spinal cord injuries, and internal organ injuries having the lowest percentages. Over 75.0% of the respondents made “appropriate” or “overly cautious” decisions for 11 of the 17 acute injury or medical condition cases. Conclusions: Results of the current study indicate that PTs felt more “prepared” and tended to make “appropriate” return to play decisions on the acute sports injury and medical condition case studies more often than coaches who participated in a similar study, regardless of level of importance of the game or whether the athlete was a starter vs. non-starter. However, for PTs who plan on assisting at sporting events, additional preparation/education may be recommended, such as what is taught in an emergency responder course. PMID:21904695

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

2011-01-01

188

Twenty-five additional cases of trisomy 9 mosaic: Birth information, medical conditions, and developmental status.  

PubMed

Limited literature exists on children and adults diagnosed with the mosaic form of trisomy 9. Data from the Tracking Rare Incidence Syndromes (TRIS) project has provided physical characteristics and medical conditions for 14 individuals. This article provides TRIS Survey results of 25 additional cases at two data points (birth and survey completion) as well as developmental status. Results confirmed a number of phenotypic features and medical conditions. In addition, a number of cardiac anomalies were reported along with feeding and respiratory difficulties in the immediate postnatal period. In addition, developmental status data indicated a range in functioning level up to skills in the 36 and 48-month range. Strengths were also noted across the sample in language and communication, fine motor and social-emotional development. Implications for professionals caring for children with this genetic condition are offered. © 2015 Wiley Periodicals, Inc. PMID:25755087

Bruns, Deborah A; Campbell, Emily

2015-05-01

189

competency Course Objective 1 1a Apply biomedical science knowledge to inpatient care of patients with acute medical conditions.  

E-print Network

knowledge to inpatient care of patients with acute medical conditions. 2 1f, 3c with common acute medical diagnoses. 6 1b, 1c, 2e, 2h Describe the work up of the health-care team verbally, in writing and in the electronic medical record. 9 4a

Myers, Lawrence C.

190

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

PubMed Central

Chronic myeloid leukemia (CML) is the first human malignancy to be successfully treated with a small molecule inhibitor, imatinib, targeting a mutant oncoprotein (BCR-ABL). Despite its successes, acquired resistance to imatinib leads to reduced drug efficacy and frequent progression of disease. Understanding the characteristics of pre-existing resistant cells is important for evaluating the benefits of first-line combination therapy with second generation inhibitors. However, due to limitations of assay sensitivity, determining the existence and characteristics of resistant cell clones at the start of therapy is difficult. Here we combined a mathematical modeling approach using branching processes with experimental data on the fitness changes (i.e., changes in net reproductive rate) conferred by BCR-ABL kinase domain mutations to investigate the likelihood, composition, and diversity of pre-existing resistance. Furthermore, we studied the impact of these factors on the response to tyrosine kinase inhibitors. Our approach predicts that in most patients, there is at most one resistant clone present at the time of diagnosis of their disease. Interestingly, patients are no more likely to harbor the most aggressive, pan-resistant T315I mutation than any other resistance mutation; however, T315I cells on average establish larger-sized clones at the time of diagnosis. We established that for patients diagnosed late, the relative benefit of combination therapy over monotherapy with imatinib is significant, while this benefit is modest for patients with a typically early diagnosis time. These findings, after pre-clinical validation, will have implications for the clinical management of CML: we recommend that patients with advanced-phase disease be treated with combination therapy with at least two tyrosine kinase inhibitors. PMID:22140458

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

2011-01-01

191

Effects of pre-existing anti-carrier immunity and antigenic element multiplicity on efficacy of a modular virus-like particle vaccine.  

PubMed

Modularization of a peptide antigen for presentation on a microbially synthesized murine polyomavirus (MuPyV) virus-like particle (VLP) offers a new alternative for rapid and low-cost vaccine delivery at a global scale. In this approach, heterologous modules containing peptide antigenic elements are fused to and displayed on the VLP carrier, allowing enhancement of peptide immunogenicity via ordered and densely repeated presentation of the modules. This study addresses two key engineering questions pertaining to this platform, exploring the effects of (i) pre-existing carrier-specific immunity on modular VLP vaccine effectiveness and (ii) increase in the antigenic element number per VLP on peptide-specific immune response. These effects were studied in a mouse model and with modular MuPyV VLPs presenting a group A streptococcus (GAS) peptide antigen, J8i. The data presented here demonstrate that immunization with a modular VLP could induce high levels of J8i-specific antibodies despite a strong pre-existing anti-carrier immune response. Doubling of the J8i antigenic element number per VLP did not enhance J8i immunogenicity at a constant peptide dose. However, the strategy, when used in conjunction with increased VLP dose, could effectively increase the peptide dose up to 10-fold, leading to a significantly higher J8i-specific antibody titer. This study further supports feasibility of the MuPyV modular VLP vaccine platform by showing that, in the absence of adjuvant, modularized GAS antigenic peptide at a dose as low as 150?ng was sufficient to raise a high level of peptide-specific IgGs indicative of bactericidal activity. PMID:23532896

Chuan, Yap P; Rivera-Hernandez, Tania; Wibowo, Nani; Connors, Natalie K; Wu, Yang; Hughes, Fiona K; Lua, Linda H L; Middelberg, Anton P J

2013-09-01

192

Use of isotonic sodium bicarbonate to prevent radiocontrast nephropathy in patients with mild pre-existing renal impairment: a meta-analysis.  

PubMed

Acute renal dysfunction after radiocontrast in patients with pre-existing renal impairment is not uncommon and is associated with significant morbidity and mortality. Isotonic sodium bicarbonate solution was first reported to reduce radiocontrast nephropathy in 2004. This first study was, however; limited by its small sample size and as such, the use of isotonic sodium bicarbonate to prevent radiocontrast nephropathy is still not widely used by many anaesthetists and intensivists. We meta-analysed relevant randomised controlled studies sourced from the Cochrane Controlled Trial Register (2007 issue 4), EMBASE and MEDLINE databases (1966 to April 15, 2008) without any language restriction. The use of isotonic sodium bicarbonate was associated with a significant reduction in risk of an incremental rise in serum creatinine concentration 25% above baseline (relative risk 0.22, 95% confidence interval [CI]: 0.11 to 0.44, P < 0.0001; 2 = 0%) and had a protective effect on the absolute change in serum creatinine concentration (weighted-mean-difference -9.4 micromol/l, 95% CI: -17.2 to -1.7, P = 0.02; F = 0%) and creatinine clearance (weighted-mean-difference 3.7 ml/min, 95% CI: 0.55 to 6.80, P = 0.02; F = 57.1%) after radiocontrast. The incidence of acute renal failure requiring dialysis was low (1.4%) and was not significantly different after the use of isotonic sodium bicarbonate (relative risk 0.59, 95% CI: 0.15 to 2.42, P = 0.47; F = 0%). With the limited data available, isotonic sodium bicarbonate appears to be safe and very effective in reducing radiocontrast nephropathy in patients with mild pre-existing renal impairment. A large randomised controlled study is needed to confirm whether isotonic bicarbonate can improve patient centred clinical outcomes. PMID:18853581

Ho, K M; Morgan, D J

2008-09-01

193

Myocardial infarction worsens glomerular injury and microalbuminuria in rats with pre-existing renal impairment accompanied by the activation of ER stress and inflammation.  

PubMed

Deterioration of renal function occurs after chronic heart failure in approximately one-third of patients, particularly in those with pre-existing renal impairment such as diabetic nephropathy. Impaired renal function in these patients is always associated with a worse prognosis. However, the mechanisms underlying such deterioration of renal function are still largely unknown. In three separate protocols, we compared 1) sham operation (Ctr, n = 10) with surgically induced myocardial infarction (MI, n = 10); 2) unilateral nephrectomy (UNX, n = 10) with UNX + MI (n = 10); and 3) STZ-induced type 1 diabetes (DB, n = 10) with DB + MI (n = 10). The differences between combined injury models (UNX + MI, DB + MI) and simple MI were also examined. Renal remodeling, function, ER stress (CHOP and GRP78) and inflammation (infiltration of inflammatory cells, NF-?B p65) were evaluated 12 weeks after MI. In common SD rats, MI activated less glomerular ER stress and inflammation, resulting in a minor change of glomerular remodeling and microalbuminuria. However, MI significantly increased the glomerular expression of GRP78 and CHOP in UNX and DB rats. In addition, it also promoted the infiltration of CD4+ T cells, particularly inflammatory cytokine (IFN-?, IL-17, IL-4)-producing CD4+ T cells, and the expression of NF-?B p65 in the glomeruli. By contrast, significant glomerular fibrosis, glomerulosclerosis, podocyte injury and microalbuminuria were found in rats with UNX + MI and DB + MI. MI significantly increased chronic glomerular injury and microalbuminuria at 12 weeks in rats with pre-existing renal impairment, i.e., UNX and DB, but not common SD rats. These changes were accompanied by increased glomerular ER stress and immune-associated inflammation. PMID:25173645

Dong, Zhifeng; Wu, Penglong; Li, Yongguang; Shen, Yuan; Xin, Ping; Li, Shuai; Wang, Zhihua; Dai, Xiaoyan; Zhu, Wei; Wei, Meng

2014-12-01

194

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

NASA Astrophysics Data System (ADS)

Luminescent down shifting (LDS) technique is one effective way to improve the poor response of multi-crystalline silicon (mc-Si) photovoltaic (PV) modules at short wavelength less than 400 nm. Eu3+ complexes are effective LDS species for PV modules due to their large stokes' shift and high luminescent quantum efficiency (LQE). Although Eu3+ complexes have been utilized in PV modules as LDS species widely, they have not been encapsulated into the pre-existing poly-ethylene vinyl acetate (EVA) layer of modules between glass and solar cell by now. The aim of our work is to enhance the performance of mc-Si PV modules by encapsulating high efficient Eu3+ complexes into their pre-existing EVA layers which would not modify the well-established manufacturing process for PV modules. In this work, two Eu3+ complexes with different absorption spectrum were encapsulated into the commercial EVA layer by soaking method for the first time and used in the encapsulation of mc-Si PV modules. Hereinto, Eu(TTA)3(TPPO)2 (TTA = 2-thenoyltrifluoroacetonate, TPPO = triphenylphosphine oxide) (EuTT) with absorption spectrum less than 400 nm and high LQE (0.73) improves the external quantum efficiency of mc-Si PV module from 0.05 to 0.20, which produces a 0.42% increases in its power conversion efficiency. In addition, it is found that the enhancement brought by Eu(TTA)3(TPPO)2 can reduce cost of power generated by mc-Si devices from US1/Wp to US0.98/Wp according to the calculation. Therefore, Eu(TTA)3(TPPO)2 as LDS species with high LQE and low cost is promising for enhancing the performance of mc-Si PV modules in practical application.

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

2013-03-01

195

How prepared are medical students to diagnose and manage common ocular conditions  

PubMed Central

It is essential that primary care physicians have a solid fund of knowledge of the diagnosis and management of common eye conditions as well as ocular emergencies, as management of these diseases commonly involves appropriate referral to an ophthalmologist. Thus, it is crucial to receive comprehensive clinical knowledge of ophthalmic disease in the primary care setting during medical school. This study investigated how well prepared medical students are to diagnose and manage common ocular conditions. The study used scores from a standardized 12-question quiz administered to fourth-year medical students (N = 97; 88% response rate) and second-year medical students (N = 97; 97% response rate). The quiz comprising diagnosis and referral management questions covered the most frequently tested ophthalmology topics on board exams and assessed students’ ability to recognize when referral to an ophthalmologist is appropriate. Fourth-year medical students had quiz scores ranging from 0%-94.5% with an average score of 68.7%. Second-year students had quiz scores ranging from 27.2%–86.4%, with an average score of 63.8%. Passing rate was 70%. Student’s t-test showed fourth-year students had a significantly higher quiz average (P = 0.003). In general, both classes performed better on diagnostic questions (fourth-year, 73.7%; second year, 65.8%) rather than on management questions (fourth-year, 64.8%; second year, 61.8%). Both second-year and fourth-year students on average fell short on passing the ophthalmology proficiency quiz, and in general students were more adept at diagnosing rather than managing ocular conditions and emergencies. PMID:25417863

Esparaz, Elizabeth Shanika; Binder, S. Bruce; Borges, Nicole J.

2014-01-01

196

How prepared are medical students to diagnose and manage common ocular conditions.  

PubMed

It is essential that primary care physicians have a solid fund of knowledge of the diagnosis and management of common eye conditions as well as ocular emergencies, as management of these diseases commonly involves appropriate referral to an ophthalmologist. Thus, it is crucial to receive comprehensive clinical knowledge of ophthalmic disease in the primary care setting during medical school. This study investigated how well prepared medical students are to diagnose and manage common ocular conditions. The study used scores from a standardized 12-question quiz administered to fourth-year medical students (N = 97; 88% response rate) and second-year medical students (N = 97; 97% response rate). The quiz comprising diagnosis and referral management questions covered the most frequently tested ophthalmology topics on board exams and assessed students' ability to recognize when referral to an ophthalmologist is appropriate. Fourth-year medical students had quiz scores ranging from 0%-94.5% with an average score of 68.7%. Second-year students had quiz scores ranging from 27.2%-86.4%, with an average score of 63.8%. Passing rate was 70%. Student's t-test showed fourth-year students had a significantly higher quiz average (P = 0.003). In general, both classes performed better on diagnostic questions (fourth-year, 73.7%; second year, 65.8%) rather than on management questions (fourth-year, 64.8%; second year, 61.8%). Both second-year and fourth-year students on average fell short on passing the ophthalmology proficiency quiz, and in general students were more adept at diagnosing rather than managing ocular conditions and emergencies. PMID:25417863

Esparaz, Elizabeth Shanika; Binder, S Bruce; Borges, Nicole J

2014-01-01

197

A Review of Therapeutic Uses of Mirtazapine in Psychiatric and Medical Conditions  

PubMed Central

Objective: To review the literature examining the use of mirtazapine with an emphasis on its therapeutic benefits for psychiatric patients with comorbid medical conditions. Data Sources: MEDLINE, PsycINFO, Global Health, and AGRICOLA were searched using the terms mirtazapine OR Remeron. Limits were English language, human, year 1980–2012, treatment and prevention, and therapy. Study Selection: Two hundred ninety-three articles were identified. Data Extraction: Identified articles were reviewed with a focus on indications and therapeutic benefits in patients with medical comorbidities. Results: Mirtazapine is an effective antidepressant with unique mechanisms of action. It is characterized by a relatively rapid onset of action, high response and remission rates, a favorable side-effect profile, and several unique therapeutic benefits over other antidepressants. Mirtazapine has also shown promise in treating some medical disorders, including neurologic conditions, and ameliorating some of the associated debilitating symptoms of weight loss, insomnia, and postoperative nausea and vomiting. Conclusions: Mirtazapine offers clinicians multiple therapeutic advantages especially when treating patients with comorbid medical illness. PMID:24511451

Voronovich, Zoya; Carley, Joseph A.

2013-01-01

198

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

Microsoft Academic Search

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

Angelico Mendy; Janvier Gasana; Edgar Ramos Vieira

2011-01-01

199

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

Microsoft Academic Search

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

C.-A. Siegrist

1997-01-01

200

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

201

Collaborative Care for Depressed Patients With Chronic Medical Conditions: A Randomized Trial in Puerto Rico  

PubMed Central

Objective This study examined whether a collaborative care model for depression would improve clinical and functional outcomes for depressed patients with chronic general medical conditions in primary care practices in Puerto Rico. Methods A total of 179 primary care patients with major depression and chronic general medical conditions were randomly assigned to receive collaborative care or usual care. The collaborative care intervention involved enhanced collaboration among physicians, mental health specialists, and care managers paired with depression-specific treatment guidelines, patient education, and follow-up. In usual care, study personnel informed the patient and provider of the diagnosis and encouraged patients to discuss treatment options with their provider. Depression severity was assessed with the Hopkins Symptom Checklist; social functioning was assessed with the 36-item Short Form. Results Compared with usual care, collaborative care significantly reduced depressive symptoms and improved social functioning in the six months after randomization. Integration of collaborative care in primary care practices considerably increased depressed patients' use of mental health services. Conclusions Collaborative care significantly improved clinical symptoms and functional status of depressed patients with coexisting chronic general medical conditions receiving treatment for depression in primary care practices in Puerto Rico. These findings highlight the promise of the collaborative care model for strengthening the relationship between mental health and primary care services in Puerto Rico. PMID:20123819

Vera, Mildred; Perez-Pedrogo, Coralee; Huertas, Sarah Enid; Reyes-Rabanillo, Maria Leticia; Juarbe, Deborah; Huertas, Aracelis; Reyes-Rodriguez, Mae Lynn; Chaplin, William

2010-01-01

202

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

203

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. PMID:24527681

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

204

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. PMID:22936202

Kiwilsza, Ma?gorzata; Sporniak-Tutak, Katarzyna

2012-01-01

205

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

PubMed

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

Kiwilsza, Ma?gorzata; Sporniak-Tutak, Katarzyna

2012-09-01

206

Pre-Existing Cross-Reactive Antibodies to Avian Influenza H5N1 and 2009 Pandemic H1N1 in US Military Personnel  

PubMed Central

We studied cross-reactive antibodies against avian influenza H5N1 and 2009 pandemic (p) H1N1 in 200 serum samples from US military personnel collected before the H1N1 pandemic. Assays used to measure antibodies against viral proteins involved in protection included a hemagglutination inhibition (HI) assay and a neuraminidase inhibition (NI) assay. Viral neutralization by antibodies against avian influenza H5N1 and 2009 pH1N1 was assessed by influenza (H5) pseudotyped lentiviral particle-based and H1N1 microneutralization assays. Some US military personnel had cross-neutralizing antibodies against H5N1 (14%) and 2009 pH1N1 (16.5%). The odds of having cross-neutralizing antibodies against 2009 pH1N1 were 4.4 times higher in subjects receiving more than five inactivated whole influenza virus vaccinations than those subjects with no record of vaccination. Although unclear if the result of prior vaccination or disease exposure, these pre-existing antibodies may prevent or reduce disease severity. PMID:24277784

Pichyangkul, Sathit; Krasaesub, Somporn; Jongkaewwattana, Anan; Thitithanyanont, Arunee; Wiboon-ut, Suwimon; Yongvanitchit, Kosol; Limsalakpetch, Amporn; Kum-Arb, Utaiwan; Mongkolsirichaikul, Duangrat; Khemnu, Nuanpan; Mahanonda, Rangsini; Garcia, Jean-Michel; Mason, Carl J.; Walsh, Douglas S.; Saunders, David L.

2014-01-01

207

Genome-wide Reinforcement of Cohesin Binding at Pre-existing Cohesin Sites in Response to Ionizing Radiation in Human Cells*  

PubMed Central

The cohesin complex plays a central role in genome maintenance by regulation of chromosome segregation in mitosis and DNA damage response (DDR) in other phases of the cell cycle. The ATM/ATR phosphorylates SMC1 and SMC3, two core components of the cohesin complex to regulate checkpoint signaling and DNA repair. In this report, we show that the genome-wide binding of SMC1 and SMC3 after ionizing radiation (IR) is enhanced by reinforcing pre-existing cohesin binding sites in human cancer cells. We demonstrate that ATM and SMC3 phosphorylation at Ser1083 regulate this process. We also demonstrate that acetylation of SMC3 at Lys105 and Lys106 is induced by IR and this induction depends on the acetyltransferase ESCO1 as well as the ATM/ATR kinases. Consistently, both ESCO1 and SMC3 acetylation are required for intra-S phase checkpoint and cellular survival after IR. Although both IR-induced acetylation and phosphorylation of SMC3 are under the control of ATM/ATR, the two forms of modification are independent of each other and both are required to promote reinforcement of SMC3 binding to cohesin sites. Thus, SMC3 modifications is a mechanism for genome-wide reinforcement of cohesin binding in response to DNA damage response in human cells and enhanced cohesion is a downstream event of DDR. PMID:20501661

Kim, Beom-Jun; Li, Yehua; Zhang, Jinglan; Xi, Yuanxin; Li, Yumei; Yang, Tao; Jung, Sung Yun; Pan, Xuewen; Chen, Rui; Li, Wei; Wang, Yi; Qin, Jun

2010-01-01

208

Genome-wide reinforcement of cohesin binding at pre-existing cohesin sites in response to ionizing radiation in human cells.  

PubMed

The cohesin complex plays a central role in genome maintenance by regulation of chromosome segregation in mitosis and DNA damage response (DDR) in other phases of the cell cycle. The ATM/ATR phosphorylates SMC1 and SMC3, two core components of the cohesin complex to regulate checkpoint signaling and DNA repair. In this report, we show that the genome-wide binding of SMC1 and SMC3 after ionizing radiation (IR) is enhanced by reinforcing pre-existing cohesin binding sites in human cancer cells. We demonstrate that ATM and SMC3 phosphorylation at Ser(1083) regulate this process. We also demonstrate that acetylation of SMC3 at Lys(105) and Lys(106) is induced by IR and this induction depends on the acetyltransferase ESCO1 as well as the ATM/ATR kinases. Consistently, both ESCO1 and SMC3 acetylation are required for intra-S phase checkpoint and cellular survival after IR. Although both IR-induced acetylation and phosphorylation of SMC3 are under the control of ATM/ATR, the two forms of modification are independent of each other and both are required to promote reinforcement of SMC3 binding to cohesin sites. Thus, SMC3 modifications is a mechanism for genome-wide reinforcement of cohesin binding in response to DNA damage response in human cells and enhanced cohesion is a downstream event of DDR. PMID:20501661

Kim, Beom-Jun; Li, Yehua; Zhang, Jinglan; Xi, Yuanxin; Li, Yumei; Yang, Tao; Jung, Sung Yun; Pan, Xuewen; Chen, Rui; Li, Wei; Wang, Yi; Qin, Jun

2010-07-23

209

SIV replication in the infected rhesus macaque is limited by the size of the pre-existing Th17 cell compartment  

PubMed Central

The mechanisms by which some HIV-infected subjects resist disease progression, while others progress rapidly, are incompletely understood. Viral and host genetic factors, such as nef deletions and MHC alleles, explain a portion of the observed variability. However, it has been difficult to identify host immune functions that may be present before infection and that allow resistance to lentiviral disease progression. Here we show that SIV replication in the infected rhesus macaque is limited by the size of the pre-existing Th17 cell compartment: animals with a high representation of such cells in blood and intestinal tissue prior to infection experienced peak and set-point viral loads approximately one log unit lower than those with a lower representation of Th17 cells. Reciprocally, treatment of macaques with interleukin-2 (IL-2) and granulocyte colony stimulating factor (G-CSF) before infection led to depletion of Th17 cells, reduction of the ratio between Th17 cells and CD3+CD4+CD25+CD127low regulatory T cells (Tregs), and higher viral loads for six months after infection. These results demonstrate that the composition of the host immune system before infection has an influence on the course of disease after infection. Furthermore, to the extent that this influence shapes and interacts with T-cell-mediated responses to virus, our findings provide a new framework for understanding inter-individual variation in responses to therapies and vaccines against HIV. PMID:22649090

Hartigan-O’Connor, Dennis J.; Abel, Kristina; Van Rompay, Koen K. A.; Kanwar, Bittoo; McCune, Joseph M.

2012-01-01

210

A Critical Shock Mach Number for Particle Acceleration in the Absence of Pre-existing Cosmic Rays: M=\\sqrt{5}  

NASA Astrophysics Data System (ADS)

It is shown that, under some generic assumptions, shocks cannot accelerate particles unless the overall shock Mach number exceeds a critical value M\\gt\\sqrt{5}. The reason is that for M\\le \\sqrt{5} the work done to compress the flow in a particle precursor requires more enthalpy flux than the system can sustain. This lower limit applies to situations without significant magnetic field pressure. In case that the magnetic field pressure dominates the pressure in the unshocked medium, i.e., for low plasma beta, the resistivity of the magnetic field makes it even more difficult to fulfill the energetic requirements for the formation of shock with an accelerated particle precursor and associated compression of the upstream plasma. We illustrate the effects of magnetic fields for the extreme situation of a purely perpendicular magnetic field configuration with plasma beta ? = 0, which gives a minimum Mach number of M = 5/2. The situation becomes more complex, if we incorporate the effects of pre-existing cosmic rays, indicating that the additional degree of freedom allows for less strict Mach number limits on acceleration. We discuss the implications of this result for low Mach number shock acceleration as found in solar system shocks, and shocks in clusters of galaxies.

Vink, Jacco; Yamazaki, Ryo

2014-01-01

211

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

PubMed Central

OBJECTIVE: To describe characteristics associated with inappropriate hospital use by patients in Manitoba in order to help target concurrent utilization review. Utilization review was developed to reduce inappropriate hospital use but can be a very resource-intensive process. DESIGN: Retrospective chart review of a sample of adult patients who received care for medical conditions in a sample of Manitoba hospitals during the fiscal year 1993-94; assessment of patients at admission and for each day of stay with the use of a standardized set of objective, nondiagnosis-based criteria (InterQual). PATIENTS: A total of 3904 patients receiving care at 26 hospitals. OUTCOME MEASURES: Acute (appropriate) and nonacute (inappropriate) admissions and days of stay for adult patients receiving care for medical conditions. RESULTS: After 1 week, 53.2% of patients assessed as needing acute care at admission no longer required acute care. Patients 75 years of age or older consumed more than 50% of the days of stay, and 74.8% of these days of stay were inappropriate. Four diagnostic categories accounted for almost 60% of admissions and days, and more than 50% of those days of stay were inappropriate. Patients admitted through the emergency department were more likely to require acute care (60.9%) than others (41.7%). Patients who were Treaty Indians had a higher proportion of days of stay requiring acute care than others (45.9% v. 32.8%). Patients' income and day of the week on admission (weekday v. weekend) were not predictive factors of inappropriate use. CONCLUSION: Rather than conducting a utilization review for every patient, hospitals might garner more information by targeting patients receiving care for medical conditions with stays longer than 1 week, patients with nervous system, circulatory, respiratory or digestive diagnoses, elderly patients and patients not admitted through the emergency department. PMID:9327796

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

1997-01-01

212

STUDENT ASSESSMENT MEDICAL FORMSTUDENT ASSESSMENT MEDICAL FORMSTUDENT ASSESSMENT MEDICAL FORMSTUDENT ASSESSMENT MEDICAL FORM Yonsei University  

E-print Network

treated by a psychiatrist, psychoanalyst, or psychologist for any mental, emotional or nervous disorder) Do you have any pre-existing conditions? YES NO 2) Do you currently receive any treatments NO 9) Have you ever received treatment for drug or alcohol addiction? YES NO 10) Have you ever been

Burgstaller, Bernd

213

The efficacy of sodium bicarbonate in preventing contrast-induced nephropathy in patients with pre-existing renal insufficiency: a meta-analysis  

PubMed Central

Objective The aim of this meta-analysis was to explore the efficacy of sodium bicarbonate in preventing contrast-induced nephropathy (CIN). Methods We searched PubMed, Medline and the Cochrane Library from 1 January 2004 to 1 August 2014. The effect estimate was expressed as a pooled OR with 95% CI, using the fixed-effects or random-effects model. Results 20 randomised controlled trials (n=4280) were identified. Hydration with sodium bicarbonate was associated with a significant decrease in CIN among patients with pre-existing renal insufficiency (OR 0.67, 95% CI 0.47 to 0.96; p=0.027). However, moderate heterogeneity was noted across trials (I2=48%; p=0.008). Subgroup analyses indicated a better effect of sodium bicarbonate in studies using low-osmolar (OR 0.59, 95% CI 0.37 to 0.93; p=0.024) compared with iso-osmolar contrast agents (OR 0.76, 95% CI 0.43 to 1.34; p=0.351). The odds of CIN with sodium bicarbonate were lower in studies including only patients undergoing emergency (OR 0.16, 95% CI 0.05 to 0.51; p=0.002) compared with elective procedures (OR 0.76, 95% CI 0.54 to 1.06; p=0.105). Sodium bicarbonate was more beneficial in patients given a bolus injection before procedures (OR 0.15, 95% CI 0.04 to 0.54; p=0.004) compared with continuous infusion (OR 0.75, 95% CI 0.53 to 1.05; p=0.091). Sodium bicarbonate plus N-acetylcysteine (OR 0.17, 95% CI 0.04 to 0.79; p=0.024) was better than sodium bicarbonate alone (OR 0.71, 95% CI 0.48 to 1.03; p=0.071). The effect of sodium bicarbonate was considered greater in papers published before (OR 0.19, 95% CI 0.09 to 0.41; p=0.000) compared with after 2008 (OR 0.85, 95% CI 0.62 to 1.16; p=0.302). However, no significant differences were found in mortality (OR 0.69, 95% CI 0.36 to 1.32; p=0.263) or requirement for dialysis (OR 1.08, 95% CI 0.52 to 2.25; p=0.841). Conclusions Sodium bicarbonate is effective in preventing CIN among patients with pre-existing renal insufficiency. However, it fails to lower the risks of dialysis and mortality and therefore cannot improve the clinical prognosis of patients with CIN. PMID:25783425

Zhang, Bin; Liang, Long; Chen, Wenbo; Liang, Changhong; Zhang, Shuixing

2015-01-01

214

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

PubMed Central

Regenerating elastic matrices lost to disease (e.g. in aneurysms) is vital to re-establishing vascular homeostasis but is challenged by poor elastogenicity of post-neonatal cells. We previously showed exogenous hyaluronan oligomers (HA-o) and TGF-?1 to synergistically enhance tropo and matrix elastin deposition by healthy adult rat aortic SMCs (RASMCs). Towards treating aortic aneurysms (AAs), which exhibit cause- and site-specific heterogeneity in matrix content/structure and contain proteolytically-injured SMCs, we investigated impact of pre-existing elastic matrix degeneration on elastogenic induction of injured RASMCs. Elastin-rich RASMC layers at 21 days of culture, were treated with 0.15 U/ml (PPE15) and 0.75 U/ml (PPE75) of porcine pancreatic elastase to degrade the elastic matrix variably, or left uninjured (control). One set of cultures was harvested at 21d, before and after injury, to quantify viable cell count, matrix elastin loss. Other injured cell layers were cultured to 42d with or without factors (0.2 ?g/ml HA oligomers, 1 ng/ml TGF-?1). We showed that (a)ability of cultures to self-repair and regenerate elastic matrices following proteolysis is limited when elastolysis is severe, (b)HA oligomers and TGF-?1 elastogenically stimulate RASMCs in mildly-injured (i.e., PPE15) cultures to restore both elastic matrix amounts and elastic-fiber deposition to levels in healthy cultures, and (c) in severely injured (i.e., PPE75) cultures, the factors stimulate matrix elastin synthesis and crosslinking, though not to control levels. The outcomes underscore need to enhance elastogenic factor doses based on severity of elastin loss. This study will help customize therapies for elastin regeneration within AAs based on cause and location. PMID:20653044

Gacchina, Carmen E.; Ramamurthi, Anand

2010-01-01

215

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

216

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

217

Sensitive Detection of Pre-Existing BCR-ABL Kinase Domain Mutations in CD34+ Cells of Newly Diagnosed Chronic-Phase Chronic Myeloid Leukemia Patients Is Associated with Imatinib Resistance: Implications in the Post-Imatinib Era  

PubMed Central

Background BCR-ABL kinase domain mutations are infrequently detected in newly diagnosed chronic-phase chronic myeloid leukemia (CML) patients. Recent studies indicate the presence of pre-existing BCR-ABL mutations in a higher percentage of CML patients when CD34+ stem/progenitor cells are investigated using sensitive techniques, and these mutations are associated with imatinib resistance and disease progression. However, such studies were limited to smaller number of patients. Methods We investigated BCR-ABL kinase domain mutations in CD34+ cells from 100 chronic-phase CML patients by multiplex allele-specific PCR and sequencing at diagnosis. Mutations were re-investigated upon manifestation of imatinib resistance using allele-specific PCR and direct sequencing of BCR-ABL kinase domain. Results Pre-existing BCR-ABL mutations were detected in 32/100 patients and included F311L, M351T, and T315I. After a median follow-up of 30 months (range 8–48), all patients with pre-existing BCR-ABL mutations exhibited imatinib resistance. Of the 68 patients without pre-existing BCR-ABL mutations, 24 developed imatinib resistance; allele-specific PCR and BCR-ABL kinase domain sequencing detected mutations in 22 of these patients. All 32 patients with pre-existing BCR-ABL mutations had the same mutations after manifestation of imatinib-resistance. In imatinib-resistant patients without pre-existing BCR-ABL mutations, we detected F311L, M351T, Y253F, and T315I mutations. All imatinib-resistant patients except T315I and Y253F mutations responded to imatinib dose escalation. Conclusion Pre-existing BCR-ABL mutations can be detected in a substantial number of chronic-phase CML patients by sensitive allele-specific PCR technique using CD34+ cells. These mutations are associated with imatinib resistance if affecting drug binding directly or indirectly. After the recent approval of nilotinib, dasatinib, bosutinib and ponatinib for treatment of chronic myeloid leukemia along with imatinib, all of which vary in their effectiveness against mutated BCR-ABL forms, detection of pre-existing BCR-ABL mutations can help in selection of appropriate first-line drug therapy. Thus, mutation testing using CD34+ cells may facilitate improved, patient-tailored treatment. PMID:23409026

Iqbal, Mudassar; Naqvi, Mubashar Iqbal; Gill, Ammara; Taj, Abid Sohail; Qayyum, Abdul; ur-Rehman, Najeeb; Khalid, Ahmad Mukhtar; Shah, Ijaz Hussain; Khalid, Muhammad; Haq, Riazul; Khan, Mahwish; Baig, Shahid Mahmood; Jamil, Abid; Abbas, Muhammad Naeem; Absar, Muhammad; Mahmood, Amer; Rasool, Mahmood; Akhtar, Tanveer

2013-01-01

218

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

Microsoft Academic Search

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

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

219

Diabetes type II, other medical conditions and pancreatic cancer risk: a prospective study in The Netherlands  

PubMed Central

Background: To date, only a few risk factors for pancreatic cancer have been established. We examined prospectively relations between several medical conditions and pancreatic cancer incidence. Methods: In 1986, 120?852 participants completed a baseline questionnaire on cancer risk factors, including several self-reported physician diagnosed medical conditions. At baseline, a random subcohort of 5000 participants was selected using a case-cohort approach for analysis. After 16.3 years of follow-up, 448 pancreatic cancer cases (63% microscopically confirmed) were available for analysis. Results: Diabetes mellitus type II and hepatitis were positively associated with pancreatic cancer risk (multivariable-adjusted hazard ratio: 1.79; 95% confidence interval: 1.12–2.87 and hazard ratio: 1.37; 95% confidence interval: 1.04–1.81, respectively). Furthermore, a positive trend in risk with increasing years of diagnosis of diabetes (P=0.004) and of hepatitis (P=0.02) was observed. However, an inverse association was observed between hypertension and pancreatic cancer risk, this was found among microscopically confirmed cases only (hazard ratio: 0.66; 95% confidence interval: 0.49–0.90), while years since diagnosis of hypertension significantly decreased cancer risk (P for trend=0.02). Conclusion: In this prospective study, a positive association was observed between self-reported physician diagnosed diabetes mellitus type II and hepatitis and pancreatic cancer risk, whereas an inverse association was observed with hypertension. PMID:24149173

Eijgenraam, P; Heinen, M M; Verhage, B A J; Keulemans, Y C; Schouten, L J; van den Brandt, P A

2013-01-01

220

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. PMID:22690034

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

2012-01-01

221

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

Code of Federal Regulations, 2014 CFR

...pertinent parts of the beneficiary's medical record (for example, history, physical...in the pertinent portion of the medical record (for example, history, physical...cosign the pertinent portion of the medical record indicating the occurrence of...

2014-10-01

222

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

Code of Federal Regulations, 2013 CFR

...pertinent parts of the beneficiary's medical record (for example, history, physical...in the pertinent portion of the medical record (for example, history, physical...cosign the pertinent portion of the medical record indicating the occurrence of...

2013-10-01

223

The medical directorship of renal dialysis facilities under the new Medicare conditions for coverage: challenges and opportunities.  

PubMed

The new Medicare conditions for coverage for providers of end-stage renal disease services provide both a challenge and an opportunity for medical directors. The conditions expect active clinical leadership in quality improvement and the performance of the facility staff and medical staff. These new rules define patient assessment and care planning processes that complement the quality assessment and performance improvement (QAPI) program. Infection control, patient safety and error reduction are given new emphasis. The interdisciplinary team (IDT) under the leadership of the medical director will advance the quality and safety of the patients under their care. Patients' rights and autonomy are stressed. The QAPI/IDT will monitor complaints, satisfaction surveys, and grievances to minimize involuntary discharge. The medical director will report the results of the QAPI program to the governing body. Medical directors will find that participation in renal network quality improvement programs and initiatives will enhance their facility's QAPI program. PMID:19169012

DeOreo, Peter B

2009-01-01

224

Mechanical ventilation using non-injurious ventilation settings causes lung injury in the absence of pre-existing lung injury in healthy mice  

PubMed Central

Introduction Mechanical ventilation (MV) may cause ventilator-induced lung injury (VILI). Present models of VILI use exceptionally large tidal volumes, causing gross lung injury and haemodynamic shock. In addition, animals are ventilated for a relative short period of time and only after a 'priming' pulmonary insult. Finally, it is uncertain whether metabolic acidosis, which frequently develops in models of VILI, should be prevented. To study VILI in healthy mice, the authors used a MV model with clinically relevant ventilator settings, avoiding massive damage of lung structures and shock, and preventing metabolic acidosis. Methods Healthy C57Bl/6 mice (n = 66) or BALB/c mice (n = 66) were ventilated (tidal volume = 7.5 ml/kg or 15 ml/kg; positive end-expiratory pressure = 2 cmH2O; fraction of inspired oxygen = 0.5) for five hours. Normal saline or sodium bicarbonate were used to correct for hypovolaemia. Lung histopathology, lung wet-to-dry ratio, bronchoalveolar lavage fluid protein content, neutrophil influx and levels of proinflammatory cytokines and coagulation factors were measured. Results Animals remained haemodynamically stable throughout the whole experiment. Lung histopathological changes were minor, although significantly more histopathological changes were found after five hours of MV with a larger tidal volume. Lung histopathological changes were no different between the strains. In both strains and with both ventilator settings, MV caused higher wet-to-dry ratios, higher bronchoalveolar lavage fluid protein levels and more influx of neutrophils, and higher levels of proinflammatory cytokines and coagulation factors. Also, with MV higher systemic levels of cytokines were measured. All parameters were higher with larger tidal volumes. Correcting for metabolic acidosis did not alter endpoints. Conclusions MV induces VILI, in the absence of a priming pulmonary insult and even with use of relevant (least injurious) ventilator settings. This model offers opportunities to study the pathophysiological mechanisms behind VILI and the contribution of MV to lung injury in the absence of pre-existing lung injury. PMID:19152704

Wolthuis, Esther K; Vlaar, Alexander PJ; Choi, Goda; Roelofs, Joris JTH; Juffermans, Nicole P; Schultz, Marcus J

2009-01-01

225

HIGHLIGHTING DIFFERENCES BETWEEN CONDITIONAL AND UNCONDITIONAL QUANTILE REGRESSION APPROACHES THROUGH AN APPLICATION TO ASSESS MEDICATION ADHERENCE  

PubMed Central

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

2014-01-01

226

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. PMID:24949281

2014-01-01

227

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

Code of Federal Regulations, 2011 CFR

...where appropriate, as well as the family and/or other caregiver(s), receive instruction in the safe use of durable medical...patient and family instruction. The patient, family, and/or caregiver must be able to demonstrate the appropriate use of...

2011-10-01

228

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

Code of Federal Regulations, 2010 CFR

...where appropriate, as well as the family and/or other caregiver(s), receive instruction in the safe use of durable medical...patient and family instruction. The patient, family, and/or caregiver must be able to demonstrate the appropriate use of...

2010-10-01

229

Hurricane Katrina’s Impact on the Care of Survivors with Chronic Medical Conditions  

PubMed Central

BACKGROUND Hurricane Katrina affected a population with significant levels of chronic disease. OBJECTIVE The extent to which Hurricane Katrina disrupted treatments is not known but would be useful information for future disaster planning. PARTICIPANTS 1,043 displaced and nondisplaced English-speaking Katrina survivors ages 18 and older who resided in affected areas before the hurricane. DESIGN AND SETTING A geographically representative telephone survey conducted between January 19 and March 31, 2006. MEASUREMENTS AND MAIN RESULTS The proportions of survivors with chronic illnesses in the 12 months before the hurricane and the extent to which those with chronic illnesses cut back or terminated treatments because of the disaster. Correlates and reasons given by survivors for disrupted treatment were identified. Most (73.9%) Katrina survivors had 1 or more chronic conditions in the year before the hurricane; of these, 20.6% cut back or terminated their treatment because of the disaster. Disruptions in treatment were significantly more common among the non-elderly, uninsured, socially isolated, those with housing needs, or for conditions remaining relatively asymptomatic but still dangerous if untreated. Frequent reasons for disrupted care included problems accessing physicians (41.1%), medications (32.5%), insurance/financial means (29.3%), transportation (23.2%), or competing demands on time (10.9%). CONCLUSIONS Many Katrina survivors burdened by chronic disease had their treatments disrupted by the disaster. Future disaster management plans should anticipate and address such chronic care needs, with timely reestablishment of primary care services, access to medications, and means to address financial and structural barriers to treatment. PMID:17657545

2007-01-01

230

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

PubMed Central

Background The 23-valent pneumococcal polysaccharide vaccine (PPV23) is recommended for persons aged < 65 years with chronic medical conditions. We evaluated the risk and mortality from invasive pneumococcal disease (IPD) among persons with and without the underlying medical conditions which are considered PPV23 indications. Methods Population-based data on all episodes of IPD (positive blood or cerebrospinal fluid culture) reported by Finnish clinical microbiology laboratories during 1995–2002 were linked to data in national health care registries and vital statistics to obtain information on the patient's preceding hospitalisations, co-morbidities, and outcome of illness. Results Overall, 4357 first episodes of IPD were identified in all age groups (average annual incidence, 10.6/100,000). Patients aged 18–49 and 50–64 years accounted for 1282 (29%) and 934 (21%) of IPD cases, of which 372 (29%) and 427 (46%) had a current PPV23 indication, respectively. Overall, 536 (12%) IPD patients died within one month of first positive culture. Persons aged 18–64 years accounted for 254 (47%) of all deaths (case-fatality proportion, 12%). Of those who died 117 (46%) did not have a vaccine indication. In a survival model, patients with alcohol-related diseases, non-haematological malignancies, and those aged 50–64 years were most likely to die. Conclusion In the general population of non-elderly adults, almost two-thirds of IPD and half of fatal cases occurred in persons without a recognised PPV23 indication. Policymakers should consider additional prevention strategies such as lowering the age of universal PPV23 vaccination and introducing routine childhood pneumococcal conjugate immunisation which could provide substantial health benefits to this population through indirect vaccine effects. PMID:18647385

2008-01-01

231

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

Microsoft Academic Search

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

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

1989-01-01

232

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

Code of Federal Regulations, 2014 CFR

... Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE...PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.12...

2014-10-01

233

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

Code of Federal Regulations, 2011 CFR

... Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE...PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.12...

2011-10-01

234

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

Code of Federal Regulations, 2012 CFR

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

2012-10-01

235

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

Microsoft Academic Search

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

Elizabeth Chapman

2002-01-01

236

Medications  

MedlinePLUS

Accessible Search Form Advanced Search Search the NHLBI, use radio buttons below to select whole site or Disease and Conditions Index only NHLBI Entire Site NHLBI Entire Site 1 Health Topics 2 News & Resources 3 ...

237

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

Code of Federal Regulations, 2010 CFR

...or judgment is received for more than one wound or medical condition, can the refundable...judgment is received for more than one wound or medical condition, can the refundable...owed to the United States? (a) All wounds, diseases or other medical...

2010-04-01

238

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

Code of Federal Regulations, 2011 CFR

...or judgment is received for more than one wound or medical condition, can the refundable...judgment is received for more than one wound or medical condition, can the refundable...owed to the United States? (a) All wounds, diseases or other medical...

2011-04-01

239

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

Code of Federal Regulations, 2013 CFR

...or judgment is received for more than one wound or medical condition, can the refundable...judgment is received for more than one wound or medical condition, can the refundable...owed to the United States? (a) All wounds, diseases or other medical...

2013-04-01

240

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

Code of Federal Regulations, 2014 CFR

...or judgment is received for more than one wound or medical condition, can the refundable...judgment is received for more than one wound or medical condition, can the refundable...owed to the United States? (a) All wounds, diseases or other medical...

2014-04-01

241

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

Code of Federal Regulations, 2012 CFR

...or judgment is received for more than one wound or medical condition, can the refundable...judgment is received for more than one wound or medical condition, can the refundable...owed to the United States? (a) All wounds, diseases or other medical...

2012-04-01

242

Equity and medical practice variation: relationships between standardised discharge ratios in total and for selected conditions in English districts.  

PubMed Central

STUDY OBJECTIVE--The aim was to investigate relationships for residents of English district health authorities between rates of discharges from acute hospitals for all conditions and variations in discharge rates for eight common conditions (five surgical, three medical). DESIGN--Hospital Inpatient Enquiry data on discharges for 1984 were analysed. Standardised discharge ratios (ratios of actual to expected numbers of discharges x 100) were derived for selected conditions and all conditions; and correlation coefficients for these statistics were calculated. Districts were grouped into quintiles according to the value of the standardised discharge ratio, and systematic variation within each quintile was calculated for the selected conditions. SETTING--The study involved all 192 English district health authorities, but 57 were excluded because the proportion of unspecified diagnoses exceeded 5%. PATIENTS--The analyses were based on 336,799 cases from 135 districts. MEASUREMENTS AND MAIN RESULTS--Discharge ratios for the medical conditions and one surgical condition were significantly correlated with the levels of total discharge rates (p less than 0.01). The medical conditions showed greater systematic variation in discharge ratios than the surgical conditions. There was no consistent pattern in the values of systematic variation for the selected conditions across the different levels of discharge ratios for all conditions. CONCLUSIONS--It is argued that the changes in the NHS introduced in April 1991 are intended to introduce greater equity in the standardised discharge ratios and increase the total numbers of discharges. The results of this analysis suggest that, even if these objectives were achieved, they may not result in increased levels of elective care, nor result in greater equity in terms of rates of discharge for individual conditions. PMID:1573361

Price, C E; Paul, E A; Bevan, R G; Holland, W W

1992-01-01

243

Out-of-hours and weekend admissions to Danish medical departments: admission rates and 30-day mortality for 20 common medical conditions  

PubMed Central

Objectives Knowledge on timing of admissions and mortality for acute medical patients is limited. The aim of the study was to examine hospital admission rates and mortality rates for patients with common medical conditions according to time of admission. Design Nationwide population-based cohort study. Setting Population of Denmark. Participants Using the Danish National Registry of Patients covering all Danish hospitals, we identified all adults with the first acute admission to a medical department in Denmark during 2010. Primary and secondary outcome measures Hourly admission rates and age-standardised and sex-standardised 30-day mortality rates comparing weekday office hours, weekday out of hours, weekend daytime hours and weekend night-time hours. Results In total, 174?192 acute medical patients were included in the study. The admission rates (patients per hour) were 38.7 (95% CI 38.4 to 38.9) during weekday office hours, 13.3 (95% CI 13.2 to 13.5) during weekday out of hours, 19.8 (95% CI 19.6 to 20.1) during weekend daytime hours and 7.9 (95% CI 7.8 to 8.0) during weekend night-time hours. Admission rates varied between medical conditions. The proportion of patients admitted to an intensive care unit (ICU) increased outside of office hours. The age-standardised and sex-standardised 30-day mortality rate was 5.1% (95% CI 5.0% to 5.3%) after admission during weekday office hours, 5.7% (95% CI 5.5% to 6.0%) after admission during weekday out of hours, 6.4% (95% CI 6.1% to 6.7%) after admission during weekend daytime hours and 6.3% (95% CI 5.9% to 6.8%) after admission during weekend night-time hours. For the majority of the medical conditions examined, weekend admission was associated with highest mortality. Conclusions While admission rates decreased from office hours to weekend hours there was an observed increase in mortality. This may reflect differences in severity of illness as the proportion admitted to an ICU increased during the weekend. PMID:25762233

Sřrensen, Henrik Toft; Christiansen, Christian Fynbo

2015-01-01

244

An interdisciplinary approach to the management of complex medical and dental conditions.  

PubMed

Dental and medical practice often requires an interdisciplinary approach integrating the knowledge, skills and experience of all the disciplines of dentistry, medicine and its associated fields into comprehensive treatment to maximize results. Rapid and comprehensive scientific and technological advances have made it difficult for dental and medical practitioners to keep up to date in their fields; thus, to decrease practitioner frustration and increase patient benefits, an interdisciplinary approach has become essential. This report illustrates how therapy was coordinated for a young medically compromised patient with dental phobia and significant dental problems. The latest advances in dental techniques and materials, medical technology and pharmacology are highlighted. The communication and cooperation of team members with each other and with the patient and guardians is illustrated. The astute observation by a medical practitioner in an unrelated discipline led to the improvement in the quality of life for a patient. PMID:11225529

Rogers, J P; Stewart, P R; Stapleton, J V; Hribar, D L; Adams, P; Gale, A E

2000-12-01

245

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

Code of Federal Regulations, 2014 CFR

...to surgery or a procedure requiring anesthesia services. The medical history and...to surgery or a procedure requiring anesthesia services. (B) An updated examination...to surgery or a procedure requiring anesthesia services. (ii) Admitting...

2014-10-01

246

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

Code of Federal Regulations, 2011 CFR

...to surgery or a procedure requiring anesthesia services. The medical history and...to surgery or a procedure requiring anesthesia services. (B) An updated examination...to surgery or a procedure requiring anesthesia services. (ii) Admitting...

2011-10-01

247

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

Code of Federal Regulations, 2013 CFR

...authentification and protects the security of all record entries. ...ensuring the confidentiality of patient records. In-formation from...cannot gain access to or alter patient records. Original medical...diagnosis, and describe the patient's progress and response...

2013-10-01

248

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

Code of Federal Regulations, 2010 CFR

...authentification and protects the security of all record entries. ...ensuring the confidentiality of patient records. In-formation from...cannot gain access to or alter patient records. Original medical...diagnosis, and describe the patient's progress and response...

2010-10-01

249

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

Code of Federal Regulations, 2011 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...

2011-10-01

250

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

Code of Federal Regulations, 2012 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...

2012-10-01

251

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

252

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

Code of Federal Regulations, 2010 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...

2010-10-01

253

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

Code of Federal Regulations, 2014 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...

2014-10-01

254

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

MedlinePLUS

... Print Share Glossary previous page Related Topics Cataracts Delirium Dementia Fainting (Syncope) Falls Prevention Geriatrics Glaucoma Macular ... an overactive bladder muscle, urinary tract infection, constipation, delirium, heart disease, diabetes, dementia, medication side effects, and ...

255

Disparities in the Reporting and Treatment of Health Conditions in Children: An Analysis of the Medical Expenditure Panel Survey  

PubMed Central

Objectives To determine whether racial and ethnic disparities in health care use differ for physical and behavioral health conditions. Data Sources Secondary analysis of the 1996–1997 Medical Expenditure Panel Survey. Study Design Retrospective cohort study of children aged 2–18 years old who were members of participating households. Children were categorized as Hispanic, black, or white. Differences in caregiver-reported behavioral and physical health conditions and services use were compared, and estimates were weighted to reflect the complex sampling scheme. Principal Findings Of eligible children weighted to represent over 44 million in each year, 13–15 percent were Hispanic, 14 percent black, and 68–70 percent white. After adjusting for potential confounding, Hispanic and black children were less likely to report externalizing behavioral conditions than white children. Black but not Hispanic children were more likely than white children to report asthma. In addition, Hispanic and black children were less likely to report ambulatory visits, and black children were less likely to report receiving a prescription medication than white children. There were no differences in reported emergency room visits or hospitalizations. Interactions between race and various health conditions, health status, insurance, and income were not significant. Conclusions In this nationally representative sample, we identified racial and ethnic disparities in the reporting of health conditions and the use of discretionary health services. Disparities differed between those with behavioral conditions and those with physical conditions. These disparities were not explained by traditional measures including the presence of health conditions, health status, insurance, and family income, and suggest that national surveys such as Medical Expenditure Panel Survey may benefit from the inclusion of additional explanatory measures. PMID:16584463

Guevara, James P; Mandell, David S; Rostain, Anthony L; Zhao, Huaqing; Hadley, Trevor R

2006-01-01

256

Potential Therapeutic Competition in Community-Living Older Adults in the U.S.: Use of Medications That May Adversely Affect a Coexisting Condition  

PubMed Central

Objective The 75% of older adults with multiple chronic conditions are at risk of therapeutic competition (i.e. treatment for one condition may adversely affect a coexisting condition). The objective was to determine the prevalence of potential therapeutic competition in community-living older adults. Methods Cross-sectional descriptive study of a representative sample of 5,815 community-living adults 65 and older in the U.S, enrolled 2007–2009. The 14 most common chronic conditions treated with at least one medication were ascertained from Medicare claims. Medication classes recommended in national disease guidelines for these conditions and used by ?2% of participants were identified from in-person interviews conducted 2008–2010. Criteria for potential therapeutic competition included: 1), well-acknowledged adverse medication effect; 2) mention in disease guidelines; or 3) report in a systematic review or two studies published since 2000. Outcomes included prevalence of situations of potential therapeutic competition and frequency of use of the medication in individuals with and without the competing condition. Results Of 27 medication classes, 15 (55.5%) recommended for one study condition may adversely affect other study conditions. Among 91 possible pairs of study chronic conditions, 25 (27.5%) have at least one potential therapeutic competition. Among participants, 1,313 (22.6%) received at least one medication that may worsen a coexisting condition; 753 (13%) had multiple pairs of such competing conditions. For example, among 846 participants with hypertension and COPD, 16.2% used a nonselective beta-blocker. In only 6 of 37 cases (16.2%) of potential therapeutic competition were those with the competing condition less likely to receive the medication than those without the competing condition. Conclusions One fifth of older Americans receive medications that may adversely affect coexisting conditions. Determining clinical outcomes in these situations is a research and clinical priority. Effects on coexisting conditions should be considered when prescribing medications. PMID:24586786

Lorgunpai, Songprod Jonathan; Grammas, Marianthe; Lee, David S. H.; McAvay, Gail; Charpentier, Peter; Tinetti, Mary E.

2014-01-01

257

Effect of Providing Conditional Economic Compensation on Uptake of Voluntary Medical Male Circumcision in Kenya  

PubMed Central

IMPORTANCE Novel strategies are needed to increase the uptake of voluntary medical male circumcision (VMMC) in sub-Saharan Africa and enhance the effectiveness of male circumcision as an HIV prevention strategy. OBJECTIVE To determine whether small economic incentives could increase circumcision prevalence by addressing reported economic barriers to VMMC and behavioral factors such as present-biased decision making. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial conducted between June 22, 2013, and February 4, 2014, among 1504 uncircumcised men aged 25 to 49 years in Nyanza region, Kenya. VMMC services were provided free of charge and participants were randomized to 1 of 3 intervention groups or a control group. INTERVENTIONS Participants in the 3 intervention groups received varying amounts of compensation conditional on undergoing circumcision at 1 of 9 study clinics within 2 months of enrollment. Compensation took the form of food vouchers worth 200 Kenya shillings (?US $2.50), 700 Kenya shillings (?US $8.75), or 1200 Kenya shillings (?US $15.00), which reflected a portion of transportation costs and lost wages associated with getting circumcised. The control group received no compensation. MAIN OUTCOMES AND MEASURES VMMC uptake within 2 months. RESULTS Analysis of data for 1502 participants with complete data showed that VMMC uptake within 2 months was higher in the US $8.75 group (6.6%; 95% CI, 4.3%–9.5% [25 of 381]) and the US $15.00 group (9.0%; 95% CI, 6.3%–12.4% [34 of 377]) than in the US $2.50 group (1.9%; 95% CI, 0.8%–3.8% [7 of 374]) and the control group (1.6%; 95% CI, 0.6%–3.5% [6 of 370]). In logistic regression analysis, the US $8.75 group had significantly higher VMMC uptake than the control group (adjusted odds ratio [AOR] 4.3; 95% CI, 1.7–10.7), as did the US $15.00 group (AOR 6.2; 95% CI, 2.6–15.0). Effect sizes for the US $8.75 and US $15.00 groups did not differ significantly (P = .20). CONCLUSIONS AND RELEVANCE Among uncircumcised men in Kenya, compensation in the form of food vouchers worth approximately US $8.75 or US $15.00, compared with lesser or no compensation, resulted in a modest increase in the prevalence of circumcision after 2 months. The effects of more intense promotion or longer implementation require further investigation. PMID:25042290

Thirumurthy, Harsha; Masters, Samuel H.; Rao, Samwel; Bronson, Megan A.; Lanham, Michele; Omanga, Eunice; Evens, Emily; Agot, Kawango

2014-01-01

258

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

259

Six new examples of the bipartite trapezoid bone: Morphology, significant population variation, and an examination of pre-existing criteria to identify bipartition of individual carpal bones.  

PubMed

Carpal bone bipartition is a developmental variant resulting in the division of a normally singular carpal into two distinct segments. Cases involving the scaphoid are best known, though many other carpals can be affected, including the trapezoid. Six new examples of bipartite trapezoids, identified in African and Asian anatomical and archeological samples, are reported here and compared with the eight previously known. While the site of bipartition is consistent, the resulting segments exhibit variability in their articulations with neighboring carpals. Five of the six affected trapezoids were identified in African or African-derived samples, yielding a significantly higher frequency (0.323%) of bipartite trapezoid than seen in anatomical or archeological series of European origin. Bilateral bipartite trapezoids in archeological remains from the Mid Holocene site of Gobero (Niger) are potentially the oldest bipartite carpals yet identified in humans. Their discovery may indicate that trapezoid bipartition is a condition that has been present in African populations since prehistoric times, though more data are needed. Because bipartite carpals may be symptomatic and can occur as part of syndromes, the significant population variation in frequency identified here has potential utility in both anatomical and clinical contexts. However, a comparison of the morphological appearance of bipartite trapezoids with the suggested criteria for bipartite scaphoid diagnosis indicates that these criteria are not equally applicable to other carpals. Fortunately, due to the rarity of fracture, identification of the bipartite trapezoid and separating it from pathological conditions is considerably easier than diagnosing a bipartite scaphoid. PMID:25556074

Burnett, Scott E; Stojanowski, Christopher M; Mahakkanukrauh, Pasuk

2015-03-01

260

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

261

[Norwegian front fighters 1940-1945, 50 years later. Experiences, strains, medical and social conditions].  

PubMed

The author describes a medical and social investigation of 181 Norwegian war veterans who served on the Eastern Front during World War II. To ensure representativity, special emphasis is placed on 76 Norwegians in 1st Company, Regiment Norge, as listed in January 1944. They have been interviewed about hardships during war service in the civil war in Spain and until spring 1945, during captivity in Russia, in other Allied forces' camps and in Norwegian camps and prisons after the war. Their medical and social status from 1940 until today has been studied. The "front fighters" are a heavily strained group. This is best illustrated by their death rates during the war and in the first years after the war. However, as a group, they have more resources than the general population, and have done comparatively well since the war, in spite of physical and social handicaps. PMID:7770837

Stridsklev, I C

1995-04-30

262

The Association of Pre-Existing Left Atrial Fibrosis with Clinical Variables in Patients Referred for Catheter Ablation of Atrial Fibrillation  

PubMed Central

INTRODUCTION Atrial fibrillation (AF) recurrence after ablation is associated with left atrial (LA) fibrosis on late gadolinium enhanced (LGE) magnetic resonance imaging (MRI). We sought to determine pre-ablation, clinical characteristics that associate with the extent of LA fibrosis in patients undergoing catheter ablation for AF. METHODS AND RESULTS Consecutive patients presenting for catheter ablation of AF were enrolled and underwent LGE-MRI prior to initial AF ablation. The extent of fibrosis as a percentage of total LA myocardium was calculated in all patients prior to ablation. The cohort was divided into quartiles based on the percentage of fibrosis. Of 60 patients enrolled in the cohort, 13 had <5% fibrosis (Group 1), 15 had 5–7% fibrosis (Group 2), 17 had 8–13% fibrosis (Group 3), and 15 had 14–36% fibrosis (Group 4). The extent of LA fibrosis was positively associated with time in continuous AF, and the presence of persistent or longstanding persistent AF. However, no statistically significant difference was observed in the presence of comorbid conditions, age, BMI, LA volume, or family history of AF among the four groups. After adjusting for diabetes and hypertension in a multivariable linear regression model, paroxysmal AF remained independently and negatively associated with the extent of fibrosis (?4.0 ± 1.8, P = 0.034). CONCLUSION The extent of LA fibrosis in patients undergoing AF ablation is associated with AF type and time in continuous AF. Our results suggest that the presence and duration of AF are primary determinants of increased atrial LGE. PMID:25368540

Dewire, Jane; Khurram, Irfan M; Pashakhanloo, Farhad; Spragg, David; Marine, Joseph E; Berger, Ronald D; Ashikaga, Hiroshi; Rickard, John; Zimmerman, Stefan L; Zipunnikov, Vadim; Calkins, Hugh; Nazarian, Saman

2014-01-01

263

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

264

Identifying patients with chronic conditions using pharmacy data in Switzerland: an updated mapping approach to the classification of medications  

PubMed Central

Background Quantifying population health is important for public health policy. Since national disease registers recording clinical diagnoses are often not available, pharmacy data were frequently used to identify chronic conditions (CCs) in populations. However, most approaches mapping prescribed drugs to CCs are outdated and unambiguous. The aim of this study was to provide an improved and updated mapping approach to the classification of medications. Furthermore, we aimed to give an overview of the proportions of patients with CCs in Switzerland using this new mapping approach. Methods The database included medical and pharmacy claims data (2011) from patients aged 18 years or older. Based on prescription drug data and using the Anatomical Therapeutic Chemical (ATC) classification system, patients with CCs were identified by a medical expert review. Proportions of patients with CCs were calculated by sex and age groups. We constructed multiple logistic regression models to assess the association between patient characteristics and having a CC, as well as between risk factors (diabetes, hyperlipidemia) for cardiovascular diseases (CVD) and CVD as one of the most prevalent CCs. Results A total of 22 CCs were identified. In 2011, 62% of the 932?612 subjects enrolled have been prescribed a drug for the treatment of at least one CC. Rheumatologic conditions, CVD and pain were the most frequent CCs. 29% of the persons had CVD, 10% both CVD and hyperlipidemia, 4% CVD and diabetes, and 2% suffered from all of the three conditions. The regression model showed that diabetes and hyperlipidemia were strongly associated with CVD. Conclusions Using pharmacy claims data, we developed an updated and improved approach for a feasible and efficient measure of patients’ chronic disease status. Pharmacy drug data may be a valuable source for measuring population’s burden of disease, when clinical data are missing. This approach may contribute to health policy debates about health services sources and risk adjustment modelling. PMID:24172142

2013-01-01

265

Do(es) your child(ren) have any medical conditions, special needs or take any medication we need to be aware of? Street City State Zip  

E-print Network

consent for emergency diagnostic medical, dental, surgical procedures and hospitalization, and which not be available to authorize medical, dental, surgical care and/or hospitalization for my child while s

266

The following employee has a medical condition which is affecting their ability to work and may require assistance and/or information from the Wellness Resources.  

E-print Network

require assistance and/or information from the Wellness Resources. Employee has been made awareThe following employee has a medical condition which is affecting their ability to work and may of this referral. Yes Name: ___________________________________ Employee ID #: __________________________ Dept

Saskatchewan, University of

267

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

268

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

Microsoft Academic Search

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

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

1993-01-01

269

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

270

Measurement of Serum Melatonin in Intensive Care Unit Patients: Changes in Traumatic Brain Injury, Trauma, and Medical Conditions  

PubMed Central

Melatonin is an endogenous hormone mainly produced by the pineal gland whose dysfunction leads to abnormal sleeping patterns. Changes in melatonin have been reported in acute traumatic brain injury (TBI); however, the impact of environmental conditions typical of the intensive care unit (ICU) has not been assessed. The aim of this study was to compare daily melatonin production in three patient populations treated at the ICU to differentiate the role of TBI versus ICU conditions. Forty-five patients were recruited and divided into severe TBI, trauma without TBI, medical conditions without trauma, and compared to healthy volunteers. Serum melatonin levels were measured at four daily intervals at 0400?h, 1000?h, 1600?h, and 2200?h for 7?days post-ICU admission by commercial enzyme linked immunosorbent assay. The geometric mean concentrations (95% confidence intervals) of melatonin in these groups showed no difference being 8.3 (6.3–11.0), 9.3 (7.0–12.3), and 8.9 (6.6–11.9) pg/mL, respectively, in TBI, trauma, and intensive care cohorts. All of these patient groups demonstrated decreased melatonin concentrations when compared to control patients. This study suggests that TBI as well as ICU conditions, may have a role in the dysfunction of melatonin. Monitoring and possibly substituting melatonin acutely in these settings may assist in ameliorating long-term sleep dysfunction in all of these groups, and possibly contribute to reducing secondary brain injury in severe TBI. PMID:25477861

Seifman, Marc A.; Gomes, Keith; Nguyen, Phuong N.; Bailey, Michael; Rosenfeld, Jeffrey V.; Cooper, David J.; Morganti-Kossmann, Maria Cristina

2014-01-01

271

Pharmacological modulation of caspase-8 in thymus-related medical conditions.  

PubMed

The thymus is a lymphoid organ that governs the development of a diverse T-cell repertoire capable of defending against nonself-antigens and avoiding autoimmunity. However, the thymus can also succumb to different diseases. Hypertrophic diseases, such as thymomas, are typically associated with impairment of negative selection, which leads to autoimmune disease, or disruption of positive selection, which results in immunodeficiency. Hypotrophic diseases of the thymus can manifest during acute infections, cancer, allogeneic bone marrow transplantation, or with aging. This condition leads to decreased immune function and can be treated by either replacing lost thymic tissue or by preventing thymic tissue death. Studies have demonstrated the critical role of caspase-8 in regulating apoptosis in the thymus. In this review, we discuss how pharmacological activation and inhibition of caspase-8 can be used to treat hypertrophic and hypotrophic diseases of the thymus, respectively, to improve its function. PMID:25060674

Pozzesi, Nicola; Fierabracci, Alessandra; Thuy, Trinh Thy; Martelli, Maria Paola; Liberati, Anna Marina; Ayroldi, Emira; Riccardi, Carlo; Delfino, Domenico V

2014-10-01

272

Special Medical Conditions Associated with Catatonia in the Internal Medicine Setting: Hyponatremia-Inducing Psychosis and Subsequent Catatonia  

PubMed Central

Diagnosis and treatment of catatonia in the psychiatry consultation service is not infrequent. Usually, the patient either presents to the Emergency Department or develops catatonia on the medical floor. This condition manifests with significant behavioral changes (from mildly decreased speech output to complete mutism) that interfere with the ability to communicate. After structural brain disorders are excluded, one of the diagnoses that always should be considered is catatonia. However, the causes of catatonia are numerous, ranging from psychiatric causes to a plethora of medical illnesses. Therefore, it is not surprising that there are many proposed underlying mechanisms of catatonia and that controversy persists about the etiology of specific cases. There are only 6 reports of hyponatremia-induced catatonia and psychosis in the literature. Here, we present the case of a 30-year-old woman with catatonia and psychosis induced by hyponatremia, and we use this report to exemplify the multitude of biologic causes of catatonia and to propose a new way to look at the neuroanatomical basis of processing, particularly the vertical processing systems we believe are involved in catatonia. PMID:25102520

Novac, Andrei A; Bota, Daniela; Witkowski, Joanne; Lipiz, Jorge; Bota, Robert G

2014-01-01

273

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.

274

Mothers of Children Diagnosed With Attention-Deficit\\/Hyperactivity Disorder: Health Conditions and Medical Care Utilization in Periods Before and After Birth of the Child  

Microsoft Academic Search

Background: Analyzing health conditions and medical utilization of mothers of children with attention-deficit\\/hyperactivity disorder (ADHD) can shed light on biologic, environmental, and psychoso- cial factors relating to ADHD. Objective: To examine health conditions, health care utilization, and costs of mothers of children with ADHD in periods before the child was diagnosed. Methods: Using automated data from Northern California Kaiser Permanente

G. Thomas Ray; Lisa A. Croen; Laurel A. Habel

2009-01-01

275

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

276

Conditionals  

E-print Network

This article introduces the classic accounts of the meaning of conditionals (material implication, strict implication, variably strict conditional) and discusses the difference between indicative and subjunctive/counterfactual ...

von Fintel, Kai

2011-01-01

277

Identifying relationships between drugs and medical conditions: winning experience in the Challenge 2 of the OMOP 2010 Cup  

E-print Network

There is a growing interest in using a longitudinal observational databases to detect drug safety signal. In this paper we present a novel method, which we used online during the OMOP Cup. We consider homogeneous ensembling, which is based on random re-sampling (known, also, as bagging) as a main innovation compared to the previous publications in the related field. This study is based on a very large simulated database of the 10 million patients records, which was created by the Observational Medical Outcomes Partnership (OMOP). Compared to the traditional classification problem, the given data are unlabelled. The objective of this study is to discover hidden associations between drugs and conditions. The main idea of the approach, which we used during the OMOP Cup is to compare the numbers of observed and expected patterns. This comparison may be organised in several different ways, and the outcomes (base learners) may be quite different as well. It is proposed to construct the final decision function as an...

Nikulin, Vladimir

2011-01-01

278

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

Code of Federal Regulations, 2014 CFR

...rehabilitation potential, functional limitations, activities permitted, nutritional requirements, medications and treatments, any safety measures to protect against injury, instructions for timely discharge or referral, and any...

2014-10-01

279

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

PubMed

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

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

2011-01-01

280

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. PMID:21949429

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

2011-01-01

281

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

282

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.

283

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 PMID:23772344

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

2013-01-01

284

Medical Transcriptionists: Making Medical Histories.  

ERIC Educational Resources Information Center

Medical transcriptionists are experts in the language of medicine. Describes what they do and what their working conditions, earnings, employment prospects, and training requirements are. Includes sources of additional information. (Author)

Shniper, Lynn

2001-01-01

285

Supporting medical students with mental  

E-print Network

-to-moderate mental health conditions 23­24 15 Severe mental illnesses 25 16 Eating disorders 26­27 17 SubstanceSupporting medical students with mental health conditions #12;02 | General Medical Council Contents Supporting medical students with mental health conditions #12;General Medical Council | 01 Supporting medical

Heinke, Dietmar

286

Do differences in methods for constructing SF36 physical and mental health summary measures change their associations with chronic medical conditions and utilization?  

Microsoft Academic Search

Background and objective: Various approaches have been employed to derive physical health and mental health summary scores for the SF-36 and the RAND-36, but head-to-head comparisons of alternative scoring algorithms are rare. We determined whether the associations of the physical and mental health summary scores with chronic medical conditions and utilization would differ depending on the scoring algorithm used. Methods:

William E. Cunningham; Terry T. Nakazono; Kai Li Tsai; Ron D. Hays

2003-01-01

287

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

Microsoft Academic Search

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

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

2006-01-01

288

Parent & Educators' Drug Reference: A Guide to Common Medical Conditions & Drugs Used in School-Aged Children.  

ERIC Educational Resources Information Center

This book provides a guide to more than 180 drugs used for children. An introduction precedes the four major sections of the guide. Section 1 provides an overview of pharmacology and therapeutics in chapters on the basics of pharmacology, the language of pharmacology and therapeutics, compliance, side effects, medications in school, and drug…

Agins, Alan P.

289

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.

290

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. PMID:24829727

Assari, Shervin

2014-01-01

291

Chronic Condition Combinations and Health Care Expenditures and Out-of-Pocket Spending Burden Among Adults, Medical Expenditure Panel Survey, 2009 and 2011  

PubMed Central

Introduction Little is known about how combinations of chronic conditions in adults affect total health care expenditures. Our objective was to estimate the annual average total expenditures and out-of-pocket spending burden among US adults by combinations of conditions. Methods We conducted a cross-sectional study using 2009 and 2011 data from the Medical Expenditure Panel Survey. The sample consisted of 9,296 adults aged 21 years or older with at least 2 of the following 4 highly prevalent chronic conditions: arthritis, diabetes mellitus, heart disease, and hypertension. Unadjusted and adjusted regression techniques were used to examine the association between chronic condition combinations and log-transformed total expenditures. Logistic regressions were used to analyze the relationship between chronic condition combinations and high out-of-pocket spending burden. Results Among adults with chronic conditions, adults with all 4 conditions had the highest average total expenditures ($20,016), whereas adults with diabetes/hypertension had the lowest annual total expenditures ($7,116). In adjusted models, adults with diabetes/hypertension and hypertension/arthritis had lower health care expenditures than adults with diabetes/heart disease (P < .001). In adjusted models, adults with all 4 conditions had higher expenditures compared with those with diabetes and heart disease. However, the difference was only marginally significant (P = .04). Conclusion Among adults with arthritis, diabetes, heart disease, and hypertension, total health care expenditures differed by type of chronic condition combinations. For individuals with multiple chronic conditions, such as heart disease and diabetes, new models of care management are needed to reduce the cost burden on the payers. PMID:25633487

Raval, Amit D.; Sambamoorthi, Usha

2015-01-01

292

The use of a frailty index to predict adverse health outcomes (falls, fractures, hospitalization, medication use, comorbid conditions) in people with intellectual disabilities.  

PubMed

Frailty in older people can be seen as the increased likelihood of future negative health outcomes. Lifelong disabilities in people with intellectual disabilities (ID) may not only influence their frailty status but also the consequences. Here, we report the relation between frailty and adverse health outcomes in older people with ID (50 years and over). In a prospective population based study, frailty was measured at baseline with a frailty index in 982 older adults with ID (?50 yr). Information on negative health outcomes (falls, fractures, hospitalization, increased medication use, and comorbid conditions) was collected at baseline and after a three-year follow-up period. Odds ratios or regression coefficients for negative health outcomes were estimated with the frailty index, adjusted for gender, age, level of ID, Down syndrome and baseline adverse health condition. The frailty index was related to an increased risk of higher medication use and several comorbid conditions, but not to falls, fractures and hospitalization. Frailty at baseline was related to negative health outcomes three years later in older people with ID, but to a lesser extent than found in the general population. PMID:25576875

Schoufour, Josje D; Echteld, Michael A; Bastiaanse, Luc P; Evenhuis, Heleen M

2015-03-01

293

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. PMID:23580018

Sterling, Stacy; Chi, Felicia; Hinman, Agatha

2011-01-01

294

California emergency department visit rates for medical conditions increased while visit rates for injuries fell, 2005-11.  

PubMed

The emergency department (ED) is the source of most hospital admissions; provides care for patients with no other point of access to the health care system; receives advanced care referrals from primary care physicians; and provides surveillance data on injuries, infectious diseases, violence, and adverse drug events. Understanding the changes in the profile of disease in the ED can inform emergency services administration and planning and can provide insight into the public's health. We analyzed the trends in the diagnoses seen in California EDs from 2005 to 2011, finding that while the ED visit rate for injuries decreased by 0.7 percent, the rate of ED visits for noninjury diagnoses rose 13.4 percent. We also found a rise in symptom-related diagnoses, such as abdominal pain, along with nervous system disorders, gastrointestinal disease, and mental illness. These trends point out the increasing importance of EDs in providing care for complex medical cases, as well as the changing nature of illness in the population needing immediate medical attention. PMID:25847645

Hsia, Renee Y; Nath, Julia B; Baker, Laurence C

2015-04-01

295

A cross-sectional assessment of the prevalence of multiple chronic conditions and medication use in a sample of community-dwelling adults with fibromyalgia in Olmsted County, Minnesota  

PubMed Central

Objectives The objective of this study was to evaluate the problem of multiple chronic conditions and polypharmacy in patients with fibromyalgia. Design Retrospective medical record review. Setting Olmsted County, Minnesota. Participants 1111 adults with fibromyalgia. Primary and secondary outcome measures Number and type of chronic medical and psychiatric conditions, medication use. Results Medical record review demonstrated that greater than 50% of the sample had seven or more chronic conditions. Chronic joint pain/degenerative arthritis was the most frequent comorbidity (88.7%), followed by depression (75.1%), migraines/chronic headaches (62.4%) and anxiety (56.5%). Approximately, 40% of patients were taking three or more medications for symptoms of fibromyalgia. Sleep aids were the most commonly prescribed medications in our sample (33.3%) followed by selective serotonin reuptake inhibitors (28.7%), opioids (22.4%) and serotonin norepinephrine reuptake inhibitors (21.0%). Conclusions The results of our study highlight the problem of multiple chronic conditions and high prevalence of polypharmacy in fibromyalgia. Clinicians who care for patients with fibromyalgia should take into consideration the presence of multiple chronic conditions when recommending medications. PMID:25735301

Vincent, Ann; Whipple, Mary O; McAllister, Samantha J; Aleman, Katherine M; St Sauver, Jennifer L

2015-01-01

296

Quality in health care. Medical or managerial?  

PubMed

Explores the notion that the introduction of total quality management (TQM) in the public health-care sector indicates a conceptual break with a tradition in which the authority to define and interpret the meaning of medical practice has been located solely within the medical profession. It also serves to shift the focus of medical practice away from its contextual and interactional character towards numerical representations and codification in monetary terms. Further, it is argued that the realization of management ideals in everyday practice is dependent more on the availability of pre-existing technologies and standard procedures than on the ingenuity of particular organizational and institutional actors. These arguments are illustrated with the reutilization for TQM purposes of "local incident reports" in a Swedish hospital organization. PMID:11200301

Hansson, J

2000-01-01

297

Sociodemographic characteristics and chronic medical conditions as risk factors for herpes zoster: a population-based study from primary care in Madrid (Spain).  

PubMed

The objectives of this study were to estimate incidence density rates (IDR) of herpes zoster (HZ) and to analyze the association with sociodemographic characteristics and selected chronic medical conditions. The study cohort consisted of the adult population included in the Public Health System of the Autonomous Community of Madrid, Spain on 1/10/2009 (5?244?402 persons). Data source were electronic medical records from primary care between 1/10/2009-31/12/2012. Individual socioeconomic status (SES) was inferred by geocoding. Poisson regression analyses were stratified by sex, to identify factors associated with HZ. We identified 81?541 incident cases of HZ (61.7% in women and 46.5% in the group aged 60 and over). IDR was 4.11 per 1000 person-years in men and 5.95 in women. IDR were higher with age, in autochthonous population, those with lower SES and in patients with immunodeficiencies. After adjustment, higher incidence rate ratios were found with age, autochthonous origin, lower SES, and in patients with HIV-infection/AIDS (3.20, CI95% 2.90-3.53 in men and 2.98, CI95% 2.58-3.45 in women), and other immunodeficiencies (1.57, CI95% 1.41-1.75 and 1.65, CI95% 1.50-1.80). COPD, asthma, DM, ischemic heart disease, other cardiovascular diseases, and cancer were also associated with an increased incidence of HZ. We conclude that older, autochthonous patients with lower SES and with certain underlying medical conditions had a higher probability of suffering HZ. Electronic databases are useful for estimating the incidence of HZ, and for finding associations with sociodemographic and clinical characteristics. Identifying unrecognized risk factors for HZ, such as asthma or cardiovascular diseases, is crucial to interpret the epidemiology of HZ, to target vaccination programs and to monitor their effect. PMID:24805130

Esteban-Vasallo, María D; Domínguez-Berjón, M Felicitas; Gil-Prieto, Ruth; Astray-Mochales, Jenaro; Gil de Miguel, Angel

2014-01-01

298

Comparison of spiritual well-being and coping strategies of patients with generalized anxiety disorder and with minor general medical conditions.  

PubMed

The purpose of the present study was to compare the spiritual well-being and coping strategies of patients with generalized anxiety disorder (GAD) and those with general medical conditions (GMC). The sample was comprised of 40 participants with GAD fulfilling the diagnostic criteria of DSM IV-TR and 50 participants with GMC. The descriptive statistics, correlation analysis and independent sample t test were used for data analysis. The results revealed the significant negative correlation of spiritual wellness with GAD symptoms and positive correlation between spiritual wellness, active practical and religious-focused coping strategies. The independent sample t test showed that spiritual wellness of participants with GMC was higher than participants with GAD. Moreover, out of 13 dimensions of spiritual wellness inventory, the scores of participants with minor general medical conditions in the dimensions of conception of divinity, present centeredness, hope, forgiveness, conscientiousness and spiritual freedom remained significantly higher than those with GAD. The participants with GMC used more active practical coping strategies and religious-focused coping strategies than participants with GAD. There was no difference between two groups of participants in using active distracting coping strategies, while avoidance-focused coping strategies were used by participants with GAD more than those with GMC. PMID:24535043

Amjad, Faiza; Bokharey, Iram Zehra

2015-04-01

299

Medical Device Safety  

MedlinePLUS

A medical device is any product used to diagnose, cure, or treat a condition, or to prevent disease. They range ... may need one in a hospital. To use medical devices safely Know how your device works. Keep instructions ...

300

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

301

Diagnosis and treatment of cancer in medical textbooks of ancient Iran  

PubMed Central

Research shows that ancient Iranians were among the pioneers of medical science, and are therefore admired and praised by non-Iranian scholars for their efforts and accomplishments in this field. Investigations of medical and historical texts indicate that between the 10th and the 18th century A.D., ancient Iran experienced a golden age of medicine. Great physicians such as Rhazes, al-Ahwazi, Avicenna and others reviewed the medical textbooks of civilizations such as Greece and India, Theories were scientifically criticized, superstitious beliefs were discarded, valuable innovations were added to pre-existing knowledge and the ultimate achievements were compiled as precious textbooks. Alhawi by Rhazes, Cannon by Avicenna, and Kamil al-Sina’ah by al-Ahwazi are among the works that were treasured by domestic and foreign scientists alike, as well as future generations who continued to appreciate them for centuries. The above-mentioned textbooks discuss diseases and conditions related to neurosurgery, ophthalmology, ear, nose and throat, gastroenterology, urology, skeletomuscular system and other specialties, as well as cancer and similar subjects. One of the richest texts on the description, diagnosis, differential diagnosis, and prognosis of cancer and therapeutic approaches is Alhawi by Mohammad ibn Zakarya al Razi (Rhazes). This article presents a brief summary of Rhazes’ views about the definition of cancer, types, signs and symptoms, prevalence, complications, medical care, treatment and even surgical indications and contraindications. Moreover, his opinions are compared against the views of other physicians and theories of modern medicine. It is also recommended to review the medical heritage of Iran and evaluate the proposed treatments based on modern methodologies and scientific approaches. PMID:25512835

Tabatabaei, Seyed Mahmoud; Ali Tabatabaei, Seyed Mohammad

2014-01-01

302

Impact of cardiovascular risk factors and medication use on the efficacy of remote ischaemic conditioning: post hoc subgroup analysis of a randomised controlled trial  

PubMed Central

Objectives Remote ischaemic conditioning (RIC) promotes cardioprotection in patients undergoing primary percutaneous coronary intervention (pPCI) for ST-elevation myocardial infarction (STEMI). The effect of RIC may be modified by cardiovascular risk factors and their medications. We examined whether cardiovascular risk factors, lipid and glucose levels, and medication use influenced the efficacy of RIC in patients with STEMI treated with pPCI. Design Post hoc subgroup analysis of a single-centre randomised controlled trial. Participants A total of 139 patients with STEMI, randomised during ambulance transport to hospital for pPCI with (n=71) or without (n=68) RIC, met the trial criteria and achieved data for a myocardial salvage index (MSI). Interventions RIC was administered through intermittent arm ischaemia with four cycles of 5?min inflation and 5?min deflation of a blood pressure cuff. Primary outcome measures MSI, estimated by single-photon emission CT. We evaluated the efficacy of RIC on the MSI in patient subgroups of cardiovascular risk factors, lipid and glucose levels, and medication use. Results We found no significant difference in the efficacy of RIC in subgroups of cardiovascular risk factors, lipid and glucose levels, and medication use. However, point estimates indicated a reduced effect of RIC among smokers (median difference in MSI between RIC and control groups: ?0.02 (95% CI ?0.32 to 0.28) in smokers vs 0.25 (95% CI 0.08 to 0.42) in non-smokers, p value for interaction=0.13) and an increased effect of RIC in statin users (median difference in MSI between RIC and control groups: 0.34 (95% CI 0.03 to 0.65) in statin users vs 0.09 (95% CI ?0.11 to 0.29) in non-statin users, p value for interaction=0.19). Conclusions RIC as an adjunct to pPCI seems to improve MSI in our trial population of patients with STEMI regardless of most cardiovascular risk factors and their medications. Our post hoc finding on a limited sample size calls for further investigation in large-scale multicentre trials. Trial registration number NCT00435266. PMID:25838505

Sloth, Astrid Drivsholm; Schmidt, Michael Rahbek; Munk, Kim; Schmidt, Morten; Pedersen, Lars; Toft Sřrensen, Henrik; Břtker, Hans Erik; Břttcher, M

2015-01-01

303

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

304

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

PubMed

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?conditions on ER visits by 4% per 1,000 MWh (P?conditioning. PMID:21267601

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

2012-01-01

305

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. PMID:21485748

Cizza, Giovanni

2011-01-01

306

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. PMID:23606978

Al-Dharrab, Ayman A.; Tayel, Seham B.; Abodaya, Mona H.

2013-01-01

307

Diurnal and twenty-four hour patterning of human diseases: acute and chronic common and uncommon medical conditions.  

PubMed

The symptom intensity and mortality of human diseases, conditions, and syndromes exhibit diurnal or 24 h patterning, e.g., skin: atopic dermatitis, urticaria, psoriasis, and palmar hyperhidrosis; gastrointestinal: esophageal reflux, peptic ulcer (including perforation and hemorrhage), cyclic vomiting syndrome, biliary colic, hepatic variceal hemorrhage, and proctalgia fugax; infection: susceptibility, fever, and mortality; neural: frontal, parietal, temporal, and occipital lobe seizures, Parkinson's and Alzheimer's disease, hereditary progressive dystonia, and pain (cancer, post-surgical, diabetic neuropathic and foot ulcer, tooth caries, burning mouth and temporomandibular syndromes, fibromyalgia, sciatica, intervertebral vacuum phenomenon, multiple sclerosis muscle spasm, and migraine, tension, cluster, hypnic, and paroxysmal hemicranial headache); renal: colic and nocturnal enuresis and polyuria; ocular: bulbar conjunctival redness, keratoconjunctivitis sicca, intraocular pressure and anterior ischemic optic neuropathy, and recurrent corneal erosion syndrome; psychiatric/behavioral: major and seasonal affective depressive disorders, bipolar disorder, parasuicide and suicide, dementia-associated agitation, and addictive alcohol, tobacco, and heroin cravings and withdrawal phenomena; plus autoimmune and musculoskeletal: rheumatoid arthritis, osteoarthritis, axial spondylarthritis, gout, Sjögren's syndrome, and systemic lupus erythematosus. Knowledge of these and other 24 h patterns of human pathophysiology informs research of their underlying circadian and other endogenous mechanisms, external temporal triggers, and more effective patient care entailing clinical chronopreventive and chronotherapeutic strategies. PMID:25129839

Smolensky, Michael H; Portaluppi, Francesco; Manfredini, Roberto; Hermida, Ramon C; Tiseo, Ruana; Sackett-Lundeen, Linda L; L Haus, Erhard

2014-07-18

308

Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation  

PubMed Central

Background The pediatric complex chronic conditions (CCC) classification system, developed in 2000, requires revision to accommodate the International Classification of Disease 10th Revision (ICD-10). To update the CCC classification system, we incorporated ICD-9 diagnostic codes that had been either omitted or incorrectly specified in the original system, and then translated between ICD-9 and ICD-10 using General Equivalence Mappings (GEMs). We further reviewed all codes in the ICD-9 and ICD-10 systems to include both diagnostic and procedural codes indicative of technology dependence or organ transplantation. We applied the provisional CCC version 2 (v2) system to death certificate information and 2 databases of health utilization, reviewed the resulting CCC classifications, and corrected any misclassifications. Finally, we evaluated performance of the CCC v2 system by assessing: 1) the stability of the system between ICD-9 and ICD-10 codes using data which included both ICD-9 codes and ICD-10 codes; 2) the year-to-year stability before and after ICD-10 implementation; and 3) the proportions of patients classified as having a CCC in both the v1 and v2 systems. Results The CCC v2 classification system consists of diagnostic and procedural codes that incorporate a new neonatal CCC category as well as domains of complexity arising from technology dependence or organ transplantation. CCC v2 demonstrated close comparability between ICD-9 and ICD-10 and did not detect significant discontinuity in temporal trends of death in the United States. Compared to the original system, CCC v2 resulted in a 1.0% absolute (10% relative) increase in the number of patients identified as having a CCC in national hospitalization dataset, and a 0.4% absolute (24% relative) increase in a national emergency department dataset. Conclusions The updated CCC v2 system is comprehensive and multidimensional, and provides a necessary update to accommodate widespread implementation of ICD-10. PMID:25102958

2014-01-01

309

Increased IgG4 responses to multiple food and animal antigens indicate a polyclonal expansion and differentiation of pre-existing B cells in IgG4-related disease  

PubMed Central

Background IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory condition, characterised by an elevated serum IgG4 concentration and abundant IgG4-positive plasma cells in the involved organs. An important question is whether the elevated IgG4 response is causal or a reflection of immune-regulatory mechanisms of the disease. Objectives To investigate if the IgG4 response in IgG4-RD represents a generalised polyclonal amplification by examining the response to common environmental antigens. Methods Serum from 24 patients with IgG4-RD (14 treatment-naive, 10 treatment-experienced), 9 patients with primary sclerosing cholangitis and an elevated serum IgG4 (PSC-high IgG4), and 18 healthy controls were tested against egg white and yolk, milk, banana, cat, peanut, rice and wheat antigens by radioimmunoassay. Results We demonstrated an elevated polyclonal IgG4 response to multiple antigens in patients with IgG4-RD and in PSC-high IgG4, compared with healthy controls. There was a strong correlation between serum IgG4 and antigen-specific responses. Responses to antigens were higher in treatment-naive compared with treatment-experienced patients with IgG4-RD. Serum electrophoresis and immunofixation demonstrated polyclonality. Conclusions This is the first study to show enhanced levels of polyclonal IgG4 to multiple antigens in IgG4-RD. This supports that elevated IgG4 levels reflect an aberrant immunological regulation of the overall IgG4 response, but does not exclude that causality of disease could be antigen-driven. PMID:25646372

Culver, Emma L; Vermeulen, Ellen; Makuch, Mateusz; van Leeuwen, Astrid; Sadler, Ross; Cargill, Tamsin; Klenerman, Paul; Aalberse, Rob C; van Ham, S Marieke; Barnes, Eleanor; Rispens, Theo

2015-01-01

310

[Forward medical air evacuation].  

PubMed

The medical chain which assures the treatment of casualties from the theatre of operations back to France comprises several links connected by medical air transport. Whether it is tactical or strategic, it forms an integral part of the treatment pathway and offers casualties the best possible conditions for medical treatment with a high degree of safety, speed and traceability. PMID:25464630

Czerniak, Erik; Le Dorze, Patrick Causse; Hersan, Olivier; Pohl, Jean-Baptiste; Angot, Emmanuel

2014-09-01

311

Myasthenia Gravis Medication Information Card (Drugs to be Avoided or Used with Caution in Myasthenia Gravis)  

MedlinePLUS

... Medical Conditions: ____________________________ ____________________________ ____________________________ Current Medications: ____________________________ ____________________________ ____________________________ MYASTHENIA GRAVIS MEDICATION INFORMATION CARD Drugs to be Avoided or Used with Caution ...

312

Please complete your claim details and send by fax to 1300 365 848, email to corporateclaims@hba.com.au or mail in a stamped envelope to Customer Administration GPO Box 990 Adelaide SA 5001.  

E-print Network

Given name and initial of patient Date of birth Date of service Medical symptoms you wish to claim that you are claiming for a pre-existing condition. Preferred payment I would like this benefit to be paid;Visitors cover ­ medical certificate Please complete if claiming for a pre-existing medical condition

313

Acute behavioral crises in psychiatric inpatients with autism spectrum disorder (ASD): Recognition of concomitant medical or non-ASD psychiatric conditions predicts enhanced improvement.  

PubMed

During adolescence, some individuals with autism spectrum disorder (ASD) engage in severe challenging behaviors, such as aggression, self-injury, disruption, agitation and tantrums. We aimed to assess risk factors associated with very acute behavioral crises in adolescents with ASD admitted to a dedicated neurobehavioral unit. We included retrospectively in 2008 and 2009 29 adolescents and young adults with ASD hospitalized for severe challenging behaviors and proposed a guideline (Perisse et al., 2010) that we applied prospectively for 29 patients recruited for the same indications between 2010 and 2012. In total, 58 patients were admitted (n=70 hospitalizations, mean age=15.66 (±4.07) years, 76% male). We systematically collected data describing socio-demographic characteristics, clinical variables (severity, presence of language, cognitive level), comorbid organic conditions, etiologic diagnosis of the episode, and treatments. We explored predictors of Global Assessment Functioning Scale (GAFS) score and duration of hospitalization at discharge. All but 2 patients exhibited severe autistic symptoms and intellectual disability (ID), and two-thirds had no functional verbal language. During the inpatient stay (mean=84.3 (±94.9) days), patients doubled on average their GAFS scores (mean=17.66 (±9.05) at admission vs. mean=31.4 (±9.48) at discharge). Most common etiologies for acute behavioral crises were organic causes [n=20 (28%), including epilepsy: n=10 (14%) and painful medical conditions: n=10 (14%)], environmental causes [n=17 (25%) including lack of treatment: n=11 (16%) and adjustment disorder: n=6 (9%)], and non-ASD psychiatric condition [n=33 (48%) including catatonia: n=5 (7%), major depressive episode: n=6 (9%), bipolar disorder: n=4 (6%), schizophrenia: n=6 (9%), other/unknown diagnosis: n=12 (17%)]. We found no influence of age, gender, socio-economic status, migration, level of ID, or history of seizure on improvement of GAFS score at discharge. Severity of autism at admission was the only negative predictor (p<.001). Painful medical conditions (p=.04), non-ASD psychiatric diagnoses (p=.001), prior usage of specialized ASD care programs (p=.004), functional language (p=.007), as well as a higher number of challenging behaviors upon admission (p=.001) were associated with higher GAFS scores at discharge. Clinical severity at admission, based on the number of challenging behaviors (r=.35, p=.003) and GAFS score (r=-.32, p=.008) was correlated with a longer inpatient stay. Longer hospitalization was however correlated (r=.27, p=.03) with higher GAFS score at discharge even after adjustment for confounding factors. Challenging behaviors among adolescents with ASD may stem from diverse risk factors, including environmental problems, comorbid acute psychiatric conditions, or somatic illness such as epilepsy or acute pain. The management of these behavioral challenges requires a unified, multidisciplinary approach. PMID:25575287

Guinchat, Vincent; Cravero, Cora; Diaz, Lautaro; Périsse, Didier; Xavier, Jean; Amiet, Claire; Gourfinkel-An, Isabelle; Bodeau, Nicolas; Wachtel, Lee; Cohen, David; Consoli, Angčle

2015-03-01

314

Action Rules Discovery without Pre-existing Classification Rules  

Microsoft Academic Search

Action rules describe possible transitions of objects from one state to another with respect to a distinguished attribute.\\u000a Previous research on action rule discovery usually requires the extraction of classification rules before constructing any\\u000a action rule. In this paper, we present a new algorithm that discovers action rules directly from a decision system. It is\\u000a a bottom-up strategy which has

Zbigniew W. Ras; Agnieszka Dardzinska

2008-01-01

315

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

316

Pre-existing brain states predict risky choices.  

PubMed

Rational decision-making models assume that people resolve an economic problem based on its properties and the underlying utility. Here we challenge this view by examining whether pre-stimulus endogenous neuronal fluctuations can bias economic decisions. We recorded subjects' pre-stimulus neural activation patterns with fMRI before presentation and choice between pairs of certain outcomes and risky gambles. Our results indicate that activities in the left nucleus accumbens and medial frontal gyrus can bias subsequent risky decision making, showing that neuronal activities in regions associated with uncertainty and reward processing are involved in biasing subsequent choice selection. This finding challenges theories which propose that choices merely reveal stable underlying distributions of hedonic utility. Endogenous brain states of this sort might originate from a systematic cause or a stochastic type of neural noise, which can be construed as contextual factors that shape people's decision making. PMID:25067816

Huang, Yu-Feng; Soon, Chun Siong; Mullette-Gillman, O'Dhaniel A; Hsieh, Po-Jang

2014-11-01

317

DOD MEDICAL EXAMINATION REVIEW BOARD (DODMERB) REPORT OF MEDICAL HISTORY  

E-print Network

. Any mental condition or illness 24. Frequent trouble sleeping 25. Hearing loss 26. Ear, noseDOD MEDICAL EXAMINATION REVIEW BOARD (DODMERB) REPORT OF MEDICAL HISTORY (This information ability. Be perfectly honest! Your medical records may be requested to clarify your medical history. 7

Maxwell, Bruce D.

318

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

319

ACCURATE 3D LOCATION OF MINE INDUCED SEISMICITY IN COMPLEX NEAR-FIELD UNDERGROUND CONDITIONS  

E-print Network

ACCURATE 3D LOCATION OF MINE INDUCED SEISMICITY IN COMPLEX NEAR-FIELD UNDERGROUND CONDITIONS S resolution microseismic networks in the vicinity of hazardous mining fronts, and completing a pre- existing mine scale seismic network, is supposed to help detecting much smaller events and processing seismic

Paris-Sud XI, Université de

320

Medication errors in children.  

PubMed

Medication errors commonly involve children, with dosing errors being the most common. Medication errors are more frequent among the most sick patients who have urgent and complex medical conditions. Physicians who are less experienced, tired, depressed, and burnt out make more errors. The systems approach views every medical error as a system failure. The focus is on how to change the system in order to prevent errors. Adopting the systems approach will enhance patients' safety. Strategies that have been found to be effective in reducing medication errors include the use of computerized physician order entry systems, pre-printed order forms, color-coded systems, and involving pharmacists in clinical care. PMID:19127955

Kozer, Eran

2009-01-01

321

Therapeutic Antioxidant Medical Gas  

PubMed Central

Medical gases are pharmaceutical gaseous molecules which offer solutions to medical needs and include traditional gases, such as oxygen and nitrous oxide, as well as gases with recently discovered roles as biological messenger molecules, such as carbon monoxide, nitric oxide and hydrogen sulphide. Medical gas therapy is a relatively unexplored field of medicine; however, a recent increasing in the number of publications on medical gas therapies clearly indicate that there are significant opportunities for use of gases as therapeutic tools for a variety of disease conditions. In this article, we review the recent advances in research on medical gases with antioxidant properties and discuss their clinical applications and therapeutic properties. PMID:19177183

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

2009-01-01

322

Family and Medical Leave Act  

MedlinePLUS

... CARING FOR A CHILD: FAMILY & MEDICAL LEAVE ACT If your child's heart condition is serious and ... in the hospital, the Family and Medical Leave Act of 1993 requires that covered employers provide up ...

323

Medical Assistants  

MedlinePLUS

... clinical work. Administrative medical assistants often fill out insurance forms or code patients’ medical information. They often ... may update a patient’s medical file, fill out insurance forms, and answer telephone calls in a practitioner’s ...

324

Alcohol-medical drug interactions.  

PubMed

Concomitant use of alcohol and medications may lead to potentially serious medical conditions. Increasing prescription medication abuse in today's society necessitates a deeper understanding of the mechanisms involved in alcohol-medication interactions in order to help prevent adverse events. Interactions of medications with alcohol result in altered bioavailability of the medication or alcohol (pharmacokinetic interactions) or modification of the effects at receptor or ion channel sites to alter behavioral or physical outcome (pharmacodynamic interactions). The nature of pharmacokinetic or pharmacodynamic interactions involved in alcohol-medication interactions may differ between acute and chronic alcohol use and be influenced by race, gender, or environmental or genetic factors. This review focuses on the mechanisms underlying pharmacokinetic and pharmacodynamic interactions between alcohol and medications and provides examples for such interactions from replicated research studies. In conclusion, further translational research is needed to address several gaps in our current knowledge of alcohol-medication interactions, including those under various pathologic conditions. PMID:25307595

Johnson, Bankole A; Seneviratne, Chamindi

2014-01-01

325

49 CFR 40.265 - What happens when an employee is unable to provide a sufficient amount of breath for an alcohol...  

Code of Federal Regulations, 2013 CFR

...and (B) of this section, a medical condition includes an ascertainable physiological condition (e.g., a respiratory system dysfunction) or a medically documented pre-existing psychological disorder, but does not include unsupported...

2013-10-01

326

49 CFR 40.265 - What happens when an employee is unable to provide a sufficient amount of breath for an alcohol...  

Code of Federal Regulations, 2012 CFR

...and (B) of this section, a medical condition includes an ascertainable physiological condition (e.g., a respiratory system dysfunction) or a medically documented pre-existing psychological disorder, but does not include unsupported...

2012-10-01

327

49 CFR 40.265 - What happens when an employee is unable to provide a sufficient amount of breath for an alcohol...  

Code of Federal Regulations, 2011 CFR

...and (B) of this section, a medical condition includes an ascertainable physiological condition (e.g., a respiratory system dysfunction) or a medically documented pre-existing psychological disorder, but does not include unsupported...

2011-10-01

328

49 CFR 40.265 - What happens when an employee is unable to provide a sufficient amount of breath for an alcohol...  

Code of Federal Regulations, 2014 CFR

...and (B) of this section, a medical condition includes an ascertainable physiological condition (e.g., a respiratory system dysfunction) or a medically documented pre-existing psychological disorder, but does not include unsupported...

2014-10-01

329

Medication-induced osteoporosis  

Microsoft Academic Search

Osteoporosis, a condition of low bone mass and microarchitectural deterioration, results in fractures with minimal trauma.\\u000a Secondary osteoporosis is defined as bone loss resulting from either specific clinical disorders or medications. Some medications\\u000a that can induce osteoporosis are discussed. Specifically, this article reviews the pathogenesis of glucocorticoid-induced\\u000a bone loss and demonstrates the means to successfully manage the condition with a

Meng-Yi Weng

2007-01-01

330

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.

331

Medical applications of artificial olfactometry  

NASA Technical Reports Server (NTRS)

The present invention provides methods for detecting the presence of an analyte indicative of various medical conditions, including halitosis, periodontal disease and other diseases are also disclosed.

Lewis, Nathan S. (Inventor); Severin, Erik J. (Inventor); Wong, Bernard (Inventor); Kelso, David M. (Inventor); Munoz, Beth C. (Inventor)

2005-01-01

332

DOD MEDICAL EXAMINATION REVIEW BOARD (DODMERB) REPORT OF MEDICAL HISTORY  

E-print Network

. Learning disabilities or speech problems YES NO YES NO nervousness 23. Any mental condition or illness 24DOD MEDICAL EXAMINATION REVIEW BOARD (DODMERB) REPORT OF MEDICAL HISTORY (This information records may be requested to clarify your medical history. 7. HAVE YOU EVER OR DO YOU NOW USE ANY

de Lijser, Peter

333

Medical marijuana: legal considerations.  

PubMed

In 1998, Washington State passed a law, Initiative 692 (I-692), that gives individuals who are charged with possession of marijuana for medical purposes a possible affirmative defense. The law lets these individuals provide a note from their doctor or a copy of their medical records stating they have a condition that may benefit from the use of marijuana. I-692 does not legalize the medical use of marijuana and does not affect Federal law, which makes obtaining, possessing, and growing marijuana illegal. The Washington law limits the amount of marijuana a patient can possess to a 60-day supply and defines the conditions for which medical marijuana may be used. These conditions include HIV, cancer, multiple sclerosis, and epilepsy. PMID:11366751

Schouten, J T

1999-01-01

334

42 CFR 410.132 - Medical nutrition therapy.  

Code of Federal Regulations, 2010 CFR

...there is a change of diagnosis, medical condition, or treatment regimen...physician in the beneficiary's medical record. Referrals must be made for each...required by a change of diagnosis, medical condition, or treatment...

2010-10-01

335

Medical Management  

MedlinePLUS

... form Search Charcot-Marie-Tooth Disease (CMT) Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...

336

Oral Medication  

MedlinePLUS

... doctor before starting anything new — even over-the-counter items. Explore: Oral Medication How Much Do Oral Medications Cost? Save money by finding the right type and dosage of medicine for your needs. In this section Treatment and ...

337

Medication Errors  

MedlinePLUS

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

338

Medical Transcriptionists  

MedlinePLUS

... an understanding of medical terminology, anatomy and physiology, grammar, and word-processing software. Pay The median annual ... an understanding of medical terminology, anatomy and physiology, grammar, and word-processing software. Education Employers prefer to ...

339

Medical marijuana and children.  

PubMed

Medical marijuana is legal for use by minors in many states, but not Delaware. Anecdotes have accumulated suggesting efficacy in managing seizures in children and several other conditions in adults. Currently well-designed studies in children are lacking. Challenges to effective pediatric medical marijuana use remain at the level of biochemistry, the individual patient, and society. Appropriate and effective use of medical marijuana in children will require significant legislative changes at the state and federal level, as well as high-quality research and standardization of marijuana strains. PMID:25647865

Stubblefield, Sam

2014-11-01

340

Health of women after wartime deployments: correlates of risk for selected medical conditions among females after initial and repeat deployments to Afghanistan and Iraq, active component, U.S. Armed Forces.  

PubMed

Women account for approximately 10 percent of all U.S. military deployers to Afghanistan and Iraq. This analysis estimates the percentages of female deployers (n=154,548) who were affected by selected illnesses and injuries after first through third deployments to Iraq/Afghanistan in relation to age group, service branch, military occupation, marital status, pre-deployment medical history, "dwell time" prior to 2nd and 3rd deployments, and length of deployment. Of these factors, diagnosis of a condition before deployment was by far the strongest predictor of diagnosis of the condition after deployment. Durations of dwell times before repeat deployments were not strong predictors of post-deployment diagnoses of any of the conditions considered. For several conditions (e.g., PTSD, disorders of joints, peripheral enthesopathies, infertility), the percentages of deployers diagnosed with the conditions sharply increased with deployment length. Post-deployment morbidity moderately increased with increasing numbers of deployments in the case of some conditions (e.g., PTSD, migraine, musculoskeletal disorders), but not others. The findings suggest that limiting wartime deployments to nine months may have broad beneficial effects on the post-deployment health of female service members. However, limiting the number of wartime deployments and lengthening "dwell times" before repeat deployments would likely not have strong and broad beneficial effects on the health of female veterans. Further research to mitigate the effects of heavy loads and repetitive stresses on the musculoskeletal systems of combat deployed females is indicated. PMID:22876800

2012-07-01

341

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

342

Survival of Pseudodiplorchis americanus (Monogenea) under controlled environmental conditions.  

PubMed

Populations of Pseudodiplorchis americanus infecting the desert toad, Scaphiopus couchii, have previously been shown to be remarkably stable from year to year, despite wide variation in conditions promoting invasion. The present study aimed to document the survival of both first-year and pre-existing adults under controlled laboratory temperatures. First-year worm survival in experimentally infected toads was shown to be very high for the first 5 months after migration to the definitive site, and there was no difference in survival at 25 degrees C or 15-20 degrees C. There was also no density-dependent survival during the same period: 20% of worms were recovered from the host urinary bladder, irrespective of initial intensities. After the first 5 months, there was a progressive loss of worms in toads maintained at 25 degrees C but not at 15-20 degrees C. Pre-existing adult populations were shown to be virtually identical to those under natural conditions for the first 4 months after toad capture. Following this, at 25 degrees C, populations declined and no pre-existing adults were recovered after 11-14 months. There was no such loss of pre-existing adults at 15-20 degrees C for up to 14 months. A diurnal temperature cycle of 20-34 degrees C (simulating temperatures during the desert summer) did not lead to a significant loss of worms. These observations suggest that during one annual cycle in the desert, when temperatures remain above 20 degrees C for less than 6 months, most adult worms established in the host urinary bladder will survive to the next transmission opportunity. However, the similar longevity of first-year and pre-existing adults in laboratory maintained toads shows that loss of worms cannot be due solely to parasite ageing. Temperature-dependent survival of P. americanus is suggestive of a host immune response. Low temperatures, which inhibit parasite growth and development, are essential for the survival of P. americanus. PMID:8159464

Tocque, K; Tinsley, R C

1994-02-01

343

Medical Dictionary of Popular Medical Terms  

NSDL National Science Digital Library

Created by MedicineNet.com, this free and constantly revised encylopedic dictionary of classic and contemporary medical terms contains over 9,000 entries. Written entirely by physicians for both professional and non-professional readers, the dictionary also includes "pertinent scientific items, abbreviations, acronyms, jargon, institutions, projects, symptoms, syndromes, eponyms, medical history -- all having to do with medicine and the biomedical sciences, particularly anything of value and of interest." Users can browse the dictionary by alphabetical entry or conduct a keyword search. The length of dictionary entries vary widely, and some are quite brief. Some, however (mostly conditions or diseases), include links to detailed articles and related forums at the MedicineNet main site. While new medical information sites seem to pop up every day, the depth of Medterms, the frequent updates, and its doctor-only editors mark it as a notable resource.

344

Healthcare services for those with musculoskeletal conditions: a rheumatology service. Recommendations of the European Union of Medical Specialists Section of Rheumatology/European Board of Rheumatology 2006  

PubMed Central

Musculoskeletal conditions are very common across Europe. They affect all age groups, and the associated physical disability is an enormous burden on individuals and society. They can be effectively prevented and controlled in many situations, but this is not at present fully achieved. This report outlines what is required to achieve this and the role of rheumatology in providing these healthcare services. Strategies are given for the prevention and management of musculoskeletal conditions. The needs of people with these conditions are expressed in the PARE Manifesto and the clinical needs have been identified. The healthcare services required to implement these strategies and meet these needs are considered focusing on what services a rheumatology centre should provide. A key principle is that management of musculoskeletal conditions requires a coordinated, integrated, multidisciplinary and multiprofessional approach providing access to a combination of expertise and competencies. Guidance is given of what a rheumatology service should be expected to offer. For a rheumatology centre to provide these services, the need for appropriate facilities and resources is identified, which considers physical resources as well as personnel, training and management needs. Maintaining high standards of care and achieving the best outcomes at all times needs the monitoring of quality indicators as well as ongoing education and research. In conclusion, improving musculoskeletal health is dependent on access to effective treatments and this document shows how the services provided by a rheumatology centre is central to this. PMID:17158137

Rheumatology, Anthony D Woolf and The European Union of Medical Specialists Section of

2007-01-01

345

Comparison of health behaviour and oral\\/medical conditions in non-insulin-dependent (type II) diabetics and non-diabetics  

Microsoft Academic Search

One hundred and two dentate patients with type II diabetes mellitus and 98 non-diabetic subjects were examined for oral conditions and metabolic state. Self-reported health behaviour was analysed. From factor analysis four factors emerged: general health behaviour (GHB), perceived fatigue (PF), diet control (DC) and regular diet (RD). In diabetics PF, DC and RD were significantly higher than that in

Makoto Kawamura; Setsuko Fukuda; Kunio Kawabata; Yoshifumi Iwamoto

1998-01-01

346

Medical Care Costs Associated with Traumatic Brain Injury over the Full Spectrum of Disease: A Controlled Population-Based Study  

PubMed Central

Abstract Data on traumatic brain injury (TBI) economic outcomes are limited. We used Rochester Epidemiology Project (REP) resources to estimate long-term medical costs for clinically-confirmed incident TBI across the full range of severity after controlling for pre-existing conditions and co-occurring injuries. All Olmsted County, Minnesota, residents with diagnoses indicative of potential TBI from 1985–2000 (n=46,114) were identified, and a random sample (n=7175) was selected for medical record review to confirm case status, and to characterize as definite (moderate/severe), probable (mild), or possible (symptomatic) TBI. For each case, we identified one age- and sex-matched non-TBI control registered in REP in the same year (±1 year) as case's TBI. Cases with co-occurring non-head injuries were assessed for non-head-injury severity and assigned similar non-head-injury-severity controls. The 1145 case/control pairs for 1988–2000 were followed until earliest death/emigration of either member for medical costs 12 months before and up to 6 years after baseline (i.e., injury date for cases and comparable dates for controls). Differences between case and control costs were stratified by TBI severity, as defined by evidence of brain injury; comparisons used Wilcoxon signed-rank plus multivariate modeling (adjusted for pre-baseline characteristics). From baseline until 6 years, each TBI category exhibited significant incremental costs. For definite and probable TBI, most incremental costs occurred within the first 6 months; significant long-term incremental medical costs were not apparent among 1-year survivors. By contrast, cost differences between possible TBI cases and controls were not as great within the first 6 months, but were substantial among 1-year survivors. Although mean incremental costs were highest for definite cases, probable and possible cases accounted for>90% of all TBI events and 66% of total incremental costs. Preventing probable and possible events might facilitate substantial reductions in TBI-associated medical care costs. PMID:22414023

Brown, Allen W.; Hall Long, Kirsten; Ransom, Jeanine E.; Mandrekar, Jay; Osler, Turner M.; Malec, James F.

2012-01-01

347

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

348

[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

349

Medication safety in neonates.  

PubMed

Newborn intensive care units (NICUs) are high-risk areas of care, where complex medical interventions are performed, and are recognized as a resource for improved outcome in premature and low-birth-weight infants or those presenting with acute conditions. This critical environment, along with the vulnerable nature of the population it serves, places patients at risk for medication errors, which can result in permanent harm or death. Promoting safe medication practices requires participation of all individuals involved in the medication use process (e.g., physicians, nurses, nurse practitioners, physician assistants, pharmacists, respiratory therapists, pharmacy technicians). The following recommendations, organized in accordance with the Institute for Safe Medication Practices' Key Elements of the Medication Use System™, will focus on significant areas of concern within the NICU. All individuals caring for neonates, supported by administrators and organizational leaders, should recognize themselves as active partners responsible for the safety of this fragile patient population by participating in the design and sustainment of a safe and efficient medication use system. PMID:21861251

Dabliz, Rabih; Levine, Stuart

2012-01-01

350

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

351

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

352

Recognizing medical emergencies  

MedlinePLUS

... go there in an emergency. Wear a medical identification tag if you have a chronic condition or look for one on a person who has any of the symptoms mentioned. Get a personal emergency response system if you are elderly, especially ...

353

Medical Device Safety  

MedlinePLUS

... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Medical Devices Print this page Share this page E-mail this page Home Medical Devices Medical Device Safety Medical Device Safety Search the Medical Device Safety Section Medical ...

354

46 CFR 10.303 - Medical waivers, limitations, and restrictions.  

Code of Federal Regulations, 2014 CFR

...medical evidence indicates that the condition is sufficiently controlled and the effects of medication pose no significant risk to maritime and public safety. The Coast Guard retains final authority for the issuance of medical waivers....

2014-10-01

355

77 FR 40355 - Workshop on Pet Medications Issues  

Federal Register 2010, 2011, 2012, 2013, 2014

...appropriate course of treatment for any medical condition, including whether...veterinarian. The American Veterinary Medical Association (AVMA) advises veterinarians...See Principles of Veterinary Medical Ethics of the AVMA,...

2012-07-09

356

Medical Hypnosis for Hyperemesis Gravidarum  

Microsoft Academic Search

Hyperemesis gravidarum in pregnancy is a serious condition that is often resistant to conservative treatments. Medical hypnosis is a well-documented alternative treatment. This article reviews the empirical studies of medical hypnosis for treating hyper- emesis gravidarum, explains basic concepts, and details the treatment mechanisms. The importance of a thorough differential diagnosis and appropriate referrals is stressed. The article presents three

Eric P. Simon; Jennifer Schwartz

357

FOR FAMILY MEDICAL LEAVE AND SHORT TERM DISABILITY PLAN DARTMOUTH COLLEGE MEDICAL CERTIFICATION FORM  

E-print Network

FOR FAMILY MEDICAL LEAVE AND SHORT TERM DISABILITY PLAN DARTMOUTH COLLEGE MEDICAL CERTIFICATION FORM Certification of Health Care Provider for Employee's Serious Health Condition Family and Medical to the EMPLOYEE: Please complete Section II before giving this form to your medical provider. The FMLA permits

Myers, Lawrence C.

358

Botox (Medical)  

MedlinePLUS

... included in your message Your e-mail address: Your name: Your friend's e-mail address: Your friend's name: ... Close without sharing. Give Us Feedback Botox (Medical) Your name First Name MI Laast Name Your e-mail ...

359

Medication Treatments  

MedlinePLUS

... Information How is the FMR1 mutation related to Fragile X-associated disorders? What causes it? How many people ... approved any drugs specifically for the treatment of Fragile X or its symptoms. But in many cases, medications ...

360

Medical Scientists  

MedlinePLUS

... must use their expertise to determine the best method for solving a specific research question. Data-analysis skills. Medical scientists use statistical techniques, so that they can properly quantify and ...

361

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 ...

362

Cardiac Medications  

MedlinePLUS

... lowering medications may interact with grapefruit, grapefruit juice, pomegranate and pomegranate juice. Please talk to your health care provider ... attacks, or "little strokes") and other forms of cardiovascular disease. Usually prescribed preventively when plaque buildup is ...

363

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

364

Medical Acoustics  

NASA Astrophysics Data System (ADS)

Medical acoustics can be subdivided into diagnostics and therapy. Diagnostics are further separated into auditory and ultrasonic methods, and both employ low amplitudes. Therapy (excluding medical advice) uses ultrasound for heating, cooking, permeablizing, activating and fracturing tissues and structures within the body, usually at much higher amplitudes than in diagnostics. Because ultrasound is a wave, linear wave physics are generally applicable, but recently nonlinear effects have become more important, even in low-intensity diagnostic applications.

Beach, Kirk; Dunmire, Barbrina

365

Medical education.  

PubMed

In theory, the Medical Council of India (MCI) determines the standards and qualifications of medical schools. It also sanctions curricula and ensures standards. Yet no standards exist on the mode of selection in medical schools, duration of study, course content, student stipends or period of internship. It takes 4.5 years to finish medical school. Students undergo preclinical, paraclinical, and clinical training. Most courses are in English which tends to favor the urban elite. Students cannot always communicate with patients in local languages. Textbooks often provide medical examples unrelated to India. Pedagogy consists mainly of lectures and rote learning predominates. Curricula tend not to provide courses in community health. Students pick up on the elitist attitudes of the faculty. For example, faculty do not put much emphasis on community health, individual health, equity in health care delivery, and teamwork. Further the education system is not patient oriented, but hospital or disease oriented. Faculty should train students in creating sanitation programs, knowing local nutritious foods, and in making community diagnoses. Yet they tend to be practitioners 1st then educators. Further faculty are not paid well and are not always invited to take part in improving curriculum, so morale is often low. Moreover experience in health planning and management issues is not required for administrators. In addition, medical schools are not well equipped with learning aids, libraries, or teaching staff. Tax revenues finance medical education. 75% of graduating physicians set up a private practice. Further many physicians go to urban areas. 34-57% emigrate to other countries. The problems of medical education will not be solved until the political and economic system becomes more responsive to the health needs of the people. PMID:12343653

Krishnan, P

1992-01-01

366

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

367

Medical Products Research  

NASA Technical Reports Server (NTRS)

Ventrex Laboratories, Inc. develops, manufactures and markets a line of medical diagnostic assays based on biochemical techniques, in particular immunochemical techniques. Their products are sold worldwide to hospitals and medical laboratories for use in testing blood samples and other biological fluids. Analysis of a patient's body fluids, compared with normal values, aids a physician in confirming or otherwise diagnosing a suspected disease condition. NERAC's rapid information retrieval has provided Ventrex invaluable up-to-date information, and has permitted large scale savings. NERAC's service was particularly important in the development of a new product in the company's Ventre/Sep line, which is used in radioimmunoassays.

1982-01-01

368

Medical News Today  

NSDL National Science Digital Library

This website presents Medical News Today, an organization based in the United Kingdom, aimed at providing "the latest news headlines from the world of medicine and healthcare today and every day." The site offers 19 pages of recent news headline lists, with each headline hyperlinked to its article (or part of its article). Most article pages contain an original URL or some other contact or source information. In addition, the article pages allow site visitors to write an opinion piece about the article, as well as view other visitors' opinions. This website also provides search engines for medical abbreviations and terms, and links to information about healthcare, conditions, and patient resources.

369

BOISE STATE UNIVERSITY AUTHORIZATION FOR LIMITED RELEASE OF MEDICAL INFORMATION  

E-print Network

medical information (including pertinent medical records), and to discuss my medical condition providers.) 1. 2. 3. I understand that the forgoing records and medical information are limited onlyBOISE STATE UNIVERSITY AUTHORIZATION FOR LIMITED RELEASE OF MEDICAL INFORMATION ("Release") I

Barrash, Warren

370

Physicians and airline medical emergencies.  

PubMed

Physician passengers on airlines are frequently called to assist the flight crew if an emergency medical situation arises. There have been numerous studies and reports pertaining to medical emergencies inflight, the various aspects of crew responsibility and reaction, and the types of emergency medical supplies available. This paper is to present the comments and opinions of physicians who have been called upon to assist the flight crew during inflight emergency medical situations. The background information is presented followed by statistics as to types of conditions encountered; physicians' responses; physicians' comments as to airline emergency medical supplies; flight crew, airline, and airport responses to medical emergencies and suggestions from physicians as to what significant changes may be indicated. PMID:880187

Hays, M B

1977-05-01

371

[Future trend medical apps. From the apps store directly into medical practice?].  

PubMed

In day to day medical care, patients, nursing staff and doctors currently face a bewildering and rapidly growing number of health-related apps running on various "smart" devices and there are also uncountable possibilities for the use of such technology. Concerning regulation, a risk-based approach is applied for development and use (including safety and security considerations) of medical and health-related apps. Considering safety-related issues as well as organizational matters, this is a sensible approach but requires honest self-assessment as well as a high degree of responsibility, networking and good quality management by all those involved. This cannot be taken for granted. Apart from regulatory aspects it is important to not only consider what is reasonable, helpful or profitable. Quality aspects, safety matters, data protection and privacy as well as liability issues must also be considered but are often not adequately respected. If software quality is compromised, this endangers patient safety as well as data protection, privacy and data integrity. This can for example result in unwanted advertising or unauthorized access to the stored data by third parties; therefore, local, regional and international regulatory measures need to be applied in order to ensure safe use of medical apps in all possible areas, including the operating room (OR) with its highly specialized demands. Lawmakers need to include impulses from all stakeholders in their considerations and this should include input from existing private initiatives that already deal with the use and evaluation of apps in a medical context. Of course, this process needs to respect pre-existing national, European as well as international (harmonized) standards. PMID:25388438

Gehring, H; Pramann, O; Imhoff, M; Albrecht, U-V

2014-12-01

372

[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

373

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. PMID:18366134

2009-01-01

374

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

375

Medical Instrumentation  

NSDL National Science Digital Library

Students learn about the sorts of devices designed by biomedical engineers and the many other engineering specialties that are required in their design of medical diagnostics, therapeutic aids, surgical devices and procedures, and replacement parts. They discuss the special considerations that must be made when dealing with the human body, such as being minimally invasive, biocompatible, keeping sterile, lightweight, corrosion resistant, long lasting and electrically safe. They also explore how "form fits function." Students gain an appreciation for the amazing devices that improve our quality of life. This lesson serves as a starting point for students to begin to ponder how the medical devices in their everyday lives work.

2014-09-18

376

Integrated Medical Model Overview  

NASA Technical Reports Server (NTRS)

The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project.

Myers, J.; Boley, L.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.; Saile, L.; Shah, R.; Garcia, Y.; Sirmons. B.; Walton, M.; Reyes, D.

2015-01-01

377

Common Childhood Orthopedic Conditions  

MedlinePLUS

... might be linked to other conditions, such as cerebral palsy, muscle weakness disorders, autism, or other nervous system ... be related to existing medical problems such as cerebral palsy. Doctors rarely have to treat pigeon-toed feet. ...

378

Medical Applications  

NASA Astrophysics Data System (ADS)

The recent progress in medical imaging techniques such as magnetic-resonance imaging (nmr or mri), computer tomography (CT with X-rays), and positron-emission tomography (PET scanning using short-lived radioactive nuclei) has been impressive. Two areas where diagnostic tools lacked behind have been tomography of the blood vessels of the brain and of the bronchi.

Schieck, Hans Paetz Gen.

379

[Medical care in Santiago, 1993].  

PubMed

Results of morbidity and medical care surveys performed in Santiago in 1993-94 are presented in this paper. The study has been done in an aleatory population sample of 4,700 people coming from 1,000 dwellings. Main results are as following: The Health National Fund (FONASA) is the most important financing medical care's agency in Santiago (49% out of total population). A majority of medical services are given in private offices or clinics. Medical care systems show significant differences among the studied city districts. A significant direct correlation between people's income and private practice is noticed. One half of acute diseases had medical care and the other half used self care practices; the proportion of medical care is 29% in the case of chronic disease patients. National Health Service eligible people show a significant higher morbidity rate and medical consultation rate than other groups. Lack of medical care mainly depends on low severity of illness episodes or lack of symptoms in chronic disease conditions. In 12% out of total cases, lack of medical care was due to problems in the medical care systems. The quality of care was judged "good or excellent" by 82% of the people, "fair" by 9%, and "bad or deficient" by the remaining 8%. Personal expenditures due to health care are high, one third depending on medical care and two thirds on dental care. In the case of medical care the reasons for expenditures are linked to chronic diseases (60%), acute diseases (28%), injuries and health examinations (15%). Main activities causing personal disbursements are the purchase of drugs (44%), medical visits (30%), laboratory tests (13%) and hospital charges (7%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7569440

Medina, E; Kaempffer, A M; Cornejo, E; Hernández, E; Wall, V

1995-01-01

380

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

381

Treating Child Obesity and Associated Medical Conditions  

ERIC Educational Resources Information Center

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 childhood obesity and treating serious obesity-related health complications. She notes that although pediatricians are concerned about the obesity problem, most…

Caprio, Sonia

2006-01-01

382

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

383

20 CFR 220.110 - Medically disabled.  

Code of Federal Regulations, 2011 CFR

...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...

2011-04-01

384

20 CFR 220.110 - Medically disabled.  

Code of Federal Regulations, 2014 CFR

...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...

2014-04-01

385

20 CFR 220.110 - Medically disabled.  

Code of Federal Regulations, 2012 CFR

...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...

2012-04-01

386

20 CFR 220.110 - Medically disabled.  

Code of Federal Regulations, 2013 CFR

...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...

2013-04-01

387

20 CFR 220.110 - Medically disabled.  

Code of Federal Regulations, 2010 CFR

...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...

2010-04-01

388

10 CFR 712.14 - Medical assessment.  

Code of Federal Regulations, 2013 CFR

...suicide, homicide, or physical harm; or (5) Medical conditions such as cardiovascular disease, endocrine disease, cerebrovascular or other neurologic disease, or the use of drugs for the treatment of conditions that may adversely...

2013-01-01

389

10 CFR 712.14 - Medical assessment.  

Code of Federal Regulations, 2014 CFR

...suicide, homicide, or physical harm; or (5) Medical conditions such as cardiovascular disease, endocrine disease, cerebrovascular or other neurologic disease, or the use of drugs for the treatment of conditions that may adversely...

2014-01-01

390

10 CFR 712.14 - Medical assessment.  

Code of Federal Regulations, 2012 CFR

...suicide, homicide, or physical harm; or (5) Medical conditions such as cardiovascular disease, endocrine disease, cerebrovascular or other neurologic disease, or the use of drugs for the treatment of conditions that may adversely...

2012-01-01

391

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 â??Word of the Dayâ?ť, 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 â??Top 10 Medtermsâ?ť, which is also a good way to start exploring the materials here.

392

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. PMID:19893712

Gründel, M.; Güthoff, F.

2008-01-01

393

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

394

Medical humanities in the undergraduate medical curriculum.  

PubMed

The medical humanities have been introduced in medical curricula over the past 30 years in the western world. Having medical humanities in a medical school curriculum can nurture positive attitudes in the regular work of a clinician and contribute equally to personality development. Though substantial evidence in favour of a medical humanities curriculum may be lacking, the feedback is positive. It is recommended that medical humanities be introduced into the curriculum of every medical school with the purpose of improving the quality of healthcare, and the attitudes of medical graduates. PMID:23099601

Supe, Avinash

2012-01-01

395

[Medical writers in medical research.  

PubMed

Larger research units often comprise persons of several professions in order to secure a high level of efficiency and quality in the different tasks. In Denmark, employees with special competencies within the field of writing and publication are rarely used in research units. The purpose of this study was to present the advantages and challenges associated with the involvement of medical writers in academic environments. PMID:23952980

Burcharth, Jakob; Pommergaard, Hans-Christian; Danielsen, Anne Kjćrgaard; Rosenberg, Jacob

2013-08-19

396

Medical problems of surgical patients. Hypertension and ischaemic heart disease.  

PubMed Central

Pre-existing disease in the form of hypertension or ischaemic heart disease may increase morbidity and mortality in patients presenting for anaesthesia and surgery. The interaction of these two cardiovascular conditions in relation to anaesthesia has been studied in a series of 115 patients. The results did not support the view that antihypertensive drugs and beta-receptor blocking agents should be withdrawn before anaesthesia and surgery. The main cause for concern in providing anaesthesia for these patients is that sympathetic nervous activation induced either by anaesthetic manoeuvres or by surgical stimulation may lead to reflex cardiovascular responses which, by increasing myocardial oxygen demand, lead to episodes of myocardial ischaemia. In this respect beta-receptor blocking drugs appear to have a protective effect on the ischaemic myocardium. PMID:10825

Prys-Roberts, C.

1976-01-01

397

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

398

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

399

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

400

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.

University of Nebraska State Museum

2001-01-01

401

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

402

Recent Medical Device Recalls  

MedlinePLUS

... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Medical Devices Print this page Share this page E-mail this page Home Medical Devices Medical Device Safety Medical Device Recalls List of ...

403

Medical alert bracelet (image)  

MedlinePLUS

People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will ... People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will ...

404

In-flight Medical Emergencies  

PubMed Central

Introduction: Research and data regarding in-flight medical emergencies during commercial air travel are lacking. Although volunteer medical professionals are often called upon to assist, there are no guidelines or best practices to guide their actions. This paper reviews the literature quantifying and categorizing in-flight medical incidents, discusses the unique challenges posed by the in-flight environment, evaluates the legal aspects of volunteering to provide care, and suggests an approach to managing specific conditions at 30,000 feet. Methods: We conducted a MEDLINE search using search terms relevant to aviation medical emergencies and flight physiology. The reference lists of selected articles were reviewed to identify additional studies. Results: While incidence studies were limited by data availability, syncope, gastrointestinal upset, and respiratory complaints were among the most common medical events reported. Chest pain and cardiovascular events were commonly associated with flight diversion. Conclusion: When in-flight medical emergencies occur, volunteer physicians should have knowledge about the most common in-flight medical incidents, know what is available in on-board emergency medical kits, coordinate their therapy with the flight crew and remote resources, and provide care within their scope of practice. PMID:24106549

Chandra, Amit; Conry, Shauna

2013-01-01

405

The Medical System in Ghana  

PubMed Central

Ghana is a developing country in West Africa with a population of about 25 million. Medical illnesses in Ghana overlap with those in developed countries, but infection, trauma, and women’s health problems are much more prominent. Medical practice in rural Africa faces extremely limited resources, a multiplicity of languages (hundreds in Ghana), and presentation of severe illnesses at later stages than seen elsewhere. Despite these limitations, Ghana has established a relatively successful national medical insurance system, and the quality of medical practice is high, at least where it is available. Ghana also has a well-established and sophisticated administrative structure for the supervision of medical education and accreditation, but it has proven very difficult to extend medical training to rural areas, where health care facilities are particularly short of personnel. Physicians are sorely needed in rural areas, but there are few because of the working conditions and financial limitations. Hospital wards and clinics are crowded; time per patient is limited. This article details some of the differences between medical practice in Ghana and that in wealthier countries and how it functions with very limited resources. It also introduces the medical education and training system in Ghana. The following article describes an attempt to establish and maintain a residency training program in General Medicine in a rural area of Ghana. PMID:25191147

Drislane, Frank W.; Akpalu, Albert; Wegdam, Harry H.J.

2014-01-01

406

Medical Technology 1 Running Head: USE OF TECHNOLGY IN A MEDICAL SETTING  

E-print Network

depending on the technology condition. These findings have implications for healthcare providers such as howMedical Technology 1 Running Head: USE OF TECHNOLGY IN A MEDICAL SETTING The Use of Different Technologies During a Medical Interview: Effects on Perceived Quality of Care Julia M. DeBlasio, Britt Caldwell

407

Preparing Children for Medical Examinations: The Importance of Previous Medical Experience  

Microsoft Academic Search

The relationship between past medical experience and children’s response to preparation for medical examinations was investigated in 79 pediatric outpatients aged 3 to 12 years. Children were randomly assigned to one of five preparation conditions prior to receiving a medical examination and a throat culture: sensory information about the exam, training in coping skills (deep breathing and positive self-talk), combined

Lynnda M. Dahlquist; Karen M. Gil; F. Daniel Armstrong; David D. DeLawyer; Paul Greene; Donald Wuori

1986-01-01

408

Using Home Visits to Understand Medication Errors in Children  

Microsoft Academic Search

Current research methods are not well designed to detect medication errors that occur at home. We developed home visit methods to investigate home medication errors in children with chronic conditions. These methods include observation of parent administration of medication to the child by a trained nurse observer who takes detailed ethnographic notes; review of all prescription and over-the-counter medications for

Kathleen E. Walsh; Christopher J. Stille; Kathleen M. Mazor; Jerry H. Gurwitz

409

Prioritizing Medical Resources for Exploration Missions  

NASA Technical Reports Server (NTRS)

Long duration missions beyond low Earth orbit introduce new constraints to the medical system. Factors such as the inability to evacuate to Earth in a timely manner, communication delay, limitations in available medical equipment, and the clinical background of the crew will all have an impact on the assessment and treatment of medical conditions. The Exploration Medical Capability (ExMC) Element of NASAs Human Research Program seeks to improve the way the element derives its mitigation strategies for the risk of "Unacceptable Health and Mission Outcomes Due to Limitation of In-flight Medical Capabilities."

Shah, R. V.; Kerstman, E. L.

2015-01-01

410

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

411

Medical telesensors  

NASA Astrophysics Data System (ADS)

Medical telesensors are self-contained integrated circuits for measuring and transmitting vital signs over a distance of approximately 1-2 meters. The circuits are unhoused and contain a sensor, signal processing and modulation electronics, a spread-spectrum transmitter, an antenna and a thin-film battery. We report on a body-temperature telesensor, which is sufficiently small to be placed on a tympanic membrane in a child's ear. We also report on a pulse-oximeter telesensor and a micropack receiver/long- range transmitter unit, which receives form a telesensor array and analyzes and re-transmits the vital signs over a longer range. Signal analytics are presented for the pulse oximeter, which is currently in the form of a finger ring. A multichip module is presented as the basic signal-analysis component. The module contains a microprocessor, a field=programmable gate array, memory elements and other components necessary for determining trauma and reporting signals.

Ferrell, Trinidad L.; Crilly, P. B.; Smith, S. F.; Wintenberg, Alan L.; Britton, Charles L., Jr.; Morrison, Gilbert W.; Ericson, M. N.; Hedden, D.; Bouldin, Donald W.; Passian, A.; Downey, Todd R.; Wig, A. G.; Meriaudeau, Fabrice

1998-05-01

412

Medical audit, continuing medical education and quality assurance.  

PubMed

Medical audit and continuing medical education (CME) are now the mainstays of quality assurance in hospitals. Audits should address problems that have serious consequences for patients if proper treatment is not given. The single most important step is the selection of essential or scientific criteria that relate process to outcomes. CME does less than commonly believed to improve care. Today, quality assurance increasingly means a near-guarantee to every patient of appropriate treatment and fewest possible complications. Maintenance of the public trust rests on a firm commitment of the medical staff and board to this principle, implemented through an organized program of quality assurance. Under these conditions, medical audit and CME can effectively improve care by improving physician performance. PMID:987652

Sanazaro, P J

1976-09-01

413

Medical Use of Recreational Drugs by AIDS Patients  

Microsoft Academic Search

A survey of 72 patients at an AIDS clinic regarding self-medication with recreational drugs for medical or psychological conditions related to their illness disclosed that marijuana was the primary drug used. The perceived benefit was for gastrointestinal conditions such as nausea, vomiting, indigestion and appetite improvement. Use of other “recreational” drugs as self-medication was reported to usually be ineffective or

Daniel A. Dansak

1997-01-01

414

Application for Emergency Medical Transfer of IFQ Page 1 of 8  

E-print Network

(NO MEDICAL CONDITION) 1. Name: 2. NMFS Person ID: 3. Date of Birth: 4. Permanent Business Mailing if the applicant has received a medical transfer in any 2 of the previous 5 years for the same medical condition the Transferor (Medical Condition) qualify for a hired master exception under 50 CFR 679.42(i)(1)? YES

415

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

416

Medical genetics in Paraguay.  

PubMed

Paraguay is a developing country with low levels of health coverage, with 81% of the population without health insurance, a proportion that reaches 98.1% among the poor, 93% among the rural population and 91.7% among the mainly Guarani-speaking population. The infant mortality rate is 19.4 per 1,000, although there is gross under-reporting. Maternal mortality rate is alarmingly high at 110.9 per 100,000 livebirths, reaching 420.5 in rural areas. There are only two clinical geneticists and four biochemists trained in human genetics, and virtually all genetic services in the country are concentrated in the 'Instituto de Investigaciones en Ciencias de la Salud' (IICS) from the National University. The teaching of medical genetics in medical schools is included in physiology and pathology courses, while at the postgraduate level, training in medical genetics is limited to pediatrics and gynecology. In 1999, a pilot newborn screening program was initiated to determine the frequency of congenital hypothyroidism and phenylketonuria and to provide early treatment for affected babies. Another pilot project recently launched by the Ministry of Health is the Program for the Prevention of Neural Tube Defects, mandating folic acid fortification of flour, but as of the end of 2003 it had not been implemented. Paraguay lacks adequate resources to provide accurate diagnoses and treatment of genetic conditions. PMID:15539832

Ascurra de Duarte, Marta

2004-01-01

417

Medical muddle.  

PubMed

Nanette Gartrell, MD, is a psychiatrist and researcher whose investigations have documented the mental health and psychological well-being of lesbian, gay, bisexual, and transgender (LGBT) people over the past four decades. Nanette is the principal investigator of an ongoing longitudinal study of lesbian families in which the children were conceived by donor insemination. Now in its 27th year, this project has been cited internationally in the debates over equality in marriage, foster care, and adoption. Previously on the faculty at Harvard Medical School and the University of California, San Francisco, Nanette is currently a Visiting Distinguished Scholar at the Williams Institute, UCLA School of Law. In 2013, Nanette received the Association of Women Psychiatrists Presidential Commendation Award for "selfless and enduring vision, leadership, wisdom, and mentorship in the fields of women's mental health, ethics, and gender research." At the age of 63, Nanette experienced a 3 ˝ month period of intractable, incapacitating dizziness for which there was never a clear diagnosis. PMID:24400630

Gartrell, Nanette

2014-01-01

418

22 CFR 71.10 - Emergency medical assistance.  

Code of Federal Regulations, 2011 CFR

...required on a routine basis to sustain life; (5) Preventive or protective medications and medical supplies and equipment (vaccinations, inoculations, etc.) required to combat epidemic conditions (general or intramural); (6) Childbirth...

2011-04-01

419

A medication extraction framework for electronic health records  

E-print Network

This thesis addresses the problem of concept and relation extraction in medical documents. We present a medical concept and relation extraction system (medNERR) that incorporates hand-built rules and constrained conditional ...

Bodnari, Andreea

2012-01-01

420

22 CFR 71.10 - Emergency medical assistance.  

Code of Federal Regulations, 2013 CFR

...required on a routine basis to sustain life; (5) Preventive or protective medications and medical supplies and equipment (vaccinations, inoculations, etc.) required to combat epidemic conditions (general or intramural); (6) Childbirth...

2013-04-01

421

22 CFR 71.10 - Emergency medical assistance.  

Code of Federal Regulations, 2012 CFR

...required on a routine basis to sustain life; (5) Preventive or protective medications and medical supplies and equipment (vaccinations, inoculations, etc.) required to combat epidemic conditions (general or intramural); (6) Childbirth...

2012-04-01

422

22 CFR 71.10 - Emergency medical assistance.  

Code of Federal Regulations, 2014 CFR

...required on a routine basis to sustain life; (5) Preventive or protective medications and medical supplies and equipment (vaccinations, inoculations, etc.) required to combat epidemic conditions (general or intramural); (6) Childbirth...

2014-04-01

423

46 CFR 10.304 - General medical exam.  

Code of Federal Regulations, 2014 CFR

...sudden incapacitation or debilitating complication. This exam must also document any condition requiring medication that impairs cognitive ability, judgment, or reaction time. The Coast Guard will provide guidance on the conduct of general medical...

2014-10-01

424

42 CFR 405.2113 - Medical review board.  

Code of Federal Regulations, 2010 CFR

...PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of End-Stage Renal Disease (ESRD) Services § 405.2113 Medical review board. (a) General. The medical review board must...

2010-10-01

425

Scottish Canadian Medical Programme  

E-print Network

educationally and socially. Competition is particularly fierce for the undergraduate Medical Schools at St. St Andrews The Medical School at St Andrews now resides in the UK's newest medical building, which UK medical school for student satisfaction; 94% of St Andrews' medical students gave the School top

Brierley, Andrew

426

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

427

Space Station medical sciences concepts  

NASA Technical Reports Server (NTRS)

Current life sciences concepts relating to Space Station are presented including the following: research, extravehicular activity, biobehavioral considerations, medical care, maintenance of dental health, maintaining health through physical conditioning and countermeasures, protection from radiation, atmospheric contamination control, atmospheric composition, noise pollution, food supply and service, clothing and furnishings, and educational program possibilities. Information on the current status of Soviet Space Stations is contained.

Mason, J. A. (editor); Johnson, P. C., Jr. (editor)

1984-01-01

428

Asthma Medications and Pregnancy  

MedlinePLUS

... MD Medical Director, Health Initiatives View full profile Asthma and Pregnancy: Asthma Medications We would like to avoid all medicine ... make sure you are using it correctly. Other Asthma Related Medication Treatment Annual influenza vaccine (flu shot) ...

429

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.

430

Nutrition Therapy Services (Medical)  

MedlinePLUS

... service covered? Search Medicare.gov for covered items Nutrition therapy services (medical) How often is it covered? Medicare Part B (Medical Insurance) covers medical nutrition therapy services and certain related services. A registered ...

431

77 FR 58840 - Request for Comments and Announcement of Workshop on Pet Medications Issues  

Federal Register 2010, 2011, 2012, 2013, 2014

...appropriate course of treatment for any medical condition, including whether...veterinarian. The American Veterinary Medical Association (AVMA) advises veterinarians...See Principles of Veterinary Medical Ethics of the AVMA,...

2012-09-24

432

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

433

Teaching Medical Ethics to Medical Students.  

ERIC Educational Resources Information Center

The evolution and goals of teaching medical ethics, the nature of medical ethics, and integrating such teaching into the curriculum are examined. Because moral considerations are as much a part of medical decisions as technical considerations, teaching is best done in the context of real cases. (Author/MLW)

Loewy, Erich H.

1986-01-01

434

Environmental Conditions Environmental Conditions  

E-print Network

in habitat conditions. Stream flows, water temperatures, substrate characteristics and other combined watershed processes and human activities that influence flow, water quality, upland and riparian conditions feet in one mile The watershed includes approximately 760 miles of perennial streams and 1,440 miles

435

Instructional Intranets in Graduate Medical Education.  

ERIC Educational Resources Information Center

Three major issues have led to changes in graduate medical education: shortages of academic and community physician time to devote to teaching; limited resident exposure to various medical conditions due to shifts in training venues; and residents' lack of training in information technologies. Internal organizational networks (intranets) can be…

Zucker, Susan; White, James A.; Fabri, Peter J.; Khonsari, Laleh S.

1998-01-01

436

Exploration Medical Capability (ExMC) Projects  

NASA Technical Reports Server (NTRS)

During missions to the Moon or Mars, the crew will need medical capabilities to diagnose and treat disease as well as for maintaining their health. The Exploration Medical Capability Element develops medical technologies, medical informatics, and clinical capabilities for different levels of care during space missions. The work done by team members in this Element is leading edge technology, procedure, and pharmacological development. They develop data systems that protect patient's private medical information, aid in the diagnosis of medical conditions, and act as a repository of relevant NASA life sciences experimental studies. To minimize the medical risks to crew health the physicians and scientists in this Element develop models to quantify the probability of medical events occurring during a mission. They define procedures to treat an ill or injured crew member who does not have access to an emergency room and who must be cared for in a microgravity environment where both liquids and solids behave differently than on Earth. To support the development of these medical capabilities, the Element manages the development of medical technologies that prevent, monitor, diagnose, and treat an ill or injured crewmember. The Exploration Medical Capability Element collaborates with the National Space Biomedical Research Institute (NSBRI), the Department of Defense, other Government-funded agencies, academic institutions, and industry.

Wu, Jimmy; Watkins, Sharmila; Baumann, David

2010-01-01

437

Medication adherence behaviors of Medicare beneficiaries  

PubMed Central

Background Medication adherence is crucial for positive outcomes in the management of chronic conditions. Comprehensive medication consultation can improve medication adherence by addressing intentional and unintentional nonadherence. The Medicare Part D prescription drug benefit has eliminated some cost barriers. We sought to examine variables that impact self-reported medication adherence behaviors in an ambulatory Medicare-beneficiary population and to identify the factors that influence what information is provided during a pharmacist consultation. Methods Medicare beneficiaries who attended health fairs in northern California were offered medication therapy management (MTM) services during which demographic, social, and health information, and responses to survey questions regarding adherence were collected. Beneficiaries were also asked which critical elements of a consultation were typically provided by their community pharmacist. Survey responses were examined as a function of demographic, socioeconomic, and health-related factors. Results Of the 586 beneficiaries who were provided MTM services, 575 (98%) completed the adherence questions. Of responders, 406 (70%) reported taking medications “all of the time”. Of the remaining 169 (30%), the following reasons for nonadherence were provided: 123 (73%) forgetfulness; 18 (11%) side effects; and 17 (10%) the medication was not needed. Lower adherence rates were associated with difficulty paying for medication, presence of a medication-related problem, and certain symptomatic chronic conditions. Of the 532 who completed survey questions regarding the content of a typical pharmacist consultation, the topics included: 378 (71%) medication name and indication; 361 (68%) administration instructions; 307 (58%) side effects; 257 (48%) missed-dose instructions; and 245 (46%) interactions. Subsidy recipients and non-English speakers were significantly less likely to be counseled on drug name, indication, and side effects. The presence of certain health conditions was also associated with missing consultation elements. Conclusion While Medicare beneficiaries are generally adherent to medication therapy, adherence barriers must be identified and addressed during comprehensive medication consultation. PMID:25258521

Carr-Lopez, Sian M; Shek, Allen; Lastimosa, Janine; Patel, Rajul A; Woelfel, Joseph A; Galal, Suzanne M; Gundersen, Berit

2014-01-01

438

32 CFR 732.21 - Medical board.  

Code of Federal Regulations, 2010 CFR

...guidance. (a) Chronic conditions requiring a medical board include (but are not limited to): (1) Arthritis, (2) Asthma, (3) Diabetes, (4) Gout, (5) Heart disease, (6) Hypertension, (7) Peptic ulcer disease, (8)...

2010-07-01

439

Medication Interactions: Food, Supplements and Other Drugs  

MedlinePLUS

... of when taking blood thinners , also called anticoagulants. Vitamin supplements can also disrupt a carefully balanced dosage of ... about the drug or my condition? Learn more: Vitamin Supplements: Healthy or Hoax? Over-the-Counter Medications and ...

440

Diagnostic Medical Sonographers: Seeing with Sound.  

ERIC Educational Resources Information Center

Explains how diagnostic medical sonographers use special equipment to direct high frequency sound waves into areas of a patient's body. Describes specialties within the occupation, working conditions, employment and outlook, earnings, and necessary training and qualifications. (JOW)

Lacey, Alan

2001-01-01

441

32 CFR 732.21 - Medical board.  

Code of Federal Regulations, 2013 CFR

...guidance. (a) Chronic conditions requiring a medical board include (but are not limited to): (1) Arthritis, (2) Asthma, (3) Diabetes, (4) Gout, (5) Heart disease, (6) Hypertension, (7) Peptic ulcer disease, (8)...

2013-07-01

442

32 CFR 732.21 - Medical board.  

Code of Federal Regulations, 2012 CFR

...guidance. (a) Chronic conditions requiring a medical board include (but are not limited to): (1) Arthritis, (2) Asthma, (3) Diabetes, (4) Gout, (5) Heart disease, (6) Hypertension, (7) Peptic ulcer disease, (8)...

2012-07-01

443

32 CFR 732.21 - Medical board.  

Code of Federal Regulations, 2011 CFR

...guidance. (a) Chronic conditions requiring a medical board include (but are not limited to): (1) Arthritis, (2) Asthma, (3) Diabetes, (4) Gout, (5) Heart disease, (6) Hypertension, (7) Peptic ulcer disease, (8)...

2011-07-01

444

32 CFR 732.21 - Medical board.  

Code of Federal Regulations, 2014 CFR

...guidance. (a) Chronic conditions requiring a medical board include (but are not limited to): (1) Arthritis, (2) Asthma, (3) Diabetes, (4) Gout, (5) Heart disease, (6) Hypertension, (7) Peptic ulcer disease, (8)...

2014-07-01

445

UVM OUTING CLUB MEDICAL HISTORY FORM  

E-print Network

Control) 4. Please list any allergies that you have, including: medications, food, plants, and insects condition, epilepsy, dietary restrictions, eating disorders, food allergies) 6. Are you allergic to BEE

Hayden, Nancy J.

446

User & situation models for medical information delivery  

E-print Network

-base, must be provided locally. The present work explores the design of a Medical Assistant System for such conditions. It investigates the issues regarding the kind of interaction, the system's degree of intrusion, the system's context sensitivity...

Francisco-Revilla, Luis

1998-01-01

447

Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs Medical Doctor\\/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer  

Microsoft Academic Search

ObjectiveThe primary aim of this study was to determine if there are differences in the cost of low back pain care when a patient is able to choose a course of treatment with a medical doctor (MD) versus a doctor of chiropractic (DC), given that his\\/her insurance provides equal access to both provider types.

Richard L. Liliedahl; Michael D. Finch; David V. Axene; Christine M. Goertz

2010-01-01

448

Medical marijuana: more questions than answers.  

PubMed

With 23 states and the District of Columbia having enacted medical marijuana laws as of August 2014, it is important that psychiatrists be able to address questions about medical marijuana from patients, families, and other health care professionals. The author discusses the medical literature on synthetic cannabinoids and medical marijuana. The synthetic cannabinoids dronabinol and nabilone are approved by the United States Food and Drug Administration for nausea and vomiting associated with cancer chemotherapy and appetite stimulation in patients with wasting diseases such as acquired immunodeficiency syndrome (AIDS). Results of clinical trials of these agents for other conditions have varied widely thus far. In addition, few data are available on the use of the marijuana plant as a medical treatment. The author concludes that there is a clear need for additional research on possible medical uses of cannabinoids. He notes that discussions with prospective medical marijuana patients should emphasize the importance of communication among all parties due to the possible side effects of treatment with marijuana and its potential to interact with other medications the patient may be taking. Facilitating a thorough substance abuse consultation is one of most positive ways that psychiatrists, especially addiction psychiatrists, can make an impact as medical marijuana becomes increasingly common. A careful review of the prospective medical marijuana user's substance use history, co-occurring medical and psychiatric conditions, family history, and psychosocial stressors is essential in evaluating the potential risks of medical marijuana for these patients. The author concludes that psychiatrists can have a significant impact by increasing the likelihood that medical marijuana will be used in a safe and responsible way. PMID:25226202

Hill, Kevin P

2014-09-01

449

Balancing the risk of recurrent thromboembolism and pre-existing osteoporosis in pregnancy.  

PubMed

In summary, our 31-year-old patient with hypogonadotrophic hypogonadism has severe osteoporosis caused by chronic oestrogen deficiency. Her GnRH deficiency can be overcome using ovulation induction therapy. However, if she becomes pregnant there is a small risk of recurrent thromboembolism because of her previous cerebral thrombosis. This risk is hard to quantify but would undoubtedly increase if her mobility were impaired. The metabolic and mechanical alterations of pregnancy may compromise her weakened skeleton and increase the risk of a second major fracture. Her skeletal status precludes the use of standard heparin. Fractionated low molecular weight heparins would be the prophylactic agent of choice, possibly switching to low-dose warfarin for the second trimester. Alternative prophylaxis using low-dose aspirin may be suitable, although this is not proven. The difficulty in this case is that pregnancy and the prophylactic measures designed to protect the patient may prove to be detrimental. The case also highlights the vital role of prepregnancy counselling and interdisciplinary consultation between obstetrician, haematologist and endocrinologist in order to steer the safest course through this therapeutic minefield. PMID:7742521

Kyei-Mensah, A; Machin, S J; Jacobs, H S

1995-02-01

450

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

451

Pre-Existing Background Knowledge Influences Socioeconomic Differences in Preschoolers' Word Learning and Comprehension  

ERIC Educational Resources Information Center

The goal of the current study is to explore the influence of knowledge on socioeconomic discrepancies in word learning and comprehension. After establishing socioeconomic differences in background knowledge (Study 1), the authors presented children with a storybook that incorporates this knowledge (Study 2). Results indicated that middle-income…

Kaefer, Tanya; Neuman, Susan B.; Pinkham, Ashley M.

2015-01-01

452

ORIGINAL PAPER The Effect of Pre-Existing Affect on the SexualResponses of Women  

E-print Network

a History of Childhood Sexual Abuse Alessandra H. Rellini · Samantha Elinson · Erick Janssen · Cindy M; Meston, Rellini, & Heiman, 2006). In addition, psychophysio- logical studies have found smaller genital; Rellini & Meston, 2006; Schacht et al., 2007). The current empirical literature provides little insight

453

Character displacement: in situ evolution of novel phenotypes or sorting of pre-existing variation?  

Microsoft Academic Search

Character displacement - the divergence of traits between species in response to competition for resources or mates - has long been viewed as a major cause of adaptive diversification and species coexistence. Yet, we lack answers to basic questions concerning the causes and consequences of character displacement, not the least of which is why some species are more prone than

A. M. RICE; D. W. PFENNIG

2007-01-01

454

Pre-existing structural abnormalities of the limbic system in transient global amnesia.  

PubMed

This study aimed to investigate the clinical and radiological findings in patients with transient global amnesia and to evaluate structural abnormalities using voxel-based morphometry. The subjects were diagnosed with transient global amnesia. For the voxel-based morphometry analyses, Statistical Parametric Mapping, running on the MATLAB platform (MathWorks, Natick, MA, USA), was employed to analyze the structural differences between patients with transient global amnesia and control subjects. Eighty patients met the inclusion criteria. Twenty-three patients (29%) were men, and 57 patients (71%) were women. There were significantly more women among the transient global amnesia patients compared with the general Korean population. MRI revealed hippocampal cavities in 41 patients (51%), and the incidence of such cavities was significantly different from that of the control subjects (24%). There were no differences in the clinical factors between the patients with and without hippocampal cavities. Diffusion-weighted imaging was performed in 54 patients, and 13 patients (24%) exhibited high signal intensity in the hippocampus. There were also no differences in the clinical factors between the patients with and without high signal intensities in the hippocampus on diffusion-weighted imaging. Twenty-six patients underwent three-dimensional volumetric T1-weighted imaging that produced results suitable for voxel-based morphometry, and these patients presented with gray matter volume reductions in the hippocampus, cingulum, and cerebellum. There were significant structural differences in the limbic structures between patients with transient global amnesia and the control subjects that might have contributed to vulnerability of the memory pathways of the patients with transient global amnesia. PMID:25818164

Park, Kang Min; Han, Yong Hee; Kim, Tae Hyung; Mun, Chi Woong; Shin, Kyong Jin; Ha, Sam Yeol; Park, JinSe; Kim, Sung Eun

2015-05-01

455

FDG PET/CT in malignant eccrine porocarcinoma arising in a pre-existing poroma.  

PubMed

In a 61-year-old man with known poroma of right lower abdomen, malignant transformation to porocarcinoma was suspected and confirmed by biopsy. PET/CT was requested for tumor staging, which revealed high FDG uptake in the known skin nodules located in the right side of abdominal and chest wall and identified further some adenopathy in the right axillary. All nodules and axillary lymph nodes were removed, and diagnosis of eccrine porocarcinoma was confirmed. The primary tumor and secondary lesions of porocarcinoma show a high glucose metabolism; thus, PET/CT could be useful for staging, follow-up, and detection of recurrence of patients with eccrine porocarcinoma. PMID:23917787

Golemi, Arber; Hanspeter, Esther; Brugger, Eva; Ruiu, Antonio; Farsad, Mohsen

2014-05-01

456

Triggering a Cell Shape Change by Exploiting Pre-Existing Actomyosin Contractions  

PubMed Central

Apical constriction changes cell shapes, driving critical morphogenetic events including gastrulation in diverse organisms and neural tube closure in vertebrates. Apical constriction is thought to be triggered by contraction of apical actomyosin networks. We found that apical actomyosin contractions began before cell shape changes in both C. elegans and Drosophila. In C. elegans, actomyosin networks were initially dynamic, contracting and generating cortical tension without significant shrinking of apical surfaces. Apical cell-cell contact zones and actomyosin only later moved increasingly in concert, with no detectable change in actomyosin dynamics or cortical tension. Thus, apical constriction appears to be triggered not by a change in cortical tension but by dynamic linking of apical cell-cell contact zones to an already contractile apical cortex. PMID:22323741

Roh-Johnson, Minna; Shemer, Gidi; Higgins, Christopher D.; McClellan, Joseph H.; Werts, Adam D.; Tulu, U. Serdar; Gao, Liang; Betzig, Eric; Kiehart, Daniel P.; Goldstein, Bob

2012-01-01

457

Serum Uric Acid and Subsequent Cognitive Performance in Patients with Pre-Existing Cardiovascular Disease  

PubMed Central

High serum uric acid (UA) levels are associated with numerous vascular risk factors, and vascular disease, that predispose patients to cognitive impairment, yet UA is also a major natural antioxidant and higher levels have been linked to slower progression of several neurodegenerative disease. In-order to test the association between UA and subsequent cognitive performance among patients that carry a high vascular burden, UA levels were determined by calorimetric enzymatic tests in a sub-cohort of patients with chronic cardiovascular disease who previously participating in a secondary prevention trial. After an average of 9.8±1.7 years, we assessed cognitive performance (Neurotrax Computerized Cognitive Battery) as well as cerebrovascular reactivity (CVR) and common carotid intima-media thickness (IMT). Among 446 men (mean age 62.3±6.4 yrs) mean UA levels were 5.8±1.1 mg/dL. Adjusted linear regression models revealed that low UA levels (bottom quintile) were associated with poorer cognitive performance. Adjusted differences between the bottom quintile and grouped top UA quintiles were (B coefficient±SE) ?4.23±1.28 for global cognitive scores (p = 0.001), ?4.69±1.81 for memory scores (p = 0.010), ?3.32±1.43 for executive scores (p = 0.020) and ?3.43±1.97 for visual spatial scores (p = 0.082). Significant difference was also found for attention scores (p = 0.015). Additional adjustment for impaired CVR and high common carotid IMT slightly attenuated the relationship. Stronger UA effect on cognitive performance was found for older (age>65) patients with significant age interaction for global cognitive score (p = 0.016) and for executive (p = 0.018) and attention domains (p<0.001). In conclusion, we demonstrate that low UA levels in patients with preexisting cardiovascular disease are associated with poorer cognitive function a decade later. These findings lend support to the hypothesis that oxidative stress may be involved in the pathogenesis of age-associated cognitive impairment. PMID:25794156

Molshatzki, Noa; Weinstein, Galit; Streifler, Jonathan Y.; Goldbourt, Uri; Tanne, David

2015-01-01

458

Interaction of ascending magma with pre-existing crustal structures: Insights from analogue modeling  

Microsoft Academic Search

Magma transport through dikes is a major component of the development of basaltic volcanic fields. Basaltic volcanic fields occur in many different tectonic setting, from tensile (e.g., Camargo Volcanic Field, Mexico) to compressive (e.g., Abu Monogenetic Volcano Group, Japan). However, an important observation is that, independently of their tectonic setting, volcanic fields are characterized by numerous volcanic centers showing clustering

N. Le Corvec; T. Menand; J. V. Rowland

2010-01-01

459

Hexon-chimaeric adenovirus serotype 5 vectors circumvent pre-existing anti-vector immunity  

Microsoft Academic Search

A common viral immune evasion strategy involves mutating viral surface proteins in order to evade host neutralizing antibodies. Such immune evasion tactics have not previously been intentionally applied to the development of novel viral gene delivery vectors that overcome the critical problem of anti-vector immunity. Recombinant, replication-incompetent adenovirus serotype 5 (rAd5) vector-based vaccines for human immunodeficiency virus type 1 and

Diane M. Roberts; Anjali Nanda; Menzo J. E. Havenga; Peter Abbink; Diana M. Lynch; Bonnie A. Ewald; Jinyan Liu; Anna R. Thorner; Patricia E. Swanson; Darci A. Gorgone; Michelle A. Lifton; Angelique A. C. Lemckert; Lennart Holterman; Bing Chen; Athmanundh Dilraj; Angela Carville; Keith G. Mansfield; Jaap Goudsmit; Dan H. Barouch

2006-01-01

460

Time dependence of magnetization reversal when beginning with pre-existing nucleation sites  

NASA Astrophysics Data System (ADS)

We use measurements of time and field dependent magnetization reversal in Co/Pd multilayers with perpendicular anisotropy to detect the presence of dilute enclaves of opposite magnetization within a magnetized ferromagnet. Such enclaves are stable due to dipolar fields generated by the surrounding material, and their presence at the onset of reversal can speed the process by orders of magnitude. The field required to suppress these nuclei and reach true magnetic saturation is found to be an order of magnitude higher than the observable macroscopic saturation field. Fatuzzo-Labrune model is extended to describe magnetization reversal starting with ready nucleation domains.

Windsor, Y. W.; Gerber, A.; Korenblit, I. Ya.; Karpovski, M.

2013-06-01