Sample records for primary ossification center

  1. Endometrial ossification.

    PubMed

    Ejeckam, G C; Haseeb, F; Ahamad, R; Azadeh, B

    1991-07-01

    A case of endometrial ossification in a 22-year-old woman is reported. Chronic endometritis following post-abortion evacuation was considered the basis for the osseous metaplasia in her endometrium. Besides being a reversible cause of infertility, endometrial ossification needs to be differentiated from mixed mesodermal tumours of the endometrium. PMID:1816670

  2. BMP2 induces segment-specific skeletal regeneration from digit and limb amputations by establishing a new endochondral ossification center

    PubMed Central

    Yu, Ling; Han, Manjong; Yan, Mingquan; Lee, Jangwoo; Muneoka, Ken

    2012-01-01

    Bone morphogenetic proteins (BMPs) are required for bone development, the repair of damage skeletal tissue, and the regeneration of the mouse digit tip. Previously we showed that BMP treatment can induce a regeneration response in mouse digits amputated at a proximal level of the terminal phalangeal element (P3) (Yu et al., 2010). In this study, we show that the regeneration-inductive ability of BMP2 extends to amputations at the level of the second phalangeal element (P2) of neonatal digits, and the hindlimb of adult limbs. In these models the induced regenerative response is restricted in a segment-specific manner, thus amputated skeletal elements regenerate distally patterned skeletal structures but does not form joints or more distal skeletal elements. Studies on P2 amputations indicate that BMP2-induced regeneration is associated with a localized proliferative response and the transient expression of established digit blastema marker genes. This is followed by the formation of a new endochondral ossification center at the distal end of the bone stump. The endochondral ossification center contains proliferating chondrocytes that establish a distal proliferative zone and differentiate proximally into hypertrophic chondrocytes. Skeletal regeneration occurs from proximal to distal with the appearance of osteoblasts that differentiate in continuity with the amputated stump. Using the polarity of the endochondral ossification centers induced by BMP2 at two different amputation levels, we show that BMP2 activates a level-dependent regenerative response indicative of a positional information network. In summary, our studies provide evidence that BMP2 induces the regeneration of mammalian limb structures by stimulating a new endochondral ossification center that utilizes an existing network of positional information to regulate patterning during skeletal regeneration. PMID:23041115

  3. Vascularization of primary and secondary ossification centres in the human growth plate

    PubMed Central

    2014-01-01

    Background The switch from cartilage template to bone during endochondral ossification of the growth plate requires a dynamic and close interaction between cartilage and the developing vasculature. Vascular invasion of the primarily avascular hypertrophic chondrocyte zone brings chondroclasts, osteoblast- and endothelial precursor cells into future centres of ossification. Vascularization of human growth plates of polydactylic digits was studied by immunohistochemistry, confocal-laser-scanning-microscopy and RT-qPCR using markers specific for endothelial cells CD34 and CD31, smooth muscle cells ?-SMA, endothelial progenitor cells CD133, CXCR4, VEGFR-2 and mesenchymal progenitor cells CD90 and CD105. In addition, morphometric analysis was performed to quantify RUNX2+ and DLX5+ hypertrophic chondrocytes, RANK+ chondro- and osteoclasts, and CD133+ progenitors in different zones of the growth plate. Results New vessels in ossification centres were formed by sprouting of CD34+ endothelial cells that did not co-express the mature endothelial cell marker CD31. These immature vessels in the growth plate showed no abluminal coverage with ?-SMA+ smooth muscle cells, but in their close proximity single CD133+ precursor cells were found that did not express VEGFR-2, a marker for endothelial lineage commitment. In periosteum and in the perichondrial groove of Ranvier that harboured CD90+/CD105+ chondro-progenitors, in contrast, mature vessels were found stabilized by ?-SMA+ smooth muscle cells. Conclusion Vascularization of ossification centres of the growth plate was mediated by sprouting of capillaries coming from the bone collar or by intussusception rather than by de-novo vessel formation involving endothelial progenitor cells. Vascular invasion of the joint anlage was temporally delayed compared to the surrounding joint tissue. PMID:25164565

  4. Multipurpose contrast enhancement on epiphyseal plates and ossification centers for bone age assessment

    PubMed Central

    2013-01-01

    Background The high variations of background luminance, low contrast and excessively enhanced contrast of hand bone radiograph often impede the bone age assessment rating system in evaluating the degree of epiphyseal plates and ossification centers development. The Global Histogram equalization (GHE) has been the most frequently adopted image contrast enhancement technique but the performance is not satisfying. A brightness and detail preserving histogram equalization method with good contrast enhancement effect has been a goal of much recent research in histogram equalization. Nevertheless, producing a well-balanced histogram equalized radiograph in terms of its brightness preservation, detail preservation and contrast enhancement is deemed to be a daunting task. Method In this paper, we propose a novel framework of histogram equalization with the aim of taking several desirable properties into account, namely the Multipurpose Beta Optimized Bi-Histogram Equalization (MBOBHE). This method performs the histogram optimization separately in both sub-histograms after the segmentation of histogram using an optimized separating point determined based on the regularization function constituted by three components. The result is then assessed by the qualitative and quantitative analysis to evaluate the essential aspects of histogram equalized image using a total of 160 hand radiographs that are implemented in testing and analyses which are acquired from hand bone online database. Result From the qualitative analysis, we found that basic bi-histogram equalizations are not capable of displaying the small features in image due to incorrect selection of separating point by focusing on only certain metric without considering the contrast enhancement and detail preservation. From the quantitative analysis, we found that MBOBHE correlates well with human visual perception, and this improvement shortens the evaluation time taken by inspector in assessing the bone age. Conclusions The proposed MBOBHE outperforms other existing methods regarding comprehensive performance of histogram equalization. All the features which are pertinent to bone age assessment are more protruding relative to other methods; this has shorten the required evaluation time in manual bone age assessment using TW method. While the accuracy remains unaffected or slightly better than using unprocessed original image. The holistic properties in terms of brightness preservation, detail preservation and contrast enhancement are simultaneous taken into consideration and thus the visual effect is contributive to manual inspection. PMID:23565999

  5. Primary aldosteronism in a referral hypertension center

    Microsoft Academic Search

    Giuseppe Regolisti; Franco Perazzoli; Aurelio Negro; Carlo Sani; Simona Davoli; Pietro Coghi; Ermanno Rossi

    2001-01-01

    Primary aldosteronism (PA) is a potentially curable form of secondary hypertension, but is regarded as being relatively rare in unselected hypertensive populations. The prevalence and characteristics of PA were evaluated on 1046 subsequent hypertensive patients (pts) sent to a referral Hypertension Center between January 1st 1997 and December 31st 1999. Screening of PA was performed with the captopril test. Final

  6. Impact of trochanteric heterotopic ossification on measurement of femoral bone density following cemented total hip replacement.

    PubMed

    Downing, Martin R; Knox, David; Gibson, Peter; Reid, David M; Potter, Anne; Ashcroft, George P

    2008-10-01

    During a study of bone mineral density changes around cemented femoral implants, we recognized heterotopic ossification occurring regularly in a position anterior to the greater trochanter and proximal femur. The aim of this study was to describe the incidence, distribution, and effect of this ossification on periprosthetic DXA scans following primary cemented total hip replacement. One hundred eleven patients underwent postoperative DXA examinations measuring changes in bone mineral density with heterotopic ossification identified and localized on standard radiographs with confirmation using DXA subtraction imaging. Male gender and age within the male group were significantly associated with occurrence of heterotopic ossification (p = 0.003 and 0.046, respectively). Femoral stem type, weight, and body mass index had no significant effect (p = 0.525, 0.372, and 0.243, respectively). Examining the Gruen zones in all patients suggested a median (plus interquartile range) zone 1 density drop of 4% (-12% to +7%). When separated and analyzed for the effect of heterotopic ossification, the 45 patients with heterotopic ossification showed a 2-year density gain of +6% (-5% to +15%), whereas those without heterotopic ossification showed a loss of 8% (-14% to 0%), a significant difference (p < 0.001). Zone 2 also showed a significant difference (p = 0.048). We therefore recommend that affected zones should be identified and excluded from analysis at all time points. Without this precaution, researchers risk underestimating periprosthetic bone loss in their studies and reporting misleading conclusions. PMID:18404740

  7. Heterotopic Ossification: An Unusual Presentation

    PubMed Central

    Patil, Satish G.; Siddiqua, Aaisha; Joshi, Udupi Krishna; Deshmukh, Pallavi K.; Patil, Bindu S.; Mangalgi, Anand

    2012-01-01

    Heterotopic ossification (HO) is usually seen after-trauma, following traumatic injuries, surgeries involving major joints, neurogenic injury, and burns; however, atraumatic cases have also been reported. HO tends to cause pain, swelling, and limitation of joint movements. HO has been reported in adults as well as in pediatric cases, however, our search in the English literature has not revealed a single case in the infratemporal region, especially in children of developing age, where HO tends to affect the development and growth of adjacent bones. We are reporting a case of HO in close proximity to TMJ affecting the development of mandible and maxilla. PMID:23346421

  8. NASA. Johnson Space Center primary battery applications

    NASA Technical Reports Server (NTRS)

    Bragg, Bob J.

    1991-01-01

    The role of the Power Branch/EP5 of JSC in primary battery applications is to support those JSC organizations having direct application responsibility with trade studies, battery selection recommendations, and with development, qualification, and provisioning of primary batteries. Battery subsystem management is provided. Payload hazard report preparation is supported, as is the review and comment of such reports for the JSC Payload Safety Panel, who approves the flight safety for all Orbiter payloads. JSC battery users are provided with safety analysis and test support to achieve safety approval. Finally, it is the responsibility of the Power Branch to define and maintain battery safety requirement documentation for JSC.

  9. Blast injuries and heterotopic ossification

    PubMed Central

    Alfieri, K. A.; Forsberg, J. A.; Potter, B. K.

    2012-01-01

    Heterotopic ossification (HO) is perhaps the single most significant obstacle to independence, functional mobility, and return to duty for combat-injured veterans of Operation Enduring Freedom and Operation Iraqi Freedom. Recent research into the cause(s) of HO has been driven by a markedly higher prevalence seen in these wounded warriors than encountered in previous wars or following civilian trauma. To that end, research in both civilian and military laboratories continues to shed light onto the complex mechanisms behind HO formation, including systemic and wound specific factors, cell lineage, and neurogenic inflammation. Of particular interest, non-invasive in vivo testing using Raman spectroscopy may become a feasible modality for early detection, and a wound-specific model designed to detect the early gene transcript signatures associated with HO is being tested. Through a combined effort, the goals of early detection, risk stratification, and development of novel systemic and local prophylaxis may soon be attainable. PMID:23610689

  10. Civilian primary care prescribing psychologist in an army medical center.

    PubMed

    Shearer, David S

    2012-12-01

    The present article discusses the integration of a civilian prescribing psychologist into a primary care clinic at Madigan Army Medical Center. A description of the role of the prescribing psychologist in this setting is provided. The author asserts that integrating prescribing psychology into primary care can improve patient access to skilled behavioral health services including psychotherapeutic and psychopharmacologic treatment. Potential benefits to the primary care providers (PCPs) working in primary care clinics are discussed. The importance of collaboration between the prescribing psychologist and PCP is emphasized. Initial feedback indicates that integration of a prescribing psychologist into primary care has been well received in this setting. PMID:23179076

  11. Primary production cycle in an upwelling center

    NASA Astrophysics Data System (ADS)

    MacIsaac, J. J.; Dugdale, R. C.; Barber, R. T.; Blasco, D.; Packard, T. T.

    1985-05-01

    The cycle of nitrogen and carbon productivity of phytoplankton in an upwelling center at 15°S on the coast of Peru was studied during the JOINT-II expedition of the Coastal Upwelling Ecosystems Analysis program. The productivity cycle was characterized by repeated stations at various locations in the upwelling plume, a time series of stations in mid plume, and stations located along drogue tracks. Four zones of physiological condition were distinguished along the axis of the upwelling plume. In Zone I phytoplankton upwelled with nutrient-rich water were initially 'shifted-down'; in Zone II they underwent light induced 'shift-up' to increased nutrient uptake, photosynthesis, and synthesis of macromolecules. In Zone III ambient nutrient concentrations were rapidly reduced, there was a rapid accumulation of phytoplankton biomass in the water column, and rate processes proceeded at maximal rates. In Zone IV ambient nutrient concentrations were significantly decreased, phytoplankton biomass remained high, and limitation of phytoplankton processes was beginning to be observed. Phytoplankton responded to the altered environment by undergoing 'shift-down' to lower rates of nutrient uptake, photosynthesis, and macromolecule synthesis. The time and space domain where this entire sequence occurs was relatively small; the cycle from initial upwelling to 'shift-down' was completed in 8 to 10 days within 30 to 60 km off the coast.

  12. Atypical lipomatous tumor with unusual extensive metaplastic ossification

    PubMed Central

    Javery, Omar; Jagannathan, Jyothi P.; O'Regan, Kevin; Hornick, Jason L.; Ramaiya, Nikhil

    2012-01-01

    Abstract The presence of metaplastic ossification within atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDLPS) is a rare occurrence. When present, bone formation is most often found in association with a dedifferentiated component arising within the primary tumor. It is important for the radiologist not only to recognize the differential diagnosis of a calcified or ossified soft tissue mass but also be aware of the various soft tissue neoplasms, both aggressive and non-aggressive, that may show such features. We report a case of ALT/WDLPS with unusual extensive metaplastic bone formation without an element of dedifferentiated liposarcoma. PMID:22375305

  13. Atypical Rathke's Cleft Cyst Associated with Ossification

    Microsoft Academic Search

    Yoko Nakasu; Satoshi Nakasu; Masayuki Nakajima; Ryuta Itoh; Masayuki Matsuda

    Summary: We report a case of symptomatic Rathke's cleft cyst with ossification. CT scans showed curvilinear calcifi- cation on the wall of the cyst. MR images revealed a cystic sellar lesion with a nodular solid mass extending to the floor of the third ventricle. This case shows that calcifica- tion of the suprasellar cyst does not always suggest cran- iopharyngioma.

  14. Primary and Comprehensive Stroke Centers: History, Value and Certification Criteria

    PubMed Central

    2013-01-01

    In the United States (US) stroke care has undergone a remarkable transformation in the past decades at several levels. At the clinical level, randomized trials have paved the way for many new stroke preventives, and recently, several new mechanical clot retrieval devices for acute stroke treatment have been cleared for use in practice by the US Federal Drug Administration. Furthermore, in the mid 1990s we witnessed regulatory approval of intravenous recombinant tissue plasminogen activator for administration in acute ischemic stroke. In the domain of organization of medical care and delivery of health services, stroke has transitioned from a disease dominated by neurologic consultation services only to one managed by vascular neurologists in geographical stroke units, stroke teams and care pathways, primary stroke center certification according to The Joint Commission, and most recently comprehensive stroke center designation under the aegis of The Joint Commission. Many organizations in the US have been involved to enhance stroke care. To name a few, the American Heart Association/American Stroke Association, Brain Attack Coalition, and National Stroke Association have been on the forefront of this movement. Additionally, governmental initiatives by the US Centers for Disease Control and Prevention and legislative initiatives such as the Paul Coverdell National Acute Stroke Registry program have paved the way to focus on stroke prevention, acute treatment and quality improvement. In this invited review, we discuss a brief history of organized stroke care in the United States, evidence to support the value of primary and comprehensive stroke centers, and the certification criteria and process to become a primary or comprehensive stroke center. PMID:24324943

  15. University of California Davis Center for Health Services Research in Primary Care

    E-print Network

    Carmichael, Owen

    University of California Davis Center for Health Services Research in Primary Care FOURTH ANNUAL REPORT 1997-1998 The UCD Center for Health Services Research in Primary Care has now completed an initial

  16. University of California Davis Center for Health Services Research in Primary Care

    E-print Network

    Carmichael, Owen

    University of California Davis Center for Health Services Research in Primary Care SEVENTH ANNUAL REPORT 2000-2001 The UCD Center for Health Services Research in Primary Care has now completed six years

  17. University of California Davis Center for Health Services Research in Primary Care

    E-print Network

    Carmichael, Owen

    University of California Davis Center for Health Services Research in Primary Care SIXTH ANNUAL REPORT 1999-2000 The UCD Center for Health Services Research in Primary Care has now completed five years

  18. The John D. Stoeckle Center for Primary Care Innovation Massachusetts General Hospital

    E-print Network

    Mootha, Vamsi K.

    2007 The John D. Stoeckle Center for Primary Care Innovation Massachusetts General Hospital 50.stoecklecenter.org reshaping primary care for a healthier future The John D. Stoeckle Center for PRIMARY CARE INNOVATION How You Can Help The need for outstanding primary care is great, and your charitable support

  19. The John D. Stoeckle Center for Primary Care Innovation Massachusetts General Hospital

    E-print Network

    Mootha, Vamsi K.

    The John D. Stoeckle Center for Primary Care Innovation Massachusetts General Hospital Center for Excellence in Primary Care University of California, San Francisco Primary Care: A Miracle of Modern Medicine with us! (see details, back cover) #12;Primary care: The foundation of our health care system may

  20. Primary charge separation in isolated photosystem II reaction centers

    SciTech Connect

    Seibert, M.; Toon, S. (National Renewable Energy Lab., Golden, CO (United States)); Govindjee (Illinois Univ., Urbana, IL (United States)); O'Neil, M.P.; Wasielewski, M.R. (Argonne National Lab., IL (United States))

    1992-08-24

    Primary charge-separation in isolated bacterial reaction center (RC) complex occurs in 2.8 ps at room temperature and 0.7--1.2 ps at 10 K. Because of similarities between the bacterial and photosystem II (PSII) RCs, it has been of considerable interest to obtain analogous charge-separation rates in the higher plant system. Our previous femtosecond transient absorption studies used PSII RC material stabilized with PEG or by exchanging dodecyl maltoside (DM) for Triton in the isolation procedure. These materials gave charge-separation 1/e times of 3.0 [plus minus] 0.6 ps at 4[degree]C and 1.4[plus minus] 0.2 ps at 15 K based on the risetime of transient absorption kinetics at 820 nm. These values were thought to represent the time required for formation of the P680[sup +]-Pheo[sup [minus

  1. University of California Davis Center for Health Services Research in Primary Care

    E-print Network

    Carmichael, Owen

    University of California Davis Center for Health Services Research in Primary Care THIRD ANNUAL REPORT 1996-1997 The UCD Center for Health Services Research in Primary Care has now completed an initial Administrative Base Although the Center for Health Services Research in Primary Care is currently designated

  2. Diabetes in a primary care center among Spaniards and immigrants

    PubMed Central

    Vilalta, Montserrat Roca; Castańo Pérez, Águeda; López Moya, Charo; López Olivares, Mercedes

    Diabetes is a disease with different prevalence in different populations. Objectives The aim of the present study is to describe diabetic patients in a primary care center with regard to their geographic origin, and to determine the status of their disease. Methods A cross-sectional descriptive study, with data available from clinical records in South Tarrasa primary care center (Barcelona, Spain) in 2004. Results A total of 1215 diabetic patients with an average age of 65 years, 51% female, were included in the study. Regarding their origin, 97% were from Spain, 2% from Morocco, 0.8% from Latin America, and 0.2% from the rest of Europe. The average Hb1AC was 6.9%. In type 2 diabetic patients, treatment consisted of oral hypoglycemic agents (OHA) for 46.6%, only dietetic restrictions for 36.5%, OHA + insulin for 7.9%, and only insulin for 9%. In the age group 30-39 years, 0.7% of Moroccans suffer from diabetes versus 0.5% of Spaniards. The values in the 40-49 year group are 3.9% of Moroccans, 3% of Spaniards, and 2.1% of Latin Americans. The values in the 50-59 year group are 13.5% of Moroccans, 10.6% of Spaniards, and 7.7% of Latin Americans. The values in the 60-69 year group are 40% of Moroccans, 18.8% of Spaniards, and 44.5% of Latin Americans. The values in the 70-79 year group are 67% of Moroccans, 26% of Spaniards, and 50% of Latin Americans. The average Hb1AC was 6.3% in Latin Americans, 6.9% in Spaniards, and 8.1% in Moroccans. In type 1 diabetic patients, the average Hb1AC was 10.2% in Moroccans and 8% in Spaniards; while in type 2 diabetes, the average Hb1AC was 7.8% in Moroccans and 6.9% in Spaniards. Gestational diabetes was observed in 6.1% of the Spanish, 10.9% of the Moroccan and 4.2% of the Latin American women. Conclusions A higher prevalence of diabetes was detected in Moroccans than in patients from other countries. These patients present poor control of the disease. PMID:25247004

  3. Primary charge separation in isolated photosystem II reaction centers

    SciTech Connect

    Seibert, M.; Toon, S. [National Renewable Energy Lab., Golden, CO (United States); Govindjee [Illinois Univ., Urbana, IL (United States); O`Neil, M.P.; Wasielewski, M.R. [Argonne National Lab., IL (United States)

    1992-08-24

    Primary charge-separation in isolated bacterial reaction center (RC) complex occurs in 2.8 ps at room temperature and 0.7--1.2 ps at 10 K. Because of similarities between the bacterial and photosystem II (PSII) RCs, it has been of considerable interest to obtain analogous charge-separation rates in the higher plant system. Our previous femtosecond transient absorption studies used PSII RC material stabilized with PEG or by exchanging dodecyl maltoside (DM) for Triton in the isolation procedure. These materials gave charge-separation 1/e times of 3.0 {plus_minus} 0.6 ps at 4{degree}C and 1.4{plus_minus} 0.2 ps at 15 K based on the risetime of transient absorption kinetics at 820 nm. These values were thought to represent the time required for formation of the P680{sup +}-Pheo{sup {minus}} state. Recent results of Hastings et al. obtained at high data acquisition rates and low flash intensities, suggest that the Pheo{sup {minus}} state may form more slowly. In light of this work, we have carried out additional time domain studies of both electron transport and energy transfer phenomena in stabilized DM PSII RCs at room temperature. We used a 1-kHz repetition rate femtosecond transient absorption spectrometer with a 200 fs instrumental time resolution and compared the results with those obtained by others using frequency domain hole-burning techniques.

  4. Outcome Determinants of Stroke in a Brazilian Primary Stroke Center

    PubMed Central

    Kuster, Gustavo W.; Dutra, Lívia A.; Brasil, Israel P.; Pacheco, Evelyn P.; Arruda, Márcio A. C.; Volcov, Cristiane; Domingues, Renan B.

    2014-01-01

    Background. Stroke mortality in Brazil is one of the highest among Western countries. Nonetheless, stroke outcome determinants are still poorly known in this country. In this study we evaluate outcome determinants of stroke in a primary stroke center in Săo Paulo, Brazil. Methods. We evaluated demographic, clinical, and outcome data of patients with ischemic stroke (IS), transient ischemic attack (TIA), and intracerebral hemorrhage (ICH) admitted at “Hospital Paulistano,” Săo Paulo, Brazil. In-hospital mortality and functional outcome determinants were assessed. Univariate and binary logistic regression analysis were performed. Results. Three hundred forty-one patients were included in the study, 52.2% being male with 66.8 ± 15.7 years. The stroke type distribution was IS: 59.2%, TIA: 29.6%, and ICH: 11.1%. ICH was associated with greater severity and poorer functional outcome. The determinants of poorer functional outcome were higher NIHSS, lower Glasgow score, and lower oxygen saturation level. The most important mortality determinant was the presence of visual symptoms. Conclusions. The stroke mortality and stroke outcome determinants found in the present study do not remarkably differ from studies carried out in developed countries. Stroke prognosis studies are crucial to better understand the high burden of stroke in Brazil. PMID:25580352

  5. University of California, Davis Center for Health Services Research in Primary Care

    E-print Network

    Carmichael, Owen

    University of California, Davis Center for Health Services Research in Primary Care 2005 ­ 2006 for Health Services Research in Primary Care ANNUAL REPORT 2005-2006 The University of California Davis Center for Health Services Research in Primary Care has now completed twelve years of ongoing growth

  6. University of California, Davis Center for Health Services Research in Primary Care

    E-print Network

    Carmichael, Owen

    University of California, Davis Center for Health Services Research in Primary Care 2003 - 2004 Research in Primary Care ANNUAL REPORT 2003-2004 The University of California Davis Center for Health Services Research in Primary Care has now completed nine years of continuing growth and development

  7. University of California, Davis Center for Health Services Research in Primary Care

    E-print Network

    Carmichael, Owen

    University of California, Davis Center for Health Services Research in Primary Care 2002 ­ 2003 in Primary Care ANNUAL REPORT 2002-2003 The University of California Davis Center for Health Services Research in Primary Care has now completed eight years of continuing growth and development. During

  8. University of California, Davis Center for Health Services Research in Primary Care

    E-print Network

    Carmichael, Owen

    University of California, Davis Center for Health Services Research in Primary Care 2001 ­ 2002 in Primary Care ANNUAL REPORT 2001-2002 The University of California Davis Center for Health Services Research in Primary Care has now completed seven years of continuing growth and development. During

  9. University of California, Davis Center for Health Services Research in Primary Care

    E-print Network

    Carmichael, Owen

    University of California, Davis Center for Health Services Research in Primary Care 2004 ­ 2005 for Health Services Research in Primary Care ANNUAL REPORT 2004-2005 The University of California Davis Center for Health Services Research in Primary Care has now completed eleven years of ongoing growth

  10. January 2008 The John D. Stoeckle Center for Primary Care Innovation Number 8 "Greetings and Salutations"

    E-print Network

    Mootha, Vamsi K.

    January 2008 The John D. Stoeckle Center for Primary Care Innovation Number 8 "Greetings and Salutations" News from the Frontlines of Primary Care Partners Creates Primary Care Task Force The PHS Task Force is charged with developing a Partners-wide strategy for primary care in the community. Chaired

  11. Dendriform pulmonary ossification in patient with rare earth pneumoconiosis

    PubMed Central

    Yoon, H; Moon, H; Park, S; Song, J; Lim, Y; Kohyama, N

    2005-01-01

    The case history is presented of a patient with pathologically proven dendriform pulmonary ossification and rare earth pneumoconiosis confirmed by analytical transmission electron microscopy. This is thought to be the first report of this association. PMID:16061714

  12. The Primary Cilium: A Signaling Center During Vertebrate Development

    PubMed Central

    Goetz, Sarah C.

    2011-01-01

    The primary cilium has recently stepped into the spotlight, as a flood of data demonstrate that this organelle has crucial roles in vertebrate development and human genetic diseases. Cilia are required for the response to developmental signals, and evidence is accumulating that the primary cilium is specialized for Hedgehog (Hh) signal transduction. Formation of cilia, in turn, is regulated by other signaling pathways, possibly including the planar cell polarity pathway. The cilium therefore represents a nexus for signaling pathways during development. The connections between cilia and developmental signaling have begun to clarify the basis of human diseases associated with ciliary dysfunction. PMID:20395968

  13. Diffuse pulmonary ossification and spontaneous pneumothorax in a pilot: a case report.

    PubMed

    Ekholdt, P F; Oppedal, B R; Arva, P

    1986-07-01

    A 51-year-old pilot with spontaneous pneumothorax, emphysema, and multiple horny ossification in the lung is reported. The literature concerning diffuse pulmonary ossification is reviewed and aeromedical implications are discussed. PMID:3090992

  14. [Homosexuality and adolescence. A primary health care center holistic view].

    PubMed

    Leyva Moral, Juan Manuel

    2006-09-01

    In spite of the fact that homosexuality has existed since time immemorial, homosexuality continues to be a taboo topic for many people. When time comes for a youth to reveal his/her sexual identify to his/her family many young homosexuals experience duress during this process which may have physical and psychological consequences for those youths. Therefore, it is important that all primary health care team members be capable to identify this process in order to apply the most appropriate measures. PMID:17061468

  15. Primary Charge Separation Routes in the BChl:BPhe Heterodimer Reaction Centers of Rhodobacter sphaeroides

    E-print Network

    van Stokkum, Ivo

    heterodimer reaction center, excitation of D using 880 nm excitation light results in a 43 ps decayPrimary Charge Separation Routes in the BChl:BPhe Heterodimer Reaction Centers of Rhodobacter in membrane-bound reaction centers of Rhodobacter sphaeroides in which the excitonically coupled

  16. Osteochondrosis of the accessory ossification centre of the medial malleolus.

    PubMed

    Farsetti, Pasquale; Dragoni, Massimiliano; Potenza, Vito; Caterini, Roberto

    2015-01-01

    We report a case of a painful accessory ossification centre of the medial malleolus in an 11-year-old girl who was not involved in sports activities. The patient was treated conservatively, with complete clinical and radiographic healing of the medial malleolus 6 months after the first presentation. We ruled out the uncommon pathological conditions causing chronic pain in the medial malleolus during skeletal growth, such as traction apophysitis of the medial malleolus, osteochondrosis, osteochondritis or avascular necrosis of the distal tibial epiphysis. We speculate that this painful condition may be classified as an osteochondrosis of the accessory ossification centre of the medial malleolus. PMID:25438106

  17. New Pathways for Primary Care: An Update on Primary Care Programs From the Innovation Center at CMS

    PubMed Central

    Baron, Richard J.

    2012-01-01

    Those in practice find that the fee-for-service system does not adequately value the contributions made by primary care. The Center for Medicare and Medicaid Innovation (Innovation Center) was created by the Affordable Care Act to test new models of health care delivery to improve the quality of care while lowering costs. All programs coming out of the Innovation Center are tests of new payment and service delivery models. By changing both payment and delivery models and moving to a payment model that rewards physicians for quality of care instead of volume of care, we may be able to achieve the kind of health care patients want to receive and primary care physicians want to provide. PMID:22412007

  18. Dullard/Ctdnep1 regulates endochondral ossification via suppression of TGF-? signaling.

    PubMed

    Hayata, Tadayoshi; Yoichi; Ezura; Asashima, Makoto; Nishinakamura, Ryuichi; Noda, Masaki

    2015-02-01

    Transforming growth factor (TGF)-? signaling plays critical roles during skeletal development and its excessive signaling causes genetic diseases of connective tissues including Marfan syndrome and acromelic dysplasia. However, the mechanisms underlying prevention of excessive TGF-? signaling in skeletogenesis remain unclear. We previously reported that Dullard/Ctdnep1 encoding a small phosphatase is required for nephron maintenance after birth through suppression of bone morphogenetic protein (BMP) signaling. Unexpectedly, we found that Dullard is involved in suppression of TGF-? signaling during endochondral ossification. Conditional Dullard-deficient mice in the limb and sternum mesenchyme by Prx1-Cre displayed the impaired growth and ossification of skeletal elements leading to postnatal lethality. Dullard was expressed in early cartilage condensations and later in growth plate chondrocytes. The tibia growth plate of newborn Dullard mutant mice showed reduction of the proliferative and hypertrophic chondrocyte layers. The sternum showed deformity of cartilage primordia and delayed hypertrophy. Micromass culture experiments revealed that Dullard deficiency enhanced early cartilage condensation and differentiation, but suppressed mineralized hypertrophic chondrocyte differentiation, which was reversed by treatment with TGF-? type I receptor kinase blocker LY-364947. Dullard deficiency induced upregulation of protein levels of both phospho-Smad2/3 and total Smad2/3 in micromass cultures without increase of Smad2/3 mRNA levels, suggesting that Dullard may affect Smad2/3 protein stability. The phospho-Smad2/3 level was also upregulated in perichondrium and hypertrophic chondrocytes in Dullard-deficient embryos. Response to TGF-? signaling was enhanced in Dullard-deficient primary chondrocyte cultures at late, but not early, time point. Moreover, perinatal administration of LY-364947 ameliorated the sternum deformity in vivo. Thus, we identified Dullard as a new negative regulator of TGF-? signaling in endochondral ossification. PMID:25155999

  19. Nurse Managed Center: Access to Primary Health Care for Urban Native Americans

    Microsoft Academic Search

    Donna Felber Neff; Elizabeth S. Kinion; Christen Cardina

    2007-01-01

    Urban Native Americans represent a small, diverse minority with unique health needs. The purposes of this descriptive retrospective study were to describe (a) the characteristics and primary health problems of urban Native Americans who receive primary health care at an urban nurse managed center (NMC) and (b) the nursing interventions provided at an urban NMC to urban Native Americans. A

  20. Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis

    ERIC Educational Resources Information Center

    Klein, Michael C.; Ciotoli, Carlo; Chung, Henry

    2011-01-01

    Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between…

  1. Monotreme ossification sequences and the riddle of mammalian skeletal development.

    PubMed

    Weisbecker, Vera

    2011-05-01

    The developmental differences between marsupials, placentals, and monotremes are thought to be reflected in differing patterns of postcranial development and diversity. However, developmental polarities remain obscured by the rarity of monotreme data. Here, I present the first postcranial ossification sequences of the monotreme echidna and platypus, and compare these with published data from other mammals and amniotes. Strikingly, monotreme stylopodia (humerus, femur) ossify after the more distal zeugopodia (radius/ulna, tibia/fibula), resembling only the European mole among all amniotes assessed. European moles also share extreme humeral adaptations to rotation digging and/or swimming with monotremes, suggesting a causal relationship between adaptation and ossification heterochrony. Late femoral ossification with respect to tibia/fibula in monotremes and moles points toward developmental integration of the serially homologous fore- and hindlimb bones. Monotreme cervical ribs and coracoids ossify later than in most amniotes but are similarly timed as homologous ossifications in therians, where they are lost as independent bones. This loss may have been facilitated by a developmental delay of coracoids and cervical ribs at the base of mammals. The monotreme sequence, although highly derived, resembles placentals more than marsupials. Thus, marsupial postcranial development, and potentially related diversity constraints, may not represent the ancestral mammalian condition. PMID:21521190

  2. Patterns of ossification in southern versus northern placental mammals.

    PubMed

    Hautier, Lionel; Bennett, Nigel C; Viljoen, Hermien; Howard, Lauren; Milinkovitch, Michel C; Tzika, Athanasia C; Goswami, Anjali; Asher, Robert J

    2013-07-01

    Consensus on placental mammal phylogeny is fairly recent compared to that for vertebrates as a whole. A stable phylogenetic hypothesis enables investigation into the possibility that placental clades differ from one another in terms of their development. Here, we focus on the sequence of skeletal ossification as a possible source of developmental distinctiveness in "northern" (Laurasiatheria and Euarchontoglires) versus "southern" (Afrotheria and Xenarthra) placental clades. We contribute data on cranial and postcranial ossification events during growth in Afrotheria, including elephants, hyraxes, golden moles, tenrecs, sengis, and aardvarks. We use three different techniques to quantify sequence heterochrony: continuous method, sequence-ANOVA (analysis of variance) and event-paring/Parsimov. We show that afrotherians significantly differ from other placentals by an early ossification of the orbitosphenoid and caudal vertebrae. Our analysis also suggests that both southern placental groups show a greater degree of developmental variability; however, they rarely seem to vary in the same direction, especially regarding the shifts that differ statistically. The latter observation is inconsistent with the Atlantogenata hypothesis in which afrotherians are considered as the sister clade of xenarthrans. Interestingly, ancestral nodes for Laurasiatheria and Euarchontoglires show very similar trends and our results suggest that developmental homogeneity in some ossification sequences may be restricted to northern placental mammals (Boreoeutheria). PMID:23815655

  3. Heterotopic ossification as a complication of toxic epidermal necrolysis

    Microsoft Academic Search

    Charles J. Gibson; Kanakadurga R. Poduri

    1997-01-01

    The development of heterotopic ossification (HO) as a complication of toxic epidermal necrolysis (TEN) has not been previously reported. TEN, also known as Lyell's syndrome, is a rare but serious skin disorder that typically occurs after the administration of drugs, especially sulfonamides, barbiturates, phenytoin, and nonsteroidal anti-inflammatory agents. TEN is characterized by the development of large fluid-filled bullae with separation

  4. Meniscal ossification. II. The normal pattern in the tiger knee.

    PubMed

    Ganey, T M; Ogden, J A; Abou-Madi, N; Colville, B; Zdyziarski, J M; Olsen, J H

    1994-04-01

    Examination of knee menisci of Bengal tigers revealed ossicles within the cartilaginous anterior horn of each medial meniscus. This ossification was not evident in the neonatal animal, but was present in animals aged 20 months or older. The ossicle appeared prior to the completion of skeletal maturation at the knee, and was composed of normal remodeling trabecular bone. While most animals had a single, variably sized ossicle, multiple ossicles also occurred. The meniscal cartilage apposed to the femoral articulation exhibited a distinct columnar pattern in the region of the ossicle, in contrast to the non-columnar pattern throughout the bulk of the meniscus, including the ossicle side apposed to the tibial plateau. In this particular large mammalian species medial meniscal ossification appears to be a normal anatomical variation that progressively develops following birth, and may serve as a model for the phylogenetic (developmental) theory of etiology. PMID:7517071

  5. Heterotopic Ossification Causing Radiculopathy after Lumbar Total Disc Arthroplasty.

    PubMed

    Jackson, Keith L; Hire, Justin M; Jacobs, Jeremy M; Key, Charles C; DeVine, John G

    2015-06-01

    To date, no reports have presented radiculopathy secondary to heterotopic ossification following lumbar total disc arthroplasty. The authors present a previously unpublished complication of lumbar total disk arthroplasty (TDA) secondary to heterotopic ossification (HO) in the spinal canal, and they propose a modification to the McAfee classification of HO. The patient had undergone an L5/S1 lumbar TDA two years prior due to discogenic back pain. His preoperative back pain was significantly relieved, but he developed new, atraumatic onset radiculopathy. Radiographs and a computed tomography myelogram revealed an implant malposition posteriorly with heterotopic bone formation in the canal, causing an impingement of the traversing nerve root. Revision surgery was performed with implant extraction, L5/S1 anterior lumbar interbody fusion, supplemental posterior decompression, and pedicle screw fixation. The patient tolerated the procedure well, with complete resolution of the radicular leg pain. At a two-year follow up, the patient had a solid fusion without subsidence or recurrence of heterotopic bone. This case represents a novel pattern of heterotopic ossification, and it describes a previously unreported cause for implant failure in lumbar disc replacement surgery-reinforcing the importance of proper intraoperative component positioning. We propose a modification to the existing McAfee classification of HO after TDA with the addition of Class V and VI HO. PMID:26097664

  6. Pulsed electromagnetic field may accelerate in vitro endochondral ossification.

    PubMed

    Wang, Jue; Tang, Na; Xiao, Qiang; Zhang, Li; Li, Yu; Li, Juan; Wang, Jun; Zhao, Zhihe; Tan, Lijun

    2015-01-01

    Recapitulation of embryonic endochondral bone formation is a promising alternative approach to bone tissue engineering. However, the time-consuming process is one of the reasons the approach is unpractical. Here, we aimed at accelerating the in vitro endochondral ossification process of tissue engineering by using a pulsed electromagnetic field (PEMF). The rat bone marrow-derived stem cells were chondrogenic or hypertrophic differentiated in a three-dimensional pellet culture system, and treated with different intensities of PEMF (1, 2, and 5 mT with modulation frequency 750 Hz, carrier frequency 75 Hz and a duty ratio of 0.8, 3 h/day for 4 weeks). The effects of PEMF on hypertrophy and endochondral ossification were assessed by safranin O staining, immunohistochemistry, and quantitative real-time polymerase chain reaction. The results suggest that PEMF at 1, 2, and 5 mT may inhibit the maintenance of the cartilaginous phenotype and increase cartilage-specific extracellular matrix degradation in the late stage of chondrogenic differentiation. In addition, among the three different intensities, only PEMF at 1 mT directed the differentiation of chondrogenic-induced stem cell pellets to the hypertrophic stage and promoted osteogenic differentiation. Our findings provide the feasibility to optimize the process of in vitro endochondral ossification with PEMF stimulation. PMID:25358461

  7. Extensive heterotopic ossification in patient with tubercular meningitis

    PubMed Central

    Sharma, Vijai Prakash; Yadav, Ganesh; Gupta, Anil Kumar; Kumar, Dileep

    2014-01-01

    Tubercular meningitis is a severe form of central nervous system tuberculosis with high morbidity and mortality. Apart from neurological deficits, musculoskeletal involvement is also seen in very few cases in the form of heterotopic ossification around immobile joints. A 35-year-old male case of tubercular meningitis with left hemiparesis presented with multiple joint restriction of range of motion. On clinical examination, palpable firm masses around multiple joints with painful restriction of movements were seen. X-ray films of multiple joints revealed heterotopic ossification over left shoulder, hip and knee joint with bony ankylosis of left hip and soft tissue contractures. Very few reports have been published in the literature for association of heterotopic ossification with tubercular meningitis with such extensive joint involvement which compels us to report this clinical association of tubercular meningitis. This report is intended to create caution among physicians and other caregivers for this debilitating complication of tubercular meningitis and in face of high prevalence of tuberculosis and tubercular meningitis, employ methods to prevent and treat. PMID:25540549

  8. Heterotopic Ossification Causing Radiculopathy after Lumbar Total Disc Arthroplasty

    PubMed Central

    Jackson, Keith L.; Jacobs, Jeremy M.; Key, Charles C.; DeVine, John G.

    2015-01-01

    To date, no reports have presented radiculopathy secondary to heterotopic ossification following lumbar total disc arthroplasty. The authors present a previously unpublished complication of lumbar total disk arthroplasty (TDA) secondary to heterotopic ossification (HO) in the spinal canal, and they propose a modification to the McAfee classification of HO. The patient had undergone an L5/S1 lumbar TDA two years prior due to discogenic back pain. His preoperative back pain was significantly relieved, but he developed new, atraumatic onset radiculopathy. Radiographs and a computed tomography myelogram revealed an implant malposition posteriorly with heterotopic bone formation in the canal, causing an impingement of the traversing nerve root. Revision surgery was performed with implant extraction, L5/S1 anterior lumbar interbody fusion, supplemental posterior decompression, and pedicle screw fixation. The patient tolerated the procedure well, with complete resolution of the radicular leg pain. At a two-year follow up, the patient had a solid fusion without subsidence or recurrence of heterotopic bone. This case represents a novel pattern of heterotopic ossification, and it describes a previously unreported cause for implant failure in lumbar disc replacement surgery-reinforcing the importance of proper intraoperative component positioning. We propose a modification to the existing McAfee classification of HO after TDA with the addition of Class V and VI HO.

  9. Primary electron transfer processes in photosynthetic reaction centers from oxygenic organisms.

    PubMed

    Mamedov, Mahir; Govindjee; Nadtochenko, Victor; Semenov, Alexey

    2015-08-01

    This minireview is written in honor of Vladimir A. Shuvalov, a pioneer in the area of primary photochemistry of both oxygenic and anoxygenic photosyntheses (See a News Report: Allakhverdiev et al. 2014). In the present paper, we describe the current state of the formation of the primary and secondary ion-radical pairs within photosystems (PS) II and I in oxygenic organisms. Spectral-kinetic studies of primary events in PS II and PS I, upon excitation by ~20 fs laser pulses, are now available and reviewed here; for PS II, excitation was centered at 710 nm, and for PS I, it was at 720 nm. In PS I, conditions were chosen to maximally increase the relative contribution of the direct excitation of the reaction center (RC) in order to separate the kinetics of the primary steps of charge separation in the RC from that of the excitation energy transfer in the antenna. Our results suggest that the sequence of the primary electron transfer reactions is P680 ? ChlD1 ? PheD1 ? QA (PS II) and P700 ? A 0A/A 0B ? A 1A/A 1B (PS I). However, alternate routes of charge separation in PS II, under different excitation conditions, are not ruled out. PMID:25648636

  10. Homology of the palpebral and origin of supraorbital ossifications in ornithischian dinosaurs

    E-print Network

    Homology of the palpebral and origin of supraorbital ossifications in ornithischian dinosaurs and origin of supraor- bital ossifications in ornithischian dinosaurs. Lethaia, 10.1111/j.1502 dinosaurs and its presence is considered a synapomorphy of the clade. By contrast, other ornithischians lack

  11. Bilateral ossification of the auricles: an unusual entity and review of the literature

    Microsoft Academic Search

    Nicholas S Mastronikolis; Peter Zampakis; Christina Kalogeropoulou; Theodoros Stathas; Vassiliki Siabi; Eleni Geropoulou; Panos D Goumas

    2009-01-01

    BACKGROUND: True ossification of the auricle with cartilage replacement by bone, is a very rare clinical entity and can result in an entirely rigid auricle. CASE PRESENTATION: We present a rare case of bilateral ossification of the auricles in a 75-years old man with profound progressive rigidity of both auricles. His main complaint was a mild discomfort during resting making

  12. Integration of substance use disorder services with primary care: health center surveys and qualitative interviews

    PubMed Central

    2014-01-01

    Background Each year, nearly 20 million Americans with alcohol or illicit drug dependence do not receive treatment. The Affordable Care Act and parity laws are expected to result in increased access to treatment through integration of substance use disorder (SUD) services with primary care. However, relatively little research exists on the integration of SUD services into primary care settings. Our goal was to assess SUD service integration in California primary care settings and to identify the practice and policy facilitators and barriers encountered by providers who have attempted to integrate these services. Methods Primary survey and qualitative interview data were collected from the population of federally qualified health centers (FQHCs) in five California counties known to be engaged in SUD integration efforts was surveyed. From among the organizations that responded to the survey (78% response rate), four were purposively sampled based on their level of integration. Interviews were conducted with management, staff, and patients (n?=?18) from these organizations to collect further qualitative information on the barriers and facilitators of integration. Results Compared to mental health services, there was a trend for SUD services to be less integrated with primary care, and SUD services were rated significantly less effective. The perceived difference in effectiveness appeared to be due to provider training. Policy suggestions included expanding the SUD workforce that can bill Medicaid, allowing same-day billing of two services, facilitating easier reimbursement for medications, developing the workforce, and increasing community SUD specialty care capacity. Conclusions Efforts to integrate SUD services with primary care face significant barriers, many of which arise at the policy level and are addressable. PMID:24679108

  13. Efficacy of insulin analogues in diabetic patients attending primary care centers

    PubMed Central

    Bardisi, Wedad M.; Khorsheed, Manal M.; Magliah, Faisal; Magliah, Ayman F.

    2015-01-01

    Objectives: To measure the efficacy of new insulin analogues compared with the conventional types of insulin, and to compare their effects on patient satisfaction regarding their weight changes and the frequency of hypoglycemic episodes. Methods: In this retrospective cohort observational study, data was collected from the medical records of 122 eligible diabetics on insulin therapy attending government primary care centers in Jeddah, Kingdom of Saudi Arabia from June 2013 to July 2014. The data collected considered the efficacy, safety, and patient satisfaction of the types of insulin therapy used for their treatment. Results: After 12 weeks, there was a reduction in mean glycosylated hemoglobin (HbA1c) of -0.88% for the analogue type versus -0.19% for the conventional type, and at 24 weeks, the mean drop in HbA1c was -2.02% for the analogue type versus -1.12% for the conventional type, but the differences were not statistically significant. More patients (87% versus 38%) on analogue compared with conventional insulin treatment were satisfied with therapy. Conclusion: In the primary health care setting, insulin analogues showed greater efficacy improvements than conventional insulin therapy within 6 months. However, conventional insulin therapy can still be used at primary care centers with limited resources, and when patients refuse to be converted. PMID:26108587

  14. Partnering Urban Academic Medical Centers And Rural Primary Care Clinicians To Provide Complex Chronic Disease Care

    PubMed Central

    Arora, Sanjeev; Kalishman, Summers; Dion, Denise; Som, Dara; Thornton, Karla; Bankhurst, Arthur; Boyle, Jeanne; Harkins, Michelle; Moseley, Kathleen; Murata, Glen; Komaramy, Miriam; Katzman, Joanna; Colleran, Kathleen; Deming, Paulina; Yutzy, Sean

    2013-01-01

    Many of the estimated thirty-two million Americans expected to gain coverage under the Affordable Care Act are likely to have high levels of unmet need for various chronic illnesses and to live in areas that are already underserved. In New Mexico an innovative new model of health care education and delivery known as Project ECHO (Extension for Community Healthcare Outcomes) provides high-quality primary and specialty care to a comparable population. Using state-of-the-art telehealth technology and case-based learning, Project ECHO enables specialists at the University of New Mexico Health Sciences Center to partner with primary care clinicians in underserved areas to deliver complex specialty care to patients with hepatitis C, asthma, diabetes, HIV/AIDS, pediatric obesity and mental illness. As of March 2011, 298 Project ECHO teams across New Mexico have delivered more than 10,000 specialty care consultations for hepatitis C and other chronic diseases. PMID:21596757

  15. Postencephalitic bilateral heterotopic ossification of the hip in a pediatric patient.

    PubMed

    Mohanty, Shubhranshu S; Rao, Nandan N; Dash, Kumar K; Nashikkar, Piyush S

    2015-07-01

    Heterotrophic ossification has been defined as abnormal formation of mature lamellar bone in soft tissues. Neurogenic heterotopic ossification has been well described in adults. However, it is uncommon in the pediatric population, where it has been noted to recede in some cases. There are very few reports of postmeningitis bilateral involvement of the hip. We describe a case of bilateral heterotopic ossification of hip in a 13-year-old female. The patient had a history of encephalitis, prolonged vegetative state, and intubation for 6 weeks. The patient had fixed deformities of both hips in 30° of flexion and 30° of external rotation. A diagnosis of Brooker stage 4 heterotopic ossification was made. The patient underwent a staged procedure for excision of the heterotopic mass. Postoperatively, the patient was administered radiotherapy and indomethacin for 6 weeks. At the 2-year follow-up, there was no recurrence and both the hips were mobile with full range of motion. The patient was satisfied with the result. The incidence of heterotopic ossification is less than that observed in the adult population and alkaline phosphatase levels are not significantly elevated unlike in adults. To our knowledge, there is no reported case of postencephalitic bilateral anterior heterotopic ossification of the hip in a pediatric patient treated with excision successfully. Postencephalitic heterotopic ossification in children is an uncommon condition. This condition can be treated successfully with surgical excision, combined postoperative protocol of radiotherapy, indomethacin, and immediate postoperative mobilization of the joint. PMID:25493701

  16. Intra-abdominal heterotopic ossification of the peritoneum following traumatic splenic rupture

    PubMed Central

    Ioannidis, Orestis; Sekouli, Argiro; Paraskevas, George; Kotronis, Anastasios; Chatzopoulos, Stavros; Papadimitriou, Nikolaos; Konstantara, Athina; Makrantonakis, Apostolos; Kakoutis, Emmanouil

    2012-01-01

    Intra-abdominal heterotopic ossification is extremely rare with only approximately 30 cases having been reported. While most reported cases have involved the mesentery, ossification of the peritoneum is even rarer. The pathogenesis remains undetermined but is generally considered a reactive process in response to various stimuli. Histologically, it is composed of a peripheral area with bone formation and a central area of reactive hypercellular fibrous tissue. We report a rare case of intra-abdominal heterotopic ossification of the parietal peritoneum following traumatic splenic rupture. PMID:23248662

  17. Severe soft tissue ossification in a southern right whale Eubalaena australis

    PubMed Central

    Sala, Luciano F. La; Pozzi, Luciana M.; McAloose, Denise; Kaplan, Frederick S.; Shore, Eileen M.; Kompanje, Erwin J. O.; Sidor, Inga F.; Musmeci, Luciana; Uhart, Marcela M.

    2013-01-01

    The carcass of a stranded southern right whale Eubalaena australis, discovered on the coast of Golfo Nuevo in Península Valdés, Argentina, exhibited extensive orthotopic and heterotopic ossification, osteochondroma-like lesions, and early degenerative joint disease. Extensive soft tissue ossification led to ankylosis of the axial skeleton in a pattern that, in many respects, appeared more similar to a disabling human genetic disorder, fibrodysplasia ossificans progressiva (FOP), than to more common skeletal system diseases in cetaceans and other species. This is the first reported case of a FOP-like condition in a marine mammal and raises important questions about conserved mechanisms of orthotopic and heterotopic ossification in this clade. PMID:23269389

  18. Food insecure families: description of access and barriers to food from one pediatric primary care center.

    PubMed

    DeMartini, Tori L; Beck, Andrew F; Kahn, Robert S; Klein, Melissa D

    2013-12-01

    Despite evidence that food insecurity negatively impacts child health, health care providers play little role in addressing the issue. To inform potential primary care interventions, we sought to assess a range of challenges faced by food insecure (FI) families coming to an urban, pediatric primary care setting. A cross-sectional study was performed at a hospital-based, urban, academic pediatric primary care clinic that serves as a medical home for approximately 15,000 patients with 35,000 annual visits. Subjects included a convenience sample of caregivers of children presenting for either well child or ill care over a 4 months period in 2012. A self-administered survey assessed household food security status, shopping habits, transportation access, budgeting priorities, and perceptions about nutrition access in one's community. Bivariate analyses between food security status and these characteristics were performed using Chi square statistics or Fisher's exact test. The survey was completed by 199 caregivers. Approximately 33% of families were FI; 93% received food-related governmental assistance. FI families were more likely to obtain food from a corner/convenience store, utilize food banks, require transportation other than a household car, and prioritize paying bills before purchasing food. FI families perceived less access to healthy, affordable foods within their community. Thus, FI families may face unique barriers to accessing food. Knowledge of these barriers could allow clinicians to tailor in-clinic screening and create family-centered interventions. PMID:23852328

  19. Engineering of a functional bone organ through endochondral ossification.

    PubMed

    Scotti, Celeste; Piccinini, Elia; Takizawa, Hitoshi; Todorov, Atanas; Bourgine, Paul; Papadimitropoulos, Adam; Barbero, Andrea; Manz, Markus G; Martin, Ivan

    2013-03-01

    Embryonic development, lengthening, and repair of most bones proceed by endochondral ossification, namely through formation of a cartilage intermediate. It was previously demonstrated that adult human bone marrow-derived mesenchymal stem/stromal cells (hMSCs) can execute an endochondral program and ectopically generate mature bone. Here we hypothesized that hMSCs pushed through endochondral ossification can engineer a scaled-up ossicle with features of a "bone organ," including physiologically remodeled bone, mature vasculature, and a fully functional hematopoietic compartment. Engineered hypertrophic cartilage required IL-1? to be efficiently remodeled into bone and bone marrow upon subcutaneous implantation. This model allowed distinguishing, by analogy with bone development and repair, an outer, cortical-like perichondral bone, generated mainly by host cells and laid over a premineralized area, and an inner, trabecular-like, endochondral bone, generated mainly by the human cells and formed over the cartilaginous template. Hypertrophic cartilage remodeling was paralleled by ingrowth of blood vessels, displaying sinusoid-like structures and stabilized by pericytic cells. Marrow cavities of the ossicles contained phenotypically defined hematopoietic stem cells and progenitor cells at similar frequencies as native bones, and marrow from ossicles reconstituted multilineage long-term hematopoiesis in lethally irradiated mice. This study, by invoking a "developmental engineering" paradigm, reports the generation by appropriately instructed hMSC of an ectopic "bone organ" with a size, structure, and functionality comparable to native bones. The work thus provides a model useful for fundamental and translational studies of bone morphogenesis and regeneration, as well as for the controlled manipulation of hematopoietic stem cell niches in physiology and pathology. PMID:23401508

  20. Dynamic 3D culture: models of chondrogenesis and endochondral ossification.

    PubMed

    Foster, Nicola C; Henstock, James R; Reinwald, Yvonne; El Haj, Alicia J

    2015-03-01

    The formation of cartilage from stem cells during development is a complex process which is regulated by both local growth factors and biomechanical cues, and results in the differentiation of chondrocytes into a range of subtypes in specific regions of the tissue. In fetal development cartilage also acts as a precursor scaffold for many bones, and mineralization of this cartilaginous bone precursor occurs through the process of endochondral ossification. In the endochondral formation of bones during fetal development the interplay between cell signalling, growth factors, and biomechanics regulates the formation of load bearing bone, in addition to the joint capsule containing articular cartilage and synovium, generating complex, functional joints from a single precursor anlagen. These joint tissues are subsequently prone to degeneration in adult life and have poor regenerative capabilities, and so understanding how they are created during development may provide useful insights into therapies for diseases, such as osteoarthritis, and restoring bone and cartilage lost in adulthood. Of particular interest is how these tissues regenerate in the mechanically dynamic environment of a living joint, and so experiments performed using 3D models of cartilage development and endochondral ossification are proving insightful. In this review, we discuss some of the interesting models of cartilage development, such as the chick femur which can be observed in ovo, or isolated at a specific developmental stage and cultured organotypically in vitro. Biomaterial and hydrogel-based strategies which have emerged from regenerative medicine are also covered, allowing researchers to make informed choices on the characteristics of the materials used for both original research and clinical translation. In all of these models, we illustrate the essential importance of mechanical forces and mechanotransduction as a regulator of cell behavior and ultimate structural function in cartilage. PMID:25777047

  1. Luxury Primary Care, Academic Medical Centers, and the Erosion of Science and Professional Ethics

    PubMed Central

    Donohoe, Martin

    2004-01-01

    Medical schools and teaching hospitals have been hit particularly hard by the financial crisis affecting health care in the United States. To compete financially, many academic medical centers have recruited wealthy foreign patients and established luxury primary care clinics. At these clinics, patients are offered tests supported by little evidence of their clinical and/or cost effectiveness, which erodes the scientific underpinnings of medical practice. Given widespread disparities in health, wealth, and access to care, as well as growing cynicism and dissatisfaction with medicine among trainees, the promotion by these institutions of an overt, two-tiered system of care, which exacerbates inequities and injustice, erodes professional ethics. Academic medical centers should divert their intellectual and financial resources away from luxury primary care and toward more equitable and just programs designed to promote individual, community, and global health. The public and its legislators should, in turn, provide adequate funds to enable this. Ways for academic medicine to facilitate this largesse are discussed. PMID:14748866

  2. A single center multioperator initial experience of 4195 patients at a primary radial intervention program in a tertiary level center

    PubMed Central

    Gokhroo, Rajendra K.; Kaushik, Satish K.; Padmanabhan, Deepak; Bisht, Devendra; Gupta, Sajal

    2014-01-01

    Background There has been an increase the acceptability and the number of the procedures via the radial approach. We present our experience pertaining to the clinical characteristics, procedural details and post procedural outcome of patients undergoing radial artery access, coronary angiographies over a period of 4 years at a primary care tertiary level center. Materials and methods A retrospective analysis of all the coronary artery procedures during the last 4 years was done and the various parameters related to these procedures noted. Results In 4195 procedures performed, success in radial artery procedures was achieved in 3975 (94.8%) procedures. The average puncture time and total procedure time was 9.5 + 3 min (min) and 15 + 2.5 min in the initial 500 patients, whereas the times taken in the final 695 patients were just 1.5 + 0.5 min and 3.0 + 1.5 min respectively. The total fluoroscopy time was not significantly different among the groups, when performed by an operator with training in the femoral route for angiography. Cardiology fellows needed more fluoroscopy time when mastering the radial route. Crossover of access sites was seen in 220 patients (5.2%). Conclusions After 100 procedures, radial access coronary angiographies take less than 4.5 min, with first attempt radial artery access and negligible complication rates. Prior experience of coronary angiography helps in the reduction of fluoroscopy time during the learning curve. PMID:24814110

  3. The Frank Stinchfield Award. Inhibition of heterotopic ossification with radiation therapy in an animal model.

    PubMed

    Schneider, D J; Moulton, M J; Singapuri, K; Chinchilli, V; Deol, G S; Krenitsky, G; Pellegrini, V D

    1998-10-01

    An animal model for the study of heterotopic ossification was developed and the effects of perioperative radiation were analyzed. In Phase I, New Zealand White rabbits (n = 18) underwent surgery either with or without muscle injury on each hip to establish the most reliable model in which to study heterotopic ossification. In Phase II, rabbits (n = 36) underwent either 400, 800, or 1200 cGy radiation to one hip 24 hours after bilateral hip surgery to establish a dose response relationship for postoperative radiation therapy. In Phase III, rabbits (n = 24) underwent preoperative radiation therapy (800 cGy) at 4, 16, or 24 hours preoperatively to investigate the mechanism of action and efficacy of preoperative radiation therapy. Monthly radiographs were graded by blinded observers for severity of heterotopic ossification. Mean grade, intraobserver and interobserver variability, and statistical significance were evaluated. In Phase II, 17 of 18 rabbits generated heterotopic ossification in both hips, and the mean grade of heterotopic ossification was always greater on the operative side with intentional muscle injury. Variability in the grading was considered excellent. Phase II revealed that 800 cGy was the minimal effective dose. Contrary to hypothesis, Phase III revealed an increasing grade of heterotopic ossification coinciding with a decreasing preoperative time interval, with the difference in heterotopic ossification grade with 24-hour versus 4-hour preoperative radiation being significant. The rabbit model is reliable and reproducible and closely resembles the human clinical situation after hip surgery. Preoperative and postoperative radiation effectively prevented heterotopic ossification formation. The results support the use of preoperative radiation and establish a need for additional investigation regarding the mechanism of action and timing of preoperative radiation therapy. PMID:9917589

  4. PATIENTS’ SATISFACTION WITH PRIMARY HEALTH CARE CENTERS SERVICES IN KUWAIT CITY, KUWAIT

    PubMed Central

    Al-Doghaither, Abdullah H.; Abdelrhman, Badreldin M.; Saeed, Abdalla A.W.; Al-Kamil, Abdullah A.; Majzoub, Mohieldin M.

    2001-01-01

    Background: Assessment of patient satisfaction offers a way of optimizing health status and prevents waste of medical resources. The direct measurement of patient satisfaction is a new phenomenon in Kuwait. Objective: Assess patient satisfaction with respect to primary health care services and study any patterns of association of sociodemographic variables on the patient satisfaction level. Methods: The sample consisted of 301 patients selected systematically from five primary health care centers to represent various geographic areas in Kuwait City. Just over 56% of the sample were females, 59% were married, the great majority (70.4%) were government employees, more than 60% had a monthly income of less than 900 KD, more than 54% were intermediate and high secondary school graduates, and 37% were university graduates or had advanced degrees. The data was collected by personal interview using structured questionnaire. Results: The overall mean satisfaction was 3.1 points out of five (62%). The mean satisfaction scores were 3.64, 3.29, 3.08, 3.05, 2.21 for laboratory, pharmacy, radiology, dental and physician services, respectively. The highest mean score for physician services was obtained for communication skills (2.23); for pharmacy services, the availability of medicine (4.01); for laboratory services, the availability of lab materials (3.73); for radiology services, the waiting time for x-ray (3.60); and for dental services, the adequacy of dentists (3.27). The results indicated that gender, income, marital status and occupation were the most consistent demographic predictors of satisfaction, with females, those with lower income, lower education levels and the unemployed having higher mean satisfaction scores. Conclusion: There is a need for corrective intervention in some service areas and for an educational program to inform patients of the objectives and limitations of primary health services. PMID:23008652

  5. Viral Agents of Diarrhea in Young Children in Two Primary Health Centers in Edo State, Nigeria

    PubMed Central

    Imade, Paul Erhunmwunse; Eghafona, Nosakhare Odeh

    2015-01-01

    Enteric viruses have been shown to be responsible for diarrhea among children during their early childhood. This study was carried out to determine the prevalence of rotavirus, adenovirus, and norovirus infection in young children with diarrhea in two primary health centers in Edo State, Nigeria. A total of 223 stool specimens were collected from children aged 0–36 months with clinical signs of diarrhea and 59 apparently healthy age-matched children as control. These specimens were investigated for three viral agents using immunochromatographic technique (ICT). The overall results showed that at least one viral agent was detected in 95/223 (42.6%) of the children with diarrhea while the control had none. The prevalence of rotavirus was 28.3%, adenovirus 19.3%, and norovirus 3.6%. There was a significant association between age group and infection (P < 0.0001). Seasonal pattern of enteric viruses was not statistically significant (P = 0.17). The overall coinfection rate was 7.6% and rotavirus-adenovirus coinfection had the highest with 5.4%. Rotavirus was the most prevalent viral agent. Coinfections are not uncommon among the population studied. The most commonly associated clinical symptom of viral diarrhea in this study was vomiting. Viral diagnostic tests are advocated for primary health care facilities in this locality.

  6. Viral Agents of Diarrhea in Young Children in Two Primary Health Centers in Edo State, Nigeria.

    PubMed

    Imade, Paul Erhunmwunse; Eghafona, Nosakhare Odeh

    2015-01-01

    Enteric viruses have been shown to be responsible for diarrhea among children during their early childhood. This study was carried out to determine the prevalence of rotavirus, adenovirus, and norovirus infection in young children with diarrhea in two primary health centers in Edo State, Nigeria. A total of 223 stool specimens were collected from children aged 0-36 months with clinical signs of diarrhea and 59 apparently healthy age-matched children as control. These specimens were investigated for three viral agents using immunochromatographic technique (ICT). The overall results showed that at least one viral agent was detected in 95/223 (42.6%) of the children with diarrhea while the control had none. The prevalence of rotavirus was 28.3%, adenovirus 19.3%, and norovirus 3.6%. There was a significant association between age group and infection (P < 0.0001). Seasonal pattern of enteric viruses was not statistically significant (P = 0.17). The overall coinfection rate was 7.6% and rotavirus-adenovirus coinfection had the highest with 5.4%. Rotavirus was the most prevalent viral agent. Coinfections are not uncommon among the population studied. The most commonly associated clinical symptom of viral diarrhea in this study was vomiting. Viral diagnostic tests are advocated for primary health care facilities in this locality. PMID:26064123

  7. Partnering urban academic medical centers and rural primary care clinicians to provide complex chronic disease care.

    PubMed

    Arora, Sanjeev; Kalishman, Summers; Dion, Denise; Som, Dara; Thornton, Karla; Bankhurst, Arthur; Boyle, Jeanne; Harkins, Michelle; Moseley, Kathleen; Murata, Glen; Komaramy, Miriam; Katzman, Joanna; Colleran, Kathleen; Deming, Paulina; Yutzy, Sean

    2011-06-01

    Many of the estimated thirty-two million Americans expected to gain coverage under the Affordable Care Act are likely to have high levels of unmet need because of various chronic illnesses and to live in areas that are already underserved. In New Mexico an innovative new model of health care education and delivery known as Project ECHO (Extension for Community Healthcare Outcomes) provides high-quality primary and specialty care to a comparable population. Using state-of-the-art telehealth technology and case-based learning, Project ECHO enables specialists at the University of New Mexico Health Sciences Center to partner with primary care clinicians in underserved areas to deliver complex specialty care to patients with hepatitis C, asthma, diabetes, HIV/AIDS, pediatric obesity, chronic pain, substance use disorders, rheumatoid arthritis, cardiovascular conditions, and mental illness. As of March 2011, 298 Project ECHO teams across New Mexico have collaborated on more than 10,000 specialty care consultations for hepatitis C and other chronic diseases. PMID:21596757

  8. [Assessment of quality of vaccine storage and conservation in primary health care centers].

    PubMed

    Oliveira, Valéria Conceiçăo de; Gallardo, Maria Del Pilar Serrano; Arcęncio, Ricardo Alexandre; Gontijo, Tarcísio Laerte; Pinto, Ione Carvalho

    2014-09-01

    This is an evaluative study of the quality of vaccine storage and conservation in primary health care centers (PHC) in the mid-west region of the state of Minas Gerais. Dimensions, structures and processes were the criteria used to measure the level of quality in 261 vaccine storage and conservation units in over 55 municipalities in the area. Quality levels were defined by means of a scoring system with different weighted scores attributed to indicators for each dimension being rated. Categories for quality levels were then defined as: "adequate," "inadequate" and "critical." Pearson's chi-square test was used to verify the correlation between quality level and population size and adherence to the Unified Health System. It was observed that vaccine storage and conservation quality levels were inadequate in 59.3% and critical in 26.9% of these facilities. Small municipalities that are registered for Full Primary Health Care Management featured the worst vaccine storage facilities. Vaccine conservation supervision, which spans a series of activities present in nursing praxis, indicates the need to train human resources, monitor and assess work processes and conduct further studies in the field. PMID:25184594

  9. Improving Access to Primary Care for Adolescents: School Health Centers as a Service Delivery Strategy. MCH Policy Research Brief.

    ERIC Educational Resources Information Center

    Santelli, John; Morreale, Madlyn; Wigton, Alyssa; Grason, Holly

    Recognizing that school-based health centers are one of the most promising recent innovations to address the health and related needs of adolescents, this report provides information on these centers as a strategy to improve the access of adolescents to primary care. The report is intended to assist state and local Maternal and Child Health (MCH)…

  10. Burn Injury Enhances Bone Formation in Heterotopic Ossification Model

    PubMed Central

    Peterson, Jonathan R.; De La Rosa, Sara; Sun, Hongli; Eboda, Oluwatobi; Cilwa, Katherine E.; Donneys, Alexis; Morris, Michael; Buchman, Steven R.; Cederna, Paul S.; Krebsbach, Paul H.; Wang, Stewart C.; Levi, Benjamin

    2015-01-01

    Objective To demonstrate the pro-osteogenic effect of burn injury on heterotopic bone formation using a novel burn ossicle in vivo model. Background Heterotopic ossification (HO), or the abnormal formation of bone in soft tissue, is a troubling sequela of burn and trauma injuries. The exact mechanism by which burn injury influences bone formation is unknown. The aim of this study was to develop a mouse model to study the effect of burn injury on heterotopic bone formation. We hypothesized that burn injury would enhance early vascularization and subsequent bone formation of subcutaneously implanted mesenchymal stem cells. Methods Mouse adipose-derived stem cells were harvested from C57/BL6 mice, transfected with a BMP-2 adenovirus, seeded on collagen scaffolds (ossicles), and implanted subcutaneously in the flank region of 8 adult mice. Burn and sham groups were created with exposure of 30% surface area on the dorsum to 60°C water or 30°C water for 18 seconds, respectively (n = 4/group). Heterotopic bone volume was analyzed in vivo by micro-computed tomography for 3 months. Histological analysis of vasculogenesis was performed with platelet endothelial cell adhesion molecule staining. Osteogenic histological analysis was performed by Safranin O, Picrosirius red, and aniline blue staining. Qualitative analysis of heterotopic bone composition was completed with ex vivo Raman spectroscopy. Results Subcutaneously implanted ossicles formed heterotopic bone. Ossicles from mice with burn injuries developed significantly more bone than sham control mice, analyzed by micro-computed tomography at 1, 2, and 3 months (P < 0.05), and had enhanced early and late endochondral ossification as demonstrated by Safranin O, Picrosirius red, and aniline blue staining. In addition, burn injury enhanced vascularization of the ossicles (P < 0.05). All ossicles demonstrated chemical composition characteristic of bone as demonstrated by Raman spectroscopy. Conclusions Burn injury increases the predilection to osteogenic differentiation of ectopically implanted ossicles. Early differences in vascularity correlated with later bone development. Understanding the role of burn injury on heterotopic bone formation is an important first step toward the development of treatment strategies aimed to prevent unwanted and detrimental heterotopic bone formation. PMID:23673767

  11. Primary light-energy conversion in tetrameric chlorophyll structure of photosystem II and bacterial reaction centers: I. A review

    Microsoft Academic Search

    Ravil A. Khatypov; Anton Yu. Khmelnitskiy; Maria M. Leonova; Lyudmila G. Vasilieva; Vladimir A. Shuvalov

    2008-01-01

    The purpose of the review is to show that the tetrameric (bacterio)chlorophyll ((B)Chl) structures in reaction centers of\\u000a photosystem II (PSII) of green plants and in bacterial reaction centers (BRCs) are similar and play a key role in the primary\\u000a charge separation. The Stark effect measurements on PSII reaction centers have revealed an increased dipole moment for the\\u000a transition at

  12. Is ossification of posterior longitudinal ligament an enthesopathy?

    PubMed

    Chen, Jian; Song, Dianwen; Wang, Xinwei; Shen, Xiaolong; Li, Yang; Yuan, Wen

    2011-10-01

    The purpose of this study was to investigate the relationship of ossification of posterior longitudinal ligament (OPLL) with enthesis, the site where the posterior longitudinal ligament (PLL) attaches to the vertebral body, by multi-detector CT reconstruction images. Twenty-nine patients with OPLL were studied. According to the plaques' continuity to the vertebral body, OPLL plaques were classified into two categories: "free" and "contiguous". A "broken sign" was defined as a crack between two plaques. The sites where each "contiguous" plaque attached to the vertebral body were then analysed. There were 78 ossified plaques in total, and six were "free". There were eight cases with a "broken sign", including six "free" ones. The site where all 72 "contiguous" plaques attached to the vertebral body included the zone where the PLL enthesis was situated, while other zones were included in only part of the plaques. Our conclusion was that there might be no real "free type" ossified plaques, and OPLL could start from enthesis, which indicated OPLL could be a kind of enthesopathy. PMID:21104248

  13. PIXE study of the kinetics of biomaterials ossification

    NASA Astrophysics Data System (ADS)

    Weber, G.; Robaye, G.; Braye, F.; Oudadesse, H.; Irigaray, J. L.

    1994-05-01

    Biomaterials are frequently implanted in bones. This implantation is followed by a phenomenon of ossification. The purpose of this work was to study the time evolution of the gradient of characteristic atomic element's concentrations in the bone, the implant and the bone-implant interface. We have studied two types of neutral biomaterials: pure synthetic hydroxyapatite and porite's asteroid coral. The animal implantations have been made on sheep of the same age and sex having received the same basic diet. The implantations have been made in the cortical femur. On both sides of the implant, at the same distance, two screws were placed to allow further determination of the position of the implant. The PIXE method is particularly suitable here because of the possibility to analyze directly the samples without any preparation and to choose easily the dimensions of beam used for the gradient study. The X-rays have been detected with an ultra LEGe instead of the usual Si(Li) device to avoid the Si escape peak associated with the K ? X-ray of calcium, the major constituent of bone. This peak is particularly disturbing here because its energy corresponds to the K ? line of phosphorus, an important constituent of bone. The results of these determinations are presented and discussed.

  14. Intramembranous ossification of scleral ossicles in Chelydra serpentina.

    PubMed

    Franz-Odendaal, Tamara A

    2006-01-01

    Scleral ossicles are present in many reptiles, including turtles and birds. In both groups the sclerotic ring situated in the eye is composed of a number of imbricating scleral ossicles or plates. Despite this gross morphological similarity, Andrews (1996. An endochondral rather than a dermal origin for scleral ossicles in Cryptodiran turtles. J. Herpetol. 30, 257-260) reported that the scleral ossicles of turtles develop endochondrally unlike those in birds, which develop intramembranously after a complex epithelial-mesenchymal inductive event. This study re-explores one of the species examined by Andrews in order to determine the mode of ossification of scleral ossicles in turtles. A growth series of Chelydra serpentina embryos, including the stages examined by Andrews, were examined by staining separately for cartilage and bone. Results clearly contradict Andrews (1996) and show that the scleral ossicles of Chelydra serpentina develop similarly to those in birds. That is, they develop intramembranously without a cartilage precursor and are likely induced by transient scleral papillae. The sequence of scleral papillae development is broadly similar, but the papillae themselves are not as distinct as those seen in chicken embryos. This study has important consequences for understanding the homology of scleral ossicles among tetrapods. PMID:16377163

  15. Journey toward a Patient-Centered Medical Home: Readiness for Change in Primary Care Practices

    PubMed Central

    Wise, Christopher G; Alexander, Jeffrey A; Green, Lee A; Cohen, Genna R; Koster, Christina R

    2011-01-01

    Context: Information is limited regarding the readiness of primary care practices to make the transformational changes necessary to implement the patient-centered medical home (PCMH) model. Using comparative, qualitative data, we provide practical guidelines for assessing and increasing readiness for PCMH implementation. Methods: We used a comparative case study design to assess primary care practices' readiness for PCMH implementation in sixteen practices from twelve different physician organizations in Michigan. Two major components of organizational readiness, motivation and capability, were assessed. We interviewed eight practice teams with higher PCMH scores and eight with lower PCMH scores, along with the leaders of the physician organizations of these practices, yielding sixty-six semistructured interviews. Findings: The respondents from the higher and lower PCMH scoring practices reported different motivations and capabilities for pursuing PCMH. Their motivations pertained to the perceived value of PCMH, financial incentives, understanding of specific PCMH requirements, and overall commitment to change. Capabilities that were discussed included the time demands of implementation, the difficulty of changing patients' behavior, and the challenges of adopting health information technology. Enhancing the implementation of PCMH within practices included taking an incremental approach, using data, building a team and defining roles of its members, and meeting regularly to discuss the implementation. The respondents valued external organizational support, regardless of its source. Conclusions: The respondents from the higher and lower PCMH scoring practices commented on similar aspects of readiness—motivation and capability—but offered very different views of them. Our findings suggest the importance of understanding practice perceptions of the motivations for PCMH and the capability to undertake change. While this study identified some initial approaches that physician organizations and practices have used to prepare for practice redesign, we need much more information about their effectiveness. PMID:21933274

  16. Reliability centered maintenance pilot system implementation 241-AP-tank farm primary ventilation system final report

    SciTech Connect

    MOORE TL

    2001-09-21

    When the Hanford Site Tank Farms' mission was safe storage of radioactive waste in underground storage tanks, maintenance activities focused on time-based preventive maintenance. Tank Farms' new mission to deliver waste to a vitrification plant where the waste will be processed into a form suitable for permanent storage requires a more efficient and proactive approach to maintenance. Systems must be maintained to ensure that they are operational and available to support waste feed delivery on schedule with a minimum of unplanned outages. This report describes the Reliability Centered Maintenance (RCM) pilot system that was implemented in the 241-AP Tank Farm Primary Ventilation System under PI-ORP-009 of the contract between the U.S. Department of Energy, Office of River Protection and CH2M HILL Hanford Group Inc. (CHG). The RCM analytical techniques focus on monitoring the condition of operating systems to predict equipment failures so that maintenance activities can be completed in time to prevent or mitigate unplanned equipment outages. This approach allows maintenance activities to be managed with minimal impact on plant operations. The pilot demonstration provided an opportunity for CHG staff-training in RCM principles and tailoring of the RCM approach to the Hanford Tank Farms' unique needs. This report details the implementation of RCM on a pilot system in Tank Farms.

  17. Water access and attendance for diarrhea in primary health care centers, Gaza strip.

    PubMed

    Abouteir, A; El Yaagoubi, F; Bioh-Johnson, I; Kamel, A; Godard, N; Cormerais, L; Robin, F; Lesens, O

    2011-10-01

    Water access and sanitation has worsened in Gaza strip since the conflict between Israel and Palestine in January 2009. This study aimed to investigate the relationship between attendance for diarrhea to a Primary Health Care Center (PHCC) in Gaza strip and several potential risk factors including water access. A matched case control study with prospective data record was performed. Cases were patients attending a PHCC for diarrhea, and controls were patients attending for any other cause with no diarrhea within the previous three months or since birth. We matched 133 cases and 133 controls, for date of inclusion, age, gender. All patients attended PHCC and were included in January/February 2010. A stool analysis for bacteria and parasites was performed for cases. Of the 266 patients, 62% (166) have to buy water from a private provider. In multivariate analysis, four variables were independently predictive of diarrhea: public water access (OR: 0.046; 95% CI: 0.005-0.454; P=0.0083), poultry or rabbits at home, and presence of cooker at home. A bacterial cause was found in 5.5% (7) and Giardia duodenalis in 20% (26). Treatments did not comply with WHO recommendations. Efforts should be made to improve water access and to implement guidelines for a better management of diarrhea in Gaza strip. PMID:21803391

  18. Maternal satisfaction about childhood immunization in primary health care center, Egypt

    PubMed Central

    El Gammal, Hanan Abbas Abdo Abdel Rahman

    2014-01-01

    Introduction Childhood immunization is considered to be among the most effective preventive services, and is therefore critical to monitor and evaluate. One prior study reported an association between parental satisfactions with pediatric care and up-to-date immunization at 24 months independent of maternal age, race, and education. In addition to promoting appropriate utilization, satisfaction may increase engagement in the health care process. Health system factors included inconvenient clinic hours, dates or locations, waiting lines, and conflicting information. The inconvenience of clinic hours dates of immunization clinics, and locations of clinics were reported by 75% of the parents. Methods A cross section study was conducted on three hundred and thirty five mothers chosen from PHCC participating in the study by providing information on satisfaction about the program and their knowledge about vaccination Results Inappropriate knowledge was reported by most of mothers (84.8%). And 95.2% of mothers were satisfied with childhood immunization services in primary healthcare center, compared to 4.8% who were unsatisfied with them. Conclusion This study shows that there was no statistically significant relation between maternal satisfaction with childhood immunization services and knowledge score, while in most satisfaction surveys information giving was an important need and this represent that client needs are changing, and priorities from client's perspectives are also changing, so on- going monitoring of client satisfaction is the safeguard to improve quality of care. PMID:25419295

  19. Free radical scavengers are more effective than indomethacin in the prevention of experimentally induced heterotopic ossification.

    PubMed

    Vanden Bossche, L C; Van Maele, G; Wojtowicz, I; De Cock, K; Vertriest, S; De Muynck, M; Rimbaut, S; Vanderstraeten, G G

    2007-02-01

    The pathogenesis of heterotopic ossification is still unclear and the preventive therapies are usually insufficient. The present study was designed to investigate the possible preventive effect of free radical scavengers on the development of experimentally induced heterotopic ossification in a rabbit model and to compare free radical scavengers with indomethacin to determine whether they act synergistically. A standard immobilization-manipulation model was used to induce heterotopic ossification in the hind legs of 40 1-year-old female New Zealand albino rabbits. The animals were divided into four groups and received daily either placebo, a free radical scavenger cocktail [allopurinol and N-acetylcysteine (A/A)], indomethacin or the combination of A/A and indomethacin in a randomized double-blind fashion. Every 4 days an X-ray was taken and the thickness and length of new bone formation was measured at the thigh. A marked statistically significant difference was found between the four groups. In the groups that received A/A, either alone or combined with indomethacin, an inhibition of bone growth, both in thickness and in length was demonstrated. In this experimental model free radical scavengers had a superior inhibitory effect on heterotopic ossification than indomethacin. Free radicals could play an important role in the pathogenesis of heterotopic ossification. PMID:17106886

  20. Chondrocyte-specific ablation of Osterix leads to impaired endochondral ossification

    SciTech Connect

    Oh, Jung-Hoon [Department of Molecular Medicine, Cell and Matrix Research Institute, BK21 Medical Education Program for Human Resources, Kyungpook National University School of Medicine, Daegu (Korea, Republic of)] [Department of Molecular Medicine, Cell and Matrix Research Institute, BK21 Medical Education Program for Human Resources, Kyungpook National University School of Medicine, Daegu (Korea, Republic of); Park, Seung-Yoon [Department of Biochemistry, School of Medicine, Dongguk University, Gyeongju 780-714 (Korea, Republic of)] [Department of Biochemistry, School of Medicine, Dongguk University, Gyeongju 780-714 (Korea, Republic of); Crombrugghe, Benoit de [Department of Genetics, University of Texas, M.D. Anderson Cancer Center, Houston (United States)] [Department of Genetics, University of Texas, M.D. Anderson Cancer Center, Houston (United States); Kim, Jung-Eun, E-mail: kjeun@knu.ac.kr [Department of Molecular Medicine, Cell and Matrix Research Institute, BK21 Medical Education Program for Human Resources, Kyungpook National University School of Medicine, Daegu (Korea, Republic of)] [Department of Molecular Medicine, Cell and Matrix Research Institute, BK21 Medical Education Program for Human Resources, Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2012-02-24

    Highlights: Black-Right-Pointing-Pointer Conditional ablation of Osterix (Osx) in chondrocytes leads to skeletal defects. Black-Right-Pointing-Pointer Osx regulates chondrocyte differentiation and bone growth in growth plate chondrocytes. Black-Right-Pointing-Pointer Osx has an autonomous function in chondrocytes during endochondral ossification. -- Abstract: Osterix (Osx) is an essential transcription factor required for osteoblast differentiation during both intramembranous and endochondral ossification. Endochondral ossification, a process in which bone formation initiates from a cartilage intermediate, is crucial for skeletal development and growth. Osx is expressed in differentiating chondrocytes as well as osteoblasts during mouse development, but its role in chondrocytes has not been well studied. Here, the in vivo function of Osx in chondrocytes was examined in a chondrocyte-specific Osx conditional knockout model using Col2a1-Cre. Chondrocyte-specific Osx deficiency resulted in a weak and bent skeleton which was evident in newborn by radiographic analysis and skeletal preparation. To further understand the skeletal deformity of the chondrocyte-specific Osx conditional knockout, histological analysis was performed on developing long bones during embryogenesis. Hypertrophic chondrocytes were expanded, the formation of bone trabeculae and marrow cavities was remarkably delayed, and subsequent skeletal growth was reduced. The expression of several chondrocyte differentiation markers was reduced, indicating the impairment of chondrocyte differentiation and endochondral ossification in the chondrocyte-specific Osx conditional knockout. Taken together, Osx regulates chondrocyte differentiation and bone growth in growth plate chondrocytes, suggesting an autonomous function of Osx in chondrocytes during endochondral ossification.

  1. Spongiosa primary development: a biochemical hypothesis by Turing patterns formations.

    PubMed

    López-Vaca, Oscar Rodrigo; Garzón-Alvarado, Diego Alexander

    2012-01-01

    We propose a biochemical model describing the formation of primary spongiosa architecture through a bioregulatory model by metalloproteinase 13 (MMP13) and vascular endothelial growth factor (VEGF). It is assumed that MMP13 regulates cartilage degradation and the VEGF allows vascularization and advances in the ossification front through the presence of osteoblasts. The coupling of this set of molecules is represented by reaction-diffusion equations with parameters in the Turing space, creating a stable spatiotemporal pattern that leads to the formation of the trabeculae present in the spongy tissue. Experimental evidence has shown that the MMP13 regulates VEGF formation, and it is assumed that VEGF negatively regulates MMP13 formation. Thus, the patterns obtained by ossification may represent the primary spongiosa formation during endochondral ossification. Moreover, for the numerical solution, we used the finite element method with the Newton-Raphson method to approximate partial differential nonlinear equations. Ossification patterns obtained may represent the primary spongiosa formation during endochondral ossification. PMID:23193429

  2. Radiographic monitoring of the ossification of long bones in kori ( Ardeotis kori) and white-bellied ( Eupodotis senegalensis) bustards

    Microsoft Academic Search

    J. L. Naldo; J. H. Samour; T. A. Bailey

    1998-01-01

    A serial radiographic study was conducted on eight kori bustard (Ardeotis kori) and four white-bellied bustard (Eupodotis senegalensis) chicks to determine the pattern of long bone development and to establish radiographic standards for assessing skeletal maturity. The ossification pattern, appearance of secondary ossification centres, and epiphyseal fusion of the long bones in kori and white-bellied bustards were similar to those

  3. "It's All in My Head": Teacher Thinking about Integrating a Block Play Center into an Upper Primary Classroom.

    ERIC Educational Resources Information Center

    Himel, Mabel T.

    This qualitative, ethnographic study documented an upper primary school teacher's thinking as she planned to integrate a block play center into her classroom. Data was collected through a series of seven interviews in May, July, and August. Other methods of data collection included journal entries, stimulated recall, drawings, pictures, and notes…

  4. A Person-Centered Counseling Approach as a Primary Therapeutic Support for Women with a History of Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    Edwards, Nivischi N.; Lambie, Glenn W.

    2009-01-01

    Childhood sexual abuse (CSA) is prevalent among women. Person-centered counseling (PCC) is an effective core therapeutic approach to use when treating women with this issue. This article provides (a) an overview of CSA, (b) an orientation to PCC, and (c) a case example illustrating the primary application of this approach.

  5. Comparison of Performance Achievement Award Recognition With Primary Stroke Center Certification for Acute Ischemic Stroke Care

    PubMed Central

    Fonarow, Gregg C.; Liang, Li; Smith, Eric E.; Reeves, Mathew J.; Saver, Jeffrey L.; Xian, Ying; Hernandez, Adrian F.; Peterson, Eric D.; Schwamm, Lee H.

    2013-01-01

    Background Hospital certification and recognition programs represent 2 independent but commonly used systems to distinguish hospitals, yet they have not been directly compared. This study assessed acute ischemic stroke quality of care measure conformity by hospitals receiving Primary Stroke Center (PSC) certification and those receiving the American Heart Association's Get With The Guidelines?Stroke (GWTG?Stroke) Performance Achievement Award (PAA) recognition. Methods and Results The patient and hospital characteristics as well as performance/quality measures for acute ischemic stroke from 1356 hospitals participating in the GWTG?Stroke Program 2010–2012 were compared. Hospitals were classified as PAA+/PSC+ (hospitals n=410, patients n=169 302), PAA+/PSC? (n=415, n=129 454), PAA?/PSC+ (n=88, n=26 386), and PAA?/PSC? (n=443, n=75 565). A comprehensive set of stroke measures were compared with adjustment for patient and hospital characteristics. Patient characteristics were similar by PAA and PSC status but PAA?/PSC? hospitals were more likely to be smaller and nonteaching. Measure conformity was highest for PAA+/PSC+ and PAA+/PSC? hospitals, intermediate for PAA?/PSC+ hospitals, and lowest for PAA?/PSC? hospitals (all?or?none care measure 91.2%, 91.2%, 84.3%, and 76.9%, respectively). After adjustment for patient and hospital characteristics, PAA+/PSC+, PAA+/PSC?, and PAA?/PSC+ hospitals had 3.15 (95% CIs 2.86 to 3.47); 3.23 (2.93 to 3.56) and 1.72 (1.47 to 2.00), higher odds for providing all indicated stroke performance measures to patients compared with PAA?/PSC? hospitals. Conclusions While both PSC certification and GWTG?Stroke PAA recognition identified hospitals providing higher conformity with care measures for patients hospitalized with acute ischemic stroke, PAA recognition was a more robust identifier of hospitals with better performance. PMID:24125846

  6. Heterotopic mineralization (ossification or calcification) in tendinopathy or following surgical tendon trauma

    PubMed Central

    O'Brien, Etienne J O; Frank, Cyril B; Shrive, Nigel G; Hallgrímsson, Benedikt; Hart, David A

    2012-01-01

    Heterotopic tendon mineralization (ossification or calcification), which may be a feature of tendinopathy or which may develop following surgical trauma (repair or graft harvest), has not received much attention. The purpose of this article is to review the prevalence, mechanisms and consequences of heterotopic tendon mineralization and to identify the gaps in our current understanding. We focus on endochondral heterotopic ossification and draw on knowledge of the mechanisms of this process in other tissues and conditions. Finally, we introduce a novel murine Achilles tendon needle injury model, which will enable us to further study the mechanisms and biomechanical consequences of tendon mineralization. PMID:22974213

  7. Primary breast lymphoma: 30 years of experience with diagnosis and treatment at a single medical center.

    PubMed

    Radkani, Pejman; Joshi, Devendra; Paramo, Juan C; Mesko, Thomas W

    2014-01-01

    In our retrospective study covering the past 30 years at a tertiary cancer care institution, we review 30 patients with primary breast lymphoma (stage I or II) and analyze the different treatment modalities. All 30 patients had unilateral disease, and the median age was 67.5 years. Two patients refused treatment and, hence, were excluded from our study. Of the 28 remaining patients, 11 (39%) were treated with a single treatment modality, and 17 (61%) underwent different combinations of surgery, radiation therapy, and chemotherapy. Seventeen patients underwent a surgical resection as the primary modality or as part of a multimodality therapy. Seven patients (25%) experienced a local or distal recurrence of the disease. Of these 7 patients, 6 underwent surgery as the primary treatment or as part of a combined treatment modality, and 1 underwent radiation therapy only. Eighteen patients (64%) died during the follow-up period ranging from 6 to 230 months, but only 5 of these 18 patients (28% [18% of all patients]) died of disease-specific causes. Of the 2 patients who were only treated with chemotherapy, 1 had primary breast lymphoma that never went into remission. In our study, surgery as the primary modality therapy or as part of a multimodality therapy for primary breast lymphoma is associated with a higher rate of treatment failure, whereas a combination of chemotherapy and local radiation therapy provides the best results. However, because our sample size is small, for such a rare neoplasm, definitive treatment recommendations are difficult to determine. PMID:24257833

  8. Timing of Ossification in Duck, Quail, and Zebra Finch: Intraspecific Variation, Heterochronies, and Life History Evolution

    PubMed Central

    Mitgutsch, Christian; Wimmer, Corinne; Sánchez-Villagra, Marcelo R.; Hahnloser, Richard; Schneider, Richard A.

    2011-01-01

    Skeletogenic heterochronies have gained much attention in comparative developmental biology. The temporal appearance of mineralized individual bones in a species – the species ossification sequence – is an excellent marker in this kind of study. Several publications describe interspecific variation, but only very few detail intraspecific variation. In this study, we describe and analyze the temporal order of ossification of skeletal elements in the zebra finch, Taeniopygia guttata, the Japanese quail, Coturnix coturnix japonica, and the White Pekin duck, a domestic race of the mallard Anas platyrhynchos, and explore patterns of intraspecific variation in these events. The overall sequences were found to be conserved. In the duck, variability is present in the relative timing of ossification in the occipital, the basisphenoid and the otic regions of the skull and the phalanges in the postcranium. This variation appears generally in close temporal proximity. Comparison with previously published data shows differences in ossification sequence in the skull, the feet, and the pelvis in the duck, and especially the pelvis in the quail. This clearly documents variability among different breeds. PMID:21728797

  9. Comparative patterns of postcranial ontogeny in therian mammals: an analysis of relative timing of ossification events.

    PubMed

    SAnchez-Villagra, Marcelo R

    2002-10-15

    Data on the relative sequence of ossification of postcranial elements for eight therian mammals (Myotis lucifugus, Homo sapiens, Rattus norvegicus, Mus musculus, Mesocricetus auratus, Cavia porcellus, Didelphis albiventris, and Sminthopsis macroura) and three outgroups (Chelydra serpentina, Alligator mississippiensis, and Lacerta vivipara) were taken from the literature. For each species, a matrix was constructed in which the relative timing of the onset of ossification in 24 elements was summarized. This resulted in 276 event pairs (characters) for each species. Thirty-three (33.3)% of the characters examined are uniform across all taxa, 16.3% are variable but uninformative in the phylogeny, and 50.4% potentially deliver diagnostic features for clades of two or more taxa. In all species examined, the clavicle is the first bone to appear. Placentalia is not unequivocally diagnosed by the state of any event pair, while Marsupialia has the largest amount of autapomorphies with 18. The acceleration in the timing of ossification of the scapula in relation to the hindlimb in marsupials is most probably causally correlated to movements after birth and during early phases of pre-weaning life. Marsupials are almost unique among amniotes in that the earliest onset of ossification of at least one element among carpals and among tarsals is simultaneous. Three parsimony analyses, each one with a different reptilian taxon as outgroup, were performed using event pairs as characters. In all cases, results were incongruent with the phylogeny of the studied taxa. PMID:12362432

  10. Head co-ossification, phragmosis and defence in the casque-headed tree frog Corythomantis greeningi

    Microsoft Academic Search

    C. Jared; M. M. Antoniazzi; C. A. Navas; E. Katchburian; E. Freymüller; D. V. Tambourgi; M. T. Rodrigues

    2005-01-01

    Some anurans have a peculiar casqued head with the skin co-ossified with the underlying bones. This type of skull usually is associated with phragmosis, a protective behaviour in which the animal enters a hole and closes it with the head. Although co-ossification of the head in lissamphibians frequently has been associated with water economy, recent studies of Corythomantis greeningi, a

  11. Brain injury severity and autonomic dysregulation accurately predict heterotopic ossification in patients with traumatic brain injury

    Microsoft Academic Search

    Henk T. Hendricks; A. C. H. Geurts; Bart C. van Ginneken; Anita J. Heeren; Pieter E. Vos

    2007-01-01

    Objective : To assess brain injury severity, autonomic dysregulation and systemic infection as risk factors for the occurrence of heterotopic ossification in patients with severe traumatic brain injury. Design : Historic cohort study. Setting : Radboud University Medical Centre. Subjects : All consecutively admitted patients with severe traumatic brain injury (admission Glasgow Coma Scale score 8 or less) during the

  12. Endochondral ossification for enhancing bone regeneration: converging native extracellular matrix biomaterials and developmental engineering in vivo.

    PubMed

    Dennis, S Connor; Berkland, Cory J; Bonewald, Lynda F; Detamore, Michael S

    2015-06-01

    Autologous bone grafting (ABG) remains entrenched as the gold standard of treatment in bone regenerative surgery. Consequently, many marginally successful bone tissue engineering strategies have focused on mimicking portions of ABG's "ideal" osteoconductive, osteoinductive, and osteogenic composition resembling the late reparative stage extracellular matrix (ECM) in bone fracture repair, also known as the "hard" or "bony" callus. An alternative, less common approach that has emerged in the last decade harnesses endochondral (EC) ossification through developmental engineering principles, which acknowledges that the molecular and cellular mechanisms involved in developmental skeletogenesis, specifically EC ossification, are closely paralleled during native bone healing. EC ossification naturally occurs during the majority of bone fractures and, thus, can potentially be utilized to enhance bone regeneration for nearly any orthopedic indication, especially in avascular critical-sized defects where hypoxic conditions favor initial chondrogenesis instead of direct intramembranous ossification. The body's native EC ossification response, however, is not capable of regenerating critical-sized defects without intervention. We propose that an underexplored potential exists to regenerate bone through the native EC ossification response by utilizing strategies which mimic the initial inflammatory or fibrocartilaginous ECM (i.e., "pro-" or "soft" callus) observed in the early reparative stage of bone fracture repair. To date, the majority of strategies utilizing this approach rely on clinically burdensome in vitro cell expansion protocols. This review will focus on the confluence of two evolving areas, (1) native ECM biomaterials and (2) developmental engineering, which will attempt to overcome the technical, business, and regulatory challenges that persist in the area of bone regeneration. Significant attention will be given to native "raw" materials and ECM-based designs that provide necessary osteo- and chondro-conductive and inductive features for enhancing EC ossification. In addition, critical perspectives on existing stem cell-based therapeutic strategies will be discussed with a focus on their use as an extension of the acellular ECM-based designs for specific clinical indications. Within this framework, a novel realm of unexplored design strategies for bone tissue engineering will be introduced into the collective consciousness of the regenerative medicine field. PMID:25336144

  13. Advancing survivorship care through the National Cancer Survivorship Resource Center: developing American Cancer Society guidelines for primary care providers.

    PubMed

    Cowens-Alvarado, Rebecca; Sharpe, Katherine; Pratt-Chapman, Mandi; Willis, Anne; Gansler, Ted; Ganz, Patricia A; Edge, Stephen B; McCabe, Mary S; Stein, Kevin

    2013-05-01

    The National Cancer Survivorship Resource Center (The Survivorship Center) began in 2010 as a collaboration between the American Cancer Society and the George Washington University Cancer Institute and was funded by the Centers for Disease Control and Prevention. The Survivorship Center aims to improve the overall health and quality of life of posttreatment cancer survivors. One key to addressing the needs of this ever-growing population is to develop clinical follow-up care guidelines that emphasize not only the importance of surveillance for cancer recurrence, but also address the assessment and management of the physical and psychosocial long-term and late effects that may result from having cancer and undergoing cancer treatment as well as highlight the importance of healthy behaviors that can reduce the risk of cancer recurrence, second primary cancers, and other chronic diseases. Currently, The Survivorship Center is coordinating the work of experts in oncology, primary care, and other health care professions to develop follow-up care guidelines for 10 priority cancer sites. PMID:23512728

  14. Evidence-Based Practice in the Use of Antibiotics for Respiratory Tract Infections in Primary Health Centers in Kuwait

    Microsoft Academic Search

    Salem Ayyad; Abdullah Al-Owaisheer; Faisal Al-Banwan; Abdullah Al-Mejalli; Mumtaz Shukkur; Lukman Thalib

    2010-01-01

    Objectives: The objective of this study was to evaluate the use of antibiotics in treating upper respiratory tract infections (URTIs) in primary health centers in Kuwait and investigate the extent to which antibiotic use follows international guidelines. SubjectsandMethods: A nationwide cross-sectional study was conducted with a sample size of 615 patients selected by using a multi-stage cluster sampling method. Of

  15. Person-centered approaches to primary prevention in mental health: Situation-focused and competence-enhancement

    Microsoft Academic Search

    Emory L. Cowen

    1985-01-01

    Situation-focused and competence-enhancement approaches represent different pathways toward a richer person-centered primary prevention in mental health. Each is valid in its own right. The utility of developing both strands rests precisely on the fact that they are different means to a common end. Thus, although the approaches have somewhat different conceptual footings (one is proactive, the other reactive), differ in

  16. 2004 was a productive year for the Stoeckle Center, featuring the development of several new mission-driven programs and innovative work with the primary care

    E-print Network

    Mootha, Vamsi K.

    mission-driven programs and innovative work with the primary care practices throughout the Massachusetts General Hospital (MGH) community. Education Stoeckle Center Seminars Primary care physicians (PCPs and improvements within primary care, and to educate providers about new methods and techniques to improve

  17. Cyclin-dependent kinase inhibitor p21 does not impact embryonic endochondral ossification in mice

    PubMed Central

    CHINZEI, NOBUAKI; HAYASHI, SHINYA; HASHIMOTO, SHINGO; KANZAKI, NORIYUKI; IWASA, KENJIRO; SAKATA, SHUHEI; KIHARA, SHINSUKE; FUJISHIRO, TAKAAKI; KURODA, RYOSUKE; KUROSAKA, MASAHIRO

    2015-01-01

    Endochondral ossification at the growth plate is regulated by a number of factors and hormones. The cyclin-dependent kinase inhibitor p21 has been identified as a cell cycle regulator and its expression has been reported to be essential for endochondral ossification in vitro. However, to the best of our knowledge, the function of p21 in endochondral ossification has not been evaluated in vivo. Therefore, the aim of this study was to investigate the function of p21 in embryonic endochondral ossification in vivo. Wild-type (WT) and p21 knockout (KO) pregnant heterozygous mice were sacrificed on embryonic days E13.5, E15.5 and E18.5. Sagittal histological sections of the forearms of the embryos were collected and stained with Safranin O and 5-bromo-2?-deoxyuridine (BrdU). Additionally, the expression levels of cyclin D1, type II collagen, type X collagen, Sox9, and p16 were examined using immunohistochemistry, and the expression levels of p27 were examined using immunofluorescence. Safranin O staining revealed no structural change between the cartilage tissues of the WT and p21KO mice at any time point. Type II collagen was expressed ubiquitously, while type X collagen was only expressed in the hypertrophic zone of the cartilage tissues. No differences in the levels of Sox9 expression were observed between the two groups at any time point. The levels of cyclin D1 expression and BrdU uptake were higher in the E13.5 cartilage tissue compared with those observed in the embryonic cartilage tissue at subsequent time points. Expression of p16 and p27 was ubiquitous throughout the tissue sections. These results indicate that p21 may not be essential for embryonic endochondral ossification in articular cartilage of mice and that other signaling networks may compensate for p21 deletion. PMID:25376471

  18. Idiopathic pulmonary calcification and ossification in an elderly woman with a missed diagnosis of subarachnoid haemorrhage.

    PubMed

    Odubanjo, M O; Abdulkareem, F B; Banjo, A; Ekwere, T E; Awelimobor, D I

    2013-09-01

    This is a case of idiopathic pulmonary calcification and ossification in a 70 year old with long-standing diabetes and hypertension. Thirteen years prior to her demise, she was first noticed to have multiple calcific deposits in her lungs on a chest X-ray film. She had no risk factors for soft tissue calcification and ossification. Histology of tissue from autopsy showed intraparenchymal pulmonary calcification and ossification with marrow elements. Idiopathic pulmonary calcification and ossification is rare. At autopsy, she was also found to have had bilateral subarachnoid haemorrhage (SAH), a diagnosis missed during clinical evaluation. We highlight the pertinent details in our patient's management that could have helped to prevent a missed diagnosis of SAH. Even though SAH occurs most commonly following head trauma, the more familiar medical use of SAH is for non-traumatic SAH occurring following a ruptured cerebral aneurysm. This patient had notable risk factors for cerebral aneurysm formation but an aneurysm was not identified at autopsy. The location of the blood high on the cerebral convexities further suggests a traumatic origin rather than a ruptured aneurysm. Heterotopic calcification and ossification (HO) is known to occur in the setting of severe neurologic disorders such as traumatic brain injury but the fact that the lung calcification in our patient predated the brain injury by over 10 years makes it unlikely for the HO to have been due to the brain trauma. Other organ pathologies found at autopsy include chromophobe renal cell carcinoma, renal papillary necrosis, lymphocytic thyroiditis, and seborrheic keratosis. PMID:24391231

  19. Primary radiation therapy for early breast cancer: the experience at the joint center for radiation therapy

    Microsoft Academic Search

    Jay R. Harris; Leslie Botnick; William D. Bloomer; John T. Chaffey; Samuel Hellman

    1981-01-01

    The results of primary radiation therapy in 176 consecutive patients with clinical State I and II carcinoma of the breast were reviewed. Median follow-up time was 47 months. The overall breast relapse rate was 7%. Patients undergoing interstitial implantation had a significantly lower breast relapse rate (1%) than patients not undergoing implantation (11%). Breast relapse was more common in patients

  20. Preventive Counseling Services during Primary Care Visits: A Comparison of Health Centers versus Other Physician Offices.

    PubMed

    Shi, Leiyu; Lebrun-Harris, Lydie A; Chen, Li-Ru; Parasuraman, Sarika Rane; Zhu, Jinsheng; Ngo-Metzger, Quyen; Sripipatana, Alek

    2015-01-01

    We compared preventive counseling services provided by health centers versus other physician offices. Cross-sectional data came from the 2008 National Ambulatory Medical Care Survey, including 25,177 patient visits in physician offices and 3,345 patient visits in health centers. Despite serving disproportionately more vulnerable patients, health centers provided comparable rates of preventive counseling services, compared with other physician offices: health education (39% vs. 36%), disease management (34% vs. 41%), asthma education (21% vs. 13%), tobacco education (19% for both), and weight reduction education (6% vs. 9%) (p>.05 for all). Adjusted analyses showed no association between health care setting and preventive counseling. PMID:25913348

  1. Etiology of anemia in primary hypothyroid subjects in a tertiary care center in Eastern India

    PubMed Central

    Das, Chanchal; Sahana, Pranab K.; Sengupta, Nilanjan; Giri, Debasis; Roy, Mukut; Mukhopadhyay, Prasanta

    2012-01-01

    Introduction: The association of anemia with primary hypothyroidism has been common knowledge for many years. However; its pathogenesis is far from clear in many cases. Often the causes of anemia are manifold. Aims and objectives: In this study, we evaluated the causes of anemia in patients with primary hypothyroidism. Materials and Methods: Sixty adult nonpregnant untreated primary hypothyroid patients with anemia without any obvious cause were included. All patients were subjected to full medical history, clinical examination, biochemical and imaging studies. Serum iron profile, vitamin B12, folic acid, anti parietal cell antibody, anti TPO antibody, bone marrow study, and stool for occult blood, Coomb's test, HPLC for hemoglobinopathies and complete hemogram with reticulocyte count were done and analyzed. Results: Normocytic, normochromic anemia was present in 31 patients (51.6%) followed by microcytic anemia in 26 patients (43.3%). Six patients (10%) had megaloblastic anemia with vitamin B12 deficiency including 3 cases of pernicious anemia. Two patients had combined deficiency of iron and vitamin B12. Conclusion: Normocytic normochromic anemia with normal bone marrow was commonest type of anemia in this study, followed by iron deficiency anemia. PMID:23565429

  2. Radiographic monitoring of the ossification of long bones in kori (Ardeotis kori) and white-bellied (Eupodotis senegalensis) bustards.

    PubMed

    Naldo, J L; Samour, J H; Bailey, T A

    1998-01-01

    A serial radiographic study was conducted on eight kori bustard (Ardeotis kori) and four white-bellied bustard (Eupodotis senegalensis) chicks to determine the pattern of long bone development and to establish radiographic standards for assessing skeletal maturity. The ossification pattern, appearance of secondary ossification centres, and epiphyseal fusion of the long bones in kori and white-bellied bustards were similar to those in houbara bustards (Chlamydotis undulata macqueenii), rufous-crested bustards (Eupodotis ruficrista), domestic fowl (Gallus gallus), house wrens (Troglodytes aedon aedon), racing pigeons (Columba livia). and barn owls (Tyto alba). Secondary ossification centres were present at the proximal and distal tibiotarsus, proximal tarsometatarsus and proximal metacarpal III. The ossification of long bones occurred earlier in female kori bustards compared with males. PMID:9839896

  3. Near-infrared-excitation resonance Raman spectra of the primary electron donor in photosynthetic reaction centers from Rhodobacter sphaeroides

    SciTech Connect

    Donohoe, R.J.; Dyer, R.B.; Swanson, B.I. (Los Alamos National Lab., NM (USA)); Violette, C.A.; Frank, H.A. (Univ. of Connecticut, Storrs (USA)); Bocian, D.F. (Carnegie Mellon Univ., Pittsburgh, PA (USA))

    1990-08-29

    The x-ray crystal structures of bacterial photosynthetic reaction centers (RCs) serve as bench marks for establishing a detailed description of the light-induced electron-transfer process. Much recent work has focused on the characterization of the electronic properties of the primary electron donor state (P*), which is an excited state of the special pair dimer of bacteriochlorophyll (BChl) molecules in RCs. Thus far, most studies of P* have relied on optical spectroscopic techniques. No resonance Raman (RR) experiments have been reported that directly probe this state. The authors report the results of preliminary, low-frequency RR studies that probe the photophysically important, near-infrared absorption band of the primary electron donor in RCs from Rhodobacter sphaeroides wild-type strain 2.4.1.

  4. Eleven years of primary health care delivery in an academic nursing center

    Microsoft Academic Search

    Eugenie Hildebrandt; Mary Jo Baisch; Sally P Lundeen; Jean Bell-Calvin; Sheryl Kelber

    2003-01-01

    Academic community nursing centers (CNCs) emphasize partnership with the communities they serve to provide access to services that promote, restore, and maintain health. In this study, selected data from an 11-year clinical data set are presented to show the scope of academic CNC nursing practice, describe client services and expanded nursing roles, show the use of a computerized clinical documentation

  5. A single-center study of hematopoietic stem cell transplantation for primary immune deficiencies (PIDD).

    PubMed

    Dinardo, Laura; Brown, Valerie; Perez, Elena; Bunin, Nancy; Sullivan, Kathleen E

    2012-02-01

    PIDD are rare inherited disorders that can result in life-threatening infections. Allogeneic HSCT is the only cure for many primary immune deficiencies; however, the specific diseases and optimal type(s) of transplants are not clear. This study compares transplant outcomes in a large cohort with a relatively uniform pre- and post-transplant management strategies. We conducted a retrospective analysis of 39 pediatric patients who underwent HSCT for SCID (n?=?25) or other immune deficiencies (n?=?14) from 1986 to 2010. A structured case report form was used to collect clinical information. The outcomes of survival, immune reconstitution, engraftment, incidence of GvHD and IVIG dependency were tabulated. Overall survival rates were 88% for SCID and 86% for other primary immune deficiencies, which are high compared to other historical series. No single variable was associated with mortality. Immunoglobulin dependence occurred only in patients who had X-linked SCID and a parental donor haploidentical transplant. Because of improved supportive care and use of alternative donors and conditioning regimens, HSCT has become an acceptable option for an increasing number of PIDD subtypes not previously transplanted with high frequency. This study encourages greater use of transplantation. PMID:22093026

  6. Engaging Primary Care Patients to Use a Patient-Centered Personal Health Record

    PubMed Central

    Krist, Alex H.; Woolf, Steven H.; Bello, Ghalib A.; Sabo, Roy T.; Longo, Daniel R.; Kashiri, Paulette; Etz, Rebecca S.; Loomis, John; Rothemich, Stephen F.; Peele, J. Eric; Cohn, Jeffrey

    2014-01-01

    PURPOSE Health care leaders encourage clinicians to offer portals that enable patients to access personal health records, but implementation has been a challenge. Although large integrated health systems have promoted use through costly advertising campaigns, other implementation methods are needed for small to medium-sized practices where most patients receive their care. METHODS We conducted a mixed methods assessment of a proactive implementation strategy for a patient portal (an interactive preventive health record [IPHR]) offered by 8 primary care practices. The practices implemented a series of learning collaboratives with practice champions and redesigned workflow to integrate portal use into care. Practice implementation strategies, portal use, and factors influencing use were assessed prospectively. RESULTS A proactive and customized implementation strategy designed by practices resulted in 25.6% of patients using the IPHR, with the rate increasing 1.0% per month over 31 months. Fully 23.5% of IPHR users signed up within 1 day of their office visit. Older patients and patients with comorbidities were more likely to use the IPHR, but blacks and Hispanics were less likely. Older age diminished as a factor after adjusting for comorbidities. Implementation by practice varied considerably (from 22.1% to 27.9%, P <.001) based on clinician characteristics and workflow innovations adopted by practices to enhance uptake. CONCLUSIONS By directly engaging patients to use a portal and supporting practices to integrate use into care, primary care practices can match or potentially surpass the usage rates achieved by large health systems. PMID:25354405

  7. Stimulation of experimental endochondral ossification by low-energy pulsing electromagnetic fields

    SciTech Connect

    Aaron, R.K.; Ciombor, D.M.; Jolly, G.

    1989-04-01

    Pulsed electromagnetic fields (PEMFs) of certain configuration have been shown to be effective clinically in promoting the healing of fracture nonunions and are believed to enhance calcification of extracellular matrix. In vitro studies have suggested that PEMFs may also have the effect of modifying the extracellular matrix by promoting the synthesis of matrix molecules. This study examines the effect of one PEMF upon the extracellular matrix and calcification of endochondral ossification in vivo. The synthesis of cartilage molecules is enhanced by PEMF, and subsequent endochondral calcification is stimulated. Histomorphometric studies indicate that the maturation of bone trabeculae is also promoted by PEMF stimulation. These results indicate that a specific PEMF can change the composition of cartilage extracellular matrix in vivo and raises the possibility that the effects on other processes of endochondral ossification (e.g., fracture healing and growth plates) may occur through a similar mechanism.

  8. Pycnodysostosis with Multi-Segmental Spinal Canal Stenosis due to Ossification of the Yellow Ligament

    PubMed Central

    Kanaya, Koichi; Murata, Yasuaki; Kato, Yoshiharu

    2015-01-01

    Pycnodysostosis is an autosomal recessive disorder characterized by osteosclerosis, small stature, acro-osteolysis of the distal phalanges, loss of the mandibular angle, separated cranial sutures with open fontanels, and frequent fractures. One identified cause of the disease is reduced activity of the cysteine protease cathepsin K. A 48-year-old woman with a history of frequent fractures presented with a severe gait disturbance. Radiography, computed tomography, magnetic resonance imaging, and gene analysis were performed. Physical examination revealed open fontanels, and radiographs showed increased bone density. DNA sequence analysis revealed a deletion mutation of the cathepsin K gene. We diagnosed pycnodysostosis based on these findings. The magnetic resonance and computed tomography images demonstrated multilevel spinal canal stenosis due to ossification of the yellow ligament. We performed a laminectomy, and the patient's neurological signs and symptoms improved. To our knowledge, this is the first case of pycnodysostosis with ossification of the yellow ligament. PMID:25901243

  9. Pycnodysostosis with Multi-Segmental Spinal Canal Stenosis due to Ossification of the Yellow Ligament.

    PubMed

    Wada, Keiji; Kanaya, Koichi; Murata, Yasuaki; Kato, Yoshiharu

    2015-04-01

    Pycnodysostosis is an autosomal recessive disorder characterized by osteosclerosis, small stature, acro-osteolysis of the distal phalanges, loss of the mandibular angle, separated cranial sutures with open fontanels, and frequent fractures. One identified cause of the disease is reduced activity of the cysteine protease cathepsin K. A 48-year-old woman with a history of frequent fractures presented with a severe gait disturbance. Radiography, computed tomography, magnetic resonance imaging, and gene analysis were performed. Physical examination revealed open fontanels, and radiographs showed increased bone density. DNA sequence analysis revealed a deletion mutation of the cathepsin K gene. We diagnosed pycnodysostosis based on these findings. The magnetic resonance and computed tomography images demonstrated multilevel spinal canal stenosis due to ossification of the yellow ligament. We performed a laminectomy, and the patient's neurological signs and symptoms improved. To our knowledge, this is the first case of pycnodysostosis with ossification of the yellow ligament. PMID:25901243

  10. Primary Stenting of Subclavian and Innominate Artery Occlusive Disease: A Single Center's Experience

    SciTech Connect

    Brountzos, E. N., E-mail: platanos@hol.qr; Petersen, B.; Binkert, C.; Panagiotou, I.; Kaufman, J. A. [Oregon Health Sciences University, Dotter Interventional Institute (United States)

    2004-11-15

    Purpose: To review immediate and midterm results of primary stenting for innominate and subclavian artery occlusive lesions. Methods: Retrospective data were collected from 48 consecutive symptomatic patients (27 men and 21 women, median age 64 years) having 49 subclavian and innominate artery lesions treated with stenting. Of the patients 52% had concomitant ischemic heart disease, and 30% had carotid and/or vertebral artery disease. Indication for treatment was vertebrobasilar insufficiency (VBI) in 16.6% of the patients; upper limb ischemia (ULI) in 31.3%; VBI and ULI in 12.5%; transient ischemic attack in 16.7%; angina in 12.5% before or after left internal mammary artery-to-coronary artery bypass grafting; and leg claudication in 10.4% before or after axillofemoral bypass grafting. Balloon-expandable stents were used in 44 lesions and self-expandable stents in 5 lesions. In total, 53 stents were placed in 48 patients. Results: Technical success was 96%, and clinical success 94%. We encountered four complications (two puncture site hematomas, one distal hand embolization and one transient cerebral ischemia). Two patients died within 30 days from other causes, and seven patients were lost to follow-up. Mean follow-up time was 16.7 months (range 0.3 to 68.2). Five patients had recurrent lesions treated by surgical (n = 2) or endovascular (n = 3) means. Cumulative primary patency rate was 91.7% and 77% at 12 and 24 months, respectively. Cumulative secondary patency rate was 96.5% and 91.7% at 12 and 24 months, respectively. Conclusion: Stenting of subclavian and innominate artery lesions resulted in immediate resolution of patients' symptoms with durable midterm effect and few complications in a larger patient group with serious comorbid conditions.

  11. A case of extensive heterotopic ossification following multiple ligament reconstruction after severe knee trauma

    Microsoft Academic Search

    Se Hyun Cho; Sun Chul Hwang; Kang-Il Kim; Jae Ho Yoo

    2011-01-01

    We present a case of extensive heterotopic ossification (HO) around the knee joint following multiple ligament reconstruction\\u000a after severe trauma. A 50-year-old female sustained a motor vehicle accident and underwent multiple trauma. The initial diagnosis\\u000a of the knee included avulsion fracture of the tibial attachment of the posterior cruciate ligament, multiple ligament injury\\u000a including the anterior cruciate ligament and medial

  12. Unusual fan shaped ossification in a female fetus with radiological features of boomerang dysplasia.

    PubMed

    Odent, S; Loget, P; Le Marec, B; Delezoďde, A L; Maroteaux, P

    1999-04-01

    We report on a female fetus of 24 weeks whose clinical and radiological findings were compatible with boomerang dysplasia (BD). However, histopathology was unusual with a lateral fan shaped diaphyseal ossification. This has never been described either in typical atelosteogenesis I (AT-I) or in BD. The purpose of this report is to find out if this condition is a separate lethal bone dysplasia or another histological feature of the nosological group of AT-I and BD. PMID:10227404

  13. Heterotopic ossifications following implant surgery—epidemiology, therapeutical approaches and current concepts

    Microsoft Academic Search

    Christian Zeckey; Frank Hildebrand; Michael Frink; Christian Krettek

    2011-01-01

    The pathophysiology of heterotopic ossification (HO) is still ill-understood. Several risk factors such as osteoarthritis,\\u000a male gender and injury patterns like traumatic brain injury and severe soft tissue damage have been described. Furthermore,\\u000a the pathophysiology of local and systemic factors has been investigated leading to an extended knowledge especially on the\\u000a molecular level. Knowledge of the involved cell types and

  14. Absence of Endochondral Ossification and Craniosynostosis in Posterior Frontal Cranial Sutures of Axin2?/? Mice

    PubMed Central

    Behr, Björn; Longaker, Michael T.; Quarto, Natalina

    2013-01-01

    During the first month of life, the murine posterior-frontal suture (PF) of the cranial vault closes through endochondral ossification, while other sutures remain patent. These processes are tightly regulated by canonical Wnt signaling. Low levels of active canonical Wnt signaling enable endochondral ossification and therefore PF-suture closure, whereas constitutive activation of canonical Wnt causes PF-suture patency. We therefore sought to test this concept with a knockout mouse model. PF-sutures of Axin2?/? mice, which resemble a state of constantly activated canonical Wnt signaling, were investigated during the physiological time course of PF-suture closure and compared in detail with wild type littermates. Histological analysis revealed that the architecture in Axin2?/? PF-sutures was significantly altered in comparison to wild type. The distance between the endocranial layers was dramatically increased and suture closure was significantly delayed. Moreover, physiological endochondral ossification did not occur, rather an ectopic cartilage appeared between the endocranial and ectocranial bone layers at P7 which eventually involutes at P13. Quantitative PCR analysis showed the lack of Col10?1 upregulation in Axin2?/? PF-suture. Immunohistochemistry and gene expression analysis also revealed high levels of type II collagen as compared to type I collagen and absence of Mmp-9 in the cartilage of Axin2?/? PF-suture. Moreover, TUNEL staining showed a high percentage of apoptotic chondrocytes in Axin2?/? PF-sutures at P9 and P11 as compared to wild type. These data indicated that Axin2?/? PF-sutures lack physiological endochondral ossification, contain ectopic cartilage and display delayed suture closure. PMID:23936395

  15. Novel role for cyclophilin a in regulation of chondrogenic commitment and endochondral ossification.

    PubMed

    Guo, Mian; Shen, Jia; Kwak, Jin Hee; Choi, Bogyu; Lee, Min; Hu, Shen; Zhang, Xinli; Ting, Kang; Soo, Chia B; Chiu, Robert H

    2015-06-15

    Recent studies showed that cyclophilin A (CypA) promotes NF-?B/p65 nuclear translocation, resulting in enhanced NF-?B activity and altered expression of its target genes, such as the Sox9 transcriptional factor, which plays a critical role in chondrogenic differentiation and endochondral ossification. In this report, we unveil the role of CypA in signal-induced chondrogenic differentiation and endochondral ossification. Expression levels of the chondrogenic differentiation markers and transcriptional regulators Sox9 and Runx2 were all significantly lower in CypA knockdown chondrogenic cells than in wild-type cells, indicating that CypA plays a functional role in chondrogenic differentiation. In vitro differentiation studies using micromass cultures of mouse limb bud cells further supported the conclusion that CypA is needed for chondrogenic differentiation. Newborn CypA-deficient pups double stained with alcian blue and alizarin red exhibited generalized, pronounced skeletal defects, while high-resolution micro-computed tomography (microCT) analyses of the femurs and lumbar vertebrae revealed delayed or incomplete endochondral ossification. Comparative histology and immunohistochemistry (IHC) analyses further verified the effects of CypA deficiency on chondrogenic differentiation. Our results provide evidence for the important contribution of CypA as a pertinent component acting through NF-?B-Sox9 in regulation of chondrogenesis signaling. These findings are important to better understand signal-induced chondrogenesis of chondrogenic progenitors in physiological and pathophysiological contexts. PMID:25870110

  16. Variation in mammalian proximal femoral development: comparative analysis of two distinct ossification patterns

    PubMed Central

    Serrat, Maria A; Reno, Philip L; McCollum, Melanie A; Meindl, Richard S; Lovejoy, C Owen

    2007-01-01

    The developmental anatomy of the proximal femur is complex. In some mammals, including humans, the femoral head and greater trochanter emerge as separate ossification centres within a common chondroepiphysis and remain separate throughout ontogeny. In other species, these secondary centres coalesce within the chondroepiphysis to form a single osseous epiphysis much like the proximal humerus. These differences in femoral ontogeny have not been previously addressed, yet are critical to an understanding of femoral mineralization and architecture across a wide range of mammals and may have key implications for understanding and treating hip abnormalities in humans. We evaluated femora from 70 mammalian species and categorized each according to the presence of a ‘separate’ or ‘coalesced’ proximal epiphysis based on visual assessment. We found that ossification type varies widely among mammals: taxa in the ‘coalesced’ group include marsupials, artiodactyls, perissodactyls, bats, carnivores and several primates, while the ‘separate’ group includes hominoids, many rodents, tree shrews and several marine species. There was no clear relationship to body size, phylogeny or locomotion, but qualitative and quantitative differences between the groups suggest that ossification type may be primarily an artefact of femoral shape and neck length. As some osseous abnormalities of the human hip appear to mimic the normal morphology of species with coalesced epiphyses, these results may provide insight into the aetiology and treatment of human hip disorders such as femoroacetabular impingement and early-onset osteoarthritis. PMID:17331175

  17. Primary care program improves reimbursement. The Federally Qualified Health Center program helps hospitals improve services to the medically indigent.

    PubMed

    Fahey, T M; Gallitano, D G

    1993-03-01

    Under a program created by Congress in 1989, certain primary care treatment centers serving the medically and economically indigent can become Federally Qualified Health Centers (FQHCs). Recently enacted rules and regulations allow participants in the FQHC program to receive 100 percent reasonable cost reimbursement for Medicaid services and 80 percent for Medicare services. An all-inclusive annual cost report is the basis for determining reimbursement rates. The report factors in such expenses as physician and other healthcare and professional salaries and benefits, medical supplies, certain equipment depreciation, and overhead for facility and administrative costs. Both Medicaid and Medicare reimbursement is based on an encounter rate, and states employ various methodologies to determine the reimbursement level. In Illinois, for example, typical reimbursement for a qualified encounter ranges from $70 to $88. To obtain FQHC status, an organization must demonstrate community need, deliver the appropriate range of healthcare services, satisfy management and finance requirements, and function under a community-based governing board. In addition, an FQHC must provide primary healthcare by physicians and (where appropriate) midlevel practitioners; it must also offer its community diagnostic laboratory and x-ray services, preventive healthcare and dental care, case management, pharmacy services, and arrangements for emergency services. Because FQHCs must be freestanding facilities, establishing them can trigger a number of ancillary legal issues, such as those involved in forming a new corporation, complying with not-for-profit corporation regulations, applying for tax-exempt status, and applying for various property and sales tax exemptions. Hospitals that establish FQHCs must also be prepared to relinquish direct control over the delivery of primary care services. PMID:10124301

  18. The Use and Implementation of Interactive Writing as an Instructional Method for Primary Teachers in Texas Educational Service Center Region 2

    ERIC Educational Resources Information Center

    Fabela, Rachelle M.

    2013-01-01

    This doctoral study investigated the use and implementation of interactive writing as an instructional method for primary teachers in Texas Educational Service Center Region 2. The descriptive study involved 152 survey respondents and eight interview participants. The primary instrument was a questionnaire (Interactive Writing Survey) that…

  19. Evidence for Highly Dispersive Primary Charge Separation Kinetics and Gross Heterogeneity in the Isolated PS II Reaction Center of Green Plants †

    Microsoft Academic Search

    K. Riley; R. Jankowiak; M. Rätsep; G. J. Small; V. Zazubovich

    2004-01-01

    Despite the availability of an X-ray structure and many spectroscopic studies, important issues related to structural heterogeneity, excitonic structure, primary charge separation (CS), and excitation energy transfer dynamics of the isolated reaction center (RC) of photosystem II (PS II) remain unresolved. The issues addressed here include (1) whether the primary CS kinetics at low temperatures are highly dispersive (due to

  20. The Residency Program in Social Medicine of Montefiore Medical Center: 37 Years of Mission-Driven, Interdisciplinary Training in Primary Care, Population Health, and Social Medicine

    Microsoft Academic Search

    A. H. Strelnick; Debbie Swiderski; Alice Fornari; Victoria Gorski; Eliana Korin; Philip Ozuah; Janet M. Townsend; Peter A. Selwyn

    2008-01-01

    Founded in 1970 to train physicians to practice in community health centers and underserved areas, the Residency Program in Social Medicine (RPSM) of Montefiore Medical Center, Bronx, New York, has graduated 562 board-eligible family physicians, general internists, and pediatricians whose careers fulfill this mission. The RPSM was a model for federal funding for primary care residency programs and has received

  1. Two Programs for Primary Care Practitioners: Family Medicine Training in an Affiliated University Hospital Program and Primary Care Graduate Training in an Urban Private Medical Center

    ERIC Educational Resources Information Center

    Farley, Eugene S.; Piemme, Thomas E.

    1975-01-01

    Eugene Farley describes the University of Rochester and Highland Hospital Family Medicine Program for teaching of primary care internists, primary care pediatricians, and family doctors. Thomas Piemme presents the George Washington University School of Medicine alternative, a 2-year program in an ambulatory setting leading to broad eligibility in…

  2. Primary Cutting Balloon Angioplasty for Treatment of Venous Stenoses in Native Hemodialysis Fistulas: Long-Term Results from Three Centers

    Microsoft Academic Search

    Rajesh Bhat; Kieran McBride; Sam Chakraverty; Raghunandan Vikram; Alison Severn

    2007-01-01

    Aim. To evaluate the technical success and patency rates following primary cutting balloon angioplasty for venous stenoses in native dialysis fistulas. Methods. Forty-one patients (26 men, 15 women; age range 26-82 years, average age 59 years) underwent 50 (repeat procedures in 9 patients) primary cutting balloon (PCB) angioplasty procedures in three institutions by three primary operators. The indication was primary

  3. Low Rates of Heterotopic Ossification After Resurfacing Hip Arthroplasty With Use of Prophylactic Radiotherapy in Select Patients

    PubMed Central

    Kruser, Tim J.; Kozak, Kevin R.; Cannon, Donald M.; Platta, Christopher S.; Heiner, John P.; Illgen, Richard L.

    2012-01-01

    Recent reports have noted higher rates of heterotopic ossification (HO) with surface replacement arthroplasty (SRA) than with traditional total hip arthroplasty in the absence of postoperative HO prophylaxis. This study reports rates and grades of HO in 44 SRA patients with at least 1 year of follow-up. Heterotopic ossification prophylaxis was used in 32 (73%) of 44 cases. Heterotopic ossification prophylaxis consisted of radiotherapy (22/32), nonsteroidal anti-inflammatory drugs (8/32), or both (2/32). One case of clinically significant HO was documented in the no-prophylaxis group. This strategy of selective HO prophylaxis in patients felt by orthopedic surgeons to be at high risk of HO resulted in low rates of clinically relevant HO after SRA (1/44, 2.3%). Further study is needed to establish optimal selection criteria for HO prophylaxis after SRA. PMID:22245125

  4. Unusual fan shaped ossification in a female fetus with radiological features of boomerang dysplasia

    PubMed Central

    Odent, S.; Loget, P.; Le Marec, B.; Delezoide, A.; Maroteaux, P.

    1999-01-01

    We report on a female fetus of 24 weeks whose clinical and radiological findings were compatible with boomerang dysplasia (BD). However, histopathology was unusual with a lateral fan shaped diaphyseal ossification. This has never been described either in typical atelosteogenesis I (AT-I) or in BD. The purpose of this report is to find out if this condition is a separate lethal bone dysplasia or another histological feature of the nosological group of AT-I and BD. ???Keywords: boomerang dysplasia; atelosteogenesis; lethal chondrodysplasia; lethal dwarfism PMID:10227404

  5. Genomic study of ossification of the posterior longitudinal ligament of the spine

    PubMed Central

    IKEGAWA, Shiro

    2014-01-01

    Ossification of the posterior longitudinal ligament of the spine (OPLL) is a common disease after the middle age. OPLL frequently causes serious neurological problems due to compression of the spinal cord and/or nerve roots. OPLL occurs in patients with monogenic metabolic diseases including rickets/osteomalacia and hypoparathyroidism; however most of OPLL is idiopathic and is considered as a multi-factorial (polygenic) disease influenced by genetic and environmental factors. Genomic studies for the genetic factors of OPLL have been conducted, mainly in Japan, including linkage and association studies. This paper reviews the recent progress in the genomic study of OPLL and comments on its future direction. PMID:25504229

  6. Genetics of Ossification of the Posterior Longitudinal Ligament of the Spine: A Mini Review

    PubMed Central

    2014-01-01

    Ossification of the posterior longitudinal ligament of the spine (OPLL) is a common disease in aging populations and sometimes results in serious neurological problems due to compression of the spinal cord and nerve roots. OPLL is a multi-factorial (polygenic) disease controlled by genetic and environmental factors. Studies searching for the genetic component of OPLL, using linkage and association analyses, are in progress and several susceptibility genes have been reported. This paper reviews the recent progress in the genetic study of OPLL and comments on its future task. PMID:25006569

  7. As good as physicians: patient perceptions of physicians and non-physician clinicians in rural primary health centers in India

    PubMed Central

    Rao, Krishna D; Stierman, Elizabeth; Bhatnagar, Aarushi; Gupta, Garima; Gaffar, Abdul

    2013-01-01

    ABSTRACT Background: Attracting physicians to rural areas has been a long-standing challenge in India. Government efforts to address the shortage of rural physicians include posting non-physician clinicians (NPCs) at primary health centers (PHCs) in select areas. Performance assessments of NPCs have typically focused on the technical quality of their care with little attention to the perspectives of patients. This study investigates patient views of physicians (Medical Officers) and NPCs in terms of patient satisfaction, perceived quality, and provider trust. NPCs include: Indian system of medicine physicians (AYUSH Medical Officers) and clinicians with 3 years of training, such as Rural Medical Assistants (RMAs). At PHCs without clinicians, paramedics provide clinical care, although they are not trained for this. Methods: PHCs in the state of Chhattisgarh were stratified by provider type: Medical Officer, AYUSH Medical Officer, RMA, or paramedic. PHCs were randomly sampled in each group. A total of 1,082 exiting patients were sampled from138 PHCs. Factor analysis was used to identify perceived quality domains. Multiple regression analysis was used to test for group differences. Results: Patients of Medical Officers and NPCs reported similar levels of satisfaction, trust, and perceived quality, with scores of 84% for Medical Officers, 80% for AYUSH Medical Officers, and 85% for RMAs. While there were no significant differences in these outcomes between these groups, scores for paramedical staff were significantly lower, at 73%. Conclusions: Physicians and NPCs performed similarly in terms of patient satisfaction, trust, and perceived quality. From a patient's perspective, this supports the use and scale up of NPCs in primary care settings in India. Leaving clinician posts vacant undermines public trust and quality perceptions of government health services. PMID:25276553

  8. Assessment of modularity in the urodele skull: an exploratory analysis using ossification sequence data.

    PubMed

    Laurin, Michel

    2014-12-01

    The potential presence of developmental modules is studied in the urodele skull using several classical statistical methods that have not previously been used in this context. Principal component analysis (PCA) of ossification sequence data on 21 bones in 21 extant urodele species suggests the presence of up to four developmental modules, but examination of statistically significant correlations using phylogenetic independent contrasts (PIC) and correcting for multiple tests using the false discovery rate suggests the presence of only two modules of uneven size and of two bones that may not be part of these modules. Thus, PCA does not appear to be a reliable method to investigate modularity; direct investigation of statistically significant correlations using PIC or other phylogeny-informed methods is recommended. A binomial test of the distribution of significant correlations between characters shows significant heterogeneity, which suggests that modularity is indeed present in the data. A cluster analysis gives inconsistent results that apparently do not reflect developmental modules. The data include a phylogenetic signal, as shown by a permutation-based test with squared change parsimony, but this is detectable only when the whole matrix is analyzed, and a plot of the tree onto developmental space through Evolutionary PCA shows that homoplasy is pervasive. Evolutionary rates between characters vary about 90-fold. Canonical variates analyses suggest that obligatorily neotenic urodeles may be discriminated from other urodeles on the basis of cranial ossification sequence data. PMID:24816835

  9. CASE REPORT An Unusual Case of Abdominal Compartment Syndrome Following Resection of Extensive Posttraumatic Mesenteric Ossification

    PubMed Central

    Nabulyato, William M.; Alsahiem, Hebah; Hall, Nigel R.; Malata, Charles M.

    2013-01-01

    Introduction: Heterotopic mesenteric ossification is an extremely rare condition, which often follows trauma and is frequently symptomatic. To date, there are no reports in the literature of abdominal compartment syndrome occurring after surgical resection of mesenteric calcification. The present report documents an unusual case of compartment syndrome complicating resection of extensive mesenteric calcification despite abdominal closure with the components-separation technique. Method: A 48-year-old man undergoing components-separation technique for posttraumatic laparostomy hernia repair (ileostomy reversal and sigmoid stricture correction) was found to have extensive heterotopic mesenteric calcification, which needed resection. Results: Resection of the mesenteric calcification was complicated by intraoperative hemorrhage and unplanned small bowel resection. Later the patient developed secondary hemorrhage leading to an abdominal compartment syndrome, which was successfully treated by decompression, hemostasis, and Permacol-assisted laparotomy wound closure. The patient remains symptom-free more than 2 years after surgery. Discussion: The case herein reported gives an account of the rare occurrence of abdominal compartment syndrome following resection of posttraumatic ectopic mesenteric ossifications. It is highly unusual in that it occurred because of “secondary hemorrhage” and despite abdominal closure with the components-separation technique, which had been undertaken precisely to prevent compartment syndrome with direct closure. It therefore highlights the need for continued clinical vigilance in complex posttraumatic cases. PMID:23573333

  10. Foxp1/2/4 regulate endochondral ossification as a suppresser complex.

    PubMed

    Zhao, Haixia; Zhou, Wenrong; Yao, Zhengju; Wan, Yong; Cao, Jingjing; Zhang, Lingling; Zhao, Jianzhi; Li, Hanjun; Zhou, Rujiang; Li, Baojie; Wei, Gang; Zhang, Zhenlin; French, Catherine A; Dekker, Joseph D; Yang, Yingzi; Fisher, Simon E; Tucker, Haley O; Guo, Xizhi

    2015-02-15

    Osteoblast induction and differentiation in developing long bones is dynamically controlled by the opposing action of transcriptional activators and repressors. In contrast to the long list of activators that have been discovered over past decades, the network of repressors is not well-defined. Here we identify the expression of Foxp1/2/4 proteins, comprised of Forkhead-box (Fox) transcription factors of the Foxp subfamily, in both perichondrial skeletal progenitors and proliferating chondrocytes during endochondral ossification. Mice carrying loss-of-function and gain-of-function Foxp mutations had gross defects in appendicular skeleton formation. At the cellular level, over-expression of Foxp1/2/4 in chondroctyes abrogated osteoblast formation and chondrocyte hypertrophy. Conversely, single or compound deficiency of Foxp1/2/4 in skeletal progenitors or chondrocytes resulted in premature osteoblast differentiation in the perichondrium, coupled with impaired proliferation, survival, and hypertrophy of chondrocytes in the growth plate. Foxp1/2/4 and Runx2 proteins interacted in vitro and in vivo, and Foxp1/2/4 repressed Runx2 transactivation function in heterologous cells. This study establishes Foxp1/2/4 proteins as coordinators of osteogenesis and chondrocyte hypertrophy in developing long bones and suggests that a novel transcriptional repressor network involving Foxp1/2/4 may regulate Runx2 during endochondral ossification. PMID:25527076

  11. Forensic age estimation through evaluation of the apophyseal ossification of the iliac crest in Western Chinese.

    PubMed

    Zhang, Kui; Dong, Xiao-Ai; Chen, Xiao-Gang; Li, Yuan; Deng, Zhen-Hua

    2015-07-01

    The criminal age estimation procedures have gained greatest significance to date, a reliable age diagnostics may depend on data of skeletal maturation from different socioeconomic status. In order to establish the iliac crest apophysis as a possible criterion for forensic age estimation in a different socioeconomic status, and to examine the pace of ossification for the iliac crest apophysis in Western Chinese, one thousand seven hundreds and seventy-seven conventional pelvic radiographs relating to West China Han group routinely taken between January 2010 and June 2012 have been sighted. The data was analysed with separation of the sexes. The results indicated that stage 2a was last observed in females at the age of 17.00 and in males at the age of 18.01, stage 3a was first achieved in females at the age of 14.46 and in males at the age of 15.31, stage 4 was observed between 17.95 and 25.98 years for male and between 18.36 and 25.95 years for female. By comparison with previous studies, our research indicated that Western Chinese presents a delaying development for the iliac crest apophysis. Furthermore, the present study with eight stages of ossification for the iliac crest offers a valuable alternative method of estimation of 18 years of age for Western Chinese. PMID:25982819

  12. Elements of the patient-centered medical home associated with health outcomes among veterans: the role of primary care continuity, expanded access, and care coordination.

    PubMed

    Nelson, Karin; Sun, Haili; Dolan, Emily; Maynard, Charles; Beste, Laruen; Bryson, Christopher; Schectman, Gordon; Fihn, Stephan D

    2014-01-01

    Care continuity, access, and coordination are important features of the patient-centered medical home model and have been emphasized in the Veterans Health Administration patient-centered medical home implementation, called the Patient Aligned Care Team. Data from more than 4.3 million Veterans were used to assess the relationship between these attributes of Patient Aligned Care Team and Veterans Health Administration hospitalization and mortality. Controlling for demographics and comorbidity, we found that continuity with a primary care provider was associated with a lower likelihood of hospitalization and mortality among a large population of Veterans receiving VA primary care. PMID:25180648

  13. Putative Hydrogen Bond to Tyrosine M208 in Photosynthetic Reaction Centers from Rhodobacter capsulatus Significantly Slows Primary Charge Separation

    PubMed Central

    2015-01-01

    Slow, ?50 ps, P* ? P+HA– electron transfer is observed in Rhodobacter capsulatus reaction centers (RCs) bearing the native Tyr residue at M208 and the single amino acid change of isoleucine at M204 to glutamic acid. The P* decay kinetics are unusually homogeneous (single exponential) at room temperature. Comparative solid-state NMR of [4?-13C]Tyr labeled wild-type and M204E RCs show that the chemical shift of Tyr M208 is significantly altered in the M204E mutant and in a manner consistent with formation of a hydrogen bond to the Tyr M208 hydroxyl group. Models based on RC crystal structure coordinates indicate that if such a hydrogen bond is formed between the Glu at M204 and the M208 Tyr hydroxyl group, the ?OH would be oriented in a fashion expected (based on the calculations by Alden et al., J. Phys. Chem.1996, 100, 16761–16770) to destabilize P+BA– in free energy. Alteration of the environment of Tyr M208 and BA by Glu M204 via this putative hydrogen bond has a powerful influence on primary charge separation. PMID:24902471

  14. Barriers and Facilitators to Implementing Primary Stroke Center Policy in the United States: Results From 4 Case Study States

    PubMed Central

    Slade, Catherine P.; Brewer, Gene A.; Gase, Lauren N.

    2011-01-01

    Objectives. We identified barriers and facilitators to the state-level implementation of primary stroke center (PSC) policies, which encourage the certification or designation of specialized stroke treatment facilities and may address concerns such as transportation bypass, telemedicine, and treatment protocols. Methods. We studied the experiences of 4 states (Florida, Massachusetts, New Mexico, and New York) selected from the 18 states that had enacted PSC policies or were actively considering doing so. We conducted semistructured interviews during fieldwork in each case study state. Results. Our results showed that system fragmentation, gaps in human and financial resources, and complexity at the interorganizational and operational levels are common barriers and that policy champions, stakeholder support and communication, and operational adaptation are essential facilitators in the adoption and implementation of PSC policies. Conclusions. The identification of barriers and facilitators reveals the contextual elements that can help or hinder policy implementation and may be useful in informing policy formulation and implementation in other jurisdictions. Proactively identifying jurisdictional challenges and opportunities may help facilitate the policy process for PSC designation and allow jurisdictions to develop more effective stroke systems of care. PMID:21233430

  15. Palmitoyl Acyltransferase, Zdhhc13, Facilitates Bone Mass Acquisition by Regulating Postnatal Epiphyseal Development and Endochondral Ossification: A Mouse Model

    PubMed Central

    Song, I-Wen; Li, Wei-Ru; Chen, Li-Ying; Shen, Li-Fen; Liu, Kai-Ming; Yen, Jeffrey J. Y.; Chen, Yi-Ju; Chen, Yu-Ju; Kraus, Virginia Byers; Wu, Jer-Yuarn; Lee, M. T. Michael; Chen, Yuan-Tsong

    2014-01-01

    ZDHHC13 is a member of DHHC-containing palmitoyl acyltransferases (PATs) family of enzymes. It functions by post-translationally adding 16-carbon palmitate to proteins through a thioester linkage. We have previously shown that mice carrying a recessive Zdhhc13 nonsense mutation causing a Zdhcc13 deficiency develop alopecia, amyloidosis and osteoporosis. Our goal was to investigate the pathogenic mechanism of osteoporosis in the context of this mutation in mice. Body size, skeletal structure and trabecular bone were similar in Zdhhc13 WT and mutant mice at birth. Growth retardation and delayed secondary ossification center formation were first observed at day 10 and at 4 weeks of age, disorganization in growth plate structure and osteoporosis became evident in mutant mice. Serial microCT from 4-20 week-olds revealed that Zdhhc13 mutant mice had reduced bone mineral density. Through co-immunoprecipitation and acyl-biotin exchange, MT1-MMP was identified as a direct substrate of ZDHHC13. In cells, reduction of MT1-MMP palmitoylation affected its subcellular distribution and was associated with decreased VEGF and osteocalcin expression in chondrocytes and osteoblasts. In Zdhhc13 mutant mice epiphysis where MT1-MMP was under palmitoylated, VEGF in hypertrophic chondrocytes and osteocalcin at the cartilage-bone interface were reduced based on immunohistochemical analyses. Our results suggest that Zdhhc13 is a novel regulator of postnatal skeletal development and bone mass acquisition. To our knowledge, these are the first data to suggest that ZDHHC13-mediated MT1-MMP palmitoylation is a key modulator of bone homeostasis. These data may provide novel insights into the role of palmitoylation in the pathogenesis of human osteoporosis. PMID:24637783

  16. Ossification of the posterior longitudinal ligament in the thoracic spine causing intermittent paraplegia in an Englishman: case report

    Microsoft Academic Search

    H Nakamura; H V Crock; B P Galbally; J Dawson

    1992-01-01

    Compression of the spinal cord due to ossification of the posterior longitudinal ligament (OPLL) often leads to quadriplegia or paraplegia in Japanese patients. This disease is uncommon in other races. We report the case of a middle-aged Englishman who presented with complaints of intermittent paraparesis due to OPLL at the T5-T6 level in his thoracic spine.

  17. Cochlear implantation in children with bacterial meningitic deafness: The influence of the degree of ossification and obliteration on impedance and charge of the implant.

    PubMed

    Durisin, Martin; Büchner, Andreas; Lesinski-Schiedat, Anke; Bartling, Sönke; Warnecke, Athanasia; Lenarz, Thomas

    2015-05-01

    Objectives To determine impedance values and charge consumption following cochlear implantation post-meningitic deaf children depending on the grade of cochlear ossification and obliteration. Methods Post-meningitic deaf (n = 49) and control (n = 43) children treated with cochlear implants were included in the study. Impedance and charge values were calculated for each group. The degree of ossification of the cochlea was evaluated from a high-resolution computed tomography (HRCT) scan whereas the degree of obliteration was determined intraoperatively by the surgeon. Results Pneumococci were the principal pathogen responsible for bacterial meningitis, followed by meningococci. In HRCT scans, the degree of ossification was 1 and 2 in 29% of patients. The results of the intraoperative assessment of the cochlea showed obliteration grade 1 in 38% and grade 2 in 23% of cases. Children in the meningitis group showed significant higher impedances comparing to the control group. A significantly increased charge consumption was observed in patients with a grade 2 ossification when compared to those without ossification (P = 0.02). Discussion Cochlea implanted children with meningitis-related deafness exhibit higher impedances, especially in the region of the basal and middle turn, however, not depending on the degree of cochlear ossification. High impedances and charge in the meningitis group may be explained by alterations in the central auditory pathway or on the electrode surface. Conclusion To optimize the outcome in post-meningitic deaf children, surgery is advisable at an early stage prior to the onset of cochlear ossification. PMID:25130272

  18. Efficacy and safety of rituximab treatment in early primary Sjögren's syndrome: a prospective, multi-center, follow-up study

    PubMed Central

    2013-01-01

    Introduction Primary Sjögren’s syndrome (pSS) is an autoimmune disorder affecting exocrine glands; however, a subgroup of pSS patients experience systemic extra-glandular involvement leading to a worsening of disease prognosis. Current therapeutic options are mainly empiric and often translated by other autoimmune diseases. In the last few years growing evidence suggests that B-cell depletion by rituximab (RTX) is effective also in pSS. Patients with early active disease appear to be those who could benefit the most from RTX. The aim of this study was to investigate the efficacy and safety of RTX in comparison to disease modifying anti-rheumatic drugs (DMARDs) in early active pSS patients. Methods Forty-one patients with early pSS and active disease (EULAR Sjogren’s syndrome disease activity index, ESSDAI???6) were enrolled in the study. Patients were treated with either RTX or DMARDs in two different Rheumatology centers and followed up for 120 weeks. Clinical assessment was performed by ESSDAI every 12 weeks up to week 120 and by self-reported global disease activity pain, sicca symptoms and fatigue on visual analogic scales, unstimulated saliva flow and Schirmer’s I test at week 12, 24, 48, 72, 96, and 120. Laboratory assessment was performed every 12 weeks to week 120. Two labial minor salivary gland (MSG) biopsies were obtained from all patients at the time of inclusion in the study and at week 120. Results Our study demonstrated that RTX treatment results in a faster and more pronounced decrease of ESSDAI and other clinical parameters compared to DMARDs treatment. No adverse events were reported in the two groups. We also observed that RTX is able to reduce glandular infiltrate, interfere with B/T compartmentalization and consequently with the formation of ectopic lymphoid structures and germinal center-like structures in pSS-MSGs. Conclusions To our knowledge, this is the first study performed in a large cohort of early active pSS patients for a period of 120 weeks. We showed that RTX is a safe and effective agent to be employed in pSS patients with systemic, extra-glandular involvement. Furthermore, our data on pSS-MSGs provide additional biological basis to employ RTX in this disease. PMID:24286296

  19. Hematopoietic Stem Cell Transplantations for Primary Immune Deficiencies: 3 Decades of Experience From a Tertiary Medical Center.

    PubMed

    Rousso, Sharon Z; Shamriz, Oded; Zilkha, Amir; Braun, Jacques; Averbuch, Diana; Or, Reuven; Weintraub, Michael; Revel-Vilk, Shoshana; Stepensky, Polina

    2015-07-01

    Hematopoietic stem cell transplantation (HSCT) remains the leading treatment for the majority of severe primary immune deficiency (PID). This study aims to analyze changes in outcome over time. We conducted a retrospective analysis of HSCT in children with PID in a tertiary medical center over the period of 1983 to 2012. We identified 93 children with PID with a median follow-up of 3.6 years (range, 29 d to 21.2 y) after HSCT. The 2-year survival rates after HSCT for children with severe combined immune deficiency, hemophagocytic lymphohistiocytosis/lymphoproliferative disease, Wiskott-Aldrich syndrome, granulocyte defect, and undefined PID were 65.7%±6.8%, 80%±10.3%, 83.3%±15.2%, 75%±12.5%, and 25%±21.7%, respectively. Survival was associated with year of HSCT and matching. The hazard ratio (HR) (95% CI) for HSCT done in 1983 to 1999 compared with 2000 to 2012 and for matched (related and unrelated) compared with mismatched donor were 2.14 (0.99 to 4.653) and 3.07 (1.46 to 6.4), respectively. Survival was not associated with age, sex of the recipient, underlying PID, conditioning regimen, and presence of acute graft-versus-host disease. After adjustment to the underlying PID, donor and use of fludarabine-based conditioning, the HR (95% CI) for HSCT from the year 2000 was 4.69 (range, 1.4 to 15.45). Advances in HSCT over time have improved the survival of children with PID. PMID:25985240

  20. Primary Cutting Balloon Angioplasty for Treatment of Venous Stenoses in Native Hemodialysis Fistulas: Long-Term Results from Three Centers

    Microsoft Academic Search

    Rajesh Bhat; Kieran McBride; Sam Chakraverty; Raghunandan Vikram; Alison Severn

    2007-01-01

    Aim  To evaluate the technical success and patency rates following primary cutting balloon angioplasty for venous stenoses in native\\u000a dialysis fistulas.\\u000a \\u000a \\u000a \\u000a Methods  Forty-one patients (26 men, 15 women; age range 26–82 years, average age 59 years) underwent 50 (repeat procedures in 9 patients)\\u000a primary cutting balloon (PCB) angioplasty procedures in three institutions by three primary operators. The indication was\\u000a primary stenosis in

  1. Theory of optical spectra of photosystem II reaction centers: location of the triplet state and the identity of the primary electron donor.

    PubMed

    Raszewski, Grzegorz; Saenger, Wolfram; Renger, Thomas

    2005-02-01

    Based on the structural analysis of photosystem II of Thermosynechococcus elongatus, a detailed calculation of optical properties of reaction-center (D1-D2) complexes is presented applying a theory developed previously. The calculations of absorption, linear dichroism, circular dichroism, fluorescence spectra, all at 6 K, and the temperature-dependence of the absorption spectrum are used to extract the local optical transition energies of the reaction-center pigments, the so-called site energies, from experimental data. The site energies are verified by calculations and comparison with seven additional independent experiments. Exciton relaxation and primary electron transfer in the reaction center are studied using the site energies. The calculations are used to interpret transient optical data. Evidence is provided for the accessory chlorophyll of the D1-branch as being the primary electron donor and the location of the triplet state at low temperatures. PMID:15556979

  2. Theory of Optical Spectra of Photosystem II Reaction Centers: Location of the Triplet State and the Identity of the Primary Electron Donor

    PubMed Central

    Raszewski, Grzegorz; Saenger, Wolfram; Renger, Thomas

    2005-01-01

    Based on the structural analysis of photosystem II of Thermosynechococcus elongatus, a detailed calculation of optical properties of reaction-center (D1–D2) complexes is presented applying a theory developed previously. The calculations of absorption, linear dichroism, circular dichroism, fluorescence spectra, all at 6 K, and the temperature-dependence of the absorption spectrum are used to extract the local optical transition energies of the reaction-center pigments, the so-called site energies, from experimental data. The site energies are verified by calculations and comparison with seven additional independent experiments. Exciton relaxation and primary electron transfer in the reaction center are studied using the site energies. The calculations are used to interpret transient optical data. Evidence is provided for the accessory chlorophyll of the D1-branch as being the primary electron donor and the location of the triplet state at low temperatures. PMID:15556979

  3. TARGETING RUNX2 EXPRESSION IN HYPERTROPHIC CHONDROCYTES IMPAIRS ENDOCHONDRAL OSSIFICATION DURING EARLY SKELETAL DEVELOPMENT

    PubMed Central

    Ding, Ming; Lu, Yaojuan; Abbassi, Sam; Li, Feifei; Li, Xin; Song, Yu; Geoffroy, Valérie; Im, Hee-Jeong; Zheng, Qiping

    2012-01-01

    Runx2 is a known master transcription factor for osteoblast differentiation, as well as an essential regulator for chondrocyte maturation. Recently, more and more data has shown that Runx2 regulates hypertrophic chondrocyte-specific type X collagen gene (Col10a1) expression in different species. However, how Runx2 regulation of Col10a1 expression impacts chondrocyte maturation, an essential step of endochondral bone formation, remains unknown. We have recently generated transgenic mice in which flag-tagged Runx2 was driven by a cell-specific Col10a1 control element. Significantly increased level of Runx2 and Col10a1 mRNA transcripts were detected in transgenic mouse limbs at both E17.5 (embryonic day 17.5) and P1 (postnatal day1) stages, suggesting an in vivo correlation of Runx2 and Col10a1 expression. Surprisingly, skeletal staining suggested delayed ossification in both the axial and the appendicular skeleton of transgenic mice from E14.5 until P6. Histological analysis showed elongated hypertrophic zones in transgenic mice, with less von Kossa and TUNEL staining in long bone sections at both E17.5 and P1 stages, suggesting defective mineralization due to delayed chondrocyte maturation or apoptosis. Indeed, we detected increased level of anti-apoptotic genes Bcl-2, Opn, and Sox9 in transgenic mice by real-time RT-PCR. Moreover, immunohistochemistry and Western blotting analysis also suggested increased Sox9 expression in hypertrophic chondrocytes of transgenic mice. Together, our data suggest that targeting Runx2 in hypertrophic chondrocytes upregulates expression of Col10a1 and other marker genes (such as Sox9 etc.). This will change the local matrix environment, delay chondrocyte maturation, reduce apoptosis and matrix mineralization, and eventually, lead to impaired endochondral ossification. PMID:22223437

  4. Neurological heterotopic ossification following spinal cord injury is triggered by macrophage-mediated inflammation in muscle.

    PubMed

    Genęt, François; Kulina, Irina; Vaquette, Cedryck; Torossian, Frédéric; Millard, Susan; Pettit, Allison R; Sims, Natalie A; Anginot, Adrienne; Guerton, Bernadette; Winkler, Ingrid G; Barbier, Valérie; Lataillade, Jean-Jacques; Le Bousse-Kerdilčs, Marie-Caroline; Hutmacher, Dietmar W; Levesque, Jean-Pierre

    2015-06-01

    Neurological heterotopic ossification (NHO) is the abnormal formation of bone in soft tissues as a consequence of spinal cord or traumatic brain injury. NHO causes pain, ankyloses, vascular and nerve compression and delays rehabilitation in this high-morbidity patient group. The pathological mechanisms leading to NHO remain unknown and consequently there are no therapeutic options to prevent or reduce NHO. Genetically modified mouse models of rare genetic forms of heterotopic ossification (HO) exist, but their relevance to NHO is questionable. Consequently, we developed the first model of spinal cord injury (SCI)-induced NHO in genetically unmodified mice. Formation of NHO, measured by micro-computed tomography, required the combination of both SCI and localized muscular inflammation. Our NHO model faithfully reproduced many clinical features of NHO in SCI patients and both human and mouse NHO tissues contained macrophages. Muscle-derived mesenchymal progenitors underwent osteoblast differentiation in vitro in response to serum from NHO mice without additional exogenous osteogenic stimuli. Substance P was identified as a candidate NHO systemic neuropeptide, as it was significantly elevated in the serum of NHO patients. However, antagonism of substance P receptor in our NHO model only modestly reduced the volume of NHO. In contrast, ablation of phagocytic macrophages with clodronate-loaded liposomes reduced the size of NHO by 90%, supporting the conclusion that NHO is highly dependent on inflammation and phagocytic macrophages in soft tissues. Overall, we have developed the first clinically relevant model of NHO and demonstrated that a combined insult of neurological injury and soft tissue inflammation drives NHO pathophysiology. Copyright © 2015 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. PMID:25712044

  5. Ontogenetic and structural variation of mineralizations and ossifications in the integument within ceratophryid frogs (anura, Ceratophryidae).

    PubMed

    Quinzio, Silvia; Fabrezi, Marissa

    2012-12-01

    Ceratophryidae represent a monophyletic group of terrestrial and aquatic frogs inhabiting lowlands of South America where they are more diverse in semiarid environments of the Chaco region. Adult morphology of ceratophryids presents some features associated to terrestrial and fossorial life such as hyper-ossified skulls, spade feet for digging, among others. For anurans, different mineralized structures have been described in the integument as calcium reservoirs and related to the terrestrial life and water balance (e.g., the calcified layer and dermal ossifications). We describe the ontogeny of the integument in the three genera of ceratophryids (Chacophrys, Ceratophrys, and Lepidobatrachus) that inhabit in semiarid environments. Data obtained demonstrated the early acquisition of metamorphic transformations in the integument layers in larvae of Ceratophrys cranwelli and Lepidobatrachus spp. and a continuous increment in the thickness of them up to old postmetamorphic stages. The integument of ceratophryids develops calcium deposits as the calcified layer during postmetamorphic stages. Furthermore, dorsal shields are also present in adult stages independently of terrestrial versus aquatic lifestyles. While the calcified layer seems to be a feature of a fully developed integument, in which their layers have acquired the adult thickness, dorsal shields develop at premetamorphic stages in L. llanensis and postmetamorphic individuals of C. cranwelli. In ceratophryids, similar to other studied taxa (e.g., Brachycephalus spp.) dorsal shields develop via an intramembranous ossification in which the calcified layer does not precede its differentiation. Within anurans, the occurrence of dorsal shields in the monophyletic ceratophryids suggested a distinctive evolutionary history in the lineage. PMID:23074148

  6. Indacaterol therapy in moderate-to-severe chronic obstructive pulmonary disease: findings from a single-center primary care cohort

    PubMed Central

    Singh, Mukesh P

    2013-01-01

    Background Once-daily long-acting ?2-agonists (LABAs) are an important treatment option, either alone or in combination with other inhaled long-acting bronchodilators in the management of chronic obstructive pulmonary disease (COPD). Aims/objectives To audit the effectiveness of indacaterol as maintenance therapy in patients with moderate-to-severe COPD (Global initiative for chronic Obstructive Lung Disease [GOLD] stage II/III). Methods This was a single-center audit of a primary care COPD cohort comprising all patients treated with indacaterol following treatment escalation (as per National Institute for Health and Care Excellence guidelines) or failure with other therapies. The sample was restricted to patients treated for a minimum of 12 months with indacaterol, for whom preswitching and follow-up spirometry as well as exacerbation frequency data were available (GOLD spirometry guidelines). Pulmonary function was assessed by spirometry (recorded as forced expiratory volume in 1 second [FEV1] expressed as percentage predicted). Relevant self-reported qualitative information was recorded in descriptive terms for quality of life (QoL) assessment. Results A total of 15 patients met the audit inclusion criteria (66.6% male, mean age 64.9±7.7 years). COPD disease duration ranged from 1 to 22 years; 93% had GOLD stage II or III COPD. Follow-up ranged in duration from 12 to 27 months. Indacaterol was associated with a significant reduction in exacerbation frequency compared with the 12 months prior to initiation (P=0.02). In those patients who experienced three or more exacerbations/year, mean exacerbation rate fell from 5.43±1.07 to 2.43±0.2 after 12 months treatment with indacaterol (P=0.02). A reduction in dyspnea was noted in 53% of patients. Similarly, improvements in exercise tolerance and well-being were self-reported in 67% and 93%, respectively. Conclusion Indacaterol was found to be an effective LABA as an escalation or switch medication in patients with moderate-to-severe COPD. Indacaterol was effective both as monotherapy and in combination with a long-acting muscarinic antagonist. Switching to indacaterol from a LABA/inhaled corticosteroid fixed-combination inhaler significantly reduced the number of acute exacerbations and also improved self-reported QoL. PMID:24353411

  7. Primary Cutting Balloon Angioplasty for Treatment of Venous Stenoses in Native Hemodialysis Fistulas: Long-Term Results from Three Centers

    SciTech Connect

    Bhat, Rajesh [Ninewells Hospital, Department of Clinical Radiology (United Kingdom)], E-mail: raj.bhat@nhs.net; McBride, Kieran [Queen Margaret Hospital (United Kingdom); Chakraverty, Sam; Vikram, Raghunandan; Severn, Alison [Ninewells Hospital, Department of Clinical Radiology (United Kingdom)

    2007-11-15

    Aim. To evaluate the technical success and patency rates following primary cutting balloon angioplasty for venous stenoses in native dialysis fistulas. Methods. Forty-one patients (26 men, 15 women; age range 26-82 years, average age 59 years) underwent 50 (repeat procedures in 9 patients) primary cutting balloon (PCB) angioplasty procedures in three institutions by three primary operators. The indication was primary stenosis in 21 patients, recurrent lesions in 15, and immature fistulas in 5. A PCB was used alone in 17 cases, but was followed by a larger standard balloon in 33 cases. Follow-up included ultrasound, flow analysis and urea reduction ratio, and ranged from 2 to 30 months (mean 14 months). Results. The technical success rate was 98%. All procedures were relatively painless. Two PCBs burst and 4 leaked, but without causing any morbidity. Nineteen fistulas were still working at last follow-up. Primary patency rates at 6, 12, and 24 months using Kaplan-Meier analysis were 88%, 73%, and 34%, respectively, and the primary assisted patencies were 90%, 75%, and 50%, respectively. Conclusion. PCB angioplasty has high technical success and low complication rates. The long-term patency rates are favorable for PCB angioplasty and compare favorably with other series.

  8. Risk of symptomatic heterotopic ossification following plate osteosynthesis in multiple trauma patients: an analysis in a level-1 trauma centre

    PubMed Central

    Zeckey, Christian; Hildebrand, Frank; Mommsen, Philipp; Schumann, Julia; Frink, Michael; Pape, Hans-Christoph; Krettek, Christian; Probst, Christian

    2009-01-01

    Background Symptomatic heterotopic ossification (HO) in multiple trauma patients may lead to follow up surgery, furthermore the long-term outcome can be restricted. Knowledge of the effect of surgical treatment on formation of symptomatic heterotopic ossification in polytrauma is sparse. Therefore, we test the effects of surgical treatment (plate osteosynthesis or intramedullary nailing) on the formation of heterotopic ossification in the multiple trauma patient. Methods We retrospectively analysed prospectively documented data of blunt multiple trauma patients with long bone fractures which were treated at our level-1 trauma centre between 1997 and 2005. Patients were distributed to 2 groups: Patients treated by intramedullary nails (group IMN) or plate osteosynthesis (group PLATE) were compared. The expression and extension of symptomatic heterotopic ossifications on 3-6 months follow-up x-rays in antero-posterior (ap) and lateral views were classified radiologically and the maximum expansion was measured in millimeter (mm). Additionally, ventilation time, prophylactic medication like indomethacine and incidence and correlation of head injuries were analysed. Results 101 patients were included in our study, 79 men and 22 women. The fractures were treated by intramedullary nails (group IMN n = 50) or plate osteosynthesis (group PLATE n = 51). Significantly higher radiologic ossification classes were detected in group PLATE (2.9 ± 1.3) as compared to IMN (2.2 ± 1.1; p = 0.013). HO size in mm ap and lateral showed a tendency towards larger HOs in the PLATE group. Additionally PLATE group showed a higher rate of articular fractures (63% vs. 28% in IMN) while IMN demonstrated a higher rate of diaphyseal fractures (72% vs. 37% in PLATE; p = 0.003). Ventilation time, indomethacine and incidence of head injuries showed no significant difference between groups. Conclusion Fracture care with plate osteosynthesis in polytrauma patients is associated with larger formations of symptomatic heterotopic ossifications (HO) while intramedullary nailing was associated with a higher rate of remote HO. For future fracture care of multiply injured patients these facts may be considered by the responsible surgeon. PMID:19825174

  9. Trauma-induced myelopathy in patients with retro-odontoid pseudotumour and ossification of the anterior longitudinal ligament: a report of two cases.

    PubMed

    Tobari, Yoshiko; Kimura, Atsushi; Sasaki, Satoru; Tajiri, Yasuhito; Seichi, Atsushi

    2014-12-01

    We report 2 cases of acute, progressive myelopathy after a fall in elderly patients who had a retroodontoid pseudotumour and extensive ossification of the anterior longitudinal ligament. PMID:25550033

  10. Fibrodysplasia Ossificans Progressiva-related Activated Activin-like Kinase Signaling Enhances Osteoclast Formation during Heterotopic Ossification in Muscle Tissues*

    PubMed Central

    Yano, Masato; Kawao, Naoyuki; Okumoto, Katsumi; Tamura, Yukinori; Okada, Kiyotaka; Kaji, Hiroshi

    2014-01-01

    Fibrodysplasia ossificans progressiva is characterized by extensive ossification within muscle tissues, and its molecular pathogenesis is responsible for the constitutively activating mutation (R206H) of the bone morphogenetic protein type 1 receptor, activin-like kinase 2 (ALK2). In this study, we investigated the effects of implanting ALK2 (R206H)-transfected myoblastic C2C12 cells into nude mice on osteoclast formation during heterotopic ossification in muscle and subcutaneous tissues. The implantation of ALK2 (R206H)-transfected C2C12 cells with BMP-2 in nude mice induced robust heterotopic ossification with an increase in the formation of osteoclasts in muscle tissues but not in subcutaneous tissues. The implantation of ALK2 (R206H)-transfected C2C12 cells in muscle induced heterotopic ossification more effectively than that of empty vector-transfected cells. A co-culture of ALK2 (R206H)-transfected C2C12 cells as well as the conditioned medium from ALK2 (R206H)-transfected C2C12 cells enhanced osteoclast formation in Raw264.7 cells more effectively than those with empty vector-transfected cells. The transfection of ALK2 (R206H) into C2C12 cells elevated the expression of transforming growth factor (TGF)-?, whereas the inhibition of TGF-? signaling suppressed the enhanced formation of osteoclasts in the co-culture with ALK2 (R206H)-transfected C2C12 cells and their conditioned medium. In conclusion, this study demonstrated that the causal mutation transfection of fibrodysplasia ossificans progressiva in myoblasts enhanced the formation of osteoclasts from its precursor through TGF-? in muscle tissues. PMID:24798338

  11. Variation and timing of the cranial ossification sequence of the oriental fire-bellied toad,Bombina orientalis (Amphibia, Discoglossidae)

    Microsoft Academic Search

    James Hanken; Brian K. Hall

    1984-01-01

    The sequence of appearance of the 17 different skull bones in the oriental fire-bellied toad, Bombina orientalis, is described. Data are based primarily on samples of ten or 11 laboratory-reared specimens of each of 11 Gosner developmental stages (36-46) representing middle through late meta- morphosis. Ossification commences as early as stage 37 (hind limb with all five toes distinct), but

  12. Bilateral diffuse pulmonary ectopic ossification after marrow allograft in a dog. Evidence for allotransplantation of hemopoietic and mesenchymal stem cells

    SciTech Connect

    Sale, G.E.; Storb, R.

    1983-11-01

    In light of recent studies showing successful transplantation of both bony and stromal elements by marrow transplantation, we report an unexpected phenomenon occurring in a canine radiation chimera. Nine hundred fifty-six days after a successful and uneventful DLA-matched marrow allograft, a dog suddenly died of respiratory failure. Autopsy revealed extensive ossification of the lungs with multiple sites of trilineage marrow engraftment. The entire complement of bony elements can apparently be allografted using marrow grafting techniques.

  13. Incidence and ossification of sesamoid bones in the hands and feet: a radiographic study in an Arab population.

    PubMed

    Dharap, A S; Al-Hashimi, H; Kassab, S; Abu-Hijleh, M F

    2007-05-01

    The incidence and ossification of sesamoid bones in the hands and feet were studied in 922 radiographs (400 hands and 522 feet) in an Arab population from Bahrain, 5-83 years of age and consisting of 549 adults (393 men and 156 women) and 373 children (286 boys and 97 girls). All radiographs of the hand and foot in the adult population showed two sesamoid bones in the thumb metacarpophalangeal (MCP) joint and in the hallucal metatarsophalangeal (MTP) joint, respectively. Only 2.3% and 1.5% of hands showed sesamoids at the MCP joints of the middle and ring fingers respectively compared to a reported incidence of 7.1% for each digit in Caucasians. The incidence of sesamoids in the MTP joints of third and fourth toes (0.6% each) and inferior to the hallucal interphalangeal joint (3.1%) is probably the lowest reported so far in the literature. In the hands, ossification commenced first in the thumb sesamoids, at the age of 10 years in females and 11 years in males and was completed by the age of 13 and 14 years, respectively. In the feet, ossification began first in the hallucal sesamoids at the age of 8 years in females and 9 years in males and was completed by the age of 10 years in both sexes. The incidence and ossification of sesamoids in the hands and feet in the Arab population from Bahrain seem to differ considerably from reports in other populations. The clinical significance of our findings is discussed. PMID:16944528

  14. Formation and ossification of limb elements in Trachemys scripta and a discussion of autopodial elements in turtles.

    PubMed

    Sheil, Christopher A; Portik, Daniel

    2008-06-01

    Though sequences of formation and ossification of bony elements have been described for many taxa, controversy surrounds the formation of limb elements in turtles. Three hypotheses for patterns of formation of autopodial elements have been proposed, differing primarily in the origin of Distal Carpal/Tarsal 3, the digital arch, and Centrale 4. Patterns of formation and ossification of limb elements are described for Trachemys scripta. These patterns are compared to similar data for representatives of four families of turtles (Cheloniidae, Chelydridae, Emydidae, and Trionychidae). Hypotheses of limb formation are compared in the context of new and published data. Three species (Trachemys scripta, Chrysemys picta, and Chelydra serpentina) suggest that Distal Carpal 3 forms by branching from the ulnare, whereas Distal Carpal 3 may branch from Distal Carpal 4 in Macrochelys temminckii and Chelonia mydas; data from Graptemys nigrinoda, Apalone spinifera, and Eretmochelys imbricata did not provide evidence for the origin of Distal Carpal 3. Centrale 4 was not observed to branch from the ulnare and apparently arises by de-novo condensation. Distal Carpal 4 did not branch from Centrale 4 in any species. Until the developmental origins of Distal Carpal 3 and Centrale 4 are understood, interspecific variation in the origin of these elements remains, and may explain some of the observed differences. Trends of ossification in the fore- and hind limb autopodium also are summarized. Homology of elements in pedal Digit V is discussed, and we suggest that the hooked proximal element of this digit be recognized as Distal Tarsal 5. PMID:18624573

  15. Volume 100, number 1 FEBS LETTERS April 1919 PRIMARY PHOTOCHEMISTRY OF THE REACTION CENTER OF PHOTOSYSTEM I

    E-print Network

    Govindjee

    was resuspended in 0.05 M potassium phosphate (pH 7.8) 10 mM KCl, 5 mM MgCl and 0.4 M sucrose. The chlorophyll photosynthesis has, thus far, remained unexplored as reaction center chlorophyll a (Chl a) complexes have not yet, initiated by the reaction center chlorophyll a P680-690, leads to O2 evolution and the reduction

  16. Quality of Type II Diabetes Care in Primary Health Care Centers in Kuwait: Employment of a Diabetes Quality Indicator Set (DQIS)

    PubMed Central

    Badawi, Dalia; Saleh, Shadi; Natafgi, Nabil; Mourad, Yara; Behbehani, Kazem

    2015-01-01

    Diabetes Mellitus is one of the major public health challenges, affecting more than 347 million adults worldwide. The impact of diabetes necessitates assessing the quality of care received by people with diabetes, especially in countries with a significant diabetes burden such as Kuwait. This paper aimed at piloting an approach for measuring Type II diabetes care performance through the use of a diabetes quality indicator set (DQIS) in primary health care. The DQIS for Kuwait was adapted from that developed by the National Diabetes Quality Improvement Alliance and the International Diabetes Federation. Five key care domains/measures were employed: (1) Blood glucose level measurement, (2) Cholesterol level measurement, (3) Blood pressure measurement, (4) Kidney function testing and (5) Smoking status check. The sample included the four major primary health care centers with the highest case load in Kuwait City, 4,241 patients in 2012 and 3,211 in 2010. Findings revealed the applicability and utility of employing performance indicators for diabetes care in Kuwait. Furthermore, findings revealed that many of the primary health care centers have achieved noteworthy improvement in diabetes care between 2010 and 2012, with the exception of smoking status check. The DQIS can help policymakers identify performance gaps and investigate key system roadblocks related to diabetes care in Kuwait. PMID:26176691

  17. Heterotopic ossifications after arthroscopic management of femoroacetabular impingement: the role of NSAID prophylaxis

    PubMed Central

    Randelli, Filippo; Pierannunzii, Luca; Ragone, Vincenza; Aliprandi, Alberto; Buly, Robert

    2010-01-01

    Background Open hip surgery is known to be a risk for heterotopic ossification (HO), and nonsteroidal anti-inflammatory drugs (NSAIDs) have been widely recognized as an effective prevention. Hip arthroscopy is gaining popularity thanks to the possibility of treating femoroacetabular impingement (FAI) with a minimally invasive technique, however little is known about its rate of postoperative HO. The aim of the present study is to evaluate HO prevalence after hip arthroscopy for FAI and its relationship with NSAID prophylaxis. Materials and methods We retrospectively reviewed 300 FAI cases who have been managed with hip arthroscopy in two different hospitals from April 2006 to May 2009. All medical records and indications at discharge were analyzed, focusing on administration of NSAIDs, as well as follow-up roentgenograms with regard to presence of HO around the hip joint. The patients were divided into two groups: a treatment group of 285 hips which received NSAID prophylaxis and a control group of 15 hips which did not. Results Five hips presented HO, with overall prevalence of 1.6%. All five patients with HO belonged to the control group. No HO was observed in the treatment group. Thus, HO rate turned out to be significantly higher (P < 0.001) in patients who did not receive NSAIDs after surgery. Conclusion Arthroscopic treatment of FAI is not exempt from potential development of HO. NSAIDs after arthroscopic FAI treatment seem to be an effective prevention. PMID:21116673

  18. Ossification defects detected in CT scans represent early osteochondrosis in the distal femur of piglets.

    PubMed

    Olstad, Kristin; Kongsro, Jřrgen; Grindflek, Eli; Dolvik, Nils Ivar

    2014-08-01

    The purpose of the current study was to validate the use of CT for selection against osteochondrosis in pigs by calculating positive predictive value and comparing it to the positive predictive value of macroscopic evaluation, using histological examination as the reference standard. Eighteen male, hereditarily osteochondrosis-predisposed piglets underwent terminal examination at biweekly intervals from the ages of 82-180 days old, including CT scanning, macroscopic, and histological evaluation of the left distal femur. Areas of ischemic chondronecrosis (osteochondrosis) were confirmed in histological sections from 44/56 macroscopically suspected lesions, resulting in a positive predictive value of 79% (95% CI: 67-84%). Suspected lesions, that is; focal, radiolucent defects in the ossification front in CT scans corresponded to areas of ischemic chondronecrosis in 36/36 histologically examined lesions, resulting in a positive predictive value of 100% (95% CI: 90-100%). CT was superior to macroscopic evaluation for diagnosis of early stages of osteochondrosis in the distal femur of piglets. The current histologically validated observations can potentially be extrapolated to diagnostic monitoring of juvenile osteochondritis dissecans in children, or to animal models of human juvenile articular cartilage injury and repair. PMID:24740876

  19. Heterotopic ossification as an unusual complication after Guillain-Barré syndrome: a case report.

    PubMed

    Ryu, Su-Ra; Kim, Jae-Hyung; Choi, In-Sung; Han, Jae-Young; Lee, Sam-Gyu

    2008-03-01

    Heterotopic ossification (HO) is the abnormal development of bone within soft tissue. It is frequently encountered after traumatic brain injury or spinal cord injury, rather than lower motoneuron disease. It has been reported as a rare complication in Guillain-Barré syndrome (GBS). We present the case of a 31-year-old woman who suffered from pain and swelling with limitation of the passive range of motion on right hip joint, and who had been diagnosed with GBS about 1 year previously. She was wheelchair-bound and had incomplete tetraplegia with flaccidity. She was diagnosed as HO based on the radiologic imaging study. She did not reveal any encephalopathy-related symptoms or signs, and hypercalcemia, and/or related metabolic derangement during 1.5-year follow-up period. Owing to the paucity of other causative factors, we presumed that the long-time hypomobility, even though not accompanied by hypercalcemia, played a major role for the development of HO. Early active rehabilitative management was initiated. The outcome is not promising because of her long-standing paralyzed state; however, it was possible to prevent the aggravation of HO. PMID:18295638

  20. School Health Primary Care Programs in Community and Migrant Health Centers and Health Care for the Homeless Projects. Directory.

    ERIC Educational Resources Information Center

    Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Bureau of Primary Health Care.

    This directory identifies 254 Community and Migrant Health Centers (C/MHC) and Health Care for the Homeless (HCH) programs in 10 regions of the United States that, in response to local requests and with mostly local resources, developed either school-based or school-linked health programs. Each listing provides information under the following…

  1. Evaluation of Frequency of Four Common Nasal Anatomical Deformities in Primary Rhinoplasty in A Tehran Plastic Surgery Center

    PubMed Central

    Eskandarlou, Mehdi; Motamed, Sadrollahe

    2014-01-01

    BACKGROUND In rhinoplasty, functional and cosmetic problems including imbalance between the nasal subunits and face are aimed to be corrected. So there is a need for careful preoperative evaluation and treatment of these patients. According to functional and aesthetic effects of these variables in rhinoplasty, evaluation of the frequency with focus to diagnostic methods was undertaken. METHODS In a descriptive study, 100 volunteer patients for primary rhinoplasty were enrolled. After history taking, nasal examination, desirable paraclinical work up and photography taking, presence of 4 anatomical variants was evaluated on the base of definition about normal and abnormal characteristic of organ. RESULTS Twenty nine male and 71 female patients underwent primary rhinoplasty. Open rhinoplasty was done in 85 and the close technique in 15 patients. 77% of patients had at least one of four anatomical nasal variations. The most common anomaly was alar cartilage malposition (51%) and frequency of others was low radix (36%), inadequate tip projection (35%) and middle vault collapse (15%). Frequency of low radix in male patients was 2.5 times more than females. CONCLUSON Success in rhinoplasty needs careful nasal analysis and evaluation. As at least one of four anatomical nasal variations is diagnosed before surgery, the correction has an important role on the outcome. As frequency of middle vault narrowing was low, a definitive diagnosis of alar cartilage malpositioning seems necessary in surgical exploration. Needs for correction and methods of treatment of variants can be based on dynamic interplay between nasal subunits. PMID:25489536

  2. Intensity modulated radiotherapy (IMRT) combined with concurrent but not adjuvant chemotherapy in primary nasopharyngeal cancer – a retrospective single center analysis

    PubMed Central

    2013-01-01

    Background We report our experience in 49 consecutive patients with nasopharyngeal carcinoma who were treated by Intensity-modulated radiation therapy (IMRT) combined with simultaneous but not adjuvant chemotherapy (CHT). Methods The medical records of 49 patients with histologically proven primary nasopharygeal carcinoma treated with IMRT and concurrent platin-based CHT (predominantly cisplatin weekly) were retrospectively reviewed. The majority of patients showed advanced clinical stages (stage III/IV:72%) with undifferentiated histology (82%). IMRT was performed in step-and-shoot technique using an integrated boost concept in 84%. In this concept, the boost volume covered the primary tumor and involved nodes with doses of 66–70.4 Gy (single dose 2.2 Gy). Uninvolved regional nodal areas were covered with doses of 54–59.4 Gy (median single dose 1.8 Gy). At least one parotid gland was spared. None of the patients received adjuvant CHT. Results The median follow-up for the entire cohort was 48 months. Radiation therapy was completed without interruption in all patients and 76% of the patients received at least 80% of the scheduled CHT. Four local recurrences have been observed, transferring into 1-, 3-, and 5-year Local Control (LC) rates of 98%, 90% and 90%. One patient developed an isolated regional nodal recurrence, resulting in 1-, 3-, and 5-year Regional Control (RC) rates of 98%. All locoregional failures were located inside the radiation fields. Distant metastases were found in six patients, transferring into 1-, 3, and 5-year Distant Control (DC) rates of 92%, 86% and 86%. Progression free survival (PFS) rates after 1, 3 and 5 years were 86%, 70% and 69% and 1-, 3- and 5-year Overall Survival (OS) rates were 96%, 82% and 79%. Acute toxicity???grade III mainly consisted of dysphagia (32%), leukopenia (24%), stomatitis (16%), infection (8%) and nausea (8%). Severe late toxicity (grade III) was documented in 18% of the patients, mainly as xerostomia (10%). Conclusion Concurrent chemoradiation without the addition of adjuvant chemotherapy cycles using IMRT with an integrated boost concept yielded good disease control and overall survival in patients suffering from primary nasopharyngeal cancer with acceptable acute side effects and limited rates of late toxicity. PMID:23347410

  3. Association between alendronate, serum alkaline phosphatase level, and heterotopic ossification in individuals with spinal cord injury.

    PubMed

    Ploumis, Avraam; Donovan, Jayne M; Olurinde, Mobolaji O; Clark, Dana M; Wu, Jason C; Sohn, Douglas J; O'Connor, Kevin C

    2015-03-01

    Context/objective Only sparse evidence exists regarding the effectiveness of oral alendronate (ALN) in the prevention of heterotopic ossification (HO) in patients with spinal cord injury (SCI). The objective of this study is to investigate the protective effect of oral ALN intake on the appearance of HO in patients with SCI. Study design Retrospective database review. Setting A Spinal Cord Unit at a Rehabilitation Hospital. Participants Two hundred and ninety-nine patients with SCI during acute inpatient rehabilitation. Interventions Administration of oral ALN. Outcome measures The incidence of HO during rehabilitation was compared between patients with SCI receiving oral ALN (n = 125) and patients with SCI not receiving oral ALN (n = 174). The association between HO and/or ALN intake with HO risk factors and biochemical markers of bone metabolism were also explored. Results HO developed in 19 male patients (6.35%), however there was no significant difference in the incidence of HO in patients receiving oral ALN or not. The mean odds ratio of not developing versus developing HO given ALN exposure was 0.8. Significant correlation was found between abnormal serum alkaline phosphatase (ALP) levels and HO appearance (P < 0.001) as well as normal serum ALP and ALN intake (P < 0.05). Conclusion Even though there was no direct prevention of HO in patients with SCI by oral ALN intake, abnormal serum ALP was found more frequently in patients with HO development and without oral ALN intake. This evidence could suggest that ALN may play a role in preventing HO, especially in patients with acute SCI with increasing levels of serum ALP. PMID:24820653

  4. Progress on clinical characteristics and identification of location of thoracic ossification of the ligamentum flavum.

    PubMed

    Feng, Fa-Bo; Sun, Chui-Guo; Chen, Zhong-Qiang

    2015-05-01

    Thoracic ossification of the ligamentum flavum (TOLF) is the most common cause for thoracic spinal stenosis. TOLF is usually complicated by thoracic disc herniation, ossi?cation of the posterior longitudinal ligament and degenerative spinal diseases such as cervical spondylosis and lumbar spinal stenosis, and the ossi?cation also usually has a discontinuous or continuous multi-segment distribution. The resultant superposition of several symptoms makes the clinical manifestations complex. Currently, the diagnosis of TOLF depends mainly on the patient's symptoms, physical examination and thoracic CT and MRI examinations. Identification of the location of TOLF depends more on the doctor's subjective judgement. Diagnostic problems are related to the specific region and level of surgical decompression: if the extent of decompression is insufficient, the treatment is inadequate, resulting in residual symptoms. Obversely, unnecessary trauma and a various complications will occur if the decompression is too extensive. Hence, the clinical features and process of diagnosis, especially the means of identifying the location, still require further improvement. It is necessary to establish a simple and accurate means of identifying the segment of TOLF that is responsible for the neurologic deficit: a number of spinal surgeons have been working hard on this. This article will provided an overview of the clinical features of TOLF and the related problems of clinical identification of the location of the segment causing the neurological deficit. The relationship between the imaging manifestations and clinical characteristics still need to be explored with the aim of establishing a simple and precise method for determining precisely whether TOLF is related to spinal cord injury or not, thus reducing surgical trauma and achieving an optimal prognosis. PMID:26033987

  5. Acute closed traumatic sciatic nerve injury: a complication of heterotopic ossification and prominence of the femoral nail: a case report.

    PubMed

    Niempoog, Sunyarn; Chumchuen, Sukanis

    2014-08-01

    The report of a 27-years-old man with presence of heterotopic ossification (HO) after femoral nailing 7years ago who developed foot drop afterfalling to the ground on his buttocks. Radiographs revealed a prominence ofthefemoral nail with HO in his right hip. EMG confirmedperoneal nerve injury ofthe hip region. Femoral nail and the HO were removed and external neurolysis was performed. At 9 months after surgery, he had not regain motor power thus posterior tibialis tendon transfer was performed to restore ankle dorsiflexion. Finally, at 2 years follow-up, he could ambulate well but did not regained sensation, extensor digitorum communis and peroneal muscle function. PMID:25518317

  6. Ossification Pattern of Estuarine Dolphin (Sotalia guianensis) Forelimbs, from the Coast of the State of Espírito Santo, Brazil

    PubMed Central

    Botta, Silvina; de Queiroz, Fábio Ferreira; Campos, Adélia Sepúlveda

    2015-01-01

    The estuarine dolphin, Sotalia guianensis, is one of the most abundant cetacean species in Brazil. Determination of age and of aspects associated with the development of this species is significant new studies. Counts of growth layer groups in dentin are used to estimate age of these animals, though other ways to evaluate development are also adopted, like the measurement of total length (TL). This study presents a procedure to evaluate the development of the estuarine dolphin based on the ossification pattern of forelimbs. Thirty-seven estuarine dolphins found in the state of Espírito Santo, Brazil, were examined. Age was estimated, TL was measured and ossification of epiphyses was examined by radiography. We analyzed results using the Spearman correlation. Inspection of radiographs allowed evaluation of the significance of the correlation between age and development of the proximal (r = 0.9109) and distal (r = 0.9092) radial epiphyses, and of the distal ulnar epiphyses (r = 0.9055). Radiographic analysis of forelimbs proved to be an appropriate method to evaluate physical maturity, and may be a helpful tool to estimate age of these animals in ecological and population studies. PMID:26017269

  7. Prevalence and Correlates of Depressive Symptoms and Resiliency among African American Women in a Community-Based Primary Health Care Center

    PubMed Central

    Holden, Kisha B.; Bradford, L. Dianne; Hall, Stephanie P.; Belton, Allyson S.

    2014-01-01

    The purpose of this cross-sectional pilot study was to determine the prevalence and correlates of depressive symptoms and resiliency among 290 African American women (AAW) in a community-based primary health care center. Descriptive statistics, Pearson product-moment correlation, and logistic regression analyses were conducted. Findings indicate that depressive symptoms are experienced by 49% of the participants, while 10% indicated a history of suicidal ideation. Participants had moderately high resiliency scores that had a statistically significant inverse relationship with depressive symptoms. This suggests that resiliency is potentially a protective factor for depressive symptoms. Depressive symptoms were positively correlated with participants’ diagnosis of at least one chronic disease. The strongest predictors of depressive symptoms were previous diagnoses of a mental health condition and unemployment. This study identifies risk and potential protective factors for depression among a clinic sample of AAW. PMID:24241263

  8. Prevalence and correlates of depressive symptoms and resiliency among African American women in a community-based primary health care center.

    PubMed

    Holden, Kisha B; Bradford, L Dianne; Hall, Stephanie P; Belton, Allyson S

    2013-11-01

    The purpose of this cross-sectional pilot study was to determine the prevalence and correlates of depressive symptoms and resiliency among 290 African American women (AAW) in a community-based primary health care center. Descriptive statistics, Pearson product-moment correlation, and logistic regression analyses were conducted. Findings indicate that depressive symptoms are experienced by 49% of the participants, while 10% indicated a history of suicidal ideation. Participants had moderately high resiliency scores that had a statistically significant inverse relationship with depressive symptoms. This suggests that resiliency is potentially a protective factor for depressive symptoms. Depressive symptoms were positively correlated with participants' diagnosis of at least one chronic disease. The strongest predictors of depressive symptoms were previous diagnoses of a mental health condition and unemployment. This study identifies risk and potential protective factors for depression among a clinic sample of AAW. PMID:24241263

  9. 15N electron nuclear double resonance of the primary donor cation radical P+.865 in reaction centers of Rhodopseudomonas sphaeroides: additional evidence for the dimer model.

    PubMed Central

    Lubitz, W; Isaacson, R A; Abresch, E C; Feher, G

    1984-01-01

    Four 15N hyperfine coupling constants, including signs, have been measured by electron nuclear double resonance (ENDOR) and electron nuclear nuclear triple resonance (TRIPLE) for the bacteriochlorophyll a radical cation, BChla+., in vitro and for the light-induced primary donor radical cation, P+.865, in reaction centers of Rhodopseudomonas sphaeroides R-26. A comparison of the data shows that the hyperfine coupling constants have the same sign in both radicals and are, on the average, smaller by a factor of 2 in P+.865. These results provide additional evidence that P+.865 is a bacteriochlorophyll dimer and are in contradiction with the monomer structure of P+.865 recently proposed by O'Malley and Babcock. The reduction factors of the individual 15N couplings, together with the evidence from proton ENDOR data and molecular orbital calculations, indicate a dimer structure in which only two rings (either I and I or III and III) of the bacteriochlorophyll macrocycles overlap. PMID:6096857

  10. The impact of accreditation of primary healthcare centers: successes, challenges and policy implications as perceived by healthcare providers and directors in Lebanon

    PubMed Central

    2014-01-01

    Background In 2009, the Lebanese Ministry of Public Health (MOPH) launched the Primary Healthcare (PHC) accreditation program to improve quality across the continuum of care. The MOPH, with the support of Accreditation Canada, conducted the accreditation survey in 25 PHC centers in 2012. This paper aims to gain a better understanding of the impact of accreditation on quality of care as perceived by PHC staff members and directors; how accreditation affected staff and patient satisfaction; key enablers, challenges and strategies to improve implementation of accreditation in PHC. Methods The study was conducted in 25 PHC centers using a cross-sectional mixed methods approach; all staff members were surveyed using a self-administered questionnaire whereas semi-structured interviews were conducted with directors. Results The scales measuring Management and Leadership had the highest mean score followed by Accreditation Impact, Human Resource Utilization, and Customer Satisfaction. Regression analysis showed that Strategic Quality Planning, Customer Satisfaction and Staff Involvement were associated with a perception of higher Quality Results. Directors emphasized the benefits of accreditation with regards to documentation, reinforcement of quality standards, strengthened relationships between PHC centers and multiple stakeholders and improved staff and patient satisfaction. Challenges encountered included limited financial resources, poor infrastructure, and staff shortages. Conclusions To better respond to population health needs, accreditation is an important first step towards improving the quality of PHC delivery arrangement system. While there is a need to expand the implementation of accreditation to cover all PHC centers in Lebanon, considerations should be given to strengthening their financial arrangements as well. PMID:24568632

  11. Morbidity Profile and Seasonal Variation of Diseases in a Primary Health Center in Kanpur District: A Tool for the Health Planners

    PubMed Central

    Kumari, Ranjeeta; Nath, Bhola; Midha, Tanu; Vaswani, Narain D.; Lekhwani, Seema; Singh, Bhupendra

    2012-01-01

    Objective: The objective of this study was to determine the morbidity profile of patients being treated at the Primary Health Center, their distribution according to gender, and the seasonal trend of diseases. Materials and Methods: The study was done retrospectively using secondary data, over a period of 1 year from June 2007 to July 2008, at the OPD of the Primary Health Center at Patara in Kanpur District, India. The study was aimed to study the pattern of diseases according to the classification provided by the Government of India. The data were collected from the OPD registers of the consultant medical officer, and the diagnosis was classified into communicable diseases, nutritional and metabolic disorders, infectious diseases, obstetric complications, and other diseases including injuries. Results: A total of 6838 patients had been treated at the OPD, which included 2707 males and 4131 females. It was observed that, while communicable diseases constituted about half of the total burden of the diseases with skin infections being the commonest; the non-communicable diseases constituted about one-fifth of the total disease burden. Significant gender differences were evident in the prevalence of certain diseases such as worm infestation, acute respiratory tract infection, urinary tract infection, reproductive tract infection, chronic obstructive pulmonary disease, gastritis, arthritis/gout, falls/injuries/fractures, anemia, pyrexia of unknown origin, and snake bite. Most of the diseases were observed to have a seasonal variation, with the communicable and infectious diseases peaking in the monsoon months. Surprisingly, the non-communicable diseases such as gastritis and falls and injuries also showed a seasonal variation. Conclusion: Many diseases have a seasonal variation and the burden of these diseases could be reduced if we devise measures to detect the changes in their trend through the implementation of surveillance programs in this part of the world, as has been carried out in other countries. The knowledge of the burden of the diseases would also assist the health administrators in judicious allocation of the resources. PMID:24479013

  12. The significance of a collaborative practice model in delivering care to chronically ill patients: a case study of managing diabetes mellitus in a primary health care center.

    PubMed

    Arevian, Mary

    2005-10-01

    Non-communicable diseases, especially diabetes mellitus type two (DM2) constitute major health problems in Lebanon that have an adverse impact on health and health resources. Collaborative practice interventions may improve quality care of DM2 and reduce or delay complications. The purpose of this paper was to evaluate the impact of collaborative practice on the quality and cost of effective care for diabetic patients in a primary health care center. A chart audit review of 375 diabetic patients attending an inner city health center in Beirut (Lebanon) was conducted after three and a half years of collaborative practice intervention, which included guidelines for an interdisciplinary health team. Evaluation of the impact of collaborative practice was conducted on the process and outcome of care. The results indicated a high level of enthusiasm, support and the development of team spirit at the process level. At the outcome level there was improvement in documentation, increase in patient recruitment, increase in continuity of care, improvement of glycemic control and decreased cost. In conclusion collaborative practice interventions improved process and outcome variables for diabetic patients. It is suggested that this model could be developed for use in the care of other chronic diseases. PMID:16308168

  13. Comparative ENDOR study at 34 GHz of the triplet state of the primary donor in bacterial reaction centers of Rb. sphaeroides and Bl. viridis.

    PubMed

    Marchanka, Aliaksandr; Lubitz, Wolfgang; Plato, Martin; van Gastel, Maurice

    2014-05-01

    The primary electron donor (P) in the photosynthetic bacterial reaction center of Rhodobacter sphaeroides and Blastochloris viridis consists of a dimer of bacteriochlorophyll a and b cofactors, respectively. Its photoexcited triplet state in frozen solution has been investigated by time resolved ENDOR spectroscopy at 34 GHz. The observed ENDOR spectra for (3)P865 and (3)P960 are essentially the same, indicating very similar spin density distributions. Exceptions are the ethylidene groups unique to the bacteriochlorophyll b dimer in (3)P960. Strikingly, the observed hyperfine coupling constants of the ethylidene groups are larger than in the monomer, which speaks for an asymmetrically delocalized wave function over both monomer halves in the dimer. The latter observation corroborates previous findings of the spin density in the radical cation states P 865 (•+) (Lendzian et al. in Biochim Biophys Acta 1183:139-160, 1993) and P 960 (•+) (Lendzian et al. in Chem Phys Lett 148:377-385, 1988). As compared to the bacteriochlorophyll monomer, the hyperfine coupling constants of the methyl groups 2(1) and 12(1) are reduced by at least a factor of two, and quantitative analysis of these couplings gives rise to a ratio of approximately 3:1 for the spin density on the halves PL:PM. Our findings are discussed in light of the large difference in photosynthetic activity of the two branches of cofactors present in the bacterial reaction center proteins. PMID:23184403

  14. Primary care providers human papillomavirus vaccine recommendations for the medically underserved: A pilot study in U.S. Federally Qualified Health Centers

    PubMed Central

    Roland, Katherine B.; Benard, Vicki B.; Greek, April; Hawkins, Nikki A.; Saraiya, Mona

    2015-01-01

    Introduction In the United States, Federally Qualified Health Centers (FQHCs) are safety-net clinics that provide cervical cancer screening and human papillomavirus (HPV) vaccination to medically underserved women, some of whom may be at risk for developing cervical cancer. National guidelines recommend against using screening test results or sexual history to determine vaccine eligibility. Documenting HPV vaccine recommendations and beliefs of primary care providers in FQHCs may aid in promoting evidence-based practices and prioritizing health interventions for vulnerable populations. Methods Between 2009 and 2010, we collected data from 98 primary care providers in 15 FQHC clinics in IL, USA using a cross-sectional survey. Questions assessed provider and practice characteristics, HPV vaccine recommendations, and provider’s belief about whether their screening and management procedures would change for women who were vaccinated. Results 93% of providers recommended the HPV vaccine, most frequently for females aged 13–26 years (98%). Some providers reported sometimes to always using HPV test results (12%), Pap test results (7%), and number of sexual partners (33%) to determine vaccine eligibility. More than half of providers (55%) reported they will not change their screening and management practices for vaccinated females, yet believe vaccination will yield fewer abnormal Pap tests (71%) and referrals for colposcopy (74%). Conclusion Study providers routinely recommended the HPV vaccine for their patients. However, providers made fewer recommendations to vaccinate females ages 9–12 years (which includes the target age for vaccination) compared to older females, and used pre-vaccination assessments not recommended by U.S. guidelines, such as screening test results and number of sexual partners. In order to maximize the public health benefit of the HPV vaccine to prevent cervical cancer, adherence to guidelines is necessary, especially in settings that provide care to medically underserved women. PMID:25131744

  15. Tropical Cyclone Gonu: Number of Patients and Pattern of Illnesses in the Primary Health Centers in A’Seeb Area, Muscat, Sultanate of Oman

    PubMed Central

    Alhinai, Mustafa Y.

    2011-01-01

    Objectives On June 6th 2007, a tropical Cyclone Gonu striked the coastline of Oman. The purpose of this study is to compare number of patients and pattern of illnesses between disaster (June 2007) and peace times (June 2006/2008). Methods Descriptive comparative analysis of all patients who visited primary health centers in Wilayat A’Seeb during the index days. Electronic database collected from the Health Centers (HC) were grouped into four groups; infection-related, trauma-related, acute non trauma-related, and miscellaneous group. Data were analyzed to find difference of patient influx and disease patterns between disaster and peace times. Results HC visits during the index days decreased from 9006 in 2006 to 8687 in 2007 then increased to 8786 in 2008. Neither between years variation nor between disaster and peace times difference was found to be statistically significant. The proportion of patient visited the HC due to infection-related illnesses changed from 30% in 2006, 31% in 2007, and 24% in 2008 (p<0.0001). The proportion of patients visited the HC due to trauma-related illnesses had changed from 4% in 2006, to 6.7% in 2007, and to 4.4% in 2008. (p<0.0001). Proportions for acute non trauma-related visits were 27% in 2006, 24% in 2007, and 23% in 2008 (p<0.0001). Miscellaneous group accounted for 38% in 2006, 37% in 2007, and 47% in 2008 (p<0.0001). Conclusion Tropical Cyclone Gonu caused statistically significant increase in percentages of infectious and trauma-related visits. The overall ratios of total visits did not differ from peace times. PMID:22043424

  16. The electronic structure of the primary electron donor of reaction centers of purple bacteria at atomic resolution as observed by photo-CIDNP 13C NMR

    PubMed Central

    Daviso, Eugenio; Prakash, Shipra; Alia, A.; Gast, Peter; Neugebauer, Johannes; Jeschke, Gunnar; Matysik, Jörg

    2009-01-01

    Composed of the two bacteriochlorophyll cofactors, PL and PM, the special pair functions as the primary electron donor in bacterial reaction centers of purple bacteria of Rhodobacter sphaeroides. Under light absorption, an electron is transferred to a bacteriopheophytin and a radical pair is produced. The occurrence of the radical pair is linked to the production of enhanced nuclear polarization called photochemically induced dynamic nuclear polarization (photo-CIDNP). This effect can be used to study the electronic structure of the special pair at atomic resolution by detection of the strongly enhanced nuclear polarization with laser-flash photo-CIDNP magic-angle spinning NMR on the carotenoid-less mutant R26. In the electronic ground state, PL is strongly disturbed, carrying a slightly negative charge. In the radical cation state, the ratio of total electron spin densities between PL and PM is 2:1, although it is 2.5:1 for the pyrrole carbons, 2.2:1 for all porphyrinic carbons, and 4:1 for the pyrrole nitrogen. It is shown that the symmetry break between the electronic structures in the electronic ground state and in the radical cation state is an intrinsic property of the special pair supermolecule, which is particularly attributable to a modification of the structure of PL. The significant difference in electron density distribution between the ground and radical cation states is explained by an electric polarization effect of the nearby histidine. PMID:20018724

  17. Effectiveness of an intervention in groups of family caregivers of dependent patients for their application in primary health centers. Study protocol

    PubMed Central

    2010-01-01

    Background Although Primary Health Care (PHC) Teams are used to deal with prevention and treatment of sanitary problems in adults with chronic diseases, they usually have a lack of experience in development of psychotherapeutic interventions. However, these interventions are the ones that achieve better results to reduce symptomatology and improve emotional state of caregivers. The study aims to evaluate the effectiveness of an intervention of psychotherapy in improving the mental health and Quality of life of caregivers. This intervention is based on theoretical approaches to care adjusted to cognitive theory, in order to be applied in primary health care centres. Methods/Design This is multicentre clinical trials study, randomized in two parallel groups, carry out in two PHC, Study population: 150 caregivers will be included by consecutive sampling and they will be randomized the half to experimental group and the other half to control group. They provide mostly all the assistance to care-dependent familiars receiving attention in PHC Centers. Measurements: Each caregiver will be evaluated on a personal interview. The caregivers' assessment protocol: 1) Assessment of different socio-demographic related to care, and caregiver's personal situation. 2)Care-dependent individuals will also be assessed by Barthel Index and Pfeiffer Questionnaire (SPMSQ). 3)Change in caregivers will be the principal measure: family function (Family APGAR Questionnaire), burden short questionnaire (Short Zarit Burden Interview), quality of life (Ruiz & Baca: 1993 Questionnaire), the Duke-UNK Functional Social Support Questionnaire, the General Health Questionnaire-12, and changes in Dysfunctional Thoughts about caring. 4) Intervention implementation measures will also be assessed. Intervention: A psychotherapeutic intervention will be 8 sessions of 90 minutes in groups. This intervention has been initially developed for family caregivers of patients with dementia. Discussion Psychotherapeutic interventions have been proved to obtain better results to reduce symptomatology and improve emotional state of caregivers. Moreover, this intervention has been proved to be effective in a different setting other than PHC, and was developed by professionals of Mental Health. If we found that this intervention is effective in PHC and with our professionals, it would be an important instrument to offer to caregivers of care-dependent patients. Trial Registration ClinicalTrials.gov Identifier NCT01177696 PMID:20849630

  18. Age and outcomes of primary percutaneous intervention for ST elevation myocardial infarction in a tertiary center—are we there yet?

    PubMed Central

    Sharma, Vinoda; Srinivasan, Manivannan; Smith, Dave

    2015-01-01

    Background Primary percutaneous intervention (PPCI) is the treatment of choice for ST elevation myocardial infarction (STEMI) but robust evidence in the very elderly is lacking. We compared PPCI outcomes between different age quartiles (quartile 1 < 60 years, quartile 2 ? 60 to < 70 years, quartile 3 ? 70 to < 80 years, quartile 4 ? 80 years). Methods Retrospective observational analysis of our Morriston Tertiary Cardiac Center (Abertawe Bro Morgannwg University Health Board) patients from 2005 to 2010 with STEMI who underwent PPCI. Results Of 434 patients, 57 (13%) were in quartile 4 (? 80 years). In older age quartiles, patients were less likely to receive a drug eluting stent (DES, P = 0.001) or glycoprotein IIb/IIIa inhibitor (GPI, P < 0.0001). Increase in age was associated with reduced time to survival (?-coefficient: ?0.192, t: ?3.70, 95%CI: ?4.91 to ?1.50, P < 0.0001) as was the presence of cardiogenic shock (?-coefficient: ?0.194, t = 3.77, 95%CI: ?5.26 to ?1.65, P < 0.0001). Use of GPI was associated with increased time to survival (?-coefficient: 0.138, t = 2.82, 95%CI: 1.58–8.58, P = 0.005) but older age quartiles were less likely to receive GPI (P < 0.0001). In-hospital mortality (1.8% quartile 1, 3.6% quartile 2, 10.9% quartile 3 and 12.3% quartile 4, P = 0.002) and 1-year mortality (5.4% quartile 1, 5.5% quartile 2, 16.8% quartile 3 and 24.6% quartile 4, P < 0.0001, respectively) was significantly higher in older age quartiles. Conclusions Increased short term and intermediate term mortality is seen in the very elderly after PPCI. Age and cardiogenic shock were prognostic factors. Intervention should not be based on age alone and awareness regarding prognostic factors can help improve management. PMID:26089851

  19. Reliability of Schmeling's stages of ossification of medial clavicular epiphyses and its validity to assess 18 years of age in living subjects.

    PubMed

    Cameriere, R; De Luca, S; De Angelis, D; Merelli, V; Giuliodori, A; Cingolani, M; Cattaneo, C; Ferrante, L

    2012-11-01

    Nowadays, due to the global increase in migration movements, forensic age estimation of living young adults has become an important focus of interest. Minors often have no identification documents providing their correct birth dates. Establishing the age of majority is therefore fundamental in order to determine whether juvenile penal systems or penal systems in force for adults are to be applied. Radiological examination of the clavicles is one of the methods recommended by the Study Group on Forensic Age Diagnostics. In this retrospective study, a sample of chest radiographs of 274 subjects, aged between 12 and 25 years, was studied according to Schmeling's method in order to examine the ossification of both medial clavicular epiphyses. All stage classifications were evaluated by five examiners. Intra- and inter-examiner reliability was analysed by Cohen's K statistic. Intra-examiner agreement was insufficient for two of the experts. Inter-examiner agreement, among the other three operators, was moderate (K?=?0.509). Study of reliability highlighted difficulties in interpretation, the need to select qualified personnel and choice of the best radiographic image in order to reduce any anatomic overlaps. Although ossification of the medial clavicular epiphyses is recommended to assess whether an individual has already reached the age of majority or not, these results suggested that it is very difficult to clearly identify the five stages of ossification by using conventional chest radiography. PMID:22968719

  20. Chiropractic Care of a Patient With Neurogenic Heterotopic Ossification of the Anterior Longitudinal Ligament After Traumatic Brain Injury: A Case Report

    PubMed Central

    Morgan, William E.; Morgan, Clare P.

    2014-01-01

    Objective The purpose of this case report is to describe the use of chiropractic care for a patient with neurogenic heterotopic ossification of the anterior longitudinal ligament in the cervical spine and soft tissues of the right hip after a traumatic brain injury and right femur fracture. Clinical Features A 25-year-old military officer was referred to a hospital-based chiropractic clinic with complaints of pain and stiffness of the neck and back along with reduced respiratory excursions that began several months after a motor vehicle accident in which he had a traumatic brain injury. The patient had a fractured right femur from the accident, which had since been treated surgically, but had complications of heterotopic ossification in the soft tissues of the hip. His overall pain level was 3 of 10 on a verbal pain scale during use of oxycodone HCL/acetaminophen. Chest excursion was initially measured at .5 cm. Intervention and Outcome With the intent to restore respiratory chest motion and to reduce the patient's back and neck pain, the patient was placed on a program of chiropractic and myofascial manipulation, exercise therapy, and respiratory therapy. After a year of care, the patient rated overall pain at 3 of 10 verbal pain scale level but was no longer taking medications for pain and an increase in respiratory chest excursions measured at 3.5 cm. Conclusion This case demonstrated that chiropractic treatment provided benefit to a patient with heterotopic ossification concurrent with musculoskeletal pain. PMID:25435839

  1. Incidence Density of Invasive Fungal Infections during Primary Antifungal Prophylaxis in Newly Diagnosed Acute Myeloid Leukemia Patients in a Tertiary Cancer Center, 2009 to 2011

    PubMed Central

    Mulanovich, Victor E.; Jiang, Y.; Lewis, Russell E.

    2014-01-01

    Although primary antifungal prophylaxis (PAP) is routinely administered in patients with acute myeloid leukemia (AML) during remission-induction and consolidation chemotherapy, the impact of PAP on the incidence of invasive fungal infections (IFIs) is not well described. We retrospectively analyzed the incidence of IFIs in 152 patients with AML who had been admitted to a tertiary cancer center between August 2009 and March 2011 and received PAP within 120 days after first remission-induction chemotherapy. We excluded patients who had undergone stem cell transplantation. Patients received a PAP drug with anti-Aspergillus activity during 72% (7,660/10,572) of prophylaxis-days. The incidence of documented IFIs (definite or probable according to revised European Organization for Research and Treatment of Cancer [EORTC] criteria) was 2.0/1,000 prophylaxis-days (95% confidence interval [CI], 1.23 to 3.04). IFIs due to molds were more common than IFIs due to yeasts (1.5/1,000 prophylaxis-days versus 0.4/1,000 prophylaxis-days; P = 0.01). Echinocandin-based PAP (8.6 and 7.1/1,000 prophylaxis-days, respectively) was associated with higher rates of documented IFIs than anti-Aspergillus azoles (voriconazole or posaconazole) (2.4 and 1.1/1,000 prophylaxis-days, respectively) at both 42 days (P = 0.03) and 120 days (P < 0.0001) after first remission-induction chemotherapy. The incidence of overall (documented and presumed) IFIs (P < 0.001), documented IFIs (P < 0.01), and empirical antifungal therapies (P < 0.0001) was higher during the first 42 days than after day 42. Despite the broad use of PAP with anti-Aspergillus activity, IFIs, especially molds, remain a significant cause of morbidity and mortality in AML patients, predominantly during the remission-induction phase. Patients receiving echinocandin-based PAP experienced higher rates of IFIs than did those receiving anti-Aspergillus azoles. PMID:24277033

  2. Long-term Outcomes and Quality of Life of 186 Patients With Primary Parotid Carcinoma Treated With Surgery and Radiotherapy at the Daniel den Hoed Cancer Center

    SciTech Connect

    Al-Mamgani, Abrahim, E-mail: a.al-mamgani@erasmusmc.nl [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)] [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Rooij, Peter van [Department of Biostatistics, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)] [Department of Biostatistics, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Verduijn, Gerda M. [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)] [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Meeuwis, Cees A. [Department of Otorhinolaryngology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)] [Department of Otorhinolaryngology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Levendag, Peter C. [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)] [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

    2012-09-01

    Purpose: To assess the outcomes, toxicity, and quality of life (QOL) of patients with primary parotid carcinoma treated with surgery and postoperative radiotherapy at the Daniel den Hoed Cancer Center. Methods and Materials: Between 1995 and 2010, 186 patients with parotid carcinoma were treated with parotidectomy with or without neck dissection, followed by radiotherapy. Elective nodal irradiation (ENI) was applied to high-risk, node-negative disease. End points were locoregional control (LRC), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS), late toxicity, and QOL. Results: After a median follow-up of 58 months (range, 4-172 months), the 5-year Kaplan-Meier estimates for LRC, DFS, CSS, and OS were 89%, 83%, 80%, and 68%, respectively. Forty-five events were reported: 24 distant metastases (DM) and 21 locoregional failures (LRF). Event-free survival rates by histological types were 89%, 78%, 76%, 74%, and 70% for acinic cell, mucoepidermoid, adenoid cystic, adenocarcinoma, and squamous cell carcinoma, respectively. More LRF were reported in patients with squamous cell and high-grade mucoepidermoid carcinoma (21% and 19%, respectively) than in patients with other histological types (p = 0.04) and more DM in patients with adenoid cystic and adenocarcinoma (20% and 19%, respectively) than in patients with other types (p = 0.03). None of the high-risk node-negative patients who received ENI developed regional failure. On multivariate analysis, T stage, N stage, grade, and presence of perineural invasion and facial paralysis correlated significantly with DFS. The 5-year cumulative incidence of grade {>=}2 late toxicity was 8%. QOL scores deteriorate during and shortly after treatment but returned in almost all scales to baseline scores within 6 months. Conclusions: Of the entire group, surgery and postoperative radiotherapy resulted in excellent outcomes with minimal side effects and preservation of good QOL scores. However, in view of the pattern of failures observed in this study, the role of adjuvant systemic or targeted therapy in patients at high risk of DM should be investigated in prospective trials.

  3. Latest Data Show Strong Fertility Center Offers Region's Best IVF Success Rates! The Society for Assisted Reproductive Technology (SART), the primary organization of

    E-print Network

    Goldman, Steven A.

    Latest Data Show Strong Fertility Center Offers Region's Best IVF Success Rates! The Society Fertility Center surpasses the national average for IVF in women under 35 years of age. Over 51% of embryo transfers in women under age 35 resulted in live births. In fact, Strong Fertility Center's IVF success

  4. Name of Center Primary Division/Department Website Chair Aab Cardiovascular Research Institute SMD http://www.urmc.rochester.edu/cvri/ Joseph Miano, Interim Director

    E-print Network

    Portman, Douglas

    .rochester.edu/research-centers/health-care-management/index.aspx Samuel Ogie, Director Center for High-Risk Children & Youth School of Nursing http://www.son.rochester://web.anes.rochester.edu/Public/content/Education-simcenter.php David Stern, Director Center for Musculoskeletal Research Orthopaedics http

  5. Increased bone mineral density in patients with ossification of the ligamentum flavum: a case-control study.

    PubMed

    Sohn, Seil; Yoon, Ji Won; Chung, Chun Kee

    2014-01-01

    The present study investigated the bone mineral density (BMD) and the prevalence of osteoporosis in an ossification of the ligamentum flavum (OLF) patient group and a matched control group. We also investigated the correlation of BMD with the number of spine levels exhibiting OLF. From January 1999 to August 2012, 120 patients with spinal OLF underwent dual-energy X-ray absorptiometry at our institute, and 102 of those were included in our study. Control group members were age, sex, and body mass index (BMI) matched to OLF group members on a 1:1 basis. Age, sex, and BMI were similar in the OLF and control groups. BMDs of the OLF and control groups were significantly different in the lumbar spine (mean T-scores: -0.2 ± 1.5 and -0.7 ± 1.5, respectively; p = 0.03). The prevalences of osteopenia and osteoporosis tended to be lower in the OLF group (28.3% and 4.0%, respectively) than those in the control group (31.3% and 9.1%, respectively); however, the differences were not statistically significant (p = 0.41). A significant positive correlation was detected between the lumbar spine BMD and the number of spine levels exhibiting OLF (p = 0.03). PMID:23726874

  6. A genome-wide sib-pair linkage analysis of ossification of the posterior longitudinal ligament of the spine.

    PubMed

    Karasugi, Tatsuki; Nakajima, Masahiro; Ikari, Katsunori; Tsuji, Takashi; Matsumoto, Morio; Chiba, Kazuhiro; Uchida, Kenzo; Kawaguchi, Yoshiharu; Mizuta, Hiroshi; Ogata, Naoshi; Iwasaki, Motoki; Maeda, Shingo; Numasawa, Takuya; Abumi, Kuniyoshi; Kato, Tsuyoshi; Ozawa, Hiroshi; Taguchi, Toshihiko; Kaito, Takashi; Neo, Masashi; Yamazaki, Masashi; Tadokoro, Nobuaki; Yoshida, Munehito; Nakahara, Shinnosuke; Endo, Kenji; Imagama, Shiro; Demura, Satoru; Sato, Kimiaki; Seichi, Atsushi; Ichimura, Shoichi; Watanabe, Masahiko; Watanabe, Kei; Nakamura, Yutaka; Mori, Kanji; Baba, Hisatoshi; Toyama, Yoshiaki; Ikegawa, Shiro

    2013-03-01

    Ossification of the posterior longitudinal ligament of the spine (OPLL) is a common musculoskeletal disease among people after middle age. The OPLL presents with serious neurological abnormalities due to compression of the spinal cord and nerve roots. The OPLL is caused by genetic and environment factors; however, its etiology and pathogenesis still remain to be elucidated. To determine the susceptibility loci for OPLL, we performed a genome-wide linkage study using 214 affected sib-pairs of Japanese. In stratification analyses for definite cervical OPLL, we found loci with suggestive linkage on 1p21, 2p22-2p24, 7q22, 16q24 and 20p12. Fine mapping using additional markers detected the highest non-parametric linkage score (3.43, P = 0.00027) at D20S894 on chromosome 20p12 in a subgroup that had no complication of diabetes mellitus. Our result would shed a new light on genetic aspects of OPLL. PMID:23138351

  7. Posterior mini-incision total hip arthroplasty controls the extent of post-operative formation of heterotopic ossification.

    PubMed

    Edwards, D S; Barbur, S A R; Bull, A M J; Stranks, G J

    2015-08-01

    Heterotopic ossification (HO) is the formation of bone at extra-skeletal sites. Reported rates of HO after hip arthroplasty range from 8 to 90 %; however, it is only severe cases that cause problems clinically, such as joint stiffness. The effects of surgical-related controllable intra-operative risk factors for the formation of HO were investigated. Data examined included gender, age of patient, fat depth, length of operation, incision length, prosthetic fixation method, the use of pulsed lavage and canal brush, and component size and material. All cases were performed by the same surgeon using the posterior approach. A total of 510 cases of hip arthroplasty were included, with an overall rate of HO of 10.2 %. Longer-lasting operations resulted in higher grades of HO (p = 0.047). Incisions >10 cm resulted in more widespread HO formation (p = 0.021). No further correlations were seen between HO formation and fat depth, blood loss, instrumentation, fixation methods or prosthesis material. The mini-incision approach is comparable to the standard approach in the aetiology of HO formation, and whilst the rate of HO may not be controllable, a posterior mini-incision approach can limit its extent. PMID:25953634

  8. Biglycan (Bgn) and fibromodulin (Fmod) in ectopic ossification of tendon induced by exercise and in rotarod performance

    PubMed Central

    Kilts, T.; Ameye, L.; Syed-Picard, F.; Ono, M.; Berendsen, A. D.; Oldberg, A.; Heegaard, A-M.; Bi, Y.; Young, M.F.

    2009-01-01

    We describe the ectopic ossification (EO) found in tendons of biglycan (Bgn), fibromodulin (Fmod) single and double Bgn/Fmod deficient (DKO) mice with aging. At 3 months, Fmod KO, Bgn KO and DKO displayed torn cruciate ligaments and EO in their quadriceps tendon, menisci and cruciate and patellar ligaments. The phenotype was the least severe in the Fmod KO, intermediate in the Bgn KO and the most severe in the DKO. This condition progressed with age in all 3 mouse strains and resulted in the development of large supernumerary sesmoid bones. To determine the role of exercise on the extent of EO, we subjected normal and DKO mice to treadmill exercise for 3 days a week for 4 weeks. The EO in moderately exercised DKO was decreased compared to unexercised DKO mice. Finally, DKO and Bgn KO mice tested using a rotarod showed they had a reduced ability to maintain their grip on a rotating cylinder compared to WT controls. In summary, we show: 1) a detailed description of EO formed by Bgn, Fmod or combined depletion, 2) the role of exercise in modulating EO, and 3) that Bgn and Fmod are critical in controlling motor function. PMID:19422643

  9. Primary Care: A Miracle of

    E-print Network

    Mootha, Vamsi K.

    Primary Care: A Miracle of Modern Medicine What medical discovery touches everyone in the United for Primary Care Innovation Massachusetts General Hospital Center for Excellence in Primary Care University of California, San Francisco #12;1 Primary care: The foundation of our health care system may be the greatest

  10. The effects of particle size and origin of calcium carbonate on performance and ossification characteristics in broiler chicks.

    PubMed

    Guinotte, F; Nys, Y; de Monredon, F

    1991-09-01

    The following physico-chemical characteristics of various calcium sources, differing in origin and particle size were determined: mineral composition, sieve and image analysis, apparent solubility (AS), surface area (SA), porous volume, specific gravity, and compressibility (C). The AS, SA, and C values were related more to the calcium particle size than to its origin and were higher in ground calcium sources. Calcium retention of seashells treated with phosphoric acid, oyster shells, and limestone using two particle sizes, ground or particulate, was assayed in 98 broiler chicks. Particulate marble was also tested in this experiment. Calcium retention expressed as a percentage of calcium ingestion was decreased when coarse particles of calcium were supplied in lieu of pulverized sources (40 versus 49%). An experiment with a 3 x 3 x 3 factorial arrangement of treatments were tested using 576 broiler chicks. Treatments included three calcium sources (phosphorus-treated shell, oyster shell, and marble), three particle sizes [ground (less than .15 mm), medium (.6 to 1.18 mm) and coarse (greater than 1.18 mm)] and three levels of calcium (.5,.7, and .9%) with ground limestone as a reference. Performance, tibial morphometry, breaking strength variables, and ash content were measured at 4 wk of age. Weight gain and feed conversion were ameliorated with ground particles of calcium. Cortical thickness, length of the tibia, stiffness, stress, and tibia ash were diminished when coarse particles of calcium were incorporated in the diets. Conversely, the origin of the calcium source hardly affected these criteria. Additionally, the incorporation of phosphorus-treated shells was assayed in 112 broiler chicks. Coarse particles decreased calcium retention. Consequently, ultimate stress, the modulus of elasticity, and stress were impaired. It is concluded that differences in utilization of calcium carbonate sources by the broiler chick is primarily a result of particle size rather than origin. Ground particles of calcium (pan to .15 mm) significantly improves performance and tibial ossification characteristics in broiler chicks. PMID:1780262

  11. Intensity-Modulated Radiotherapy for Cervical Node Squamous Cell Carcinoma Metastases From Unknown Head-and-Neck Primary Site: M. D. Anderson Cancer Center Outcomes and Patterns of Failure

    SciTech Connect

    Frank, Steven J., E-mail: sjfrank@mdanderson.or [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Rosenthal, David I.; Petsuksiri, Janjira; Ang, K. Kian; Morrison, William H. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Weber, Randal S. [Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Glisson, Bonnie S. [Department of Thoracic /Head and Neck Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Chao, K.S. Clifford; Schwartz, David L.; Chronowski, Gregory M. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); El-Naggar, Adel K. [Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Garden, Adam S. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

    2010-11-15

    Purpose: Conventional therapy for cervical node squamous cell carcinoma metastases from an unknown primary can cause considerable toxicity owing to the volume of tissues to be irradiated. In the present study, hypothesizing that using intensity-modulated radiotherapy (IMRT) would provide effective treatment with minimal toxicity, we reviewed the outcomes and patterns of failure for head-and-neck unknown primary cancer at a single tertiary cancer center. Methods and Materials: We retrospectively reviewed the records of 52 patients who had undergone IMRT for an unknown primary at M.D. Anderson Cancer Center between 1998 and 2005. The patient and treatment characteristics were extracted and the survival rates calculated using the Kaplan-Meier method. Results: Of the 52 patients, 5 presented with Stage N1, 11 with Stage N2a, 23 with Stage N2b, 6 with Stage N2c, 4 with Stage N3, and 3 with Stage Nx disease. A total of 26 patients had undergone neck dissection, 13 before and 13 after IMRT; 14 patients had undergone excisional biopsy and presented for IMRT without evidence of disease. Finally, 14 patients had received systemic chemotherapy. All patients underwent IMRT to targets on both sides of the neck and pharyngeal axis. The median follow-up time for the surviving patients was 3.7 years. The 5-year actuarial rate of primary mucosal tumor control and regional control was 98% and 94%, respectively. Only 3 patients developed distant metastasis with locoregional control. The 5-year actuarial disease-free and overall survival rate was 88% and 89%, respectively. The most severe toxicity was Grade 3 dysphagia/esophageal stricture, experienced by 2 patients. Conclusion: The results of our study have shown that IMRT can produce excellent outcomes for patients who present with cervical node squamous cell carcinoma metastases from an unknown head-and-neck primary tumor. Severe late complications were uncommon.

  12. Correlation of serum uric acid with bone mineral density and fragility fracture in patients with primary osteoporosis: a single-center retrospective study of 253 cases

    PubMed Central

    Chen, Lin; Peng, Yongde; Fang, Fang; Chen, Jinyu; Pan, Ling; You, Li

    2015-01-01

    Objective: This study aimed to investigate the correlation of serum uric acid with bone mineral density (BMD) and fragility fracture in primary osteoporosis (PO) patients. Methods: A retrospective analysis of biochemical parameters including bone turnover markers and bone density was done in patients (n=253) received initial treatment for PO from January 2011 to May 2012 at the Shanghai First People’s Hospital. Results: Pearson correlation analysis and multiple regression analysis showed that serum uric acid positively correlated with the lumbar spine BMD (P<0.05); serum uric acid negatively correlated with urine calcium/creatinine ratio, but positively correlated with blood 25-hydroxyvitamin D (25 [OH] D) (P<0.05); the serum uric acid in postmenopausal women with the history of fragility fracture was significantly lower than that in women without the this disease history. Conclusion: Serum uric acid may be a protective factor of bone metabolism in primary osteoporosis patients.

  13. Non-traumatic calcifications/ossifications of the bone surface and soft tissues of the wrist, hand and fingers: a diagnostic approach.

    PubMed

    Touraine, S; Wybier, M; Sibileau, E; Genah, I; Petrover, D; Parlier-Cuau, C; Bousson, V; Laredo, J-D

    2014-11-01

    In the absence of obvious trauma, the calcifications/ossifications of the bone surface and soft tissues of the wrist, hand and fingers can be challenging and may not be noticed or lead to unnecessary examinations and monitoring. Although these are usually benign conditions and despite a favorable spontaneous outcome, surgical resection may be required and recurrence may occur. In practice, only paraneoplastic syndromes such as secondary hypertrophic osteoarthropathy (Pierre Marie-Bamberger syndrome) may reveal a malignant tumor, most often pulmonary. We suggest a diagnostic approach based on the initial clinical presentation (acute pain, chronic pain, growth±pain) and the radiological features. PMID:25224813

  14. Bone morphogenetic protein receptors and activin receptors are highly expressed in ossified ligament tissues of patients with ossification of the posterior longitudinal ligament.

    PubMed Central

    Yonemori, K.; Imamura, T.; Ishidou, Y.; Okano, T.; Matsunaga, S.; Yoshida, H.; Kato, M.; Sampath, T. K.; Miyazono, K.; ten Dijke, P.; Sakou, T.

    1997-01-01

    Ossification of the posterior longitudinal ligament (OPLL) is a pathological ossification in the spinal ligament, with formation of ectopic bone mainly through endochondral ossification. Bone morphogenetic proteins (BMPs) and activins are multifunctional proteins that belong to the transforming growth factor-beta superfamily and that have been implicated in the formation of new bone and cartilage. BMPs and activins signal via type I and type II receptors for BMPs (BMPRs) and activins (ActRs), respectively. OP-1/BMP-7 binds to BMPR-II and ActR-II and forms complexes with BMPR-IA and -IB and ActR-I. We studied the expression of BMPR-IA, -IB, and -II, ActR-I, ActR-II, and OP-1/BMP-7 by immunohistochemistry in ossified ligament tissues of patients with OPLL and control ligament tissues from patients with cervical disc herniation. The expression of BMPRs and ActRs was elevated in OPLL compared with controls. Expressions of BMPR-IA, -IB, and -II were observed not only in chondrocytes at the fibrocartilage tissue around the calcified zone but also in fibroblast-like spindle cells at the nonossified ligament. ActR-I and -II were found co-localized in the hypertrophic chondrocytes near the calcified zone and in the ossified tissue. OP-1/BMP-7 was expressed in chondrocytes near the calcified zone. In the control cases, the BMPRs and ActRs were only weakly expressed in the fibrocartilage tissue at the site of ligament attachments to bone and OP-1/BMP-7 was not detected. Enhanced expression of BMPRs at the nonossified ligament in OPLL patients suggests that these cells have a greater potential to differentiate into osteogenic cells than ligament cells from non-OPLL patients. The high expression of BMPRs and ActRs in the ectopic ossified ligament suggests that BMPs and activin may be tightly involved in the pathological ossification process of OPLL. Images Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 PMID:9094990

  15. Imaging features of primary Sarcomas of the great vessels in CT, MRI and PET/CT: a single-center experience

    PubMed Central

    2013-01-01

    Background To investigate the imaging features of primary sarcomas of the great vessels in CT, MRI and 18?F-FDG PET/CT. Methods Thirteen patients with a primary sarcoma of the great vessels were retrospectively evaluated. All available images studies including F-18 FDG PET(/CT) (n?=?4), MDCT (n?=?12) and MRI (n?=?6) were evaluated and indicative image features of this rare tumor entity were identified. Results The median interval between the first imaging study and the final diagnosis was 11 weeks (0–12 weeks). The most frequently observed imaging findings suggestive of malignant disease in patients with sarcomas of the pulmonary arteries were a large filling defect with vascular distension, unilaterality and a lack of improvement despite effective anticoagulation. In patients with aortic sarcomas we most frequently observed a pedunculated appearance and an atypical location of the filling defect. The F-18 FDG PET(/CT) examinations demonstrated an unequivocal hypermetabolism of the lesion in all cases (4/4). MRI proved lesion vascularization in 5/6 cases. Conclusion Intravascular unilateral or atypically located filling defects of the great vessels with vascular distension, a pedunculated shape and lack of improvement despite effective anticoagulation are suspicious for primary sarcoma on MDCT or MRI. MR perfusion techniques can add information on the nature of the lesion but the findings may be subtle and equivocal. F-18 FDG PET/CT may have a potential role in these patients and may be considered as part of the imaging workup. PMID:23924063

  16. Adventures in Cooking: A Collection of Recipes for Use in Nursery Schools, Day Care Centers, Head Start Programs, Kindergartens, and Primary Classrooms.

    ERIC Educational Resources Information Center

    Foster, Florence P.

    This is a collection of recipes which children involved in early childhood education centers can prepare for their own consumption. The recipes were contributed by teachers in such schools based on their own successful experiences in using cooking as a learning experience for children to incorporate and integrate a number of intellectual tasks,…

  17. The Role of School-Based Health Centers in Increasing Universal and Targeted Delivery of Primary and Preventive Care among Adolescents

    ERIC Educational Resources Information Center

    Parasuraman, Sarika R.; Shi, Leiyu

    2014-01-01

    Background: School-based health centers (SBHC) can provide equitable and comprehensive care for adolescents; yet, few studies have described how patterns of health service utilization differ among groups. The purpose of this study was to investigate differences in utilization and perceptions of SBHC care among adolescents. Methods: This study…

  18. Conceptual models for Mental Distress among HIV-infected and uninfected individuals: A contribution to clinical practice and research in primary-health-care centers in Zambia

    PubMed Central

    2011-01-01

    Background Mental distress is common in primary care and overrepresented among Human Immunodeficiency virus (HIV)-infected individuals, but access to effective treatment is limited, particularly in developing countries. Explanatory models (EM) are contextualised explanations of illnesses and treatments framed within a given society and are important in understanding an individual's perspective on the illness. Although individual variations are important in determining help-seeking and treatment behaviour patterns, the ability to cope with an illness and quality of life, the role of explanatory models in shaping treatment preferences is undervalued. The aim was to identify explanatory models employed by HIV-infected and uninfected individuals and to compare them with those employed by local health care providers. Furthermore, we aimed to build a theoretical model linking the perception of mental distress to treatment preferences and coping mechanisms. Methods Qualitative investigation nested in a cross-sectional validation study of 28 (male and female) attendees at four primary care clinics in Lusaka, Zambia, between December 2008 and May 2009. Consecutive clinic attendees were sampled on random days and conceptual models of mental distress were examined, using semi-structured interviews, in order to develop a taxonomic model in which each category was associated with a unique pattern of symptoms, treatment preferences and coping strategies. Results Mental distress was expressed primarily as somatic complaints including headaches, perturbed sleep and autonomic symptoms. Economic difficulties and interpersonal relationship problems were the most common causal models among uninfected individuals. Newly diagnosed HIV patients presented with a high degree of hopelessness and did not value seeking help for their symptoms. Patients not receiving anti-retroviral drugs (ARV) questioned their effectiveness and were equivocal about seeking help. Individuals receiving ARV were best adjusted to their status, expressed hope and valued counseling and support groups. Health care providers reported that 40% of mental distress cases were due to HIV infection. Conclusions Patient models concerning mental distress are critical to treatment-seeking decisions and coping mechanisms. Mental health interventions should be further researched and prioritized for HIV-infected individuals. PMID:21219644

  19. Implementation and Benefits of Psychooncological Group Interventions in German Breast Centers: A Pilot Study on Supportive-Expressive Group Therapy for Women with Primary Breast Cancer

    PubMed Central

    Reuter, Katrin; Scholl, Isabelle; Sillem, Martin; Hasenburg, Annette; Härter, Martin

    2010-01-01

    Summary Background Psychosocial treatment is an integral component in today's comprehensive breast cancer care. The main goal of this study was to test the feasibility (benefits and acceptance) of supportive-expressive group psychotherapy (SEGT), a short-term breast cancer-specific group therapy developed and tested in Anglo-American countries, within breast centers in Germany. Patients and Methods The study was realized as a single-group pre-post design. Data were analyzed by combining quantitative and qualitative research methods. The sample consisted of 49 women with breast cancer stage 1 or 2 according to TNM classification (tumor, node, metastasis). Results The results indicate positive acceptance of the group intervention. Quality of life, tumor-related fatigue and coping strategies improved after SEGT. 1 year after the intervention, the patients report lasting positive results from the group intervention. Conclusions This pilot study illustrates the importance of psychooncological group interventions for breast cancer patients and indicates that this form of outpatient psychooncological care is feasible within the German health care system, and breast centers in particular. Effectiveness has to be investigated in randomized controlled trials. PMID:20847820

  20. Implementation and Benefits of Psychooncological Group Interventions in German Breast Centers: A Pilot Study on Supportive-Expressive Group Therapy for Women with Primary Breast Cancer.

    PubMed

    Reuter, Katrin; Scholl, Isabelle; Sillem, Martin; Hasenburg, Annette; Härter, Martin

    2010-01-01

    BACKGROUND: Psychosocial treatment is an integral component in today's comprehensive breast cancer care. The main goal of this study was to test the feasibility (benefits and acceptance) of supportive-expressive group psychotherapy (SEGT), a short-term breast cancer-specific group therapy developed and tested in Anglo-American countries, within breast centers in Germany. PATIENTS AND METHODS: The study was realized as a single-group pre-post design. Data were analyzed by combining quantitative and qualitative research methods. The sample consisted of 49 women with breast cancer stage 1 or 2 according to TNM classification (tumor, node, metastasis). RESULTS: The results indicate positive acceptance of the group intervention. Quality of life, tumor-related fatigue and coping strategies improved after SEGT. 1 year after the intervention, the patients report lasting positive results from the group intervention. CONCLUSIONS: This pilot study illustrates the importance of psychooncological group interventions for breast cancer patients and indicates that this form of outpatient psychooncological care is feasible within the German health care system, and breast centers in particular. Effectiveness has to be investigated in randomized controlled trials. PMID:20847820

  1. REDUCED INTENSITY HEMATOPOIETIC CELL TRANSPLANTATION FOR PATIENTS WITH PRIMARY MYELOFIBROSIS: A COHORT ANALYSIS FROM THE CENTER FOR INTERNATIONAL BLOOD AND MARROW TRANSPLANT RESEARCH

    PubMed Central

    Gupta, Vikas; Malone, Adriana K.; Hari, Parameswaran N.; Ahn, Kwang Woo; Hu, Zhen-Huan; Gale, Robert Peter; Ballen, Karen K.; Hamadani, Mehdi; Olavarria, Eduardo; Gerds, Aaron T.; Waller, Edmund K.; Costa, Luciano J.; Antin, Joseph H.; Kamble, Rammurti T.; van Besien, Koen M.; Savani, Bipin N.; Schouten, Harry C.; Szer, Jeffrey; Cahn, Jean-Yves; de Lima, Marcos J.; Wirk, Baldeep; Aljurf, Mahmoud D.; Popat, Uday; Bejanyan, Nelli; Litzow, Mark R.; Norkin, Maxim; Lewis, Ian D.; Hale, Gregory A.; Woolfrey, Ann E.; Miller, Alan M.; Ustun, Celalettin; Jagasia, Madan H.; Lill, Michael; Maziarz, Richard T.; Cortes, Jorge; Kalaycio, Matt E.; Saber, Wael

    2014-01-01

    We evaluated the outcomes and associated prognostic factors in 233 patients undergoing allogeneic hematopoietic cell transplantation (HCT) for primary myelofibrosis (MF) using reduced intensity conditioning (RIC). Median age at HCT was 55 years. Donors were: matched sibling donor (MSD), 34%; HLA-well-matched unrelated donors (URD), 45%; and partially/mismatched URD, 21%. Risk stratification according to Dynamic International Prognostic Scoring System (DIPSS): low, 12%; intermediate-1, 49%; intermediate-2, 37%; and high, 1%. The probability of survival at 5-years was 47% (95% CI 40–53). In a multivariate analysis, donor type was the only independent factor associated with survival. Adjusted probabilities of survival at 5-years for MSD, well matched URD and partially matched/mismatched URD were 56% (95% CI 44–67), 48% (95% CI 37–58), and 34% (95% CI 21–47), respectively (p=0.002). Relative risks (RR) for NRM for well-matched URD and partially matched/mismatched URD were 3.92 (p=0.006) and 9.37 (p<0.0001), respectively. A trend towards increased NRM (RR 1.7, p=0.07) and inferior survival (RR 1.37, p=0.10) was observed in DIPSS-intermediate-2/high-risk patients compared to DIPSS-low/intermediate-1 risk patients. RIC HCT is a potentially curative option for patients with MF, and donor type is the most important factor influencing survival in these patients. PMID:24161923

  2. From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi

    PubMed Central

    2011-01-01

    Background Only about one-third of eligible HIV/AIDS patients receive anti-retroviral treatment (ART). Decentralizing treatment is crucial to wider and more equitable access, but key obstacles are a shortage of trained healthcare workers (HCW) and challenges integrating HIV/AIDS care with other primary care. This report describes the development of a guideline and training program (PALM PLUS) designed to integrate HIV/AIDS care with other primary care in Malawi. PALM PLUS was adapted from PALSA PLUS, developed in South Africa, and targets middle-cadre HCWs (clinical officers, nurses, and medical assistants). We adapted it to align with Malawi's national treatment protocols, more varied healthcare workforce, and weaker health system infrastructure. Methods/Design The international research team included the developers of the PALSA PLUS program, key Malawi-based team members and personnel from national and district level Ministry of Health (MoH), professional associations, and an international non-governmental organization. The PALSA PLUS guideline was extensively revised based on Malawi national disease-specific guidelines. Advice and input was sought from local clinical experts, including middle-cadre personnel, as well as Malawi MoH personnel and representatives of Malawian professional associations. Results An integrated guideline adapted to Malawian protocols for adults with respiratory conditions, HIV/AIDS, tuberculosis, and other primary care conditions was developed. The training program was adapted to Malawi's health system and district-level supervision structure. PALM PLUS is currently being piloted in a cluster-randomized trial in health centers in Malawi (ISRCTN47805230). Discussion The PALM PLUS guideline and training intervention targets primary care middle-cadre HCWs with the objective of improving HCW satisfaction and retention, and the quality of patient care. Successful adaptations are feasible, even across health systems as different as those of South Africa and Malawi. PMID:21791048

  3. Reduced-intensity hematopoietic cell transplantation for patients with primary myelofibrosis: a cohort analysis from the center for international blood and marrow transplant research.

    PubMed

    Gupta, Vikas; Malone, Adriana K; Hari, Parameswaran N; Ahn, Kwang Woo; Hu, Zhen-Huan; Gale, Robert Peter; Ballen, Karen K; Hamadani, Mehdi; Olavarria, Eduardo; Gerds, Aaron T; Waller, Edmund K; Costa, Luciano J; Antin, Joseph H; Kamble, Rammurti T; van Besien, Koen M; Savani, Bipin N; Schouten, Harry C; Szer, Jeffrey; Cahn, Jean-Yves; de Lima, Marcos J; Wirk, Baldeep; Aljurf, Mahmoud D; Popat, Uday; Bejanyan, Nelli; Litzow, Mark R; Norkin, Maxim; Lewis, Ian D; Hale, Gregory A; Woolfrey, Ann E; Miller, Alan M; Ustun, Celalettin; Jagasia, Madan H; Lill, Michael; Maziarz, Richard T; Cortes, Jorge; Kalaycio, Matt E; Saber, Wael

    2014-01-01

    We evaluated outcomes and associated prognostic factors in 233 patients undergoing allogeneic hematopoietic cell transplantation (HCT) for primary myelofibrosis (MF) using reduced-intensity conditioning (RIC). The median age at RIC HCT was 55 yr. Donors were a matched sibling donor (MSD) in 34% of RIC HCTs, an HLA well-matched unrelated donor (URD) in 45%, and a partially matched/mismatched URD in 21%. Risk stratification according to the Dynamic International Prognostic Scoring System (DIPSS) was 12% low, 49% intermediate-1, 37% intermediate-2, and 1% high. The probability of survival at 5 yr was 47% (95% confidence interval [CI], 40% to 53%). In a multivariate analysis, donor type was the sole independent factor associated with survival. Adjusted probabilities of survival at 5-yr were 56% (95% CI, 44% to 67%) for MSD, 48% (95% CI, 37% to 58%) for well-matched URD, and 34% (95% CI, 21% to 47%) for partially matched/mismatched URD (P = .002). The relative risk (RR) for NRM was 3.92 (P = .006) for well-matched URD and 9.37 (P < .0001) for partially matched/mismatched URD. Trends toward increased NRM (RR, 1.7; P = .07) and inferior survival (RR, 1.37; P = .10) were observed in DIPSS intermediate-2/high-risk patients compared with DIPSS low/intermediate-1 risk patients. Our data indicate that RIC HCT is a potentially curative option for patients with MF, and that donor type is the most important factor influencing survival in these patients. PMID:24161923

  4. Neoplastic cells do not carry bcl2-JH rearrangements detected in a subset of primary cutaneous follicle center B-cell lymphomas.

    PubMed

    Vergier, Béatrice; Belaud-Rotureau, Marc-Antoine; Benassy, Marie-Noëlle; Beylot-Barry, Marie; Dubus, Pierre; Delaunay, Michelle; Garroste, Jean-Christophe; Taine, Laurence; Merlio, Jean-Philippe

    2004-06-01

    Whether primary cutaneous follicular lymphoma (PCFL) may or not represent a cutaneous equivalent to nodal follicular lymphoma (FL) is not determined. We have therefore investigated a series of PCFL to determine if tumoral cells carry or not the t(14;18)(q32;q21) translocation, a cytogenetic hallmark of nodal FL. Thirty cases of PFCL were selected according to the criteria of both the European Organisation for Research and Treatment of Cancer and the World Health Organization with 21 cases classified as grade 1 or 2 and 9 cases as grade 3. First, cutaneous tumors were studied by PCR for the amplification of bcl-2/JH rearrangements and by interphase fluorescence in situ hybridization using a dual color probe spanning t(14;18) breakpoints. Second, we tried to determine the origin of bcl2-JH-positive cells by a parallel bcl2-JH and immunoglobulin heavy chain gene amplification of blood mononuclear cells DNA and of DNA extracted from single microdissected B cells. Bcl2-JH rearrangements were amplified by PCR in skin of 9 of 30 (30%) patients with a similar-sized bcl2-JH rearrangement detected in the blood of 7 of these 9 cases. No t(14;18) breakpoint was detected by interphase fluorescence in situ hybridization analysis of 11 bcl2-JH-negative and 5 bcl2-JH-positive PCFL in contrast with its detection in the secondary cutaneous FL and in the nodal FL cases. Single-cell/multigene analysis showed that no single monoclonal B cells of PCFL carried the bcl2-JH rearrangement. Bystander or nontumoral t(14;18)+ B cells emigrating from blood may account for the detection of bcl2-JH rearrangements within PCFL material. Our study also underlines the diagnostic value of interphase fluorescence in situ hybridization to discriminate between t(14;18)-negative PCFL and extracutaneous FL involving the skin. PMID:15166666

  5. Primary structures of the catalytic subunits from two molecular forms of acetylcholinesterase. A comparison of NH2-terminal and active center sequences.

    PubMed

    MacPhee-Quigley, K; Taylor, P; Taylor, S

    1985-10-01

    Two distinct classes of acetylcholinesterase exist in near equal amounts in the electric organ of Torpedo californica. A globular 5.6 S form is a dimer which possesses a hydrophobic region. The second form is present as elongated species that sediment at 17 and 13 S and contain structural subunits disulfide-linked to the catalytic subunits. Removal of the structural subunits by mild proteolysis yields a tetramer of catalytic subunits which sediments at 11 S. To compare the primary structures of the catalytic subunits of the 5.6 S and 11 S forms of acetylcholinesterase, amino acid sequences from the active sites and from the amino-terminal regions have been elucidated. Active site serines were labeled with [3H]isopropyl fluorophosphate. After digestion with trypsin, the resultant peptides were resolved by elution from a size-exclusion column followed by reverse-phase high performance liquid chromatography. Each active site tryptic peptide contained 24 residues and identical sequences were found in this peptide for the 5.6 S and 11 S forms of the enzyme. The sequence flanking the active site serine revealed extensive homology with the published sequence of human serum cholinesterase as well as a lesser degree of homology with other known serine proteases and esterases. The sequences of the amino-terminal region also appear to be identical for both enzyme forms although we note variation in the ratio of Glu and Gln at position 5. The amino-terminal sequence exhibits only partial homology with the published sequence of human serum cholinesterase. PMID:3900071

  6. Changing spectrum of biopsy-proven primary glomerular diseases over the past 15 years: a single-center study in China.

    PubMed

    Pan, Xiaoxia; Xu, Jing; Ren, Hong; Zhang, Wen; Xu, Yaowen; Shen, Pingyan; Li, Xiao; Wang, Weiming; Chen, Xiaonong; Wu, Pei; Feng, Xiaobei; Hao, Cuilan; Chen, Nan

    2013-01-01

    The prevalence of chronic kidney disease (CKD) is reported to be 10.8-11.8% of the Chinese population. With economic development and longer life expectancy, the spectrum of CKD etiology has kept changing. Primary glomerular diseases (PGD) are still the most common renal diseases in China. To investigate the changing pattern of PGD in China, we retrospectively analyzed consecutive native renal biopsies performed in our hospital from 1997 to 2011. The patients were grouped according to a 3-year interval, 1997-1999 (period 1), 2000-2002 (period 2), 2003-2005 (period 3), 2006-2008 (period 4), 2009-2011 (period 5), and divided into three age groups (<20, 20-59, and ?60 years old). 8,909 qualified cases were enrolled in this study. Among 8,909 specimens, 6,337 (71.13%) were diagnosed as PGD, while this prevalence decreased significantly from 77.61% in 1997-1999 to 66.73% in 2006-2008. IgA nephropathy (IgAN) was the most common PGD (36.66%), without any significant difference in the 5 periods (p = 0.185). IgAN was the most common PGD both in patients between the 20- to 59-year-old group (45.58%) and <20-year-old group (19.29%) as well. Membranous nephropathy (MN) was the most frequently found PGD in patients at age ?60 years (39.64%). The frequency of MN was increased significantly from 6.48% in 1997-1999 to 22.79% in 2009-2011 (p < 0.001). The proportion of elderly patients increased significantly from 3.18% in 1997-1999 to 15.21% in 2009-2011 (p < 0.001). The prevalence of endocapillary proliferative glomerulonephritis (EnPGN) has decreased since 1997. PGD has remained the most common renal disease in China, although with a descending trend. The spectrum of PGD is different in different age groups. The frequency of EnPGN has decreased significantly, while that of MN has increased significantly. PMID:23689564

  7. Ossification du ligament de Hoffa: évolution finale de la maladie de Hoffa (ŕ propos d'un cas avec revue de la littérature)

    PubMed Central

    Boukhris, Jalal; Boussouga, Mostapha; Benchakroune, Mohammed; Jaafar, Abdelouahab; Chagar, Belkacem

    2014-01-01

    La responsabilité de la bourse graisseuse sous rotulienne dans certains dérangements internes du genou est connue depuis les observations originales rapportées par Hoffa en 1904. En peropératoire, Hoffa retrouvait une frange graisseuse qui occupait l'interligne articulaire, dont l'ablation faisait disparaître les symptômes. Depuis cette date, peu de publications ont été consacrées ŕ la maladie de Hoffa, et ŕ notre connaissance, aucune grande série n'a été publiée récemment dans la littérature. Ce travail comprend une revue bibliographiqe associée ŕ l’étude des différents aspects sémiologiques, étiopathogéniques et thérapeutiques de ce type d'affection, en rapportant un cas d'ossification du ligament de Hoffa qui ne serait en fait que l’évolution finale de la maladie. PMID:25852801

  8. Low temperature pulsed EPR study at 34 GHz of the triplet states of the primary electron donor P865 and the carotenoid in native and mutant bacterial reaction centers of Rhodobacter sphaeroides†

    PubMed Central

    Marchanka, Aliaksandr; Paddock, Mark; Lubitz, Wolfgang; van Gastel, Maurice

    2008-01-01

    The photosynthetic charge separation in bacterial reaction centers occurs predominantly along one of two nearly symmetric branches of cofactors. Low temperature EPR spectra of the triplet states of the chlorophyll and carotenoid pigments in the reaction center of Rb. sphaeroides R-26.1, 2.4.1 and two double mutants GD(M203)/AW(M260) and LH(M214)/AW(M260) have been recorded at 34 GHz to investigate the relative activities of the ‘A’ and ‘B’ branches. The triplet states are found to derive from radical pair and intersystem crossing mechanisms and the rates of formation are anisotropic. The former mechanism is operative for Rb. sphaeroides R-26.1, 2.4.1 and mutant GD(M203)/AW(M260) and indicates that A-branch charge separation proceeds at temperatures down to 10 K. The latter mechanism, derived from the spin polarization and operative for mutant LH(M214)/AW(M260) indicates that no long-lived radical pairs are formed upon direct excitation of the primary donor and that virtually no charge separation at the B-branch occurs at low temperatures. When the temperature is raised above 30 K, B-branch charge separation is observed, which is at most 1% of A-branch charge separation. B-branch radical pair formation can be induced at 10 K with low yield by direct excitation of the bacteriopheophytin of the B-branch at 590 nm. The formation of a carotenoid triplet state is observed. The rate of formation depends on the orientation of the reaction center in the magnetic field and is caused by a magnetic field dependence of the oscillation frequency by which the singlet and triplet radical pair precursor states interchange. Combination of these findings with literature data provides strong evidence that the thermally activated transfer step on the B-branch occurs between the primary donor, P865, and the accessory bacteriochlorophyll, whereas this step is barrierless down to 10 K along the A-branch. PMID:18052205

  9. Selective COX2 inhibitor versus nonselective COX1 and COX2 inhibitor in the prevention of heterotopic ossification after total hip arthroplasty: a meta-analysis of randomised trials

    Microsoft Academic Search

    Deting Xue; Qiang Zheng; Hang Li; Shengjun Qian; Bo Zhang; Zhijun Pan

    2011-01-01

    Whether selective cyclo-oxygenase-2 (COX-2) inhibitors are equally effective compared to nonselective NSAIDs for the prevention\\u000a of heterotopic ossification (HO) after total hip arthroplasty (THA) is still unclear. We carried out a comprehensive search\\u000a strategy, in which only randomised controlled trials were included. Two reviewers independently assessed methodological quality\\u000a and extracted outcome data. Analyses were performed using Stata version 10.0. Four

  10. Effect of ethane-1-hydroxy-1,1-bisphosphonate (EHBP) on endochondral ossification lesions induced by a lethal oral dose of uranyl nitrate.

    PubMed

    Bozal, C B; Martinez, A B; Cabrini, R L; Ubios, A M

    2005-08-01

    A 350 mg/kg body weight (b.w.) oral dose of uranyl nitrate (UN) caused 100% mortality in mice three days after administration, due to resulting kidney lesions. Mortality decreased 50% after an oral (o) or subcutaneous (sc) dose of bisodic etidronate (EHBP). Given that bone is also a target organ for uranium (U) in acute intoxication, the aim of this work was to study the effect of exposure to a lethal oral dose of UN on endochondral ossification, and the latter's response to EHBP treatment. One hundred male Balb/c mice weighing 25 g were assigned to one of ten groups. Group I served as control. Group II received a lethal 350 mg/kg b.w. oral dose of UN by gavage. Groups III, IV, VII, and VIII received an equal dose of UN immediately followed by a single 500 mg/kg oral dose of EHBP in groups III and VII and a single 50 mg/kg subcutaneous dose of EHBP in groups IV and VIII. Groups V and IX only received a single 500 mg/kg oral dose of EHBP, and groups VI and X received a single 50 mg/kg subcutaneous dose of EHBP. The animals in groups II, III, IV, V, and VI were sacrificed 48 h after the onset of the experiment, whereas those in groups VII, VIII, IX, and X were killed at 14 days. Histologic and histomorphometric studies were performed on the femurs to determine growth cartilage width, bone volume, and metaphyseal bone activity. Our results showed that all growth cartilage and metaphyseal bone histomorphometric parameters were significantly lower in animals exposed to UN at 48 h than in controls. EHPB administration was found to prevent this condition at 48 h reaching similar values to those of controls. Although histomorphometric values did not reach control values at 14 days, they were higher than those of animals exposed to UN at 48 h not treated with EHBP. It is noteworthy that these values also decreased in animals only receiving EHBP at 14 days. Our results show that EHBP effectively ameliorates the adverse effects of a lethal dose of UN on endochondral ossification. PMID:15798912

  11. Involvement of MET/TWIST/APC Combination or the Potential Role of Ossification Factors in Pediatric High-Grade Osteosarcoma Oncogenesis1

    PubMed Central

    Entz-Werle, Natacha; Lavaux, Thomas; Metzger, Nadia; Stoetzel, Corinne; Lasthaus, Christelle; Marec, Perrine; Kalifa, Chantal; Brugieres, Laurence; Pacquement, Hélčne; Schmitt, Claudine; Tabone, Marie-Dominique; Gentet, Jean-Claude; Lutz, Patrick; Babin, Annie; Oudet, Pierre; Gaub, Marie Pierre; Perrin-Schmitt, Fabienne

    2007-01-01

    Dysregulated cell growth or differentiation due to misexpression of developmental critical factors seems to be a decisive event in oncogenesis. As osteosarcomas are histologically defined by malignant osteoblasts producing an osteoid component, we prospected in pediatric osteosarcomas treated with OS94 protocol the genomic status of several genes implied in ossification processes. In 91 osteosarcoma cases, we focused on the analysis of the fibroblast growth factor receptors (FGFRs) TWIST, APC, and MET by allelotyping, real-time quantitative polymerase chain reaction, gene sequencing, and protein polymorphism study. Our study supports the frequent role of TWIST, APC, and MET as osteosarcoma markers (50%, 62%, and 50%, respectively). TWIST and MET were mainly found to be deleted, and no additional APC mutation was identified. Surprisingly, FGFRs are abnormal in only < 30%. Most of these factors and their abnormalities seem to be linked more or less to one clinical subgroup, but the most significant correlation is the link of MET, TWIST, and APC abnormalities to a worse outcome and their combination within abnormal tumors. A wider cohort is mandatory to define more robust molecular conclusions, but these results are to be considered as the beginning of a more accurate basis for diagnosis, in search of targeted therapies, and to further characterize prognostic markers. PMID:17786187

  12. Expansion of murine periosteal progenitor cells with fibroblast growth factor 2 reveals an intrinsic endochondral ossification program mediated by bone morphogenetic protein 2.

    PubMed

    van Gastel, Nick; Stegen, Steve; Stockmans, Ingrid; Moermans, Karen; Schrooten, Jan; Graf, Daniel; Luyten, Frank P; Carmeliet, Geert

    2014-09-01

    The preservation of the bone-forming potential of skeletal progenitor cells during their ex vivo expansion remains one of the major challenges for cell-based bone regeneration strategies. We report that expansion of murine periosteal cells in the presence of FGF2, a signal present during the early stages of fracture healing, is necessary and sufficient to maintain their ability to organize in vivo into a cartilage template which gives rise to mature bone. Implantation of FGF2-primed cells in a large bone defect in mice resulted in complete healing, demonstrating the feasibility of using this approach for bone tissue engineering purposes. Mechanistically, the enhanced endochondral ossification potential of FGF2-expanded periosteal cells is predominantly driven by an increased production of BMP2 and is additionally linked to an improved preservation of skeletal progenitor cells in the cultures. This characteristic is unique for periosteal cells, as FGF2-primed bone marrow stromal cells formed significantly less bone and progressed exclusively through the intramembranous pathway, revealing essential differences between both cell pools. Taken together, our findings provide insight in the molecular regulation of fracture repair by identifying a unique interaction between periosteal cells and FGF2. These insights may promote the development of cell-based therapeutic strategies for bone regeneration which are independent of the in vivo use of growth factors, thus limiting undesired side effects. PMID:24989687

  13. A new classification of peri-articular heterotopic ossification of the hip associated with neurological injury: 3D CT scan assessment and intra-operative findings.

    PubMed

    Arduini, M; Mancini, F; Farsetti, P; Piperno, A; Ippolito, E

    2015-07-01

    In this paper we propose a new classification of neurogenic peri-articular heterotopic ossification (HO) of the hip based on three-dimensional (3D) CT, with the aim of improving pre-operative planning for its excision. A total of 55 patients (73 hips) with clinically significant HO after either traumatic brain or spinal cord injury were assessed by 3D-CT scanning, and the results compared with the intra-operative findings. At operation, the gross pathological anatomy of the HO as identified by 3D-CT imaging was confirmed as affecting the peri-articular hip muscles to a greater or lesser extent. We identified seven patterns of involvement: four basic (anterior, medial, posterior and lateral) and three mixed (anteromedial, posterolateral and circumferential). Excellent intra- and inter-observer agreement, with kappa values > 0.8, confirmed the reproducibility of the classification system. We describe the different surgical approaches used to excise the HO which were guided by the 3D-CT findings. Resection was always successful. 3D-CT imaging, complemented in some cases by angiography, allows the surgeon to define the 3D anatomy of the HO accurately and to plan its surgical excision with precision. Cite this article: Bone Joint J 2015; 97-B:899-904. PMID:26130343

  14. Women's Center Women's Center

    E-print Network

    Malls, Oct. 20-24, 8:00am-5:00pm Body Positive James River Room, Webb Center, 12:30pm-1:30 pm Love Your Activists James River Room, Webb Center, 12:30pm-1:30pm December Women's Climb Night - Winter HolidayWomen's Center Fall 2014 Women's Center Fall 2014 August Women's Equality Day Front Lobby, Webb

  15. Presidential Primaries

    NSDL National Science Digital Library

    The Washington Weekly (an Internet newspaper) offers a 1996 Presidential Primaries Page that is organized by candidate within each party. For most candidates there is biographical information, voting record, list of accomplishments or stands on key issues, and a connection to the candidate's home page when available. This is a non-graphical but well organized page that provides the user with quick access to voting records, speeches and press releases, and Web pages of the candidates.

  16. The Vermont Primary Care Workforce 2012 SNAPSHOT

    E-print Network

    Hayden, Nancy J.

    The Vermont Primary Care Workforce 2012 SNAPSHOT wOrkfOrce SHOwS imPrOvemeNT buT SHOrTAge iN Adul improvement programming to Vermont's primary care practitioners and supports community health education. AHEC Area Health Education Centers Program was established in 1996 by the Office of Primary Care

  17. In situ studies of the primary immune response to (4-hydroxy-3- nitrophenyl)acetyl. IV. Affinity-dependent, antigen-driven B cell apoptosis in germinal centers as a mechanism for maintaining self- tolerance

    PubMed Central

    1995-01-01

    Germinal centers (GCs) are the sites of antigen-driven V(D)J gene hypermutation and selection necessary for the generation of high affinity memory B lymphocytes. Despite the antigen dependence of this reaction, injection of soluble antigen during an established primary immune response induces massive apoptotic death in GC B cells, but not in clonally related populations of nonfollicular B lymphoblasts and plasmacytes. Cell death in GCs occurs predominantly among light zone centrocytes, is antigen specific, and peaks within 4-8 h after injection. Antigen-induced programmed death does not involve cellular interactions mediated by CD40 ligand (CD40L) or Fas; disruption of GCs by antibody specific for CD40L was not driven by apoptosis and C57BL/6.lpr mice, though unable to express the Fas death trigger, remained fully susceptible to soluble antigen. Single injections of antigen did not significantly decrease GC numbers or average size, but repeated injections during an 18-h period resulted in fewer and substantially smaller GCs. As cell loss appeared most extensive in the light zone, decreased GC cellularity after prolonged exposure to soluble antigen implies that the Ig- centroblasts of the dark zone may require replenishment from light zone cells that have survived antigenic selection. GC cell death is avidity-dependent; oligovalent antigen induced relatively little apoptosis and GC B cells that survived long exposures to multivalent antigen expressed atypical VDJ rearrangements unlikely to encode high affinity antibody. Antigen- induced apoptotic death in GCs may represent a mechanism for the peripheral deletion of autoreactive B cell mutants much as the combinatorial repertoire of immature B lymphocytes is censored in the bone marrow. PMID:7500008

  18. Photochemically induced nuclear spin polarization in reaction centers of photosystem II observed by 13C-solid-state NMR reveals a strongly asymmetric electronic structure of the P680.+ primary donor chlorophyll

    PubMed Central

    Matysik, Jörg; Alia; Gast, Peter; van Gorkom, Hans J.; Hoff, Arnold J.; de Groot, Huub J. M.

    2000-01-01

    We report 13C magic angle spinning NMR observation of photochemically induced dynamic nuclear spin polarization (photo- CIDNP) in the reaction center (RC) of photosystem II (PS2). The light-enhanced NMR signals of the natural abundance 13C provide information on the electronic structure of the primary electron donor P680 (chlorophyll a molecules absorbing around 680 nm) and on the pz spin density pattern in its oxidized form, P680?. Most centerband signals can be attributed to a single chlorophyll a (Chl a) cofactor that has little interaction with other pigments. The chemical shift anisotropy of the most intense signals is characteristic for aromatic carbon atoms. The data reveal a pronounced asymmetry of the electronic spin density distribution within the P680?. PS2 shows only a single broad and intense emissive signal, which is assigned to both the C-10 and C-15 methine carbon atoms. The spin density appears shifted toward ring III. This shift is remarkable, because, for monomeric Chl a radical cations in solution, the region of highest spin density is around ring II. It leads to a first hypothesis as to how the planet can provide itself with the chemical potential to split water and generate an oxygen atmosphere using the Chl a macroaromatic cycle. A local electrostatic field close to ring III can polarize the electronic charge and associated spin density and increase the redox potential of P680 by stabilizing the highest occupied molecular orbital, without a major change of color. This field could be produced, e.g., by protonation of the keto group of ring V. Finally, the radical cation electronic structure in PS2 is different from that in the bacterial RC, which shows at least four emissive centerbands, indicating a symmetric spin density distribution over the entire bacteriochlorophyll macrocycle. PMID:10944191

  19. PRIMARY CARE ASSOCIATE PROGRAM PRIMARY PRECEPTOR MANUAL

    E-print Network

    Puglisi, Joseph

    PRIMARY CARE ASSOCIATE PROGRAM 2011-2013 PRIMARY PRECEPTOR MANUAL http://pcap.stanford.edu 1215 or Supplemental Preceptor PRIMARY PRECEPTOR/PRIMARY CARE ASSOCIATE PROGRAM RELATIONSHIP PRECEPTOR REQUIREMENTS: Thank you for your interest in precepting a student in the Primary Care Associate Program. Your services

  20. Primary eye care management.

    PubMed

    De Beer, Annelize

    2003-01-01

    Due to a financial recession in South Africa, the registered nurses (RNs) at an excimer laser center faced dismissal. In order to continue a career in ophthalmology, these nurses needed to create their own income. To this end, a primary eye care (PEC) clinic was established to provide examination and treatment(s) to the underprivileged community with the assistance of local ophthalmologists. The PEC clinic, which provides basic services for a nominal fee, has bridged the gap between excellent private eye care and inadequate government eye care. Since 1999, 791 patients have been examined and 515 surgical procedures have been performed. PMID:12703249

  1. Data Center at NICT

    NASA Technical Reports Server (NTRS)

    Ichikawa, Ryuichi; Sekido, Mamoru

    2013-01-01

    The Data Center at the National Institute of Information and Communications Technology (NICT) archives and releases the databases and analysis results processed at the Correlator and the Analysis Center at NICT. Regular VLBI sessions of the Key Stone Project VLBI Network were the primary objective of the Data Center. These regular sessions continued until the end of November 2001. In addition to the Key Stone Project VLBI sessions, NICT has been conducting geodetic VLBI sessions for various purposes, and these data are also archived and released by the Data Center.

  2. [Primary hyperparathyroidism].

    PubMed

    Carnevale, V; Romagnoli, E; Pipino, M; Scillitani, A; D'Erasmo, E; Minisola, S; Mazzuoli, G

    2005-01-01

    Primary hyperparathyroidism (PHPT) is characterized by excessive PTH secretion in respect to calcium homeostasis needs, due to parathyroid adenoma (80% of cases), hyperplasia (15-20%), or carcinoma (1-2%). In familial forms of PHPT, several mutations have an established role: menin gene for MEN type 1, RET for MEN type 2a, calcium-sensing receptor gene for familial hypocalciuric hypercalcemia, parafibromin gene for PHPT-jaw tumour and carcinoma. Etiology of sporadic adenomas (80% of PHPT cases) is less defined, being most commonly found a mutation of menin gene or activation of PRAD1 oncogene. In recent years, the classical features of the disease became less common. Typically, bone involvement is now represented by a reduced bone mass at skeletal sites more rich in cortical tissue. Prominently trabecular skeletal sites are relatively spared, because of the anabolic effects of a slight PTH excess on trabecular tissue. PHPT patients may have increased fracture risk, though it is not clear why bone damage is more severe in a subgroup of patients. Clinical features of hypercalcemia may be fatigue, anorexia, thirst, and polyuria. Vague neurological and psychiatric symptoms, such as weakness, anxiety, depression, paresthesias, and muscular cramps may ameliorate after parathyroidectomy. Recent reports indicate increased cardiovascular mortality in PHPT patients. Diagnosis is based on the detection of hypercalcemia, together with inappropriately high serum PTH levels. Preoperative localization of the diseased glands is mandatory in persistent or recurrent PHPT, as like as when minimally invasive surgery is planned. High resolution ultrasonography and SPECT double-phase 99m Tc-sestamibi scintigraphy are the most commonly employed techniques. Intraoperatory PTH assay may confirm successful surgery when serum concentrations decrease more than 50%. Surgical therapy is indicated in patients with renal or skeletal complications, such as in those with previous parathyrotoxic crisis. Many surgeons in recent years adopted minimally invasive parathyroidectomy. Medical treatment is an option for patients unwilling or unfitted for surgery because of severe concomitant diseases. Employed therapy includes estrogens, SERMs, bisphosphonates and calcimimetics. PMID:16382970

  3. Career Center Career Center

    E-print Network

    Stanford, Kyle

    Library Career Center Events R easons to get an internship 1. Test drive different career options 2. Gain network 5. Increase your marketability for future jobs and graduate school H ow to land an internship 1. Research Your Career Interests Narrow your career interests before you begin your internship search

  4. Nonsteroidal Anti-inflammatory Drugs as Prophylaxis for Heterotopic Ossification after Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.

    PubMed

    Kan, Shun-Li; Yang, Bo; Ning, Guang-Zhi; Chen, Ling-Xiao; Li, Yu-Lin; Gao, Shi-Jie; Chen, Xing-Yu; Sun, Jing-Cheng; Feng, Shi-Qing

    2015-05-01

    Heterotopic ossification (HO) is a frequent complication after total hip arthroplasty (THA). Nonsteroidal anti-inflammatory drugs (NSAIDs) have been used as routine prophylaxis for HO after THA. However, the efficacy of NSAIDs on HO, particularly selective NSAIDs versus nonselective NSAIDs, is uncertain.We searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, and clinicaltrials.gov to identify randomized controlled trials with respect to HO after THA. Two reviewers extracted the data and estimated the risk of bias. For the ordered data, we followed the Bayesian framework to calculate the odds ratio (OR) with a 95% credible interval (CrI). For the dichotomous data, the OR and 95% confidence interval (CI) were calculated using Stata version 12.0. The subgroup analyses and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach were used.A total of 1856 articles were identified, and 21 studies (5995 patients) were included. In the NSAIDs versus placebo analysis, NSAIDs could decrease the incidence of HO, according to the Brooker scale (OR?=?2.786, 95% CrI 1.879-3.993) and Delee scale (OR?=?9.987, 95% CrI 5.592-16.17). In the selective NSAIDs versus nonselective NSAIDs analysis, there was no significant difference (OR?=?0.7989, 95% CrI 0.5506-1.125) in the prevention of HO. NSAIDs could increase discontinuation caused by gastrointestinal side effects (DGSE) (OR?=?1.28, 95% CI 1.00-1.63, P?=?0.046) more than a placebo. Selective NSAIDs could decrease DGSE (OR?=?0.48, 95% CI 0.24-0.97, P?=?0.042) compared with the nonselective NSAIDs. There was no significant difference with respect to discontinuation caused by nongastrointestinal side effects (DNGSE) in NSAIDs versus a placebo (OR?=?1.16, 95% CI 0.88-1.53, P?=?0.297) and in selective NSAIDs versus nonselective NSAIDs (OR?=?0.83, 95% CI 0.50-1.37, P?=?0.462).NSAIDs might reduce the incidence of HO and increase DGSE in the short-term. PMID:25950691

  5. "Greetings and Salutations" News from the Frontlines of Primary Care

    E-print Network

    Mootha, Vamsi K.

    "Greetings and Salutations" News from the Frontlines of Primary Care May/June 2008 The John D. Stoeckle Center for Primary Care Innovation Number 9 GPIN Conference News Last month, the Stoeckle Center sent a group of MGH primary care practitioners to the 30th semi-annual conference of Group Practice

  6. East-West Center

    NSDL National Science Digital Library

    Started in 1960 by the U.S. Congress, the East-West Center's primary purpose is "to strengthen relations and understanding among the peoples and nations of Asia, the Pacific, and the United States." To accomplish this purpose, the Center serves as a functional hub for education, cooperative research, and scholarly dialogue. On their homepage, visitors can look over the latest news from scholars at the Center, look over a list of upcoming events sponsored by the Center, and also learn about some of their most recent publications. Academics visiting the site may wish to click on over to the "Research" area. Here they will find information on their primary areas of interest, which include population and health, environmental change, and politics and governance. Finally, visitors should look at their "Publications" area, as it includes free downloads, abstracts, and access to ordering information.

  7. 78 FR 55731 - Health Workforce Research Center Cooperative Agreement Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ...workers in community health centers, health IT, and telehealth. The other focuses primarily on primary care, including competencies for primary care teams, temporal shifts between primary and specialty practice over time, and flexibility in...

  8. Primary ciliary dyskinesia.

    PubMed

    Lobo, Jason; Zariwala, Maimoona A; Noone, Peadar G

    2015-04-01

    Primary ciliary dyskinesia (PCD) is an autosomal recessive disorder of cilia structure, function, and biogenesis leading to chronic infections of the respiratory tract, fertility problems, and disorders of organ laterality. The diagnosis can be challenging, using traditional tools such as characteristic clinical features, ciliary function, and ultrastructural defects and newer screening tools such as nasal nitric oxide levels and genetic testing add to the diagnostic algorithm. There are 32 known PCD-causing genes, and in the future, comprehensive genetic testing may screen young infants before developing symptoms, thus improving survival. Therapies include surveillance of pulmonary function and microbiology, in addition to airway clearance, antibiotics, and early referral to bronchiectasis centers. As with cystic fibrosis (CF), standardized care at specialized centers using a multidisciplinary approach likely improves outcomes. In conjunction with the CF foundation, the PCD foundation, with experienced investigators and clinicians, is developing a network of PCD clinical centers to coordinate the effort in North America and Europe. As the network grows, clinical care and knowledge will improve. PMID:25826585

  9. Mechanisms of organogenesis of primary lymphoid follicles

    Microsoft Academic Search

    Tilo Beyer; Michael Meyer-Hermann

    2006-01-01

    Primary lymphoid follicles in secondary lymphoid tissue of mammals are the backbone for the formation of follicular dendritic cell networks. These are important for germinal center reactions. In the context of organogenesis molecular requirements for the formation of follicles have been identified. The present study complements this work with a simulation of the dynamics of the primary lymphoid follicle formation.

  10. Primary cardiac tumors.

    PubMed Central

    Silverman, N A

    1980-01-01

    Cardiac tumors are a rare, but potentially curably form of heart disease. A high index of clinical suspicion is necessary for diagnosis as these tumors have protean manifestations that mimic a variety of other cardiac and noncardiac diseases. Presently, M-mode and two-dimensional echocardiography are utilized as safe, reliable, and noninvasive imaging modalities. Seventy-five per cent of these tumors are benign, with myxoma accounting for 50% and rhabodomyoma comprising 20% of lesions. Various histologic types of sarcoma are the predominant malignant cardiac neoplasms. With strict attention to avoiding perioperative tumor embolization, surgical resection of these lesions can be accomplished with minimal morbidity and mortality. Sixteen consecutive primary tumors of the heart have been surgically treated at Duke University Medical Center since 1966 with no perioperative deaths and no late recurrences. Images Figs. 2A and B. Fig. 3. Fig. 4. Figs. 5A and B Fig. 6. PMID:7362282

  11. 9. VIEW SOUTHWEST OF PRIMARY REDUCING GEARS; NOTE BRAKE WHEEL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. VIEW SOUTHWEST OF PRIMARY REDUCING GEARS; NOTE BRAKE WHEEL AND PADS AT RIGHT CENTER BEHIND PRIMARY GEAR; MITER GEAR AT CENTER IS PART OF MECHANISM FOR MANUAL OPERATION OF BRIDGE; FLANGE FOR COUPLING THE NORTH AND SOUTH REDUCTION GEAR TRAINS IS AT CENTER OF PHOTOGRAPH BEHIND SOUTH PRIMARY REDUCTION GEAR - East Washington Avenue Bridge, Spanning Pequonnock River at East Washington Avenue, Bridgeport, Fairfield County, CT

  12. Internet Stroke Center

    NSDL National Science Digital Library

    "A web resource for information about stroke care and research," the Internet Stroke Center provides updated stroke information for patients and families, as well as health care professionals. A nonprofit, educational service, the Internet Stroke Center is a product of the Stroke Center at Barnes-Jewish Hospital, Washington University Medical Center, and the Cerebrovascular Diseases Section of the Department of Neurology at Washington University School of Medicine in St. Louis. Dedicated to advancing the understanding of stroke research and clinical care, the Center's Web site also provides links to primary acute stroke facilities in St. Louis and Missouri, and a stroke trails directory that offers a select registry of clinical trials. All information provided on the site is obtained from "published accounts, meeting presentations, Internet searches, and direct correspondence."

  13. Simon Wiesenthal Center: Multimedia Learning Center Online

    NSDL National Science Digital Library

    The Simon Wiesenthal Center has done the Web-browsing public a great service by placing this extremely comprehensive and authoritative multimedia archive online. Online since 1999, the Multimedia Learning Center provides access to some of the past virtual exhibits sponsored by the Center's Museum of Tolerance (including a fine one dedicated to Polish Jews), a host of teacher's resources, and a helpful frequently-asked-questions area. The FAQ area may be most helpful for students, as it contains an interactive glossary of the Holocaust, a timeline of the Holocaust, and answers to 36 commonly asked questions about the Holocaust. The special collections area of the site contains a number of relevant primary documents related to the Holocaust, though it should be noted that the majority of them are available only in German and Hebrew.

  14. Triangle Centers

    NSDL National Science Digital Library

    Kimberling, Clark, 1942-

    A listing, with description and illustration, of 20th-century triangle centers (including: Schiffler Point, Exeter Point, Parry Point, congruent isoscelizers point, Yff Center of Congruence, isoperimetric point and equal detour point, Ajima-Malfatti Points, Apollonius Point, Morley Centers, Hofstadter Points, and equal parallelians points) and some classical triangle centers (including: centroid, incenter, circumcenter, orthocenter, Fermat Point, nine-point center, symmedian (or Lemoine) point, Gergonne point, Nagel point, Mittenpunkt, Spieker center, Feuerbach point, isodynamic points, and Napoleon points), as well as other references (to print works) and a list of journals that frequently publish items of interest to triangle geometers.

  15. Evaluation Center

    NSDL National Science Digital Library

    The Evaluation Center's mission is to advance the theory, practice, and utilization of evaluation. The Center's principal activities are research, development, dissemination, service, instruction, and national and international leadership in evaluation.

  16. Perceptual Centers (P-centers)

    ERIC Educational Resources Information Center

    Morton, John; And Others

    1976-01-01

    Words presented with regular acoustic onsets are not "perceptually" regular. The requirements for perceived regularity were investigated, and the "perceptual center" (P-center) of a word was defined as its psychological moment of occurrence. (Editor)

  17. Primary Care's Dim Prognosis

    ERIC Educational Resources Information Center

    Alper, Philip R.

    2010-01-01

    Given the chorus of approval for primary care emanating from every party to the health reform debate, one might suppose that the future for primary physicians is bright. Yet this is far from certain. And when one looks to history and recognizes that primary care medicine has failed virtually every conceivable market test in recent years, its…

  18. Perceptual centers (P-centers)

    Microsoft Academic Search

    John Morton; Steve Marcus; Clive Frankish

    1976-01-01

    Words presented with regular acoustic onsets are not perceptually regular. The requirements for perceived regularity were investigated, and the perceptual center (P-center) of a word was defined as its psychological moment of occurrence. Some properties of these perceptual centers have been empirically determined, and the range of their applicability is sketched. In particular, it is already clear that temporal alignment

  19. Primary vertex reconstruction

    E-print Network

    Krasowski, M; Männer, W; Polok, G; Witek, M

    2007-01-01

    This report reviews the improved method of primary vertex off-line reconstruction. The new method for primary vertex seed finding as well as modified procedure for vertex fit have been briefly described. Results of the primary vertex reconstruction performance are presented and compared to the previous version of the package. Improvement in the primary vertex reconstruction efficiencies is observed. Small but statistically significant bias, coming mostly from the long-living tracks as well as from a bias of the Velo measurements present in the DC06 simulation, affects the determination of the primary vertex position along the beam direction.

  20. Protein-Cofactor Interactions in Bacterial Reaction Centers from Rhodobacter sphaeroides R-26: I. Identification of the ENDOR Lines Associated with the Hydrogen Bonds to the Primary Quinone QA??

    PubMed Central

    Flores, M.; Isaacson, R.; Abresch, E.; Calvo, R.; Lubitz, W.; Feher, G.

    2006-01-01

    Hydrogen bonds are important in determining the structure and function of biomolecules. Of particular interest are hydrogen bonds to quinones, which play an important role in the bioenergetics of respiration and photosynthesis. In this work we investigated the hydrogen bonds to the two carbonyl oxygens of the semiquinone \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{Q}}_{{\\mathrm{A}}}^{{\\cdot}-}\\end{equation*}\\end{document} in the well-characterized reaction center from the photosynthetic bacterium Rhodobacter sphaeroides R-26. We used electron paramagnetic resonance and electron nuclear double resonance techniques at 35 GHz at a temperature of 80 K. The goal of this study was to identify and assign sets of 1H-ENDOR lines to protons hydrogen bonded to each of the two oxygens. This was accomplished by preferentially exchanging the hydrogen bond on one of the oxygens with deuterium while concomitantly monitoring the changes in the amplitudes of the 1H-ENDOR lines. The preferential deuteration of one of the oxygens was made possible by the different 1H ? 2H exchange times of the protons bonded to the two oxygens. The assignment of the 1H-ENDOR lines sets the stage for the determination of the geometries of the H-bonds by a detailed field selection ENDOR study to be presented in a future article. PMID:16473904

  1. Primary care: can it solve employers' health care dilemma?

    PubMed

    Sepulveda, Martin-J; Bodenheimer, Thomas; Grundy, Paul

    2008-01-01

    Employers are beginning to recognize that investing in the primary care foundation of the health care system may help address their problems of rising health care costs and uneven quality. Primary care faces a crisis as a growing number of U.S. medical graduates are avoiding primary care careers because of relatively low reimbursement and an unsatisfying work life. Yet a strong primary care sector has been associated with reduced health care costs and improved quality. Through the Patient-Centered Primary Care Collaborative and other efforts, some large employers are engaged in initiatives to strengthen primary care. PMID:18180490

  2. Computer centers

    NASA Astrophysics Data System (ADS)

    The National Science Foundation has renewed grants to four of its five supercomputer centers. Average annual funding will rise from $10 million to $14 million so facilities can be upgraded and training and education expanded. As cooperative projects, the centers also receive money from states, universities, computer vendors and industry. The centers support research in fluid dynamics, atmospheric modeling, engineering geophysics and many other scientific disciplines.

  3. Skills Center.

    ERIC Educational Resources Information Center

    Canter, Patricia; And Others

    The services of the Living Skills Center for the Visually Handicapped, a habilitative service for blind young adults, are described. It is explained that the Center houses its participants in their own apartments in a large complex and has served over 70 young people in 4 years. The evaluation section describes such assessment instruments as an…

  4. NATIONAL CENTER FOR GEOGRAPHIC INFORMATION AND ANALYSIS

    E-print Network

    California at Santa Barbara, University of

    "basic research on geographic analysis utilizing GIS" as the Center's primary mission and suggested five NATIONAL CENTER FOR GEOGRAPHIC INFORMATION AND ANALYSIS ANNUAL REPORT Year 6 (December 1, 1993 University of Maine 14 May 1995 #12; NATIONAL CENTER FOR GEOGRAPHIC INFORMATION AND ANALYSIS ANNUAL REPORT

  5. Gross Primary Productivity

    NASA Technical Reports Server (NTRS)

    2002-01-01

    NASA's new Moderate-resolution Imaging Spectroradiometer (MODIS) allows scientists to gauge our planet's metabolism on an almost daily basis. GPP, gross primary production, is the technical term for plant photosynthesis. This composite image over the continental United States, acquired during the period March 26-April 10, 2000, shows regions where plants were more or less productive-i.e., where they 'inhaled' carbon dioxide and then used the carbon from photosynthesis to build new plant structures. This false-color image provides a map of how much carbon was absorbed out of the atmosphere and fixed within land vegetation. Areas colored blue show where plants used as much as 60 grams of carbon per square meter. Areas colored green and yellow indicate a range of anywhere from 40 to 20 grams of carbon absorbed per square meter. Red pixels show an absorption of less than 10 grams of carbon per square meter and white pixels (often areas covered by snow or masked as urban) show little or no absorption. This is one of a number of new measurements that MODIS provides to help scientists understand how the Earth's landscapes are changing over time. Scientists' goal is use of these GPP measurements to refine computer models to simulate how the land biosphere influences the natural cycles of water, carbon, and energy throughout the Earth system. The GPP will be an integral part of global carbon cycle source and sink analysis, an important aspect of Kyoto Protocol assessments. This image is the first of its kind from the MODIS instrument, which launched in December 1999 aboard the Terra spacecraft. MODIS began acquiring scientific data on February 24, 2000, when it first opened its aperture door. The MODIS instrument and Terra spacecraft are both managed by NASA's Goddard Space Flight Center, Greenbelt, MD. Image courtesy Steven Running, MODIS Land Group Member, University of Montana

  6. The Impact of Primary Care: A Focused Review

    PubMed Central

    Shi, Leiyu

    2012-01-01

    Primary care serves as the cornerstone in a strong healthcare system. However, it has long been overlooked in the United States (USA), and an imbalance between specialty and primary care exists. The objective of this focused review paper is to identify research evidence on the value of primary care both in the USA and internationally, focusing on the importance of effective primary care services in delivering quality healthcare, improving health outcomes, and reducing disparities. Literature searches were performed in PubMed as well as “snowballing” based on the bibliographies of the retrieved articles. The areas reviewed included primary care definitions, primary care measurement, primary care practice, primary care and health, primary care and quality, primary care and cost, primary care and equity, primary care and health centers, and primary care and healthcare reform. In both developed and developing countries, primary care has been demonstrated to be associated with enhanced access to healthcare services, better health outcomes, and a decrease in hospitalization and use of emergency department visits. Primary care can also help counteract the negative impact of poor economic conditions on health. PMID:24278694

  7. Energy efficient data centers

    SciTech Connect

    Tschudi, William; Xu, Tengfang; Sartor, Dale; Koomey, Jon; Nordman, Bruce; Sezgen, Osman

    2004-03-30

    Data Center facilities, prevalent in many industries and institutions are essential to California's economy. Energy intensive data centers are crucial to California's industries, and many other institutions (such as universities) in the state, and they play an important role in the constantly evolving communications industry. To better understand the impact of the energy requirements and energy efficiency improvement potential in these facilities, the California Energy Commission's PIER Industrial Program initiated this project with two primary focus areas: First, to characterize current data center electricity use; and secondly, to develop a research ''roadmap'' defining and prioritizing possible future public interest research and deployment efforts that would improve energy efficiency. Although there are many opinions concerning the energy intensity of data centers and the aggregate effect on California's electrical power systems, there is very little publicly available information. Through this project, actual energy consumption at its end use was measured in a number of data centers. This benchmark data was documented in case study reports, along with site-specific energy efficiency recommendations. Additionally, other data center energy benchmarks were obtained through synergistic projects, prior PG&E studies, and industry contacts. In total, energy benchmarks for sixteen data centers were obtained. For this project, a broad definition of ''data center'' was adopted which included internet hosting, corporate, institutional, governmental, educational and other miscellaneous data centers. Typically these facilities require specialized infrastructure to provide high quality power and cooling for IT equipment. All of these data center types were considered in the development of an estimate of the total power consumption in California. Finally, a research ''roadmap'' was developed through extensive participation with data center professionals, examination of case study findings, and participation in data center industry meetings and workshops. Industry partners enthusiastically provided valuable insight into current practice, and helped to identify areas where additional public interest research could lead to significant efficiency improvement. This helped to define and prioritize the research agenda. The interaction involved industry representatives with expertise in all aspects of data center facilities, including specialized facility infrastructure systems and computing equipment. In addition to the input obtained through industry workshops, LBNL's participation in a three-day, comprehensive design ''charrette'' hosted by the Rocky Mountain Institute (RMI) yielded a number of innovative ideas for future research.

  8. Selective COX-2 inhibitor versus nonselective COX-1 and COX-2 inhibitor in the prevention of heterotopic ossification after total hip arthroplasty: a meta-analysis of randomised trials.

    PubMed

    Xue, Deting; Zheng, Qiang; Li, Hang; Qian, Shengjun; Zhang, Bo; Pan, Zhijun

    2011-01-01

    Whether selective cyclo-oxygenase-2 (COX-2) inhibitors are equally effective compared to nonselective NSAIDs for the prevention of heterotopic ossification (HO) after total hip arthroplasty (THA) is still unclear. We carried out a comprehensive search strategy, in which only randomised controlled trials were included. Two reviewers independently assessed methodological quality and extracted outcome data. Analyses were performed using Stata version 10.0. Four eligible randomised controlled trials totalling 808 patients were included. Meta-analysis results showed that no statistically significant difference was found in overall incidence of HO (RR 1.08; 95% CI 0.71-1.64), incidence of moderate severe HO (Brooker II and III) (RR 0.83; 95% CI 0.48-1.42) and any grade of Brooker classification between two groups. In summary, the selective COX-2 inhibitors are equally effective as nonselective NSAIDs for the prevention of HO after THA. Considering the gastrointestinal side effects of nonselective NSAIDs, we recommend selective COX-2 inhibitors for the prevention of HO after THA. However, future well-designed, randomised controlled trials are still needed to further confirm our results. PMID:19830425

  9. A compound heterozygote SLC26A2 mutation resulting in robin sequence, mild limbs shortness, accelerated carpal ossification, and multiple epiphysial dysplasia in two Brazilian sisters. A new intermediate phenotype between diastrophic dysplasia and recessive multiple epiphyseal dysplasia.

    PubMed

    Zechi-Ceide, Roseli Maria; Moura, Priscila Padilha; Raskin, Salmo; Richieri-Costa, Antonio; Guion-Almeida, Maria Leine

    2013-08-01

    Mutations in solute carrier family 26 (sulfate transporter), member 2 (SLC26A2) gene result in a spectrum of autosomal recessive chondrodysplasias that range from the mildest recessive form of multiple epiphysial dysplasia (rMED) through the most common diastrophic dysplasia (DTD) to lethal atelosteogenesis type II and achondrogenesis IB. The clinical variability has been ascribed to quantitative effect of mutations of the sulfate transporter activity. Here we describe two Brazilian sisters, born to healthy and non consanguineous parents, with Robin sequence, mild shortening of upper and lower limbs, brachymetacarpalia/tarsalia, additional and accelerated carpal ossification, marked genu valgum, and multiple epiphysial dysplasia. This phenotype was intermediate between DTD and rMED, and both girls have a compound heterozygous mutations for the SLC26A2, a Finnish founder mutation (c.-26 + 2T>C), and R279W. This combination of mutations has been observed in individuals with different phenotypes, including DTD, DTD variant, and rMED. The distinct phenotype of our cases reinforces the hypothesis that other factors may be influencing the phenotype as previously suggested. PMID:23840040

  10. Using Primary Source Documents.

    ERIC Educational Resources Information Center

    Mintz, Steven

    2003-01-01

    Explores the use of primary sources when teaching about U.S. slavery. Includes primary sources from the Gilder Lehrman Documents Collection (New York Historical Society) to teach about the role of slaves in the Revolutionary War, such as a proclamation from Lord Dunmore offering freedom to slaves who joined his army. (CMK)

  11. Medics in Primary School

    ERIC Educational Resources Information Center

    Press, Colin

    2003-01-01

    Some time ago a flyer on "Medics in Primary School" came the author's way. It described a programme for making placements in primary schools available to medical students. The benefits of the program to medical students and participating schools were highlighted, including opportunities to develop communication skills and demystify medicine. It…

  12. EMR Curriculum Guide: Primary.

    ERIC Educational Resources Information Center

    Ruschmeier, Veronica M., Ed.; Rockwell, Linda, Ed.

    Presented is a curriculum guide for educable mentally retarded children in primary and intermediate grades which specifies behavioral and interim objectives in the areas of basic verbal and arithmetic skills, vocational competencies, social competencies, and physical skills. Objectives such as the following are identified at the primary level:…

  13. Primary Health Care.

    ERIC Educational Resources Information Center

    Lauffer, Sandra, Ed.

    1979-01-01

    This report contains 13 articles and book/film reviews on various topics related to the diffusion of health care information in developing countries; beginning with two articles which define primary health care, and suggest principles related to the community, communication, and the health practitioner upon which primary health care should be…

  14. Organisation of Prevention in Primary Health Care.

    ERIC Educational Resources Information Center

    Council of Europe, Strasbourg (France).

    This report examines the possiblities of increasing the amount of preventive work being carried out by primary care workers in European communities. Before making practical recommendations about promoting prevention, an analysis is presented of the main present day problems. These center on the environment (not only physical but also social and…

  15. 76 FR 1441 - Health Center Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-10

    ...experienced provider of care and has a demonstrated record of compliance with Health Center Program statutory...that critical primary health care services continue and remain available to the low-income, underserved...

  16. International Quilt Study Center

    NSDL National Science Digital Library

    The world has many great textile traditions, and the art and practice of quilt-making is certainly one of them. The International Quilt Study Center (IQSC) was founded in 1997 at the University of Nebraska-Lincoln with the kind assistance of Ardis and Robert James, who donated 900 quilts. Since then, the Center has grown to include research symposia, a graduate program in textile history, and numerous online resources. Visitors may want to search the quilt collection online through their helpful search engine. Users can search by primary pattern, quilt title, quilt maker, country of origin, and predominant technique. One very interesting feature of the site is the â??Quilt of the Monthâ?ť area, where visitors can learn about some of the Centerâ??s most unique quilts, such as the Chicken Ribbons Quilt from 1913, which features blocks of blue, red, and white silver printed ribbons.

  17. Quality of primary health care in Saudi Arabia: a comprehensive review

    Microsoft Academic Search

    HANAN AL-AHMADI; MARTIN ROLAND

    2005-01-01

    Objectives. Little is known about the quality of primary care in Saudi Arabia, despite the central role of primary care centers in Saudi health strategy. This study presents an overview of quality of primary care in Saudi Arabia, and identifies factors impeding the achievement of quality, with the aim of determining how the quality of Saudi primary care could be

  18. Primary Lateral Sclerosis

    MedlinePLUS

    ... Sclerosis? Primary lateral sclerosis (PLS) is a rare neuromuscular disease with slowly progressive weakness in voluntary muscle ... NINDS conducts a broad range of research on neuromuscular disorders such as PLS. This research is aimed ...

  19. Inside the Primary Classroom.

    ERIC Educational Resources Information Center

    Simon, Brian

    1980-01-01

    Presents some of the findings of the ORACLE research program (Observational Research and Classroom Learning Evaluation), a detailed observational study of teacher-student interaction, teaching styles, and management methods within a sample of primary classrooms. (Editor/SJL)

  20. Staging Primary CNS Lymphoma

    MedlinePLUS

    ... large vein near the heart. Having a weakened immune system may increase the risk of developing primary CNS ... immunodeficiency syndrome (AIDS) or other disorders of the immune system or who have had a kidney transplant . For ...

  1. COAGULATION Primary Hemostatic Plug

    E-print Network

    9/16/2013 1 COAGULATION Hemostasis HEMOSTASIS Primary Hemostatic Plug Secondary Homostatic Plug Extrinsic Pathway Common Pathway #12;9/16/2013 3 COAGULATION FACTORS Prothrombin Group Fibrinogen Group Coagulation #12;

  2. Primary vitreoretinal lymphoma

    PubMed Central

    Mulay, Kaustubh; Narula, Ritesh; Honavar, Santosh G

    2015-01-01

    Primary vitreoretinal lymphoma (PVRL) is an uncommon, but potentially fatal intraocular malignancy, which may occur with or without primary central nervous system lymphoma (PCNSL). Considered to be a subset of PCNSL, it is mostly of diffuse large B-cell type. The diagnosis of PVRL poses a challenge not only to the clinician, but also to the pathologist. Despite aggressive treatment with chemotherapy and/or radiotherapy, relapses or CNS involvement are common. PMID:25971162

  3. Southern Rural Development Center

    NSDL National Science Digital Library

    Since John F. Kennedy and Lyndon Johnson declared war on rural poverty during their time in the White House, there has been an overriding concern with alleviating the persistently high levels of poverty in the American South. A number of organizations have developed to provide assistance to the region, and the Southern Rural Development Center (SRDC), located at Mississippi State University is one such entity. The center's mission statement reflects this sentiment, as it notes its primary directive is "to strengthen the capacity of the region's 29-land grant institutions to address critical contemporary development issues impacting the well-being of people and communities in the rural South." Visitors interested in these issues will find plenty to examine here, as they may elect to view a calendar of germane events (such as regional science conferences and the like), look over a list of their primary focus areas, learn about available funding opportunities, and download any number of policy publications and newsletters which date back to 1993.

  4. 8. VIEW FROM NORTHWEST OF CONDENSATE STORAGE TANK (LEFT), PRIMARY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. VIEW FROM NORTHWEST OF CONDENSATE STORAGE TANK (LEFT), PRIMARY WATER STORAGE TANK (CENTER), CANAL WATER STORAGE TANK (RIGHT) (LOCATIONS E,F,D) - Shippingport Atomic Power Station, On Ohio River, 25 miles Northwest of Pittsburgh, Shippingport, Beaver County, PA

  5. 42 CFR 411.175 - Basis for Medicare primary payments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 2014-10-01 false Basis for Medicare primary payments. 411.175 Section...175 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM...

  6. 42 CFR 411.175 - Basis for Medicare primary payments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 2011-10-01 false Basis for Medicare primary payments. 411.175 Section...175 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM...

  7. 42 CFR 411.175 - Basis for Medicare primary payments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 2013-10-01 false Basis for Medicare primary payments. 411.175 Section...175 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM...

  8. 42 CFR 411.175 - Basis for Medicare primary payments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 2012-10-01 false Basis for Medicare primary payments. 411.175 Section...175 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM...

  9. Mackinac Center

    NSDL National Science Digital Library

    Based in Midland, Michigan, the Mackinac Center for Public Policy is a "nonpartisan research and educational institute dedicated to improving the quality of life for all Michigan citizens by promoting sound solutions to state and local policy questions." Visitors to their website can read their blog, check out some of their publications, and also learn about some of their key topical interests. Most of their work focuses on economic policy matters, and visitors can get a sense of their viewpoints by clicking on the "Periodicals & Projects" area. The "In the Spotlight" area includes recent items of note, and recently they have featured pieces on charter schools, tax credits, and distance learning. Visitors are also encouraged to sign up to receive the Center's email updates and other materials.

  10. Primary aldosteronism and salt.

    PubMed

    Funder, John W

    2015-03-01

    For many years, primary aldosteronism was thought (and taught) to be a relatively rare (< 1 %) and benign form of high blood pressure: now we know that neither is the case. Currently, the prevalence is considered to be 5-10 % of hypertensives, on the basis of more or less stringent cutoffs for the aldosterone/renin ratio and plasma aldosterone concentration: increasingly, evidence is mounting that the true prevalence of (relatively) autonomous aldosterone secretion may be ? 30 % of hypertensives. There is, in addition, a consensus that the risk profile for patients with primary aldosteronism is substantially higher than in age-, sex-, and blood pressure-matched essential hypertensives; the cardiovascular/renal damage in primary aldosteronism is thus not a primary effect of raised blood pressure. The nexus between salt and primary aldosteronism is clear, as equivalently raised or even higher levels of plasma aldosterone in chronic sodium deficiency are homeostatic and do not cause cardiovascular damage, thus ruling out deleterious effects of aldosterone acting alone. In primary aldosteronism the normal homeostatic feedback loops between sodium status and aldosterone levels are disturbed, so that cardiovascular/renal damage reflects inappropriate aldosterone levels for sodium status. One possible actor in such a scenario is endogenous ouabain (or similar compounds), which is elevated in the sodium-loaded state and a vasoconstrictor, and thus potentially be able both to raise blood pressure and to cause cardiovascular/renal damage. A second consideration is that of the epidemiologic data linking a chronically high salt intake to a raised blood pressure. If autonomous aldosterone secretion is in fact present in ? 30 % of hypertensives, this may be the group sensitive to the pressor effects of high salt, with the remainder much less affected. Finally, at a practical level given even the currently accepted prevalence of primary aldosteronism, a radical reconsideration of first-line antihypertensive therapy is proposed. PMID:25502114

  11. Composites technology for transport primary structure

    NASA Technical Reports Server (NTRS)

    Chen, Victor; Hawley, Arthur; Klotzsche, Max; Markus, Alan; Palmer, Ray

    1991-01-01

    The ACT contract activity being performed by the McDonnell Douglas Corporation is divided into two separate activities: one effort by Douglas Aircraft in Long Beach, California with a focus on Transport Primary Wing and Fuselage Structure, and the other effort by McDonnell Aircraft in St. Louis, Missouri with a focus on Advanced Combat Aircraft Center Wing-Fuselage Structure. This presentation is on the Douglas Aircraft Transport Structure portion of the ACT program called ICAPS - Innovative Composite Aircraft Primary Structure.

  12. Primary polydipsia: a case report.

    PubMed

    Tournikioti, Kalliopi; Voumvourakis, Konstantinos; Moussas, Georgios; Plachouras, Diamantis; Michopoulos, Ioannis; Douzenis, Athanasios; Christodoulou, Christos; Lamboussis, Efstratios; Gournellis, Rossetos

    2013-08-01

    Primary polydipsia (PP) is etiologically associated with physical factors and psychiatric disorders ("psychogenic polydipsia"). We present the case of a 28-year-old man with severe symptoms of polydipsia and polyuria. After a comprehensive physical assessment, the only finding was a lesion suggestive of pituitary microadenoma in the magnetic resonance imaging (MRI) scan of the brain. A thorough clinical and diagnostic assessment and the administration of a wide range of psychometric tools revealed no major psychiatric disorder apart from chronic anxiety and mild depressive symptoms. Our patient's PP symptoms might be associated with a dysfunction of the thirst center, which is located closely to the neuroanatomical lesion found in the MRI scan. Given that the underlying pathophysiology of PP remains, to a large extent, unclear, we emphasize on the difficulties to distinguish between PP's subtypes. PMID:23896855

  13. Composite Crew Module: Primary Structure

    NASA Technical Reports Server (NTRS)

    Kirsch, Michael T.

    2011-01-01

    In January 2007, the NASA Administrator and Associate Administrator for the Exploration Systems Mission Directorate chartered the NASA Engineering and Safety Center to design, build, and test a full-scale crew module primary structure, using carbon fiber reinforced epoxy based composite materials. The overall goal of the Composite Crew Module project was to develop a team from the NASA family with hands-on experience in composite design, manufacturing, and testing in anticipation of future space exploration systems being made of composite materials. The CCM project was planned to run concurrently with the Orion project's baseline metallic design within the Constellation Program so that features could be compared and discussed without inducing risk to the overall Program. This report discusses the project management aspects of the project including team organization, decision making, independent technical reviews, and cost and schedule management approach.

  14. Measurement Centers

    NSDL National Science Digital Library

    Amy Kershaw

    2004-01-01

    During a center-based activity, groups of students will rotate around the classroom practicing non-standard unit of measurement concepts. In addition, they will have the opportunity to familiarize themselves with measuring with rulers and will participate in a lesson about capacity. From this lesson, which is "a good culmination to a unit of measurement to review and practice concepts learned," students will organize items from longest to shortest, measure using paper clips, measure in inches and feet, and participate in a demonstration on capacity.

  15. Primary breast lymphoma.

    PubMed

    Cheah, Chan Y; Campbell, Belinda A; Seymour, John F

    2014-09-01

    Primary breast lymphoma is a rare form of extranodal lymphoma, defined by the presence of a primary lesion within the breast with or without regional nodal involvement but no other extra-mammary sites of involvement. It comprises diverse histologic subtypes, but diffuse large B-cell lymphoma is the most common. In this review, we describe in detail the clinical features, diagnosis and staging, pathogenesis, risk factors and therapy of primary breast diffuse large B-cell lymphoma. We consider choice and number of cycles of chemotherapy, the indications for radiotherapy and discuss the need for central nervous system prophylaxis. We also provide a brief overview of the less commonly encountered histologic subtypes including marginal zone, follicular, Burkitt and breast implant associated anaplastic large cell lymphoma. We conclude with a suggested treatment approach and potential areas of future research. PMID:24953564

  16. Primary Care's Denominator Problem

    PubMed Central

    Anderson, John E.

    1985-01-01

    It is usually impossible to determine the size of a primary care practice for use as a denominator in calculating rates of morbid and other events within a practice. Although this denominator problem has been a major hurdle for primary care researchers, its nature and significance are not broadly appreciated. This article describes the need for a denominator, defines the term ‘practice population’, outlines the need for the practice population as a valid denominator, and identifies the areas in which the practice population is the denominator of choice. PMID:21279144

  17. Area Health Education Center (AHEC) outreach librarian

    Microsoft Academic Search

    Diana McDuffee

    2004-01-01

    Area Health Education Center (AHEC) librarians are first, and foremost, outreach librarians. Improving health care and the distribution of health-care professionals in rural and under-served areas is the origin of the AHEC program. AHEC librarians play an important role in clinical education and patient care. Their role has characteristics of both academic medical center and hospital librarians. Their primary clientele

  18. Predictions of the Space Environment Services Center

    NASA Technical Reports Server (NTRS)

    Heckman, G. R.

    1979-01-01

    The types of users of the Space Environment Services Center are identified. All the data collected by the Center are listed and a short description of each primary index or activity summary is given. Each type of regularly produced forecast is described, along with the methods used to produce each prediction.

  19. RESEARCH CENTERS National Security Education Center

    E-print Network

    RESEARCH CENTERS National Security Education Center MISSION INCUBATOR CENTERS EDUCATIONAL Security Center Leader Tom Terwilliger Program Administrator Josephine Olivas Information Science) Leader Kim Rasmussen (Acting) Program Administrator Debbie Wilke Information Science & Technology

  20. Primary intrinsic chiasmal germinoma.

    PubMed

    Chaudhry, Nauman S; Ahmad, Faiz U; Whittington, Elizabeth; Schatz, Norman; Morcos, Jacques J

    2015-06-01

    Intracranial germinomas are typically present in the suprasellar or pineal location, and their origin within the optic nerve or chiasm is extremely rare. We report a 25-year-old woman with an exophytic primary optic chiasm germinoma who underwent partial resection followed by radiation and had no detectable tumor on magnetic resonance imaging at 1-year follow-up. PMID:25621861

  1. Primary Biliary Cirrhosis

    MedlinePLUS

    ... of liver cancer every 6 to 12 months. Health care providers use blood tests, ultrasound, or both to check for signs of ... make the diagnosis of primary biliary cirrhosis. A health care provider uses the test selectively when he or she is concerned that ...

  2. Master logo Primary version

    E-print Network

    Bandara, Arosha

    of the brand. Universally recognised, it quickly and easily conveys all of our key brand values. Wherever practical, this primary version of the logo must be used. Need help with something? Contact: brand logos, trade marks, trade names, photographic and video images, sound recordings, audio tools

  3. Primary bladder neck obstruction

    Microsoft Academic Search

    J. G. Blaivas; L. J. Norlen

    1984-01-01

    Primary bladder neck obstruction is not uncommon in young and middle age men. The symptoms are confounding and routine urologic investigation including cystometry, uroflow, voiding cystourethrography and cystourethroscopy often leads to an erroneous diagnosis of “psychogenic voiding dysfunction”, “neurogenic bladder” or “prostatitis”. An accurate diagnosis can be obtained by the simultaneous measurement of detrusor pressure and uroflow, preferably accompanied by

  4. Primary Diffuse Leptomeningeal Gliosarcomatosis

    PubMed Central

    Moon, Ju Hyung; Kim, Se Hoon; Kim, Eui Hyun; Kang, Seok-Gu

    2015-01-01

    Primary diffuse leptomeningeal gliomatosis (PDLG) is a rare condition with a fatal outcome, characterized by diffuse infiltration of the leptomeninges by neoplastic glial cells without evidence of primary tumor in the brain or spinal cord parenchyma. In particular, PDLG histologically diagnosed as gliosarcoma is extremely rare, with only 2 cases reported to date. We report a case of primary diffuse leptomeningeal gliosarcomatosis. A 68-year-old man presented with fever, chilling, headache, and a brief episode of mental deterioration. Initial T1-weighted post-contrast brain magnetic resonance imaging (MRI) showed diffuse leptomeningeal enhancement without a definite intraparenchymal lesion. Based on clinical and imaging findings, antiviral treatment was initiated. Despite the treatment, the patient's neurologic symptoms and mental status progressively deteriorated and follow-up MRI showed rapid progression of the disease. A meningeal biopsy revealed gliosarcoma and was conclusive for the diagnosis of primary diffuse leptomeningeal gliosarcomatosis. We suggest the inclusion of PDLG in the potential differential diagnosis of patients who present with nonspecific neurologic symptoms in the presence of leptomeningeal involvement on MRI. PMID:25977905

  5. Primary publication in microprint

    USGS Publications Warehouse

    Herman, C.M.; Davis, D.E.

    1964-01-01

    This is a progress report on an experiment to demonstrate practicality of such publication. Based on a study conducted since 1959 through the publication of 'Wildlife Disease', the co-authors review the original aims, accomplishments, and future of primary publication in microprint. Space and cost savings, as well as author and reader reactions, portend further developments and use of this medium.

  6. GMT primary mirror support

    NASA Astrophysics Data System (ADS)

    Hull, Charlie

    2014-07-01

    The GMT primary mirror support draws on the heritage developed for the 3.5 m, 6.5 m, and 8.4 m mirrors from the Steward Observatory Mirror Lab. While similar in design philosophy and concept, each successive generation has incorporated refinements based on the experience gained from previous mirrors.

  7. Primary hyperoxaluria type I

    Microsoft Academic Search

    K. Latta; J. Brodehl

    1990-01-01

    Primary hyperoxaluria type I is a metabolic disorder caused by the deficiency of the peroxisomal alanine: glyoxylate aminotransferase. The disease is inherited as an autosomal recessive trait. The clinical course is outlined based on data from 330 published cases. Diagnostic cornerstones are clinical parameters, urinary excretion of oxalate and glycollate, and the determination of enzyme activity in liver tissue. Principles

  8. Primary glomerular disease

    Microsoft Academic Search

    Peter Mathieson

    2011-01-01

    This article reviews the clinical features, pathogenesis, investigation and management of glomerulonephritis (GN). This can occur as a primary isolated renal disease, as a manifestation of systemic diseases such as vasculitis or lupus, or secondary to drugs, infections or tumours. It is an important cause of morbidity and mortality and a potentially preventable cause of end-stage renal disease, so early

  9. Primary glomerular disease

    Microsoft Academic Search

    Momir Macanovic; Peter Mathieson

    2007-01-01

    This article reviews the clinical features, pathogenesis, investigation and management of glomerulonephritis (GN). This can occur as a primary isolated renal disease, as a manifestation of systemic diseases such as vasculitis or lupus, or secondary to drugs, infections or tumours. It is an important cause of morbidity and mortality and a potentially preventable cause of end-stage renal disease, so early

  10. Model Center

    NSDL National Science Digital Library

    2009-04-14

    A human is a complicated organism, and it is considered unethical to do many kinds of experiments on human subjects. For these reasons, biologists often use simpler 'model' organisms that are easy to keep and manipulate in the laboratory. Despite obvious differences, model organisms share with humans many key biochemical and physiological functions that have been conserved (maintained) by evolution. Each of the following model organisms has its advantages and disadvantages in different research applications. This tool allows you to examine the similarities between different systems by comparing the proteins they share and the proportion of DNA they have in common. Choose a gene from the drop-down menu and select the species you want to compare. Rolling over the images will give you a more detailed description of each model. Clicking on a gene�s name will take you to the National Center for Biological Information, where you can explore the latest relevant scientific literature.

  11. Models for Primary Eye Care Services in India

    PubMed Central

    Misra, Vasundhra; Vashist, Praveen; Malhotra, Sumit; Gupta, Sanjeev K.

    2015-01-01

    Blindness and visual impairment continues to be a major public health problem in India. Availability and easy access to primary eye care services is essential for elimination of avoidable blindness. ‘Vision 2020: The Right to Sight - India’ envisaged the need for establishing primary eye care units named vision centers for every 50,000 population in the country by the year 2020. The government of India has given priority to develop vision centers at the level of community health centers and primary health centers under the ‘National Program for Control of Blindness’. NGOs and the private sector have also initiated some models for primary eye care services. In the current situation, an integrated health care system with primary eye care promoted by government of India is apparently the best answer. This model is both cost effective and practical for the prevention and control of blindness among the underprivileged population. Other models functioning with the newer technology of tele-ophthalmology or mobile clinics also add to the positive outcome in providing primary eye care services. This review highlights the strengths and weaknesses of various models presently functioning in the country with the idea of providing useful inputs for eye care providers and enabling them to identify and adopt an appropriate model for primary eye care services. PMID:25861167

  12. A deployable primary mirror for space telescopes

    Microsoft Academic Search

    Mark S. Lake; James E. Phelps; Jack E. Dyer; David A. Caudle; Anthony Tam; Javier Escobedo; Eldon P. Kasl

    ABSTRACT NASA Langley Research Center, Composite Optics, Inc., and Nyma\\/ADF have developed jointly a deployable primary mirror for space telescopes that combines ,over five years of research on deployment ,of optical-precision structures and over ten years of development,of fabrication techniques for optical-precision composite ,mirror panels and structures. The deployable mirror is directly applicable to a broad class of non-imaging ,ŇlidarÓ

  13. Deployable primary mirror for space telescopes

    Microsoft Academic Search

    Mark S. Lake; James E. Phelps; Jack E. Dyer; David A. Caudle; Anthony Tam; Javier Escobedo-Torres; Eldon P. Kasl

    1999-01-01

    NASA Langley Research Center, Composite Optics, Inc., and Nyma\\/ADF have developed jointly a deployable primary mirror for space telescopes that combines over five years of research on deployment of optical-precision structures and over ten years of development of fabrication techniques for optical-precision composite mirror panels and structures. The deployable mirror is directly applicable to a broad class of non-imaging `lidar'

  14. Diagnosis and treatment of primary aldosteronism

    Microsoft Academic Search

    Gian Paolo D. Rossi; D. Rossi

    2011-01-01

    Primary aldosteronism involves more than 11% of hypertensive patients who are referred to specialized centers for the diagnosis\\u000a and treatment of hypertension. If not diagnosed early it causes an excess damage to the heart, vessels and kidney, which translates\\u000a into an cardiovascular events. Since these ominous consequences can be corrected with a timely diagnosis and an appropriate\\u000a therapy, physicians should

  15. Quality Standards for Nigerian Pre-Primary Centres.

    ERIC Educational Resources Information Center

    Ate, Delthyea Gautt

    Proposing quality standards for Nigerian pre-primary centers, this paper argues that the first concern must be the provision of adequate care in the form of high quality health, safety, and nutritional conditions. Care is discussed in terms of illness policy, routines for good health, physical characteristics of centers, personal hygiene,…

  16. Assessing & Developing Primary Care for Children: Reforms in Health Systems.

    ERIC Educational Resources Information Center

    Grason, Holly Allen, Ed.; Guyer, Bernard, Ed.

    This publication is a compilation of papers presented at an April 1994 workshop sponsored by the National Center for Education in Maternal and Child Health and the Bureau-funded Johns Hopkins Child and Adolescent Health Policy Center (CAHPC). The papers are as follows: (1) "Defining the Issues and Planning for Change: Health Care Systems, Primary

  17. 8. VIEW SOUTH OF PRIMARY REDUCING GEARS; HORIZONTAL ARM AT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. VIEW SOUTH OF PRIMARY REDUCING GEARS; HORIZONTAL ARM AT CENTER OF PHOTOGRAPH IS A PART OF LEVER MECHANISM THAT LOCKS MECHANICAL BRAKE; 75 LB. COUNTERWEIGHT IS AT EXTREME LEFT CENTER - East Washington Avenue Bridge, Spanning Pequonnock River at East Washington Avenue, Bridgeport, Fairfield County, CT

  18. General Information about Carcinoma of Unknown Primary

    MedlinePLUS

    ... Professional Carcinoma of Unknown Primary Treatment Carcinoma of Unknown Primary Treatment (PDQ®) General Information About Carcinoma of Unknown Primary Key Points Carcinoma of unknown primary (CUP) ...

  19. DEPARTMENT OF PRIMARY INDUSTRIES

    E-print Network

    Hamilton, Michael P.

    Pacific Research Station Moorea, French Polynesia Conservation Biology: M. Allen, M. Hamilton (co-PI), J Terheggen Budget Analyst: David Jaquez Admin Asst: Stacy Robinson Center for Integrated Space Microsystems

  20. Primary spinal epidural lymphomas

    PubMed Central

    Cugati, Goutham; Singh, Manish; Pande, Anil; Ramamurthi, Ravi; Balasubramanyam, Mahalakshmi; Sethi, Sumer K.; Singh, Ajai Kumar

    2011-01-01

    An epidural location for lymphoma is observed in 0.1–6.5% of all the lymphomas. Primary spinal epidural lymphoma (PSEL) is a subset of lymphomas, where there are no other recognizable sites of lymphomas at the time of diagnosis. The incidence of this subset of lymphomas is much less. It, however, is increasingly diagnosed, due to the increased use of more sensitive imaging modalities. For the electronic search, Pubmed was used to identify journals that enlisted and enumerated PSEL from 1961 to January 2011. The following combination of terms: “primary,” “spinal,” “epidural,” and “lymphoma” were used. The most significant articles and their bibliographies were analyzed by the authors. The symptoms, pathogenesis, diagnostic workup, histopathology, treatment, and outcome have been analyzed in a systematic manner PMID:22013369

  1. Primary oral health care.

    PubMed

    Honkala, Eino

    2014-01-01

    The aim of this review was to describe the background and evolution of primary oral health care (POHC), including the development of an oral health policy, by identifying the resources necessary for oral health services, reviewing the evidence of the effectiveness of oral health promotion and education, providing essential oral health care, and establishing evidence of the benefits of regular dental visits for effective POHC. At present, evidence for the effectiveness of oral health education and regular dental visits is very weak. Nevertheless, POHC needs to be developed as an integral part of primary health care (PHC). Therefore, a need exists to increase financial investment, resources and workforce in PHC to lower the prevalence of dental caries and periodontal disease in the Middle-East using the POHC approach. PMID:24503932

  2. Primary production: Terrestrial ecosystems

    Microsoft Academic Search

    Helmut Lieth

    1973-01-01

    The history of growth in understanding of primary productivity and in making estimates of biosphere production is reviewed. Two approaches to estimation of land production are discussed. Production may first be estimated by mean values for ecosystem types and the areas of these. A total production of 100×10\\u000a9 tons\\/year is thus estimated for the continents, making up 29% of

  3. Primary testicular lymphoma

    Microsoft Academic Search

    Umberto Vitolo; Andrés J. M. Ferreri; Emanuele Zucca

    2008-01-01

    Primary non-Hodgkin's lymphoma of the testis (PTL) accounts for about 9% of testicular neoplasms and 1–2% of all non-Hodgkin's lymphomas. It is the most common testicular malignancy in elder men. Anecdotal reports associated PTL development with trauma, chronic orchitis, cryptorchidism, or filariasis exist, but no case-control studies have confirmed their etiologic significance. Diffuse large B-cell lymphoma (DLBCL) is the most

  4. Primary Colors of Pigment

    NSDL National Science Digital Library

    In this laboratory activity, students create secondary colors by mixing primary colors. Food coloring, test tubes, and a test tube stand are used. The activity is composed of a student handout with directions and a data sheet. The resource is part of the teacher's guide accompanying the video, NASA Why Files: The Case of the Mysterious Red Light. Lesson objectives supported by the video, additional resources, teaching tips and an answer sheet are included in the teacher's guide.

  5. Primary leptomeningeal plasmablastic lymphoma

    Microsoft Academic Search

    Marlon S. Mathews; Daniela A. Bota; Ronald C. Kim; Anton N. Hasso; Mark E. Linskey

    Lymphomas that develop in human immunodeficiency virus (HIV) infected patients are predominantly aggressive B-cells lymphomas.\\u000a The most common HIV-associated lymphomas include Burkitt lymphoma, diffuse large B-cell lymphoma (that often involves the\\u000a CNS), primary effusion lymphoma, and plasmablastic lymphoma (PBL). Of these, PBL is relatively uncommon and displays a distinct\\u000a affinity for presentation in the oral cavity. In this manuscript we

  6. Acute primary herpetic gingivostomatitis

    PubMed Central

    Mohan, Ravi Prakash Sasankoti; Verma, Sankalp; Singh, Udita; Agarwal, Neha

    2013-01-01

    Herpes simplex virus (HSV) is a double-stranded virus belonging to human herpes virus family. Although it exists in eight various forms, HSV-1 causes most of the oral infections. Since dentists are more likely to be consulted in the case of oral infections, familiarity with these lesions becomes mandatory. It is more commonly reported in children and rarely in adults. This article presents an acute episode of primary herpetic gingivostomatitis in a 32-year-old male patient. PMID:23839615

  7. Primary tunnel junction thermometry.

    PubMed

    Pekola, Jukka P; Holmqvist, Tommy; Meschke, Matthias

    2008-11-14

    We describe the concept and experimental demonstration of primary thermometry based on a four-probe measurement of a single tunnel junction embedded within four arrays of junctions. We show that in this configuration random sample specific and environment-related errors can be avoided. This method relates temperature directly to Boltzmann constant, which will form the basis of the definition of temperature and realization of official temperature scales in the future. PMID:19113365

  8. Primary Tunnel Junction Thermometry

    SciTech Connect

    Pekola, Jukka P.; Holmqvist, Tommy; Meschke, Matthias [Low Temperature Laboratory, Helsinki University of Technology, P.O. Box 3500, 02015 TKK (Finland)

    2008-11-14

    We describe the concept and experimental demonstration of primary thermometry based on a four-probe measurement of a single tunnel junction embedded within four arrays of junctions. We show that in this configuration random sample specific and environment-related errors can be avoided. This method relates temperature directly to Boltzmann constant, which will form the basis of the definition of temperature and realization of official temperature scales in the future.

  9. Primary cilium: an elaborate structure that blocks cell division?

    PubMed

    Ke, Yi-Ni; Yang, Wan-Xi

    2014-09-01

    A primary cilium is a microtubule-based membranous protrusion found in almost all cell types. A primary cilium has a "9+0" axoneme that distinguishes this ancient organelle from the canonical motile "9+2" cilium. A primary cilium is the sensory center of the cell that regulates cell proliferation and embryonic development. The primary ciliary pocket is a specialized endocytic membrane domain in the basal region. The basal body of a primary cilium exists as a form of the centriole during interphase of the cell cycle. Although conventional thinking suggests that the cell cycle regulates centrosomal changes, recent studies suggest the opposite, that is, centrosomal changes regulate the cell cycle. In this regard, centrosomal kinase Aurora kinase A (AurA), Polo-like kinase 1 (Plk1), and NIMA related Kinase (Nek or Nrk) propel cell cycle progression by promoting primary cilia disassembly which indicates a non-mitotic function. However, the persistence of primary cilia during spermatocyte division challenges the dominate idea of the incompatibility of primary cilia and cell division. In this review, we demonstrate the detailed structure of primary cilia and discuss the relationship between primary cilia disassembly and cell cycle progression on the background of various mitotic kinases. PMID:24971504

  10. The Montana Model: Integrated Primary Care and Behavioral Health in a Family Practice Residency Program

    ERIC Educational Resources Information Center

    Oakley, Claire; Moore, Douglas; Burford, Duncan; Fahrenwald, Roxanne; Woodward, Kathryn

    2005-01-01

    To address the local health care needs of both patients and primary care providers in Montana, an integrated primary care and behavioral health family practice clinic was developed. In this paper we describe our experience with integrating mental health and substance abuse services into a primary care setting (a community health center) while…

  11. Primary Care Providers' Perceptions of and Experiences with an Integrated Healthcare Model

    ERIC Educational Resources Information Center

    Westheimer, Joshua M.; Steinley-Bumgarner, Michelle; Brownson, Chris

    2008-01-01

    Objective and Participants: The authors examined the experiences of primary care providers participating in an integrated healthcare service between mental health and primary care in a university health center. In this program, behavioral health providers work collaboratively with primary care providers in the treatment of students. Participants…

  12. Naam: dhr. prof. dr. G.E.H.M. Rutten Leeropdracht Diabetology in Primary Care

    E-print Network

    Utrecht, Universiteit

    Naam: dhr. prof. dr. G.E.H.M. Rutten Profiel Leeropdracht Diabetology in Primary Care Faculteit Medicine Onderdeel Julius Center for Health Sciences and Primary Care Research Contactgegevens Telefoon on diabetes and cardiovascular complications, diabetes primary care and diabetes and clinical infections. He

  13. Integrating Primary Oral Health Care into Primary Care.

    ERIC Educational Resources Information Center

    Isman, Robert E.

    1993-01-01

    Primary oral health care, and the scope of services it includes, are defined. The proposed scope of services is a set of basic dental services used by the Indian Health Service. Policy recommendations for improving the integration of primary oral health services with primary health care and delivery are offered. (Author/MSE)

  14. Neurobiology in primary headaches.

    PubMed

    Edvinsson, Lars; Uddman, Rolf

    2005-06-01

    Primary headaches such as migraine and cluster headache are neurovascular disorders. Migraine is a painful, incapacitating disease that affects a large portion of the adult population with a substantial economic burden on society. The disorder is characterised by recurrent unilateral headaches, usually accompanied by nausea, vomiting, photophobia and/or phonophobia. A number of hypothesis have emerged to explain the specific causes of migraine. Current theories suggest that the initiation of a migraine attack involves a primary central nervous system (CNS) event. It has been suggested that a mutation in a calcium gene channel renders the individual more sensitive to environmental factors, resulting in a wave of cortical spreading depression when the attack is initiated. Genetically, migraine is a complex familial disorder in which the severity and the susceptibility of individuals are most likely governed by several genes that vary between families. Genom wide scans have been performed in migraine with susceptibility regions on several chromosomes some are associated with altered calcium channel function. With positron emission tomography (PET), a migraine active region has been pointed out in the brainstem. In cluster headache, PET studies have implicated a specific active locus in the posterior hypothalamus. Both migraine and cluster headache involve activation of the trigeminovascular system. In support, there is a clear association between the head pain and the release of the neuropeptide calcitonin gene-related peptide (CGRP) from the trigeminovascular system. In cluster headache there is, in addition, release of the parasympathetic neuropeptide vasoactive intestinal peptide (VIP) that is coupled to facial vasomotor symptoms. Triptan administration, activating the 5-HT(1B/1D) receptors, causes the headache to subside and the levels of neuropeptides to normalise, in part through presynaptic inhibition of the cranial sensory nerves. These data suggest a central role for sensory and parasympathetic mechanisms in the pathophysiology of primary headaches. The positive clinical trial with a CGRP receptor antagonist offers a new promising way of treatment. PMID:15914251

  15. Nurturing Second Graders' Literacy and Language Development through Child-Centered versus Curriculum-Centered Experiences.

    ERIC Educational Resources Information Center

    Esch, Gwendolyn C.

    A practicum was designed and implemented to foster 24 second graders' literacy and language development via child-centered as opposed to curriculum-centered experiences. The primary goal was to improve students' quality and quantity of writing by allowing extra time, much exposure to more and various non-basal literature, hands-on activities, and…

  16. Why Mental Health Centers Should Not Do Home-Based Family Centered Services.

    ERIC Educational Resources Information Center

    Leverington, John J.; Bryce, Marvin

    Home Based Family Centered (HBFC) services give primary responsibility for evaluation, service planning, and counseling to the direct service in-home family therapist. In the mental health center (MHC), the psychiatrist may see a child once in the office and make a diagnosis and recommendation for the child, and sometimes for the parents. Also in…

  17. Primary pulmonary nodular amyloidosis.

    PubMed

    Agresta, F; Marin, A; Della Libera, D; Romanzi, F; Ciardo, L F; Bittesini, L; Nardini, S; Bedin, N

    2005-09-01

    Primary nodular amyloidosis of the lung is an uncommon manifestation. The disease runs a benign course, but offers diagnostic problems due to non-specific radiological features entering the big field of the solitary nodule. We describe the case of a 60 year old man with multiple nodules on the left lung operated on diagnostic and therapeutic video-assisted thoracoscopy and discuss the possibilities, if any, of suspecting such a disease through radiologic characteristics along with findings from the patient's history, physical examination and laboratory tests. PMID:16312210

  18. Primary care. Central reservations.

    PubMed

    Pattinson, John

    2003-01-16

    A primary care trust has established a call centre for booking appointments for community services. The service handles bookings for physiotherapy, minor surgery and retinal screening. Since it went live in April 2002, the service has booked 2,000 appointments, reduced waiting times for physiotherapy appointments from 16 to four weeks and cut non-attendance rates from 18 to 2 per cent. It is hoped to increase operating hours to 7.30 pm and extend to cover other services. PMID:12561492

  19. Primary Productivity: Grass

    NSDL National Science Digital Library

    Angela Morrow

    In this activity students will use grass plants grown over a one week period in the classroom to calculate productivity rates using two methods of collection. At the end of this lab students will understand the concept of primary productivity and will have used one or more methods to calculate it. They will have also been introduced to the concepts of standing biomass, net productivity versus gross productivity, and the importance of comparing dry weight versus wet weight. This activity has an accompanying teacher site with hints and more information. There are also links to several other sites with more information on this topic.

  20. PATTERNS OF PRIMARY MOULT IN

    E-print Network

    de Villiers, Marienne

    biometrics and primary moult in Namibia ............ 55 Chapter 4 The Red-billed Quelea in southern Africa and Southern Masked Weavers in southern Africa species, migration. Ringers in southern Africa have been submitting primary moult data to SAFRING

  1. Triple synchronous primary lung cancer.

    PubMed

    Zardo, Patrick; Krüer, Thomas; Schiffmann, Stefan; Freermann, Stefan; Fischer, Stefan

    2014-09-01

    Synchronous multiple primary lung cancer is rare and difficult to differentiate from metastatic disease. State-of-the-art diagnostic tools may contribute to discern synchronous multiple primary lung cancer from lung cancer or other primary tumors with pulmonary metastases, thus allowing implementation of curative strategies. We report the case of a 72-year-old woman with 3 synchronous primary lung cancers. PMID:24887854

  2. Solid Medical Waste Management in Healthcare Centers in Palestine

    Microsoft Academic Search

    Issam A. Al-Khatib; Mohamed Abu-Dayah; Hussein Hajjeh; Tayseer Al-Shanbleh

    \\u000a This chapter discusses the current situation of solid waste management in healthcare centers in Palestine. The monthly estimated\\u000a quantity of solid waste produced by the healthcare centers in Palestine was 472.9 tons. There is very little separation of\\u000a solid waste in primary healthcare centers (38.1%) as compared to secondary healthcare centers (71%). Only 17.3% of the healthcare\\u000a centers in Palestine

  3. Angiogenesis in primary hyperparathyroidism.

    PubMed

    Segiet, Oliwia Anna; Michalski, Marek; Brzozowa-Zasada, Marlena; Piecuch, Adam; ?aba, Ma?gorzata; Helewski, Krzysztof; Gabriel, Andrzej; Wojnicz, Romuald

    2015-04-01

    Angiogenesis can be described as a formation of new vessels from the existing microvasculature and is a process of great importance to the tumor development. Parathyroid tissue can trigger spontaneous induction of angiogenesis in vitro and in vivo models in a vascular endothelial growth factor (VEGF)-dependent manner. Autotransplantated parathyroid tissue after thyroidectomy is able to form new vasculature and produce parathormone, maintaining calcium homeostasis. A great amount of factors contributes to the process of new vessel formation in primary hyperparathyroidism, such as VEGF, transforming growth factor ?, and angiopoietins. Studies demonstrated that markers for angiogenesis can be useful in distinguishing between parathyroid hyperplasia and neoplasia, due to the increased angiogenesis in parathyroid proliferative lesions compared with parathyroid adenomas. These factors include, inter alia, VEGF, VEGFR2, CD105, and fibroblast growth factor-2. Although these differences appear promising in the differential diagnosis, there is an overlap between benign and malignant parathyroid lesions and there is no definite cutoff value. Loss of heterozygosity and comparative genomic hybridization studies revealed chromosomal regions frequently altered in parathyroid tumorigenesis at 9p21, 1p21-22, 1p35-36, and 11q13. Therefore, immunohistochemistry and genetic testing should be an additional diagnostic marker in combination with the traditional criteria. A better understanding of angiogenesis in primary hyperparathyroidism could result in more precise assessment of diagnosis and more effective treatment, especially in those cases, in which the commonly used parameters are insufficient. PMID:25648902

  4. Primary testicular lymphoma.

    PubMed

    Vural, Filiz; Cagirgan, Seckin; Saydam, Guray; Hekimgil, Mine; Soyer, Nur Akad; Tombuloglu, Murat

    2007-11-01

    We evaluated clinical features, management and survival of 12 patients with primary testicular non-Hodgkin's lymphoma presented to our hematology unit between January 1992 and July 2006, retrospectively. The median age of patients was 47 years at presentation (range 29-78 years) and > 80% of them were < 50 years old. In the majority of cases, orchidectomy was performed as diagnostic and first-line therapeutic procedures. Dominant histological subtype was diffuse large B-cell non-Hodgkin's lymphoma. Seven patients out of 12 (58%) were Ann Arbor stages I and II, and the remaining five patients (42%) were stages III and IV. All the patients received doxorubicin-based chemotherapy and achieved complete remission. The addition of rituximab and central nervous system prophylaxis with intrathecal combined chemotherapy containing methotrexate, cytarabine and dexametasone were applied to three patients who were recently admitted. The rate of relapse was 8% and progression-free survival (PFS) at 10 years was 88%. Median duration of response was 84 months (range 14-173 months), median 97.5 months of follow-up. All patients are alive and in case remission. Because of the spreading nature and relapse probability at different sites, including central nervous system and contralateral testis, systemic treatment with doxorubicin-based chemotherapy with or without prophylaxis for contralateral testis and the central nervous system seems to improve the outcome of primary testicular lymphoma. PMID:18020104

  5. Primary leptomeningeal plasmablastic lymphoma.

    PubMed

    Mathews, Marlon S; Bota, Daniela A; Kim, Ronald C; Hasso, Anton N; Linskey, Mark E

    2011-09-01

    Lymphomas that develop in human immunodeficiency virus (HIV) infected patients are predominantly aggressive B-cells lymphomas. The most common HIV-associated lymphomas include Burkitt lymphoma, diffuse large B-cell lymphoma (that often involves the CNS), primary effusion lymphoma, and plasmablastic lymphoma (PBL). Of these, PBL is relatively uncommon and displays a distinct affinity for presentation in the oral cavity. In this manuscript we report a previously undescribed primary leptomeningeal form of PBL in a patient with acquired immunodeficiency syndrome. A 40-year-old HIV positive man presented with acute onset confusion, emesis, and altered mental status. Lumbar puncture showed numerous nucleated cells with atypical plasmocyte predominance. CSF flowcytometry showed kappa restriction with CD8 and CD38 positivity and negative lymphocyte markers, while the MRI showed diffuse leptomeningeal enhancement. As the extensive systemic work-up failed to reveal any disease outside the brain, an en bloc diagnostic brain and meningeal biopsy was performed. The biopsy specimen showed sheets of plasmacytoid cells with one or more large nuclei, prominent nuclear chromatin, scattered mitoses, and abundant cytoplasm, highly suggestive of plasmablastic lymphoma. HIV-associated malignancies have protean and often confusing presentations, which pose diagnostic difficulties posed to the practicing neurological-surgeons. Even in cases where an infectious cause is suspected for the meningeal enhancement, neoplastic involvement should be considered, and cytology and flow-cytometry should be routinely ordered on the CSF samples. PMID:21359853

  6. Professional Issues for Primary Teachers

    ERIC Educational Resources Information Center

    Browne, Ann, Ed.; Haylock, Derek, Ed.

    2004-01-01

    This book is intended to be a contribution to raising the awareness of primary teachers and trainee teachers as to what is involved in all the different professional dimensions of their work in schools. The book deals with the key professional issues in primary teaching that are addressed in primary teacher training courses. The book aims to…

  7. Primary Aluminum Plants Worldwide - 1998

    USGS Publications Warehouse

    1999-01-01

    The 1990 U.S. Bureau of Mines publication, Primary Aluminum Plants Worldwide, has been updated and is now available. The 1998 USGS edition of Primary Aluminum Plants Worldwide is published in two parts. Part I—Detail contains information on individual primary smelter capacity, location, ownership, sources of energy, and other miscellaneous information. Part II—Summary summarizes the capacity data by country

  8. Primary Teacher Education in Malaysia

    ERIC Educational Resources Information Center

    Ching, Chin Phoi; Yee, Chin Peng

    2012-01-01

    In Malaysia the training of primary school teachers is solely carried out by teacher training institutes which offer the Bachelor of Teaching with Honors (Primary education) program and was first launched in 2007. This program prepares primary school teachers specializing in various subjects or major and is carried out in 27 teacher training…

  9. Clinical Psychology Center Center Review Recommendation

    E-print Network

    Vonessen, Nikolaus

    through annual audits and performance evaluations." Comments: The Clinical Psychology Center's dedicationClinical Psychology Center Center Review Recommendation B. Review and Approval Process 2 to address issues of common interest. The purpose of the Clinical Psychology Center (CPC) is to serve

  10. STRONG FERTILITY CENTER Strong Fertility Center

    E-print Network

    Goldman, Steven A.

    STRONG FERTILITY CENTER Strong Fertility Center Women's Lifestyle Center The Women's Lifestyle with the improved lifestyle. Also, we work together with the Strong Fertility Center to coordinate your fertility fertility treatments. · A complete nutritional consultation with our registered dietician, Tracy Cherry, RD

  11. TPMG Northern California Appointments and Advice Call Center

    Microsoft Academic Search

    Patricia Conolly; Leslie Levine; Debra J. Amaral; Bruce H. Fireman; Tom Driscoll

    2005-01-01

    Kaiser Permanente (KP) has been developing its use of call centers as a way to provide an expansive set of healthcare services to KP members efficiently and cost effectively. Since 1995, when The Permanente Medical Group (TPMG) began to consolidate primary care phone services into three physical call centers, the TPMG Appointments and Advice Call Center (AACC) has become the

  12. Primary thrombocytosis in children.

    PubMed

    Kucine, Nicole; Chastain, Katherine M; Mahler, Michelle B; Bussel, James B

    2014-04-01

    Myeloproliferative neoplasms are uncommon disorders in children, for which we have limited understanding of the pathogenesis and optimal management. JAK2 and MPL mutations, while common drivers of myeloproliferative neoplasms in adult patients, are not clearly linked to pediatric disease. Management and clinical outcomes in adults have been well delineated with defined recommendations for risk stratification and treatment. This is not the case for pediatric patients, for whom there is neither a standard approach to workup nor any consensus regarding management. This review will discuss thrombocytosis in children, including causes of thrombocytosis in children, the limited knowledge we have regarding pediatric primary thrombocytosis, and our thoughts on potential risk stratification and management, and future questions to be answered by laboratory research and collaborative clinical study. PMID:24688110

  13. Primary thrombocytosis in children

    PubMed Central

    Kucine, Nicole; Chastain, Katherine M.; Mahler, Michelle B.; Bussel, James B.

    2014-01-01

    Myeloproliferative neoplasms are uncommon disorders in children, for which we have limited understanding of the pathogenesis and optimal management. JAK2 and MPL mutations, while common drivers of myeloproliferative neoplasms in adult patients, are not clearly linked to pediatric disease. Management and clinical outcomes in adults have been well delineated with defined recommendations for risk stratification and treatment. This is not the case for pediatric patients, for whom there is neither a standard approach to workup nor any consensus regarding management. This review will discuss thrombocytosis in children, including causes of thrombocytosis in children, the limited knowledge we have regarding pediatric primary thrombocytosis, and our thoughts on potential risk stratification and management, and future questions to be answered by laboratory research and collaborative clinical study. PMID:24688110

  14. [Primary prevention of osteopenia].

    PubMed

    Falkenbach, A

    1992-11-01

    In industrialized countries the clinical and socioeconomic importance of osteoporosis has been well recognized in recent years. Various treatments have been introduced for secondary prevention in established osteoporosis. There is, however, a deficit in the primary prevention of osteopenia. In every age group physical exercise stimulates mineralization of the bone. With regular training adolescents can achieve a higher peak bone mass. In old age the physiologic decrease of bone mass can be retarded by physical exercise. A diet rich in calcium has positive effects on mineralization of the bone. Estrogens have proved efficacious in the prevention of osteoporosis in postmenopausal women. Abstinence from nicotine and alcohol contributes to the prevention of osteopenia. PMID:1439691

  15. Primary testicular lymphoma.

    PubMed

    Vitolo, Umberto; Ferreri, Andrés J M; Zucca, Emanuele

    2008-02-01

    Primary non-Hodgkin's lymphoma of the testis (PTL) accounts for about 9% of testicular neoplasms and 1-2% of all non-Hodgkin's lymphomas. It is the most common testicular malignancy in elder men. Anecdotal reports associated PTL development with trauma, chronic orchitis, cryptorchidism, or filariasis exist, but no case-control studies have confirmed their etiologic significance. Diffuse large B-cell lymphoma (DLBCL) is the most common histotype in primary forms; aggressive histologies, especially Burkitt's lymphoma, are prevalent in cases of secondary involvement of testis. The most common clinical presentation is a unilateral painless scrotal swelling, sometimes with sharp scrotal pain or hydrocele. Systemic B symptoms are present in 25-41% of patients with advanced stage. Less frequently, abdominal pain, and ascites can be seen in patients with involvement of retroperitoneal lymph nodes. Bilateral testicular involvement is detected in up to 35% of patients. Although good results with doxorubicin-containing chemotherapy, followed or not by radiotherapy, have been reported, a high proportion of patients with stage I-II diseases experience aggressive relapses, and patients with advanced disease have a very poor prognosis. PTL has a propensity to disseminate to other extranodal organs, including the controlateral testis, CNS, skin, Waldeyer's ring, lung, pleura, and soft tissue. Orchidectomy followed by R-CHOP combination, with CNS prophylaxis, and prophylactic irradiation of the contralateral testis is the recommended first-line treatment for patients with limited disease. Management of patients with advanced or relapsed disease should follow the worldwide recommendations for nodal DLBCL. PMID:17962036

  16. Central microtubular agenesis causing primary ciliary dyskinesia.

    PubMed

    Stannard, Wendy; Rutman, Andrew; Wallis, Colin; O'Callaghan, Chris

    2004-03-01

    Primary ciliary dyskinesia is an autosomal recessive disorder characterized by chronic upper and lower respiratory tract symptoms. We report the diagnosis of primary ciliary dyskinesia associated with a circular ciliary beat pattern in three siblings. This beat pattern is consistent with a ciliary transposition defect, where a peripheral microtubule doublet is transposed to the center of the ciliary axoneme to replace the absent central microtubule pair. However, in these siblings, ultrastructural analysis of the cilia revealed an absence of the central microtubule pair only. This variant of transposition with a circular ciliary beat pattern has not been described previously. In addition, this defect, together with the transposition defect, may help explain the mechanism of the circular beat pattern and also the absence of situs inversus in these patients. PMID:14982824

  17. James Webb Space Telescope Primary Mirror Manufacturing

    NASA Astrophysics Data System (ADS)

    Lightsey, Paul; Gallagher, B.; Chaney, D.; Brown, B.

    2009-01-01

    The James Webb Space Telescope has a segmented primary mirror consisting of 18 hexagonal beryllium primary mirror segment assemblies (PMSA) that have a total collecting area greater than 25 square meters. The PMSAs are designed to operate at cryogenic temperatures (39 K) and to be actively controlled to co-phase the segments. This paper discusses the processes and testing utilized in the manufacture of these mirrors including the critical cryogenic testing performed at the XRCF facility at the NASA Marshall Space Flight Center. The manufacturing team is headed by Ball Aerospace & Technologies Corp (BATC) with support from Brush Wellman for beryllium blank fabrication, Axsys Technologies for the precision machining, L3-Tinsley for the mirror polishing, and QCI for the reflective coating application.

  18. Primary auditory cortex of cats: feature detection or something else?

    PubMed

    Nelken, Israel; Fishbach, Alon; Las, Liora; Ulanovsky, Nachum; Farkas, Dina

    2003-11-01

    Neurons in sensory cortices are often assumed to be "feature detectors", computing simple and then successively more complex features out of the incoming sensory stream. These features are somehow integrated into percepts. Despite many years of research, a convincing candidate for such a feature in primary auditory cortex has not been found. We argue that feature detection is actually a secondary issue in understanding the role of primary auditory cortex. Instead, the major contribution of primary auditory cortex to auditory perception is in processing previously derived features on a number of different timescales. We hypothesize that, as a result, neurons in primary auditory cortex represent sounds in terms of auditory objects rather than in terms of feature maps. According to this hypothesis, primary auditory cortex has a pivotal role in the auditory system in that it generates the representation of auditory objects to which higher auditory centers assign properties such as spatial location, source identity, and meaning. PMID:14669020

  19. Mississippi Technology Transfer Center

    NASA Technical Reports Server (NTRS)

    1987-01-01

    The Mississippi Technology Transfer Center at the John C. Stennis Space Center in Hancock County, Miss., was officially dedicated in 1987. The center is home to several state agencies as well as the Center For Higher Learning.

  20. Transplant Center Search Form

    MedlinePLUS

    - A + A Transplant Center Search Form Welcome to the Blood & Marrow Transplant Information Network's Transplant Center Search Form. Here you will ... transplant centers for patients with a particular disease. Transplant Center login Username: * Password: * Request new password BMT ...

  1. Sporadic Jakob-Creutzfeldt Disease Presenting as Primary Progressive Aphasia

    PubMed Central

    Johnson, David Y.; Dunkelberger, Diana L.; Henry, Maya; Haman, Aissatou; Greicius, Michael D.; Wong, Katherine; DeArmond, Stephen J.; Miller, Bruce L.; Gorno-Tempini, Maria Luisa; Geschwind, Michael D.

    2015-01-01

    Objective To report the clinical, neuropsychological, linguistic, imaging, and neuropathological features of a unique case of sporadic Jakob-Creutzfeldt disease in which the patient presented with a logopenic variant of primary progressive aphasia. Design Case report. Setting Large referral center for atypical memory and aging disorders, particularly Jakob-Creutzfeldt disease. Patient Patient presenting with logopenic variant primary progressive aphasia initially thought to be due to Alzheimer disease. Results Despite the long, slow 3.5-year course, the patient was shown to have pathology-proven sporadic Jakob-Creutzfeldt disease. Conclusions These findings expand the differential of primary progressive aphasia to include prion disease. PMID:23400721

  2. Primary prevention of type 2 diabetes: integrative public health and primary care opportunities, challenges and strategies.

    PubMed

    Green, Lawrence W; Brancati, Frederick L; Albright, Ann

    2012-04-01

    Type 2 diabetes imposes a large and growing burden on the public's health. This burden, combined with the growing evidence for primary prevention from randomized controlled trials of structured lifestyle programs leads to recommendations to include caloric reduction, increased physical activity and specific assistance to patients in problem solving to achieve modest weight loss as well as pharmacotherapy. These recommendations demand exploration of new ways to implement such primary prevention strategies through more integrated community organization, medical practice and policy. The US experience with control of tobacco use and high blood pressure offers valuable lessons for policy, such as taxation on products, and for practice in a variety of settings, such as coordination of referrals for lifestyle supports. We acknowledge also some notable exceptions to their generalizability. This paper presents possible actions proposed by an expert panel, summarized in Table 1 as recommendations for immediate action, strategic action and research. The collaboration of primary care and public health systems will be required to make many of these recommendations a reality. This paper also provides information on the progress made in recent years by the Division of Diabetes Translation at the US Centers for Disease Control and Prevention (CDC) to implement or facilitate such integration of primary care and public health for primary prevention. PMID:22399542

  3. Expression profiling of Dexamethasone-treated primary chondrocytes identifies targets of glucocorticoid signalling in endochondral bone development

    PubMed Central

    James, Claudine G; Ulici, Veronica; Tuckermann, Jan; Underhill, T Michael; Beier, Frank

    2007-01-01

    Background Glucocorticoids (GCs) are widely used anti-inflammatory drugs. While useful in clinical practice, patients taking GCs often suffer from skeletal side effects including growth retardation in children and adolescents, and decreased bone quality in adults. On a physiological level, GCs have been implicated in the regulation of chondrogenesis and osteoblast differentiation, as well as maintaining homeostasis in cartilage and bone. We identified the glucocorticoid receptor (GR) as a potential regulator of chondrocyte hypertrophy in a microarray screen of primary limb bud mesenchyme micromass cultures. Some targets of GC regulation in chondrogenesis are known, but the global effects of pharmacological GC doses on chondrocyte gene expression have not been comprehensively evaluated. Results This study systematically identifies a spectrum of GC target genes in embryonic growth plate chondrocytes treated with a synthetic GR agonist, dexamethasone (DEX), at 6 and 24 hrs. Conventional analysis of this data set and gene set enrichment analysis (GSEA) was performed. Transcripts associated with metabolism were enriched in the DEX condition along with extracellular matrix genes. In contrast, a subset of growth factors and cytokines were negatively correlated with DEX treatment. Comparing DEX-induced gene expression data to developmental changes in gene expression in micromass cultures revealed an additional layer of complexity in which DEX maintains the expression of certain chondrocyte marker genes while inhibiting factors that promote vascularization and ultimately ossification of the cartilaginous template. Conclusion Together, these results provide insight into the mechanisms and major molecular classes functioning downstream of DEX in primary chondrocytes. In addition, comparison of our data with microarray studies of DEX treatment in other cell types demonstrated that the majority of DEX effects are tissue-specific. This study provides novel insights into the effects of pharmacological GC on chondrocyte gene transcription and establishes the foundation for subsequent functional studies. PMID:17603917

  4. Primary progressive aphasia

    PubMed Central

    Mesulam, Marsel

    2014-01-01

    Primary progressive aphasia (PPA) is a clinical syndrome diagnosed when three core criteria are met. First, there should be a language impairment (i.e., aphasia) that interferes with the usage or comprehension of words. Second, the neurological work-up should determine that the disease is neurodegenerative, and therefore progressive. Third, the aphasia should arise in relative isolation, without equivalent deficits of comportment or episodic memory. The language impairment can be fluent or non-fluent and may or may not interfere with word comprehension. Memory for recent events is preserved although memory scores obtained in verbally mediated tests may be abnormal. Minor changes in personality and behavior may be present but are not the leading factors that bring the patient to medical attention or that limit daily living activities. This distinctive clinical pattern is most conspicuous in the initial stages of the disease, and reflects a relatively selective atrophy of the language network, usually located in the left hemisphere. There are different clinical variants of PPA, each with a characteristic pattern of atrophy. The underlying neuropathological diseases are heterogeneous and can include Alzheimer’s disease as well as frontotemporal lobar degeneration. The clinician’s task is to recognize PPA and differentiate it from other neurodegenerative phenotypes, use biomarkers to surmise the nature of the underlying neuropathology, and institute the most fitting multimodal interventions. PMID:24707349

  5. Autoimmune primary ovarian insufficiency.

    PubMed

    Silva, C A; Yamakami, L Y S; Aikawa, N E; Araujo, D B; Carvalho, J F; Bonfá, E

    2014-01-01

    Primary ovarian insufficiency (POI) is defined as sustained amenorrhea, increased follicle-stimulating hormone and low estrogen levels, whereas diminished ovarian reserve (DOR) is characterized as regular menses and alterations of ovarian reserve tests. POI of autoimmune origin may be associated with adrenal autoimmunity, non-adrenal autoimmunity or isolated. This autoimmune disease is characterized by serum ovarian, adrenocortical or steroidogenic cell autoantibodies. POI of adrenal autoimmune origin is the most frequent type observed in 60-80% of patients. Clinically, amenorrhea is the hallmark of POI, however before menstruation stops completely, irregular cycles occur. Infertility, hot flushes, vaginal atrophy, and dyspareunia are also common. Autoimmune oophoritis is characterized by mononuclear inflammatory cell infiltrate in the theca cells of growing follicles, with early stage follicles without lymphocytic infiltration. This infiltrate includes plasma, B and T-cells. A novel classification criterion for autoimmune POI/DOR is proposed subdividing in three distinct categories (possible, probable and confirmed) according to autoantibodies, autoimmune disease and ovarian histology. Unfortunately, up to date guidelines for the treatment of autoimmune oophoritis are not available. Strategies to POI treatment include hormone replacement and infertility therapy. Assisted conception with donated oocytes has been proven to achieve pregnancy by intra cytoplasmic sperm injection in POI women. PMID:24418305

  6. Primary gastrointestinal lymphoma

    PubMed Central

    Ghimire, Prasanna; Wu, Guang-Yao; Zhu, Ling

    2011-01-01

    Gastrointestinal tract is the most common extranodal site involved by lymphoma with the majority being non-Hodgkin type. Although lymphoma can involve any part of the gastrointestinal tract, the most frequent sites in order of its occurrence are the stomach followed by small intestine and ileocecal region. Gastrointestinal tract lymphoma is usually secondary to the widespread nodal diseases and primary gastrointestinal tract lymphoma is relatively rare. Gastrointestinal lymphomas are usually not clinically specific and indistinguishable from other benign and malignant conditions. Diffuse large B-cell lymphoma is the most common pathological type of gastrointestinal lymphoma in essentially all sites of the gastrointestinal tract, although recently the frequency of other forms has also increased in certain regions of the world. Although some radiological features such as bulky lymph nodes and maintenance of fat plane are more suggestive of lymphoma, they are not specific, thus mandating histopathological analysis for its definitive diagnosis. There has been a tremendous leap in the diagnosis, staging and management of gastrointestinal lymphoma in the last two decades attributed to a better insight into its etiology and molecular aspect as well as the knowledge about its critical signaling pathways. PMID:21390139

  7. Air Risk Information Support Center

    SciTech Connect

    Shoaf, C.R.; Guth, D.J. [Environmental Protection Agency, Washington, DC (United States)

    1990-12-31

    The Air Risk Information Support Center (Air RISC) was initiated in early 1988 by the US Environmental Protection Agency`s (EPA) Office of Health and Environmental Assessment (OHEA) and the Office of Air Quality Planning and Standards (OAQPS) as a technology transfer effort that would focus on providing information to state and local environmental agencies and to EPA Regional Offices in the areas of health, risk, and exposure assessment for toxic air pollutants. Technical information is fostered and disseminated by Air RISCs three primary activities: (1) a {open_quotes}hotline{close_quotes}, (2) quick turn-around technical assistance projects, and (3) general technical guidance projects. 1 ref., 2 figs.

  8. Advances in primary writing tremor.

    PubMed

    Hai, Chen; Yu-ping, Wang; Hua, Wei; Ying, Sun

    2010-11-01

    Primary writing tremor (PWT) is considered to be a type of task-specific tremor in which tremor predominantly occurs and interferes with handwriting. The pathophysiology of PWT is not clear. Primary writing tremor may be a variant of essential tremor, a type of focal dystonia such as writer's cramp, or a separate nosological entity. Botulinum toxin injections and deep brain stimulation may be treatment choices for primary writing tremor. PMID:20630791

  9. Center for International Development at Harvard University

    NSDL National Science Digital Library

    Established in 1998 by the Harvard Institute for International Development and the Kennedy School of Government, the Center for International Development (CID) is Harvard's primary center for research on sustainable international development. The CID is currently headed by Professor Dani Rodrik, who provides oversight and direction for the Center. On the site, visitors can learn about upcoming international development conferences sponsored by the Center, read about the various persons working at the Center, learn about various research programs, along with reading various reports associated with each area of inquiry. The site also contains a host of links to online research data sets for persons working in the field of international development, and to the Center's working papers and special reports. Some of the more compelling working papers address the situation of sustainable development in sub-Saharan Africa and the rise and fall of the Indonesian economy.

  10. University of Texas Health Science Center, Houston

    Cancer.gov

    The primary project is to focus upon translation of imaging agents and devices developed at The Baylor College of Medicine (BCM) and translated in Phase I studies at The Michael E. DeBakey Veterans Administration Medical Center (MEDVAMC) as well as at Ben Taub General Hospital (BTGH).

  11. Invitation to Learning: The Learning Center Handbook.

    ERIC Educational Resources Information Center

    Voight, Ralph Claude

    This book is intended as a guide for teachers who want a practical aid to individualization of learning. Its primary focus is on the specific steps needed to implement learning centers. This includes planning, scheduling, teacher-student relationships, student evaluation, and finding and using materials. The book is divided into four sections.…

  12. Seattle Opportunities Industrialization Center. Final Report.

    ERIC Educational Resources Information Center

    Opportunities Industrialization Center, Inc., Seattle, WA.

    The goals of the Opportunities Industrialization Center organization in Seattle include providing hope for impoverished and hard-core unemployed in the form of job preparation by providing adult education, pre-vocational training, skills training, counseling, job development, placement and followup. Another primary goal of OIC is providing and…

  13. New England Instructional Television Research Center (NETREC).

    ERIC Educational Resources Information Center

    Friedlander, Bernard Z.; Wetstone, Harriet S.

    Projects of the New England Instructional Television Research Center (NITREC) are summarized in a collection of papers. Objectives, rationale, and program of NETREC are defined, along with methods of formative evaluation during production. Seven videotest research projects cover methods of evaluating communicative effectiveness of primary-grade…

  14. Technology Transfer Center | Competitive Service Center

    Cancer.gov

    The Technology Transfer Center (TTC) is a designated Competitive Service Center (CSC) for technology transfer to other NIH Institutes and Centers (ICs). The CSC at TTC offers a range of services and works with each client IC to determine the IC's unique technology transfer needs.

  15. Goddard Space Flight Center- Visitor Center

    NSDL National Science Digital Library

    The homepage of the Visitor Center at Goddard Space Flight Center provides access to a variety of information about the history, missions, and upcoming events at the center. Users can find information on public exhibits, educational resources, and programs on space and Earth science and technology.

  16. The National Lending Library: Information Resource Center Extraordinaire

    ERIC Educational Resources Information Center

    Peck, Theodore P.

    1973-01-01

    This article provides a brief glimpse of the National Lending Library at Boston Spa in Yorkshire which is the primary bibliographic resource center for science and technology in Great Britain. (Author)

  17. Primary biliary cirrhosis

    PubMed Central

    Kumagi, Teru; Heathcote, E Jenny

    2008-01-01

    Primary biliary cirrhosis (PBC) is a chronic and slowly progressive cholestatic liver disease of autoimmune etiology characterized by injury of the intrahepatic bile ducts that may eventually lead to liver failure. Affected individuals are usually in their fifth to seventh decades of life at time of diagnosis, and 90% are women. Annual incidence is estimated between 0.7 and 49 cases per million-population and prevalence between 6.7 and 940 cases per million-population (depending on age and sex). The majority of patients are asymptomatic at diagnosis, however, some patients present with symptoms of fatigue and/or pruritus. Patients may even present with ascites, hepatic encephalopathy and/or esophageal variceal hemorrhage. PBC is associated with other autoimmune diseases such as Sjogren's syndrome, scleroderma, Raynaud's phenomenon and CREST syndrome and is regarded as an organ specific autoimmune disease. Genetic susceptibility as a predisposing factor for PBC has been suggested. Environmental factors may have potential causative role (infection, chemicals, smoking). Diagnosis is based on a combination of clinical features, abnormal liver biochemical pattern in a cholestatic picture persisting for more than six months and presence of detectable antimitochondrial antibodies (AMA) in serum. All AMA negative patients with cholestatic liver disease should be carefully evaluated with cholangiography and liver biopsy. Ursodeoxycholic acid (UDCA) is the only currently known medication that can slow the disease progression. Patients, particularly those who start UDCA treatment at early-stage disease and who respond in terms of improvement of the liver biochemistry, have a good prognosis. Liver transplantation is usually an option for patients with liver failure and the outcome is 70% survival at 7 years. Recently, animal models have been discovered that may provide a new insight into the pathogenesis of this disease and facilitate appreciation for novel treatment in PBC. PMID:18215315

  18. Primary hyperparathyroidism and osteoporosis.

    PubMed

    Mazzuoli, G F; D'Erasmo, E; Pisani, D

    1998-06-01

    Primary hyperparathyroidism (PHPT) is considered a cause of secondary osteoporosis as a consequence of its known catabolic effect promoting osteoclast activity and bone resorption. However, recent in vitro and in vivo studies have shown that parathyroid hormone (PTH) may also have an anabolic effect on the mammalian skeleton. These two paradoxical effects of parathyroid hormone are discussed in the light of recent results of basic research, and of bone densitometric and histomorphometric data collected in patients affected by PHPT. Review of the literature leads to the conclusion that in PHPT skeletal damage involves prevalently cortical bone, while the mineral content of trabecular bone is preserved or even increased. On the basis of bone mineral density (BMD) measurements, osteoporosis prevalence in the early postmenopausal period seems to be significantly higher in women affected by PHPT than in the general population. As age progresses, osteoporosis prevalence seems to decrease in PHPT, while it increases exponentially with age in the general population. Similarly in PHPT, vertebral and appendicular fractures occur prevalently in the earlier decades of life with a higher frequency than in normal subjects, while with advancing age the fracture incidence becomes equal to that of the general population. When bone density is measured in lateral projection at lumbar level, BMD values in patients with mild asymptomatic PHPT are significantly higher than in controls. We conclude that PTH hypersecretion may represent a risk factor for osteoporosis and fractures in the young and in the early postmenopausal period, while it may have a protective effect on trabecular bone in elderly postmenopausal women. PMID:9801732

  19. General Information about Adult Primary Liver Cancer

    MedlinePLUS

    ... General Information About Adult Primary Liver Cancer Key Points Adult primary liver cancer is a disease in ... liver. Stages of Adult Primary Liver Cancer Key Points After adult primary liver cancer has been diagnosed, ...

  20. Stages of Adult Primary Liver Cancer

    MedlinePLUS

    ... General Information About Adult Primary Liver Cancer Key Points Adult primary liver cancer is a disease in ... liver. Stages of Adult Primary Liver Cancer Key Points After adult primary liver cancer has been diagnosed, ...

  1. Uterine artery embolization for primary postpartum hemorrhage

    PubMed Central

    Kim, Tae-Hee; Lee, Hae-Hyeog; Kim, Jun-Mo; Ryu, Ae-Li; Chung, Soo-Ho; Seok Lee, Woo

    2013-01-01

    Background: Postpartum hemorrhage is the leading cause of severe maternal morbidity and death. A prompt management of uterine artery embolization (UAE) is important for a good outcome. UAE is generally accepted to be a safe and reliable procedure. Objective: To estimate critical patient characteristics influencing the success of UAE for the treatment of emergent primary postpartum hemorrhage. Materials and Methods: This was a cross sectional study that reviewed 121 patients who were diagnosed primary postpartum hemorrhage between February 2002 and December 2009 at a tertiary treatment center among 4,022 deliveries. We evaluated patient clinical characteristics associated with a successful surgical outcome of UAE. Results: The success rate for UAE was 96%. For two cases, UAE complication was associated with fever (>38.5oC). Five patients had problems that required admission to the intensive care unit (ICU). Conclusion: To increase the surgical success rate and lower the number of ICU admissions, the decision to treat primary postpartum hemorrhage using UAE should be based on individual patient clinical findings under the direction of obstetrics staff and an interventional radiologist. PMID:24639786

  2. PRIMARY STRESS ASSIGNMENT IN ITALIAN

    E-print Network

    Paris-Sud XI, Université de

    PRIMARY STRESS ASSIGNMENT IN ITALIAN: LINGUISTIC AND EXPERIMENTAL ISSUES HÉLČNE GIRAUDO * FABIO MONTERMINI * 1. INTRODUCTION Primary stress assignment is a recurrent open issue in the literature on Italian phonology. One of the most controversial points concerns the lexical vs. regular nature of stress

  3. Learning outside the Primary Classroom

    ERIC Educational Resources Information Center

    Sedgwick, Fred

    2012-01-01

    In "Learning Outside the Primary Classroom," the educationalist and writer Fred Sedgwick explores in a practical way the many opportunities for intense learning that children and teachers can find outside the confines of the usual learning environment, the classroom. This original work is based on tried and tested methods from UK primary schools.…

  4. Cancer of unknown primary (CUP)

    Microsoft Academic Search

    Nicholas Pavlidis; Karim Fizazi

    2005-01-01

    Carcinoma of unknown primary (CUP) is one of the 10 most frequent cancers worldwide. It constitutes 3–5% of all human malignancies. Patients with CUP present with metastases without an established primary site. CUP manifests as an heterogenous group of mainly epithelial cancers recognised by distinct clinicopathological entities. The diagnostic work-up includes extensive histopathology investigations and modern imaging technology. Nevertheless, the

  5. Original article Vegetative development, primary

    E-print Network

    Paris-Sud XI, Université de

    , primary growth of main axes was continuous, but the rates of shoot elongation and leaf emer- gence trees. It is sug- gested that the particular growth features of this species are relatedOriginal article Vegetative development, primary and secondary growth of the shoot system of young

  6. Primary Components of Binomial Ideals

    E-print Network

    Eser, Zekiye

    2014-07-11

    their primary components explicitly. An ideal I ? k[x_(1),….x_(n) ] is cellular if every variable is either a nonzerodivisor modulo I or is nilpotent modulo I. We characterize the minimal primary components of cellular binomial ideals explicitly. Another...

  7. Primary Components of Binomial Ideals 

    E-print Network

    Eser, Zekiye

    2014-07-11

    their primary components explicitly. An ideal I ? k[x_(1),….x_(n) ] is cellular if every variable is either a nonzerodivisor modulo I or is nilpotent modulo I. We characterize the minimal primary components of cellular binomial ideals explicitly. Another...

  8. Clinicopathologic Correlates of Primary Aldosteronism.

    PubMed

    Duan, Kai; Mete, Ozgur

    2015-07-01

    Primary aldosteronism is the most common cause of secondary hypertension, incurring significant cardiovascular morbidity and mortality. Our understanding of this disease has evolved substantially during the past decade. Recently, the molecular basis of primary aldosteronism has begun to be unraveled, with the discovery of mutations in potassium channel (KCNJ5), ATPases (ATP1A1, ATP2B3), and calcium channel (CACNA1D), and aberrant Wnt/?-catenin signaling. The most recent data suggest that 95% of cases are sporadic, whereas 5% of cases are hereditary. Pathologic correlates of primary aldosteronism include adrenal cortical hyperplasia, adenoma, and carcinoma. Although the most common clinical presentation is bilateral adrenal cortical hyperplasia, this entity is usually treated medically. Therefore, in the setting of primary aldosteronism, surgical pathologists are most commonly exposed to adrenocortical adenomas and the odd occasional carcinoma. This review provides an update on the current knowledge of primary aldosteronism and discusses the clinicopathologic correlations of this important disease. PMID:26125435

  9. Internet and the national nuclear data center

    SciTech Connect

    Burrows, T.W. [Brookhaven National Lab., Upton, NY (United States)

    1997-12-31

    The National Nuclear Data Center (NNDC) has been providing electronic access to the nuclear data bases it maintains since 1986. Originally the access was via modem and DecNet; primary access now is through the Internet. After the Internet became widely available to the scientific community, retrievals from the NNDC`s data bases have risen almost exponentially with an estimated 124,000 retrievals for 1996. Primary access is still through TELNET but there is substantial activity through the World Wide Web (W3). A current goal of the Center is to provide W3 access to all of its major data bases by the end of 1997. W3 access to the NNDC data bases will be demonstrated along with demonstrations of {open_quotes}work in progress.{close_quotes} The Center has also taken the initiative to develop and maintain new data bases covering the {open_quotes}frontiers{close_quotes} of nuclear science.

  10. Science Center Cambridge Common

    E-print Network

    Johnston Gate Science Center Fire HQ Cambridge LAW SCHOOL Cambridge Common HARVARD YARD HA HAMMOND STREETLibrary Center Holyoke Science Center Widener Fire HQ Cambridge LAW SCHOOL Cambridge Common HARVARD BROADW AY PRESCOTTS QUINCYSTREET EVERETT STREET STREET MASSACHUSETTSAVENUE CAMBRIDGE MASSACHUSETTSAVENUE

  11. PARCS: a Primary Atomic Reference Clock in Space

    Microsoft Academic Search

    S. R. Jefferts; T. P. Heavner; L. W. Hollberg; J. Kitching; D. M. Meekhof; T. E. Parker; W. Phillips; S. Rolston; H. G. Robinson; J. H. Shirley; D. B. Sullivan; F. L. Walls; N. Ashby; W. M. Klipstein; L. Maleki; D. Seidel; R. Thompson; S. Wu; L. Young; R. F. C. Vessot; A. DeMarchi

    1999-01-01

    NIST, in collaboration with the Jet Propulsion Laboratories (JPL), the University of Colorado, Politecnico di Torino and Harvard Smithsonian Center for Astrophysics (SAO) is building a laser-cooled cesium-beam atomic clock for flight on the International Space Station (ISS). The clock, named PARCS (Primary Atomic Reference Clock in Space) is designed to perform certain tests of relativity and fundamental physics and

  12. Primary EFL Teachers' Technology Use in China: Patterns and Perceptions

    ERIC Educational Resources Information Center

    Li, Guofang; Ni, Xiaopeng

    2011-01-01

    Drawing on survey data, this paper examines the patterns and perceptions of technology use by primary EFL teachers in China. Findings suggest that although Chinese EFL teachers hold positive attitudes toward the value of technology for teaching and learning, they use technology mainly for teacher-centered purposes, such as teaching preparation and…

  13. A Computational Analysis of Bone Formation in the Cranial Vault in the Mouse

    PubMed Central

    Lee, Chanyoung; Richtsmeier, Joan T.; Kraft, Reuben H.

    2015-01-01

    Bones of the cranial vault are formed by the differentiation of mesenchymal cells into osteoblasts on a surface that surrounds the brain, eventually forming mineralized bone. Signaling pathways causative for cell differentiation include the actions of extracellular proteins driven by information from genes. We assume that the interaction of cells and extracellular molecules, which are associated with cell differentiation, can be modeled using Turing’s reaction–diffusion model, a mathematical model for pattern formation controlled by two interacting molecules (activator and inhibitor). In this study, we hypothesize that regions of high concentration of an activator develop into primary centers of ossification, the earliest sites of cranial vault bone. In addition to the Turing model, we use another diffusion equation to model a morphogen (potentially the same as the morphogen associated with formation of ossification centers) associated with bone growth. These mathematical models were solved using the finite volume method. The computational domain and model parameters are determined using a large collection of experimental data showing skull bone formation in mouse at different embryonic days in mice carrying disease causing mutations and their unaffected littermates. The results show that the relative locations of the five ossification centers that form in our model occur at the same position as those identified in experimental data. As bone grows from these ossification centers, sutures form between the bones. PMID:25853124

  14. Worksite primary care clinics: a systematic review.

    PubMed

    Shahly, Victoria; Kessler, Ronald C; Duncan, Ian

    2014-10-01

    Despite levels of health spending that are higher per capita and as share of gross domestic product than any country worldwide, the US health care system is fragmented, technology and administration heavy, and primary care deficient. Studies of regional variations in US health care show similar "disconnects" between higher spending and better health outcomes. Faced with rising health benefit costs and suboptimal workforce health amid economic downturn, concerned US employers have implemented innovative payment and health care delivery strategies such as consumer-driven health plans and targeted prevention programs. The former may impose undue cost shifting, prohibitive out-of-pocket expenses, and health literacy challenges, while the latter have shown inconsistent near-term economic returns and long-term clinical efficacy. Employers have begun exploring more comprehensive health delivery platforms such as integrated worksite primary care clinics that have potential to cost-effectively address several pressing problems with current US health care: the growing primary care physician shortage, poor access to routine care, lack of coordinated and patient-centered treatment models, low rates of childhood immunizations, and "quality-blind" fee-for-service payment mechanisms. Such on-site medical clinics exploit one of the rare comparative strengths of the US health care system-its plentiful supply of highly skilled registered nurses-to offer workers and their dependents convenient, high-quality, affordable care. A relatively recent health care paradigm, worksite clinics must yet develop consistent reporting strategies and credible demonstration of outcomes. This review explores available evidence regarding worksite primary care clinics, including current rationale, historical trends, prevalence and projected growth, expected health and financial benefits, challenges, and future research directions. PMID:24835541

  15. COMMITTEE OF CENTERS AND

    E-print Network

    Massachusetts at Lowell, University of

    ........................................................ 46 5. CENTER FOR BIOMOLECULAR AND MEDICAL INFORMATICS........................................... 50 6...................................................................................................... 75 9. CENTER FOR ELECTRIC CAR AND ENERGY CONVERSION............................................... 89 FOR SUSTAINABLE ENERGY .......................................................................... 238 #12;2 20

  16. The 10 Building Blocks of High-Performing Primary Care

    PubMed Central

    Bodenheimer, Thomas; Ghorob, Amireh; Willard-Grace, Rachel; Grumbach, Kevin

    2014-01-01

    Our experiences studying exemplar primary care practices, and our work assisting other practices to become more patient centered, led to a formulation of the essential elements of primary care, which we call the 10 building blocks of high-performing primary care. The building blocks include 4 foundational elements—engaged leadership, data-driven improvement, empanelment, and team-based care—that assist the implementation of the other 6 building blocks—patient-team partnership, population management, continuity of care, prompt access to care, comprehensiveness and care coordination, and a template of the future. The building blocks, which represent a synthesis of the innovative thinking that is transforming primary care in the United States, are both a description of existing high-performing practices and a model for improvement. PMID:24615313

  17. Primary Science Curriculum Development in Africa--Strategies, Problems and Prospects with Particular Reference to the African Primary Science Programme.

    ERIC Educational Resources Information Center

    Bajah, Sam Tunde

    1981-01-01

    The African Primary Science Programme (APSP) was one of the three major projects in Africa sponsored by Educational Services Incorporated (ESI), later the Educational Development Center (EDC), Newton, Massachusetts. The problems of introducing this programme in the anglophone African States and its implications for science education are discussed.…

  18. Developing Primary Care: The Contribution of Primary Care Research Networks

    PubMed Central

    Peckham, Stephen; Hutchison, Brian

    2012-01-01

    The performance of Canada's primary care sector remains lacklustre relative to other wealthy industrialized countries, and it has been suggested that a lack of investment in research and evaluation may be a cause. One approach to improving and sustaining primary care research is through research networks. Over the past few years, significant investments have begun to be made in developing primary care networks in Canada. While Canadian experience in this area is relatively new, in the United Kingdom primary care research networks were first established in the 1980s. Initially developed at a local level, these have more recently been incorporated into large-scale national networks. This paper reviews the UK experience and highlights potential lessons for the development of networks in Canada. PMID:23968616

  19. Satellite medical centers project

    NASA Astrophysics Data System (ADS)

    Aggarwal, Arvind

    2002-08-01

    World class health care for common man at low affordable cost: anywhere, anytime The project envisages to set up a national network of satellite Medical centers. Each SMC would be manned by doctors, nurses and technicians, six doctors, six nurses, six technicians would be required to provide 24 hour cover, each SMC would operate 24 hours x 7 days. It would be equipped with the Digital telemedicine devices for capturing clinical patient information and investigations in the form of voice, images and data and create an audiovisual text file - a virtual Digital patient. Through the broad band connectivity the virtual patient can be sent to the central hub, manned by specialists, specialists from several specialists sitting together can view the virtual patient and provide a specialized opinion, they can see the virtual patient, see the examination on line through video conference or even PCs, talk to the patient and the doctor at the SMC and controlle capturing of information during examination and investigations of the patient at the SMC - thus creating a virtual Digital consultant at the SMC. Central hub shall be connected to the doctors and consultants in remote locations or tertiary care hospitals any where in the world, thus creating a virtual hub the hierarchical system shall provide upgradation of knowledge to thedoctors in central hub and smc and thus continued medical education and benefit the patient thru the world class treatment in the smc located at his door step. SMC shall be set up by franchisee who shall get safe business opportunity with high returns, patients shall get Low cost user friendly worldclass health care anywhere anytime, Doctors can get better meaningful selfemplyment with better earnings, flexibility of working time and place. SMC shall provide a wide variety of services from primary care to world class Global consultation for difficult patients.

  20. Primary sex headache in adolescents.

    PubMed

    Gelfand, Amy A; Goadsby, Peter J

    2012-08-01

    Primary headache associated with sexual activity is a rare headache disorder that has only been reported twice previously in adolescents. Although it can mimic life-threatening causes of thunderclap-onset headache, primary sex headache is benign, self-limited, and highly responsive to indomethacin. Given the sensitive nature of sexual development in adolescents, it is important that pediatric providers know when to ask about this symptom and how to proceed with diagnostics and therapy when it arises. We report 2 new adolescent cases and review the semiology, epidemiology, and treatment of primary sex headache. PMID:22753551

  1. Primary care access barriers as reported by nonurgent emergency department users: implications for the US primary care infrastructure.

    PubMed

    Hefner, Jennifer L; Wexler, Randy; McAlearney, Ann Scheck

    2015-01-01

    The objective was to explore variation by insurance status in patient-reported barriers to accessing primary care. The authors fielded a brief, anonymous, voluntary survey of nonurgent emergency department (ED) visits at a large academic medical center and conducted descriptive analysis and thematic coding of 349 open-ended survey responses. The privately insured predominantly reported primary care infrastructure barriers-wait time in clinic and for an appointment, constraints related to conventional business hours, and difficulty finding a primary care provider (because of geography or lack of new patient openings). Half of those insured by Medicaid and/or Medicare also reported these infrastructure barriers. In contrast, the uninsured predominantly reported insurance, income, and transportation barriers. Given that insured nonurgent ED users frequently report infrastructure barriers, these should be the focus of patient-level interventions to reduce nonurgent ED use and of health system-level policies to enhance the capacity of the US primary care infrastructure. PMID:24500644

  2. Arrillaga Sports Center Addition,

    E-print Network

    Bogyo, Matthew

    BioE/ChemE Building emical ding, ion Arrillaga Sports Center Addition, New EV Graduate Student Sports Ctr Music Rehearsal Facility Credit Union Recycling Center Children's Center of the Stanford and Astrophysics Arrillaga Center for Sports and Recreation Herrin Labs 155 Blackwelder Highrise Quillen Highrise

  3. Impact of a Clinical Decision Support System on the Management of Patients with Hypercholesterolemia in the Primary Healthcare Setting

    Microsoft Academic Search

    Alex Bassa; Miguel del Val; Albert Cobos; Salvador Bergonon; Carlos Crespo; Max Brosa; Silvia Munio; Cristina Espinosa

    2005-01-01

    Introduction and objectives: The Optimcare study objective was to assess the impact on effectiveness and costs of a practice guideline implemented through a clinical decision support system (CDSS) for the management of patients with hypercholesterolemia in the primary healthcare setting. Study design and perspective: The study design was a prospective, naturalistic, single-center (Vila Olimpica Primary Health Care Center, Barcelona, Spain),

  4. Transforming a family medicine center and residency program into a federally qualified health center.

    PubMed

    Cousineau, Michael R; Flores, Hector; Cheng, Scott; Gates, Jerry D; Douglas, James H; Clute, Gerald B; Coan, Carl E

    2013-05-01

    The authors describe a family medicine center before and after a merger between the Keck School of Medicine of the University of Southern California, the California Hospital Medical Center, and the Eisner Pediatric and Family Medical Center in 2012. The merger provided new opportunities to stabilize the financial base of a clinical practice struggling financially and to enhance the training of residents and other health professionals in primary care, which motivated the partners to consider this new model. After 18 months of negotiations, they were able to convert the family medicine center and residency program into a new federally qualified health center. The benefits to this new model include an increase in both patient volume and the quality of education, supporting residency accreditation; a greater number of residents from U.S. medical schools; enhanced education and preparation of primary care physicians for practice in medically underserved communities; enhanced reimbursements and new opportunities for state, local, and federal grants; and quality improvement and new information technology. The partners overcame academic, administrative, legal, and regulatory obstacles, communication barriers, and differences in culture and expectations to achieve this merger. Keys to their success include the commitment of the leaders at the three institutions to the goals of the merger, a dedicated project manager and consultants, opportunities for new revenue sources and reimbursements, and support from a pioneering charitable foundation. The authors conclude by discussing the implications of using community health centers as the focal point for training primary care clinicians and addressing workforce shortages. PMID:23524918

  5. Primary hyperparathyroidism in a child

    PubMed Central

    Anitha, A.; Babu, K.; Siddini, V.; Ballal, H. S.

    2015-01-01

    Primary hyperparathyroidism is rare in children. We report a 12-year-old girl who presented with recurrent renal calculi, muscular weakness and inability to walk; was diagnosed to have parathyroid adenoma and underwent parathyroidectomy.

  6. Primary Masters in Machine Learning

    E-print Network

    Primary Masters in Machine Learning Student Handbook #12;#12;Page 1 Masters in Machine Learning:.......................................................................................8 Machine Learning Journal Club ..................................................................12 #12;Page 3 Introduction The field of machine learning is concerned with the question of how

  7. Geriatric Depression in Primary Care

    PubMed Central

    Park, Mijung; Unützer, Jürgen

    2011-01-01

    Primary care settings present important opportunities for the detection and management of depression in older adults. As many as 10 % of older adults presenting in primary care have clinically significant depression, but only about half are recognized and only one in five depressed older adults receive effective treatment in primary care. We review common barriers to effective treatment such as atypical clinical presentations and comorbid medical conditions that are common in older adults. We identify treatment strategies such as measurement-based stepped care and collaborative care that can substantially improve the effectiveness of treatment in this setting and we highlight opportunities for addressing health disparities in geriatric depression care. We also point out the importance of engaging and supporting family caregivers of depressed older adults. We conclude by identifying three strategic areas to improve the treatment of geriatric depression in primary care: activation and engagement of patients and family members, health care provider training, and broader system changes. PMID:21536169

  8. Primary Health Faculty of Medicine,

    E-print Network

    Albrecht, David

    School of Primary Health Care Faculty of Medicine, Nursing and Health Sciences Central Clinical School Australian Centre for Blood Diseases Centre for Obesity Research and Education Medicine, Alfred Hospital Centre for Inflammatory Diseases School of Public Health & Preventive Medicine Australasian

  9. Closing the primary care gap.

    PubMed

    Stempniak, Marty

    2013-03-01

    Millions of new patients soon will flood health care systems, exacerbating a nationwide shortage of primary care physicians. This gatefold explores how nurse practitioners and physician assistants can help to fill the void. PMID:23617120

  10. Primary intrahepatic malignant epithelioid mesothelioma

    PubMed Central

    Perysinakis, Iraklis; Nixon, Alexander M.; Spyridakis, Ioannis; Kakiopoulos, George; Zorzos, Charalampos; Margaris, Ilias

    2014-01-01

    INTRODUCTION Primary malignant hepatic mesotheliomas are extremely rare. We report the case of a patient with primary intrahepatic malignant mesothelioma who was treated in our department. PRESENTATION OF CASE A 66-year old male patient was admitted to our department for the evaluation of anemia. An abdominal computed tomography scan revealed a large space occupying lesion in the right liver lobe. DISCUSSION The tumor was subsequently resected and a diagnosis of primary intrahepatic malignant mesothelioma was made after pathologic examination. The patient did not receive adjuvant therapy and is currently alive and free of disease, 36 months after the resection. CONCLUSION To our knowledge this is the eighth adult case of primary intrahepatic malignant mesothelioma reported in the literature. These tumors are rarely diagnosed preoperatively. Absence of previous asbestos exposure does not exclude malignant mesothelioma from the differential diagnosis. Proper surgical treatment may offer prolonged survival to the patient, without adjuvant therapy. PMID:25460485

  11. Problems of Primary Education Today

    ERIC Educational Resources Information Center

    Dubova, M. V.

    2014-01-01

    Primary education in Russia has failed to adapt to the needs of post-Soviet society, and is still based on rote learning and memorization instead of learning through discovery and learning to use and apply what is learned.

  12. Primary cilia in neurodevelopmental disorders

    PubMed Central

    Valente, Enza Maria; Rosti, Rasim O.; Gibbs, Elizabeth; Gleeson, Joseph G.

    2014-01-01

    Primary cilia are generally solitary organelles that emanate from the surface of almost all vertebrate cell types. Until recently, details regarding the function of these structures were lacking; however, extensive evidence now suggests that primary cilia have critical roles in sensing the extracellular environment, and in coordinating developmental and homeostatic signalling pathways. Furthermore, disruption of these functions seems to underlie a diverse spectrum of disorders, known as primary ciliopathies. These disorders are characterized by wide-ranging clinical and genetic heterogeneity, but with substantial overlap among distinct conditions. Indeed, ciliopathies are associated with a large variety of manifestations that often include distinctive neurological findings. Herein, we review neurological features associated with primary ciliopathies, highlight genotype–phenotype correlations, and discuss potential mechanisms underlying these findings. PMID:24296655

  13. Primary medical care in Spain.

    PubMed Central

    Hart, J T

    1990-01-01

    The extremely complex and rapidly but unevenly developing system of primary care in Spain is described. The health centre movement in Spain merits close attention, and could be a useful model for our own service. PMID:2117951

  14. Managing Depression in Primary Care

    Microsoft Academic Search

    Larry Culpepper; Peggy Johnson

    \\u000a The need to manage depression more effectively in primary care is well established. Major depressive disorder is a common,\\u000a chronic but episodic and costly condition for which primary care physicians provide the majority of care (1). Among nonpsychotic\\u000a patients, symptom composition and severity differs little from adults presenting to psychiatrists (2). Patients who have chronic\\u000a medical conditions such as diabetes

  15. Primary hepatic sarcomas: CT findings

    Microsoft Academic Search

    Ri-Sheng Yu; Ying Chen; Biao Jiang; Liu-Hong Wang; Xiu-Fang Xu

    2008-01-01

    Primary hepatic sarcomas are rare tumors that are difficult to diagnose clinically. Different primary hepatic sarcomas may\\u000a have different clinical, morphologic, and radiological features. In this pictorial review, we summarized computed tomography\\u000a (CT) findings of some relatively common types of hepatic sarcomas, including angiosarcoma, epithelioid hemangioendothelioma\\u000a (EHE), liposarcoma, undifferentiated embryonal sarcoma (UES), leiomyosarcoma, malignant fibrous histiocytoma (MFH), and carcinosarcoma\\u000a (including

  16. Cancer of Unknown Primary Site

    Microsoft Academic Search

    F. Anthony Greco; John D. Hainsworth

    In the United States, unknown primary cancers represented about 2% of all cancer diagnoses reported between 1973 and 1987.1\\u000a Registries from seven other countries have listed incidences from 2.3% to 7.8%.2 These patients are heterogeneous with several\\u000a clinical presentations and histologic tumor types. Most have metastatic carcinoma of unknown primary site, while others have\\u000a equivocal pathologic diagnoses with tumors difficult

  17. Cross-Sector Collaboration: The Great Lakes Environmental Finance Center.

    ERIC Educational Resources Information Center

    Austrian, Ziona; Iannone, Donald

    1997-01-01

    The Great Lakes Environmental Finance Center is one of six university-based environmental finance centers established by the federal government. Its primary mission is to help state and local government and private-sector organizations devise effective financing strategies for environmental improvement projects. Cross-sector collaboration and…

  18. SAN JOAQUIN VALLEY AEROSOL HEALTH EFFECTS RESEARCH CENTER (SAHERC)

    EPA Science Inventory

    All studies in the SAHERC were being undertaken within the primary theme of żambient particulate matter and resulting health effects in the San Joaquin Valleyż. Below is a chart outlining the relationship between the centerżs five projects. All five research projects were...

  19. A Reading Center in a University English Department.

    ERIC Educational Resources Information Center

    Hooker, Joyce

    The primary aim of the reading center at Brigham Young University (Utah) is to teach typical university students critical reading skills, not just to work with students needing remedial or basic help. The reading center also serves as a resource for teachers in all disciplines who want help in recognizing and evaluating good reading, or who want…

  20. 42 CFR 417.528 - Payment when Medicare is not primary payer.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...2014-10-01 false Payment when Medicare is not primary payer. 417.528...528 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT...AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED)...

  1. 42 CFR 417.528 - Payment when Medicare is not primary payer.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 false Payment when Medicare is not primary payer. 417.528...528 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT...AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE...

  2. 42 CFR 417.528 - Payment when Medicare is not primary payer.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...2012-10-01 false Payment when Medicare is not primary payer. 417.528...528 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT...AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED)...

  3. 42 CFR 411.206 - Basis for Medicare primary payments and limits on secondary payments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 2014-10-01 false Basis for Medicare primary payments and limits on secondary...206 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM...

  4. 42 CFR 411.206 - Basis for Medicare primary payments and limits on secondary payments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 2012-10-01 false Basis for Medicare primary payments and limits on secondary...206 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM...

  5. 42 CFR 411.206 - Basis for Medicare primary payments and limits on secondary payments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 2013-10-01 false Basis for Medicare primary payments and limits on secondary...206 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM...

  6. 42 CFR 417.528 - Payment when Medicare is not primary payer.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 false Payment when Medicare is not primary payer. 417.528...528 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT...AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE...

  7. 42 CFR 417.528 - Payment when Medicare is not primary payer.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...2013-10-01 false Payment when Medicare is not primary payer. 417.528...528 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT...AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED)...

  8. 42 CFR 411.206 - Basis for Medicare primary payments and limits on secondary payments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 2011-10-01 false Basis for Medicare primary payments and limits on secondary...206 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM...

  9. ORIGINAL PAPER Ionizing radiation induces DNA double-strand breaks in bystander primary

    E-print Network

    and Genetic Engineering, 148 Zabolotnogo St, Kiev 03143, Ukraine; 3 Center for Radiological Research, CollegeORIGINAL PAPER Ionizing radiation induces DNA double-strand breaks in bystander primary human

  10. School-Based Health Centers and the Patient-Centered Medical Home. Position Statement

    ERIC Educational Resources Information Center

    National Assembly on School-Based Health Care, 2010

    2010-01-01

    The patient-centered medical home (PCMH) is an innovative care delivery model designed to provide comprehensive primary care services to people of all ages by fostering partnerships between patients, families, health care providers and the community. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies that…

  11. The Plant Information Center (PIC): A Web-Based Learning Center for Botanical Study.

    ERIC Educational Resources Information Center

    Greenberg, J.; Daniel, E.; Massey, J.; White, P.

    The Plant Information Center (PIC) is a project funded under the Institute of Museum and Library Studies that aims to provide global access to both primary and secondary botanical resources via the World Wide Web. Central to the project is the development and employment of a series of applications that facilitate resource discovery, interactive…

  12. Primary dose in photon beams with lateral electron disequilibrium

    SciTech Connect

    Nizin, P.S. (Staten Island University Hospital, Department of Radiation Oncology, 475 Seaview Avenue, Staten Island, NY (USA)); Chang, X.S. (Joint Center for Radiation Therapy, Department of Radiation Therapy, Harvard Medical School, Boston, MA (USA))

    1991-07-01

    It is shown that in narrow monoenergetic photon beams under conditions of lateral electron disequilibrium, primary absorbed dose {ital P}({ital r}) is a simple function of beam radius {ital r} : {ital P}{sub ({ital r})}={ital P}{sub {lambda}}{center dot}(1{minus}{ital e}{sup {minus}{gamma}{center dot}{ital r}}), where {ital P}{sub {lambda}} is the primary dose in broad beams for which complete lateral electron equilibrium exists, and {gamma} depends on photon energy and absorbing medium. This formula was evaluated using Monte-Carlo-generated data for the primary dose in water from monoenergetic photons in the energy range from 2 to 8 MeV. The primary dose was studied in beams of radii 0.006 cm{lt}{ital r}{lt}5.0 cm and within the depth interval 0.5 cm{le}{ital d}{le}24 cm. It was concluded that the saturation equation above provides an accurate description of the primary dose from monoenergetic photon beams, as judged by comparison with Monte Carlo results.

  13. Restructuring VA Ambulatory Care and Medical Education: The PACE Model of Primary Care.

    ERIC Educational Resources Information Center

    Cope, Dennis W.; And Others

    1996-01-01

    The Veterans' Administration new Primary Ambulatory Care and Education (PACE) program at the Sepulveda (California) VA Medical Center, departs from traditional VA medical education models by shifting focus of care from inpatient to outpatient settings. The program uses an interdisciplinary team approach and stresses managed primary care. Aspects…

  14. Effective continuing professional development for translating shared decision making in primary care: A study protocol

    Microsoft Academic Search

    Hilary Bekker; Sophie Desroches; Mary Politi; Dawn Stacey; Francine Borduas; Francine M Cheater; Jacques Cornuz; Marie-France Coutu; Norbert Donner-Banzhoff; Nora Ferdjaoui-Moumjid; Frances Griffiths; Martin Härter; Cath Jackson; André Jacques; Tanja Krones; Michel Labrecque; Rosario Rodriguez; Michel Rousseau; Mark Sullivan

    2010-01-01

    BACKGROUND: Shared decision making (SDM) is a process by which a healthcare choice is made jointly by the healthcare professional and the patient. SDM is the essential element of patient-centered care, a core concept of primary care. However, SDM is seldom translated into primary practice. Continuing professional development (CPD) is the principal means by which healthcare professionals continue to gain,

  15. How can educational technology facilitate student engagement with online primary sources? : A user needs assessment

    Microsoft Academic Search

    Thea Lindquist; Holley Long

    2011-01-01

    Purpose – The authors received a grant to develop a digital educational tool to facilitate student engagement with online primary sources. Students and faculty were interviewed prior to developing the tool's specifications to ensure a user-centered focus. This research paper seeks to report the results of a user needs assessment that explored students' use of primary sources and their learning

  16. Primary lung cancer after breast cancer: The role of radiation therapy and cigarette smoking

    Microsoft Academic Search

    Melissa Belle Ford

    2000-01-01

    The magnitude of the interaction between cigarette smoking, radiation therapy, and primary lung cancer after breast cancer remains unresolved. This case control study further examines the main and joint effects of cigarette smoking and radiation therapy (XRT) among breast cancer patients who subsequently developed primary lung cancer, at The University of Texas M. D. Anderson Cancer Center (MDACC) in Houston,

  17. Barriers and Facilitators to Senior Centers Participating in Translational Research

    PubMed Central

    Adams, Becky; Cornell, Carol E.; Fausett, Jennifer K.; Krukowski, Rebecca A.; Love, ShaRhonda J.; Prewitt, T. Elaine; West, Delia Smith

    2014-01-01

    Senior centers are ideal locations to deliver evidence-based health promotion programs to the rapidly-growing population of older Americans to help them remain healthy and independent in the community. However, little reported research is conducted in partnership with senior centers; thus, not much is known about barriers and facilitators for senior centers serving as research sites. To fill this gap and potentially accelerate research within senior centers to enhance translation of evidence-based interventions into practice, the present study examined barriers and facilitators of senior centers invited to participate in a cluster-randomized controlled trial. Primary barriers to participation related to staffing and perceived inability to recruit older adult participants meeting research criteria. The primary facilitator was a desire to offer programs that were of interest and beneficial to seniors. Senior centers are interested in participating in research that provides benefit to older adults but may need assistance from researchers to overcome participation barriers. PMID:25651599

  18. Tropical Prediction Center: National Hurricane Center

    NSDL National Science Digital Library

    The National Hurricane Center contains news of active tropical systems; a hurricane awareness section about the hazards of hurricanes and what you can do to help protect yourself, your family, and your property; links to regional tropical cyclone centers; tropical weather outlooks, marine forecasts, and Sea Surface Temperature analyses; blank hurricane tracking charts; and current season summaries and tropical cyclone reports including synoptic history, meteorological statistics, casualties and damages, and the post-analysis best track.

  19. The Primary Group: A Systematic Orientation

    E-print Network

    Sallach, David L.

    1971-10-01

    THE PRIMARY GROUP A SYSTEMATIC ORIENTATION David L. Sallach Indiana University The rich heritage of the concept of the 'primary group' is accompanied by crippling ambiguity. An attempt is made to correct the difficulty in two ways: 1) the primary...

  20. Genetics Home Reference: Juvenile primary lateral sclerosis

    MedlinePLUS

    ... PubMed Recent literature OMIM Genetic disorder catalog Conditions > Juvenile primary lateral sclerosis On this page: Description Genetic ... names Glossary definitions Reviewed July 2013 What is juvenile primary lateral sclerosis? Juvenile primary lateral sclerosis is ...

  1. Genetics Home Reference: Juvenile primary osteoporosis

    MedlinePLUS

    ... Research studies PubMed Recent literature Conditions > Juvenile primary osteoporosis On this page: Description Genetic changes Inheritance Diagnosis ... definitions Reviewed January 2013 What is juvenile primary osteoporosis? Juvenile primary osteoporosis is a skeletal disorder characterized ...

  2. Primary Care Interventions to Prevent Child Maltreatment

    MedlinePLUS

    ... Task Force FINAL | 1 Understanding Task Force Recommendations Primary Care Interventions to Prevent Child Maltreatment The U.S. Preventive ... 2 Primary Care Interventions to Prevent Child Maltreatment Primary Care Interventions to Prevent Child Abuse and Neglect Health ...

  3. A Deployable Primary Mirror for Space Telescopes

    NASA Technical Reports Server (NTRS)

    Lake, Mark S.; Phelps, James E.; Dyer, Jack E.; Caudle, David A.; Tam, Anthony

    1999-01-01

    NASA Langley Research Center, Composite Optics, Inc., and Nyma/ADF have developed jointly a deployable primary mirror for space telescopes that combines over five years of research on deployment of optical-precision structures and over ten years of development of fabrication techniques for optical-precision composite mirror panels and structures. The deployable mirror is directly applicable to a broad class of non-imaging "lidar" (Light direction and ranging) telescopes whose figure-error requirements are in the range of one to ten microns RMS. Furthermore, the mirror design can be readily modified to accommodate imaging-quality reflector panels and active panel-alignment control mechanisms for application to imaging telescopes. The present paper: 1) describes the deployable mirror concept; 2) explains the status of the mirror development; and 3) provides some technical specifications for a 2.55- m-diameter, proof-of-concept mirror.

  4. A Deployable Primary Mirror for Space Telescopes

    NASA Technical Reports Server (NTRS)

    Lake, Mark S.; Phelps, James E.; Dyer, Jack E.; Caudle, David A.; Tam, Anthony; Escobedo, Javier; Kasl, Eldon P.

    1999-01-01

    NASA Langley Research Center, Composite Optics, Inc., and Nyma/ADF have developed jointly a deployable primary mirror for space telescopes that combines over five years of research on deployment of optical-precision structures and over ten years of development of fabrication techniques for optical-precision composite mirror panels and structures. The deployable mirror is directly applicable to a broad class of non-imaging "lidar" (light direction and ranging) telescopes whose figure-error requirements are in the range of one to ten microns RMS. Furthermore, the mirror design can be readily modified to accommodate imaging-quality reflector panels and active panel-alignment control mechanisms for application to imaging telescopes. The present paper: 1) describes the deployable mirror concept; 2) explains the status of the mirror development; and 3) provides some technical specifications for a 2.55-m-diameter, proof-of-concept mirror.

  5. Deployable primary mirror for space telescopes

    NASA Astrophysics Data System (ADS)

    Lake, Mark S.; Phelps, James E.; Dyer, Jack E.; Caudle, David A.; Tam, Anthony; Escobedo-Torres, Javier; Kasl, Eldon P.

    1999-10-01

    NASA Langley Research Center, Composite Optics, Inc., and Nyma/ADF have developed jointly a deployable primary mirror for space telescopes that combines over five years of research on deployment of optical-precision structures and over ten years of development of fabrication techniques for optical-precision composite mirror panels and structures. The deployable mirror is directly applicable to a broad class of non-imaging `lidar' (light direction and ranging) telescopes whose figure-error requirements are in the range of one to ten microns RMS. Furthermore, the mirror design can be readily modified to accommodate imaging-quality reflector panels and active panel-alignment control mechanisms for application to imaging telescopes. The present paper: (1) describes the deployable mirror concept; (2) explains the status of the mirror development; and (3) provides some technical specifications for a 2.55-m- diameter, proof-of-concept mirror.

  6. Educational paper: syndromic forms of primary immunodeficiency.

    PubMed

    Kersseboom, Rogier; Brooks, Alice; Weemaes, Corry

    2011-03-01

    The syndromic primary immunodeficiencies are disorders in which not only the immune system but also other organ systems are affected. Other features most commonly involve the ectodermal, skeletal, nervous, and gastrointestinal systems. Key in identifying syndromic immunodeficiencies is the awareness that increased susceptibility to infections or immune dysregulation in a patient known to have other symptoms or special features may hint at an underlying genetic syndrome. Because the extraimmune clinical features can be highly variable, it is more difficult establishing the correct diagnosis. Nevertheless, correct diagnosis at an early age is important because of the possible treatment options. Therefore, diagnostic work-up is best performed in a center with extensive expertise in this field, having immunologists and clinical geneticists, as well as adequate support from a specialized laboratory at hand. This paper provides the general pediatrician with the main clinical features that are crucial for the recognition of these syndromes. PMID:21337117

  7. Primary malignant neoplasm of the female urethra

    SciTech Connect

    Ampil, F.L.

    1985-12-01

    This is a retrospective review of 11 cases of primary malignant neoplasm of the female urethra seen at the Louisiana State University Medical Center in Shreveport from 1951 to 1984. The disease was relatively more frequent in the 60- to 79-year age-group. Squamous cell carcinoma was the most common among the different observed histopathology. A modified clinical staging system is introduced. At diagnosis, eight of 11 subjects (73%) had locally extensive disease. The majority of the patients were treated with radiotherapy alone or in combination with surgery. The overall severe complication rate was low. The poor results (20% local control and survival) obtained in this small experience suggest that perhaps a study using promising adjuvant chemotherapeutic agents is warranted. A literature review summary of reported radiotherapy results is included.

  8. MIT Center for Materials Science and Engineering

    NSDL National Science Digital Library

    The MIT Center for Materials Science and Engineering "is devoted to the design, creation, and fundamental understanding of materials that are capable of enhancing the human experience." Visitors to this site can peruse the eight primary sections here, which include Facilities, Research, Highlights, and Connecting to Industry. In the Research area, visitors can learn about the Center's ongoing research projects, including work on the design of nanomaterials for electrochemical energy storage and conversion. Journalists and others may find the Highlights area quite useful, as it contains updates on the Center's research accomplishments, such as the development of fibers that can detect and produce sound. The site is rounded out by a collection of related links which lead to other relevant research centers at MIT and the Lincoln Laboratory.

  9. Primary Immune Deficiency Treatment Consortium (PIDTC) Report

    PubMed Central

    Griffith, Linda M.; Cowan, Morton J.; Notarangelo, Luigi D.; Kohn, Donald B.; Puck, Jennifer M.; Pai, Sung-Yun; Ballard, Barbara; Bauer, Sarah C.; Bleesing, Jack J. H.; Boyle, Marcia; Brower, Amy; Buckley, Rebecca H.; van der Burg, Mirjam; Burroughs, Lauri M.; Candotti, Fabio; Cant, Andrew J.; Chatila, Talal; Cunningham-Rundles, Charlotte; Dinauer, Mary C.; Dvorak, Christopher C.; Filipovich, Alexandra H.; Fleisher, Thomas A.; Gaspar, Hubert Bobby; Gungor, Tayfun; Haddad, Elie; Hovermale, Emily; Huang, Faith; Hurley, Alan; Hurley, Mary; Iyengar, Sumathi; Kang, Elizabeth M.; Logan, Brent R.; Long-Boyle, Janel R.; Malech, Harry L.; McGhee, Sean A.; Modell, Fred; Modell, Vicki; Ochs, Hans D.; O'Reilly, Richard J.; Parkman, Robertson; Rawlings, David J.; Routes, John M.; Shearer, William T.; Small, Trudy N.; Smith, Heather; Sullivan, Kathleen E.; Szabolcs, Paul; Thrasher, Adrian; Torgerson, Troy R.; Veys, Paul; Weinberg, Kenneth; Zuniga-Pflucker, Juan Carlos

    2013-01-01

    The Primary Immune Deficiency Treatment Consortium (PIDTC) is a network of 33 centers in North America that study the treatment of rare and severe primary immunodeficiency diseases (PID). Current protocols address the natural history of patients treated for Severe Combined Immunodeficiency (SCID), Wiskott-Aldrich Syndrome and Chronic Granulomatous Disease through retrospective, prospective and cross-sectional studies. The PIDTC additionally seeks to: encourage training of junior investigators; establish partnerships with European and other International colleagues; work with patient advocacy groups to promote community awareness; and conduct pilot demonstration projects. Future goals include the conduct of prospective treatment studies to determine optimal therapies for PID. To date, the PIDTC has funded two pilot projects: newborn screening for SCID in Navajo Native Americans; and B cell reconstitution in SCID patients following hematopoietic stem cell transplantation. Ten junior investigators have received grant awards. The PIDTC Annual Scientific Workshop has brought together consortium members, outside speakers, patient advocacy groups, and young investigators and trainees to report progress of the protocols and discuss common interests and goals, including new scientific developments and future directions of clinical research. Here we report the progress of the PIDTC to date, highlights of the first two PIDTC workshops, and consideration of future consortium objectives. PMID:24139498

  10. Primary Care of the Renal Transplant Patient

    PubMed Central

    Unruh, Mark L.; Nolin, Thomas D.; Hasley, Peggy B.

    2010-01-01

    There has been a remarkable rise in the number of kidney transplant recipients (KTR) in the US over the last decade. Increasing use of potent immunosuppressants, which are also potentially diabetogenic and atherogenic, can result in worsening of pre-existing medical conditions as well as development of post-transplant disease. This, coupled with improving long-term survival, is putting tremendous pressure on transplant centers that were not designed to deliver primary care to KTR. Thus, increasing numbers of KTR will present to their primary care physicians (PCP) post-transplant for routine medical care. Similar to native chronic kidney disease patients, KTRs are vulnerable to cardiovascular disease as well as a host of other problems including bone disease, infections and malignancies. Deaths related to complications of cardiovascular disease and malignancies account for 60–65% of long-term mortality among KTRs. Guidelines from the National Kidney Foundation and the European Best Practice Guidelines Expert Group on the management of hypertension, dyslipidemia, smoking, diabetes and bone disease should be incorporated into the long-term care plan of the KTR to improve outcomes. A number of transplant centers do not supply PCPs with protocols and guidelines, making the task of the PCP more difficult. Despite this, PCPs are expected to continue to provide general preventive medicine, vaccinations and management of chronic medical problems. In this narrative review, we examine the common medical problems seen in KTR from the PCP’s perspective. Medical management issues related to immunosuppressive medications are also briefly discussed. PMID:20422302

  11. Center for Alternative Fuels

    NSDL National Science Digital Library

    The success of the HEV programs under this grant prompted Macomb to launch this resource, the Center for Alternative Fuels. The center holds forums in which academic and industry experts discuss the technical and societal impact of alternative fuels.

  12. National Farm Medicine Center

    MedlinePLUS

    Farm Medicine, Rural Health & Safety National Farm Medicine Center Established in 1981 in response to occupational health problems seen in farm patients coming to Marshfield Clinic, the National Farm Medicine Center ...

  13. Arkansas Water Resources Center

    E-print Network

    Soerens, Thomas

    -800 Cooperating Agencies Arkansas Water Resources Center ARKANSAS SOIL & WATER CONSERVATION COMMISSION WASHINGTON COUNTY SOIL AND WATER CONSERVATION DISTRICT UNIVERSITY OF ARKANSAS Federal Assistance Project No. C Cooperating Agencies ARKANSAS WATER RESOURCES CENTER ARKANSAS SOIL & WATER CONSERVATION COMMISSION WASHINGTON

  14. Regional Instrumentation Centers.

    ERIC Educational Resources Information Center

    Cromie, William J.

    1980-01-01

    Focuses on the activities of regional instrumentation centers that utilize the state-of-the-art instruments and methodology in basic scientific research. The emphasis is on the centers involved in mass spectroscopy, magnetic resonance spectroscopy, lasers, and accelerators. (SA)

  15. BKG Data Center

    NASA Technical Reports Server (NTRS)

    Thorandt, Volkmar; Wojdziak, Reiner

    2013-01-01

    This report summarizes the activities and background information of the IVS Data Center for the year 2012. Included is information about functions, structure, technical equipment, and staff members of the BKG Data Center.

  16. Accredited Birth Centers

    MedlinePLUS

    ... 940-2229 Accredited since September 2014 77 Boise Women's Health & Birth Center Accredited 1502 W Franklin Street Boise, ... 482-0505 Accredited Since September 2012 62 WomenCare Women's Health and Birth Center Accredited 3911 Teays Valley Road ...

  17. Nonschool Learning Center

    ERIC Educational Resources Information Center

    Brown, Doris B.

    1972-01-01

    Describes a privately financed science center, museum and planetarium - observatory in Twin Falls, Idaho. Centers three hour program includes a lecture on archaeology, time to look at displays, a lunch break, and a planetarium lecture. (RB)

  18. INTERNATIONAL PACIFIC RESEARCH CENTER

    E-print Network

    Wang, Yuqing

    INTERNATIONAL PACIFIC RESEARCH CENTER APRIL 2004­MARCH 2005 REPORT SCHOOL OF OCEAN AND EARTH RESEARCH HIGHLIGHTS Indo-Pacific Ocean Climate Pacific Research Center Design by: Susan Yamamoto Printed by: Hagadone Printing Company Photo: Waikiki

  19. Science Centers for All

    NSDL National Science Digital Library

    Christine Nucci

    2003-02-01

    University professors suggest ways to bridge gaps among diverse learners--of different cultural, socioeconomic, physiological, and linguistic backgrounds--through the use of science centers in the classroom. Includes ideas for setting up science centers and celebrating diversity.

  20. Community Center for Fraternity &

    E-print Network

    Escher, Christine

    Community Values Award Center for Fraternity & Sorority;1 The Community Values Award was devised by the OSU Center for Civic Engagement (CCE the highest average community service hours per member, allowing smaller chapters

  1. New England Public Policy Center

    NSDL National Science Digital Library

    Established in January 2005, the New England Public Policy Center at the Federal Reserve Bank of Boston provides high-quality analysis of important policy and economic issues that affect the entire New England region. The materials on their site are contained within five primary sections, which include "Publications", "Conferences & Events", and "Data & Resources". On their homepage, the "What's New" section provides information about recent publications and calls for visiting scholar applications. In the "Publications" area, visitors can browse around by topic, author, and series. Additionally, the "Data & Resources" area provides access to the monthly publication "New England Economic Indicators" and interactive data sets contained in the form of tables and charts. This same section also contains links to resources within the Boston Federal Reserve, such as community development indicators.

  2. International Center for Tropical Agriculture

    NSDL National Science Digital Library

    From cassavas to papayas, the International Center for Tropical Agriculture is concerned with the viability of crops across the world. Specifically, their stated mission is "to reduce hunger and poverty in the tropics through collaborative research that improves agricultural productivity and natural resource management." From their homepage, visitors can read press releases and statements about their most recent findings, and also look over timely documents such as "Integrated Soil Fertility Management in the Tropics" as well as their annual report. The "Research" section is another good place to wander around, as it contains reports on two of their primary areas of interest: agrobiodiversity and the interaction between people and agroecosystems. Finally, it is worth noting that many of the materials here are also available in Spanish.

  3. Woodson Research Center: Digital Collection

    NSDL National Science Digital Library

    2012-01-13

    The mission of the Woodson Research Center at Rice University is to "support the institutional, research and public service programs of the University." Their collections include the institutional records of the institution, along with materials on United States Southern history, British history and drama, Houston, and business. As part of their work, they have contributed hundreds of items to Rice University's Digital Scholarship Archive. Visitors to the site may wish to start by looking over the William Ward Watkin architectural records sub-collection. Watkin was the first supervising architect for Rice, and visitors can learn about his life's work and the very interesting tunnel system he designed for the school. Moving on, the "early Houston histories and documents" area contains 21 primary documents including "Pen and sunlight sketches of greater Houston: the most progressive metropolis in the South" from 1913 and a fascinating document from 1880 titled "Texas: the best land for the Emigrant."

  4. Portability and the National Energy Software Center

    NASA Technical Reports Server (NTRS)

    Butler, M. K.

    1978-01-01

    The software portability problem is examined from the viewpoint of experience gained in the operation of a software exchange and information center. First, the factors contributing to the program interchange to date are identified, then major problem areas remaining are noted. The import of the development of programming language and documentation standards is noted, and the program packaging procedures and dissemination practices employed by the Center to facilitate successful software transport are described. Organization, or installation, dependencies of the computing environment, often hidden from the program author, and data interchange complexities are seen as today's primary issues with dedicated processors and network communications offering an alternative solution.

  5. Center for Women and Information Technology

    NSDL National Science Digital Library

    The Center for Women and Information Technology (CWIT), located at the University of Maryland Baltimore County, was named "the best resource on women and technology on the Web" by ABCNews.com. The center's primary goal is to promote women's involvement in the IT industry. CWIT's Web site provides a wealth of information for women, ranging from learning the basics of computers to IT training and certification. Women considering IT as a field of study will also find information on financial aid and the CWIT Scholars Program. There is a list of books and many links to news articles about women and IT that are both interesting and insightful. .

  6. Larry Pileggi, Center Director

    E-print Network

    Larry Pileggi, Center Director C E N T E R F O R CIRCUIT & SYSTEM SOLUTIONS c2s2.ece Phone: 412.268.6774 Fax: 412.268.1374 pileggi@ece.cmu.edu The Center for Circuit & System Solutions (C2S semiconductor industry and US government, C2S2 is one of six research centers funded under the Focus Center

  7. Assessing Learning in the Primary Classroom. Understanding Primary Education Series

    ERIC Educational Resources Information Center

    Johnson, Sandra

    2011-01-01

    "Assessing Learning in the Primary Classroom" is an accessible introduction to the concepts critical to a professional understanding of this vital aspect of a teacher's role. It comprehensively considers the principles underpinning effective assessment, the different forms it can take and the different purposes it serves, both within and beyond…

  8. Primary prevention of chronic obstructive pulmonary disease in primary care.

    PubMed

    van der Molen, Thys; Schokker, Siebrig

    2009-12-01

    Chronic obstructive pulmonary disease (COPD) is a prevalent disease, with cigarette smoking being the main risk factor. Prevention is crucial in the fight against COPD. Whereas primary prevention is targeted on whole populations, patient populations are the focus of primary care; therefore, prevention in this setting is mainly aimed at preventing further deterioration of the disease in patients who present with the first signs of disease (secondary prevention). Prevention of COPD in primary care requires detection of COPD at an early stage. An accurate definition of COPD is crucial in this identification process. The benefits of detecting new patients with COPD should be determined before recommending screening and case-finding programs in primary care. No evidence is available that screening by spirometry results in significant health gains. Effective treatment options in patients with mild disease are lacking. Smoking cessation is the cornerstone of COPD prevention. Because cigarette smoking is not only a major cause of COPD but is also a major cause of many other diseases, a decline in tobacco smoking would result in substantial health benefits. PMID:20008880

  9. Medicine and Medical Center

    E-print Network

    Faculty of Medicine and Medical Center (FM/AUBMC) #12;400 Faculty of Medicine and Medical Center (FM/AUBMC) Graduate Catalogue 2014­15 Faculty of Medicine and Medical Center (FM/AUBMC) Officers Vice President for Medical Affairs and the Raja N. Khuri Dean of the Faculty of Medicine Ziyad Ghazzal

  10. Medicine and Medical Center

    E-print Network

    Shihadeh, Alan

    Faculty of Medicine and Medical Center (FM/AUBMC) #12;370 Faculty of Medicine and Medical Center (FM/AUBMC) Graduate Catalogue 2013­14 Faculty of Medicine and Medical Center (FM/AUBMC) Officers Vice President for Medical Affairs and the Raja N. Khuri Dean of the Faculty of Medicine Ziyad Ghazzal

  11. Vanderbilt Kennedy Center Orientation

    E-print Network

    Sarkar, Nilanjan

    2013-14 Vanderbilt Kennedy Center Orientation Manual A Guide to History, Programs, Procedures, and Training #12;Page | 1 Welcome to the Vanderbilt Kennedy Center! You may be here because you are a new Kennedy Center is an exciting, innovative organization where caring, compassion, professional expertise

  12. The Ecosystem Science Center

    E-print Network

    The Ecosystem Science Center 2010-2011 Annual report Photo, by graduate student Alex of the Ecosystem Science Center for the period July 1, 2010 July 1, 2011 Introduction to ESC ­ A Message from .......................................... 40 1 #12;A Message from the ESC Director The Ecosystem Science Center has now completed its

  13. The Ecosystem Science Center

    E-print Network

    1 The Ecosystem Science Center 2011-2012 Annual report #12;2 Table of Contents This document summarizes the activities of the Ecosystem Science Center for the period from July 1, 2011 July 1, 2012 of the Ecosystem Science Center who supported this research project in Calumet watershed with a graduate research

  14. Equality of Fitness Centers

    ERIC Educational Resources Information Center

    Swoyer, Jesse O.

    2008-01-01

    The author, who has been a personal trainer for the past ten years, recently realized that all fitness centers are not equal. In February, he was able to participate in the grand opening of the Center for Independent Living of Central PA (CILCP), a fitness center that is designed to accommodate persons with disabilities living in the Central…

  15. Technology Education Teacher Center.

    ERIC Educational Resources Information Center

    DeVore, Paul W.; McCrory, David L.

    This document describes the Technology Education Teacher Center, which was designed as a pilot model for a specific field of study--technology education. The first section of the document examines the development of the Center during its five years of operation. The second section discusses the design of the Center, concentrating on the following…

  16. COATINGS RESEARCH CENTER SUPPORT

    EPA Science Inventory

    he National Science Foundation Industry/University Cooperative Research Center (NSF I/U CRC) program, initiated in 1973, currently sponsors about 58 centers across the nation. The NSF encourages formation of Cooperative Research Centers involving more than one institution. The ...

  17. Louisiana Transportation Research Center

    E-print Network

    Harms, Kyle E.

    Louisiana Transportation Research Center LTRC www.ltrc.lsu.edu 2012-13 ANNUALREPORT #12;The Louisiana Transportation Research Center (LTRC) is a research, technology transfer, and training center administered jointly by the Louisiana Department of Transportation and Development (DOTD) and Louisiana State

  18. Child Care Center APPLICATION

    E-print Network

    Harms, Kyle E.

    Child Care Center APPLICATION Child's name:_______________________Date of birth/Expected due date payroll deduction Community #12;Child Care Center Application Process To apply for enrollment at the LSU Child Care Center, this application form must be completed, signed and received with the $45

  19. Data Center Tasking.

    ERIC Educational Resources Information Center

    Temares, M. Lewis; Lutheran, Joseph A.

    Operations tasking for data center management is discussed. The original and revised organizational structures of the data center at the University of Miami are also described. The organizational strategy addresses the functions that should be performed by the data center, anticipates the specialized skills required, and addresses personnel…

  20. Nuclear Reaction Data Centers

    SciTech Connect

    McLane, V.; Nordborg, C.; Lemmel, H.D.; Manokhin, V.N.

    1988-01-01

    The cooperating Nuclear Reaction Data Centers are involved in the compilation and exchange of nuclear reaction data for incident neutrons, charged particles and photons. Individual centers may also have services in other areas, e.g., evaluated data, nuclear structure and decay data, reactor physics, nuclear safety; some of this information may also be exchanged between interested centers. 20 refs., 1 tab.

  1. Shoulder arthropathy in primary hyperparathyroidism

    SciTech Connect

    Nussbaum, A.J.; Doppman, J.L.

    1982-12-01

    An erosive arthropathy of the hands and wrists has been recognized in patients with primary and secondary hyperparathyroidism. Recently, intra-articular erosions of the humeral head were described in six patients who had been on chronic long-term hemodialysis with secondary hyperparathyroidism. We would like to present the finding of shoulder erosions in four patients with primary hyperparathyroidism and one patient with renal osteodystrophy and suggest that the humeral erosion can occur in both an intra-articular and peri-articular location.

  2. Primary ovarian insufficiency: an update

    PubMed Central

    Cox, Leticia; Liu, James H

    2014-01-01

    Primary ovarian insufficiency is a condition that represents impaired ovarian function on a continuum with intermittent ovulation. This condition commonly leads to premature menopause, defined as cessation of ovulation prior to the age of 40 years. Because there are potential immediate and long-term consequences of hypoestrogenism, a timely diagnosis is invaluable. This comprehensive review will discuss identifiable causes for primary ovarian insufficiency, including genetic disorders and metabolic abnormalities, as well as review current strategies for diagnosis, evaluation, and management of women with this condition. PMID:24591848

  3. PRIMARY CARE RESEARCH: 2012DIVISION OF FAMILY MEDICINE AND PRIMARY CARE,

    E-print Network

    Geldenhuys, Jaco

    1 PRIMARY CARE RESEARCH: 2012DIVISION OF FAMILY MEDICINE AND PRIMARY CARE, FACULTY OF MEDICINE AND HEALTH SCIENCES, STELLENBOSCH UNIVERSITY #12;2 3 PRIMARY CARE RESEARCH 2012 PRIMARY CARE RESEARCH 2012 2 0 1 2 #12;4 5 PRIMARY CARE RESEARCH 2012 PRIMARY CARE RESEARCH 2012 INTRODUCTION CLINICAL RESEARCH

  4. The Foundation Center Online

    NSDL National Science Digital Library

    The Foundation Center: An independent nonprofit organization established by foundations in 1956 to increase public understanding of the foundation field. The Center provides a comprehensive and up-to-date database on foundations and corporate giving programs, and publishes The Foundation Directory--the classic reference work for grantseekers--and some 50 other directories, guides and research reports. Information from the database is available electronically through custom searching and online services. Center information is provided free to the public at five Foundation Center libraries and approximately 200 cooperating libraries across the country. The Center introduces thousands of grantseekers each year to the funding research process.

  5. Emergency Operations Center at Johnson Space Center

    NASA Technical Reports Server (NTRS)

    Caylor, Gary C.

    1997-01-01

    In June 1966, at the start of the Gulf Coast hurricane season, the Johnson Space Center (JSC) celebrated the opening of its new 4,000-square foot, state-of-the-art Emergency Operations Center (EOC). The new EOC has been upgraded and enhanced to support a wide spectrum of emergencies affecting JSC and neighboring communities. One of the main features of the EOC is its premier computerized dispatch center. The new system unites many of JSC's critical emergency functions into one integrated network. It automatically monitors fire alarms, security entrances, and external cameras. It contains the JSC inventory of hazardous materials, by building and room, and can call up Material Safety Data Sheets for most of the generic hazardous materials used on-site. The EOC is available for community use during area emergencies such as hurricanes and is a welcome addition to the Clear Lake/Galveston Bay Area communities' emergency response resources.

  6. Primary Sources and Inquiry Learning

    ERIC Educational Resources Information Center

    Pappas, Marjorie L.

    2006-01-01

    In this article, the author discusses inquiry learning and primary sources. Inquiry learning puts students in the active role of investigators. Questioning, authentic and active learning, and interactivity are a few of the characteristics of inquiry learning that put the teacher and library media specialist in the role of coaches while students…

  7. Presentation 7: Multiple Primary Rules

    Cancer.gov

    MP Rules - Note 2 The registrar must recognize that during the diagnostic workup the physician may start with a non-specific diagnosis (NOS) and as testing is completed, a more specific histology is identified. These diagnoses are not multiple primaries; they represent steps in the diagnostic work-up. See rules M7-M12.

  8. Department of Primary Care Respiratory

    E-print Network

    Cheng, Mei-Fang

    Department of Primary Care Respiratory Therapy - South - about it's all ChoiCes... exclusively dedicated to healthcare state-of-the-art equipment the very best faculty & students rigorous course work to the Program office at Rutgers SHRP, Respiratory Therapy Program, 40 East Laurel Road, Suite 2105, Stratford

  9. PRTR PRIMARY PUMP FLYWHEEL ANALYSIS

    Microsoft Academic Search

    J. Muraoka; R. G. Clark; E. E. Utz

    1960-01-01

    The ability of a prototype PRTR primary pump equipped with a flywheel ; (1185 lb-ft² moment of inertia) to maintain adequate coolant flow, in a ; total electric power failure, until natural convection flow became sufficient was ; investigated. Experiments showed that the flywheel decay times varied from one ; to three minutes; and analytical study showed that mechanical friction

  10. ASE and Primary School Science

    ERIC Educational Resources Information Center

    Harlen, Wynne

    2013-01-01

    This article focuses on the role of the Association for Science Education (ASE) in supporting and developing policy and practice in primary school science. It first sets the events after the formation of ASE in 1963 in the context of what went before. It then takes a mainly chronological view of some, but by no means all, of ASE's activities…

  11. Phytotherapy in primary health care.

    PubMed

    Antonio, Gisele Damian; Tesser, Charles Dalcanele; Moretti-Pires, Rodrigo Otavio

    2014-06-01

    OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population. PMID:25119949

  12. The Primary Teacher's Survival Guide.

    ERIC Educational Resources Information Center

    Heyda, Pamela A.

    This guide for primary school teachers presents commonly asked questions and answers. Chapter 1, "How Do I Set Up My Classroom?" discusses desk and furniture arrangement. Chapter 2, "How Do I Survive the First Days of School?" offers tips for meeting and greeting students, establishing routines, and presenting activities. Chapter 3, "How Do I…

  13. Chemistry I Primary Writing or

    E-print Network

    Cantlon, Jessica F.

    MTH 161 Calculus I CHM 131 Chemistry I Primary Writing or Humanities/Social Science MTH 162 Calculus II CHM 132 Chemistry II PHY 121 Physics I Mechanics MTH 163/165 Differential Equations BIO 110/141 & 122/142. Any biology, microbiology, neuroscience, chemistry, or physics course with number greater

  14. Chemistry I Primary Writing or

    E-print Network

    Goldman, Steven A.

    MTH 161 Calculus I CHM 131 Chemistry I Primary Writing or Humanities/Social Science MTH 162 Calculus II CHM 132 Chemistry II PHY 121 Physics I Mechanics MTH 163/165 Differential Equations BIO 110, chemistry, or physics course with number greater than 109 may be used to fulfill this requirement (excluding

  15. Chemistry I Primary Writing or

    E-print Network

    Cantlon, Jessica F.

    MTH 161 Calculus I CHM 131 Chemistry I Primary Writing or Humanities/Social Science MTH 162 Calculus II CHM 132 Chemistry II PHY 121 Physics I Mechanics MTH 165 Differential Equations BIO 110/142. Any biology, microbiology, neuroscience, chemistry, or physics course with number greater than 109 may

  16. Chemistry I Primary Writing or

    E-print Network

    Cantlon, Jessica F.

    MTH 161 Calculus I CHM 131 Chemistry I Primary Writing or Humanities/Social Science MTH 162 Calculus II CHM 132 Chemistry II PHY 121 Physics I Mechanics MTH 165 Differential Equations BIO 110 biology, microbiology, neuroscience, chemistry, or physics course with number greater than 109 may be used

  17. Verapamil-induced “primary” polydipsia

    Microsoft Academic Search

    I. D. Schwartz; D. Scagliotti

    1995-01-01

    An 11-month-old male infant with recurrent supraventricular tachycardia (SVT) was treated with oral verapamil. Shortly thereafter he developed marked changes in behavior including lethargy, intensely increased thirst and urination, and irritability when denied fluids. “Primary” polydipsia was diagnosed following an evaluation which showed no evidence of adrenal insufficiency, diabetes insipidus, diabetes mellitus, hypercalcemia, hyperosmolality, or renal disease. The symptoms resolved

  18. PRIMARY PREVENTION OF ADOLESCENT PREGNANCY

    Microsoft Academic Search

    Steven P Schinke; Betty J. Blythe; Lewayne D. Gilchrist; Gloria Adele Burt

    1981-01-01

    The scope and problems of adolescent pregnancy are far reaching. Social workers need strategies to help teenagers avoid early, unwanted pregnancy. This paper gives a promising approach to such primary prevention. Delivered in small groups, the cognitive-behavioral prevention strategy taps theory and empirical data on adolescent sexuality, contraception, and social work group methods. Prevention training incorporates facts about human reproduction

  19. Conditional Logic and Primary Children.

    ERIC Educational Resources Information Center

    Ennis, Robert H.

    Conditional logic, as interpreted in this paper, means deductive logic characterized by "if-then" statements. This study sought to investigate the knowledge of conditional logic possessed by primary children and to test their readiness to learn such concepts. Ninety students were designated the experimental group and participated in a 15-week…

  20. English in the Primary School.

    ERIC Educational Resources Information Center

    Tosh, J.; And Others

    1969-01-01

    Three articles deal with primary school English instruction. W. J. Jackson examines some possible sets of objectives for a language arts program--e.g., development through language of creative and reasoning faculties, awareness of language characteristics and of writing models useful in contemporary society, achievement of expected terminal and…

  1. Fatigue in primary biliary cirrhosis

    Microsoft Academic Search

    Ghulam Abbas; Roberta A. Jorgensen; Keith D. Lindor

    2010-01-01

    Primary biliary cirrhosis (PBC) is a chronic, autoimmune, cholestatic liver disease with a slowly progressive course. Without treatment, most patients eventually develop fibrosis of the liver and may need liver transplantation in the late stage of disease. Fatigue and pruritus are the most common symptoms of PBC, but the majority of patients are asymptomatic at first presentation. There is no

  2. Lead-free primary explosives

    DOEpatents

    Huynh, My Hang V.

    2010-06-22

    Lead-free primary explosives of the formula (cat).sub.Y[M.sup.II(T).sub.X(H.sub.2O).sub.6-X].sub.Z, where T is 5-nitrotetrazolate, and syntheses thereof are described. Substantially stoichiometric equivalents of the reactants lead to high yields of pure compositions thereby avoiding dangerous purification steps.

  3. Primary Schooling in West Bengal

    ERIC Educational Resources Information Center

    Sen, Amartya

    2010-01-01

    With his Nobel Prize award money, Amartya Sen set up the Pratichi Trust which carries out research, advocacy and experimental projects in basic education, primary health care, and women's development in West Bengal and Bangladesh. Professor Sen himself took active interest in this work--helping set the agenda, looking at the evidence from…

  4. Primary immunodeficiencies underlying fungal infections

    PubMed Central

    Lanternier, Fanny; Cypowyj, Sophie; Picard, Capucine; Bustamante, Jacinta; Lortholary, Olivier; Casanova, Jean-Laurent; Puel, Anne

    2014-01-01

    Purpose of review We review the primary immunodeficiencies underlying an increasing variety of superficial and invasive fungal infections. We also stress that the occurrence of such fungal infections should lead physicians to search for the corresponding single-gene inborn errors of immunity. Finally, we suggest that other fungal infections may also result from hitherto unknown inborn errors of immunity, at least in some patients with no known risk factors. Recent findings An increasing number of primary immunodeficiencies are being shown to underlie fungal infectious diseases in children and young adults. Inborn errors of the phagocyte NADPH oxidase complex (chronic granulomatous disease), severe congenital neutropenia and leukocyte adhesion deficiency type I confer a predisposition to invasive aspergillosis and candidiasis. More rarely, inborn errors of IFN-? immunity underlie endemic mycoses. Inborn errors of IL-17 immunity have recently been shown to underlie chronic mucocutaneous candidiasis, whereas inborn errors of CARD9 immunity underlie deep dermatophytosis and invasive candidiasis. Summary Chronic mucocutaneous candidiasis, invasive candidiasis, invasive aspergillosis, deep dermatophytosis, pneumocystosis, and endemic mycoses can all be caused by primary immunodeficiencies. Each type of infection is highly suggestive of a specific type of primary immunodeficiency. In the absence of overt risk factors, single-gene inborn errors of immunity should be sought in children and young adults with these and other fungal diseases. PMID:24240293

  5. User Fees in Primary Education

    ERIC Educational Resources Information Center

    Kattan, Raja Bentaouet; Burnett, Nicholas

    2004-01-01

    There are a large number of different "fees" that private households sometimes have to pay for publicly provided primary education, including tuition fees, textbook fees or costs and/or rental payments, compulsory uniforms, PTA dues, and various special fees such as exam fees, contributions to district education boards, and the like. In many…

  6. Civil Engineering in Primary Schools

    ERIC Educational Resources Information Center

    Brown, Martin; Strong, Alan

    2010-01-01

    For many children of primary school age, an engineer is the man who comes to service the central heating system or who fixes the family car when it breaks down. Most have never met a "real" professional engineer, and have no idea of what is involved in the exciting world of engineering. Most assume that engineers are men. To try to remove these…

  7. Primary Atrophic Profound Linear Scleroderma

    Microsoft Academic Search

    Maria Blaszczyk; Kamila Krysicka-Janiger

    2000-01-01

    We present 3 unusual cases of deep linear, primary atrophic scleroderma, not preceded by inflammatory reaction and sclerosis, involving the subcutis and deeper tissues. These cases differ in the course and prognosis from typical profound scleroderma since they do not lead to disfiguration and crippling deformities. In contrast to the atrophies left after regression of morphea or linear scleroderma, they

  8. Choosing a primary care provider

    MedlinePLUS

    Family doctor - how to choose one; Primary care provider - how to choose one; Doctor - how to choose a family doctor ... A PCP is your main health care provider in non-emergency ... and teach healthy lifestyle choices Identify and treat common ...

  9. The Primary Dental Care Workforce.

    ERIC Educational Resources Information Center

    Neenan, M. Elaine; And Others

    1993-01-01

    A study describes the characteristics of the current primary dental care workforce (dentists, hygienists, assistants), its distribution, and its delivery system in private and public sectors. Graduate dental school enrollments, trends in patient visits, employment patterns, state dental activities, and workforce issues related to health care…

  10. Primary intestinal lymphangiectasia (Waldmann's disease)

    Microsoft Academic Search

    Stéphane Vignes; Jérôme Bellanger

    2008-01-01

    Primary intestinal lymphangiectasia (PIL) is a rare disorder characterized by dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen and responsible for protein-losing enteropathy leading to lymphopenia, hypoalbuminemia and hypogammaglobulinemia. PIL is generally diagnosed before 3 years of age but may be diagnosed in older patients. Prevalence is unknown. The main symptom is predominantly bilateral lower limb

  11. Can a secondary isotope effect be larger than a primary?

    PubMed

    Perrin, Charles L; Burke, Kathryn D

    2015-05-21

    Primary and secondary (18)O equilibrium isotope effects on the acidities of a variety of Brřnsted and Lewis acids centered on carbon, boron, nitrogen, and phosphorus were computed by density-functional theory. For many of these acids, the secondary isotope effect was found to be larger than the primary isotope effect. This is a counterintuitive result, because the H atom that is lost is closer to the (18)O atom that is responsible for the primary isotope effect. The relative magnitudes of the isotope effects can be associated with the vibrational frequency and zero-point energy of the X?O vibrations, which are greater than those of the X-O vibrations. However, the difference between these contributions is small, and the major responsibility for the larger secondary isotope effect comes from the moment-of-inertia factor, which depends on the position of the (18)O atom relative to the principal axes of rotation. PMID:25879248

  12. Pioneering community-oriented primary care.

    PubMed

    Susser, M

    1999-01-01

    This is a retrospective report on the importance of Kark and Cassel's 1952 paper on community-oriented primary care (COPC). In 1978, WHO and UNICEF endorsed COPC. However, the ideas girding and framing this approach had first been given full expression in practice some four decades earlier. In Depression-Era South Africa, Sidney Kark, a leader of the National Department of Health, converted the emergent discipline of social medicine into a unique form of comprehensive practice and established the Pholela Health Center, which was the explicit model for COPC. COPC as founded and practiced by Kark was a community, family and personal practice; it also was a multidisciplinary and team practice. Furthermore, the innovations of COPC entailed monitoring, evaluation, and research. Evaluation is the essence of Kark and Kassel's paper, which offers a convincing demonstration of the effects of COPC. Its key findings include the following: 1) that there was a decline in the incidence of syphilis in the area served by the health center; 2) that diet and nutrition improved; and 3) that the crude mortality rate as well as the infant mortality rate--the standard marker--declined in Pholela. In the succeeding decades, OPC had an international legacy (through WHO and H. Jack Geiger's influence in the US Office of Economic Opportunity), which came full circle in the 1980s, when a young generation of South Africans began to search their history for models for their health care programs at the dawn of the post-Apartheid Era. PMID:10361769

  13. US Approaches to Physician Payment: The Deconstruction of Primary Care

    PubMed Central

    Berenson, Robert A.

    2010-01-01

    The purpose of this paper is to address why the three dominant alternatives to compensating physicians (fee-for-service, capitation, and salary) fall short of what is needed to support enhanced primary care in the patient-centered medical home, and the relevance of such payment reforms as pay-for-performance and episodes/bundling. The review illustrates why prevalent physician payment mechanisms in the US have failed to adequately support primary care and why innovative approaches to primary care payment play such a prominent role in the PCMH discussion. FFS payment for office visits has never effectively rewarded all the activities that comprise prototypical primary care and may contribute to the “hamster on a treadmill” problems in current medical practice. Capitation payments are associated with risk adjustment challenges and, perhaps, public perceptions of conflict with patients’ best interests. Most payers don’t employ and therefore cannot generally place physicians on salary; while in theory such salary payments might neutralize incentives, operationally, “time is money;” extra effort devoted to meeting the needs of a more complex patient will likely reduce the services available to others. Fee-for-service, the predominant physician payment scheme, has contributed to both the continuing decline in the primary care workforce and the capability to serve patients well. Yet, the conceptual alternative payment approaches, modified fee-for-service (including fee bundles), capitation, and salary, each have their own problems. Accordingly, new payment models will likely be required to support restoration of primary care to its proper role in the US health care system, and to promote and sustain the development of patient-centered medical homes. PMID:20467910

  14. [Primary suture following the bile duct exploration in cholelithiasis].

    PubMed

    Piecuch, Jerzy; Arendt, Jerzy; Gradzik, Robert; Rudzki, Marek; Sosada, Krystyn; Waniczek, Dariusz

    2004-01-01

    Classical performance of bile duct exploration is always strictly connected with the problem of an incised bile duct closure. In majority of surgical centers an external T-tube drainage was carried out in last century. But is an external drainage the best method to be used? The aim of the paper was to establish criteria for including (or excluding) patients to groups undergoing primary suture of bile duct. The comparison of the patients in whom bile duct exploration was followed by primary suture with the group in which T-tube was left in bile duct lumen was performed. Recently in our Department a classical method has been used to operate on 65 patients with cholelithiasis. In 42 patients a preoperatively planned bile duct exploration has been performed. In 14 patients a T-tube was left after the exploration, in 24 patients bile duct was closed with a primary suture. In other 18 patients with residual and recurrent bile duct stones T-tube was left in bile duct only in two patients. Based on literature analysis, our observations, and surgical experience criteria for including and excluding patients for primary suture of bile duct have been established. Groups of patients with and without T-tube were compared, considering complications and economic aspects of hospitalization. Our opinion is that whenever in specialized surgical centers detailed criteria are established and followed precisely, primary bile duct closure is a simple and safe procedure, responsible for few complications. The cost of hospitalization in the case of primary suture is half as much as the price of the hospitalization in the case of T-tube. PMID:15518068

  15. Climatic Data Center Climatic Data Center

    E-print Network

    Network (USCRN) for the continental United States. Coupled with an ongoing commitment to the network Climatology Network (USHCN-M) to regionally complement the USCRN. NCDC expanded climate service activities, and decide what scientific records are preserved in a NOAA archive. The Center made important contributions

  16. Physician Interactions with Electronic Health Records in Primary Care

    PubMed Central

    Montague, Enid; Asan, Onur

    2013-01-01

    Objective It is essential to design technologies and systems that promote appropriate interactions between physicians and patients. This study explored how physicians interact with Electronic Health Records (EHRs) to understand the qualities of the interaction between the physician and the EHR that may contribute to positive physician-patient interactions. Study Design Video-taped observations of 100 medical consultations were used to evaluate interaction patterns between physicians and EHRs. Quantified observational methods were used to contribute to ecological validity. Methods Ten primary care physicians and 100 patients from five clinics participated in the study. Clinical encounters were recorded with video cameras and coded using a validated objective coding methodology in order to examine how physicians interact with electronic health records. Results Three distinct styles were identified that characterize physician interactions with the EHR: technology-centered, human-centered, and mixed. Physicians who used a technology-centered style spent more time typing and gazing at the computer during the visit. Physicians who used a mixed style shifted their attention and body language between their patients and the technology throughout the visit. Physicians who used the human-centered style spent the least amount of time typing and focused more on the patient. Conclusion A variety of EHR interaction styles may be effective in facilitating patient-centered care. However, potential drawbacks of each style exist and are discussed. Future research on this topic and design strategies for effective health information technology in primary care are also discussed. PMID:24009982

  17. Primary non-compliance with prescribed medication in primary care

    Microsoft Academic Search

    P H Beardon; M M McGilchrist; A D McKendrick; D G McDevitt; T M MacDonald

    1993-01-01

    OBJECTIVE--To determine the rate of patients not redeeming their prescriptions (primary noncompliance) and assess the factors influencing this. DESIGN--Observational study comparing copies of prescriptions written by general practitioners with those dispensed by pharmacists and subsequent case record review. SETTING--A large rural general practice in Tayside. SUBJECTS--All 4854 patients who received prescriptions (20,921) written between January 1989 and March 1989. MAIN

  18. Learning Discrete Mathematics and Computer Science via Primary Historical Sources

    NSDL National Science Digital Library

    This site offers 18 curricular modules based on primary historical sources for undergraduate courses in discrete mathematics, combinatorics, logic, abstract algebra, graph theory, analysis of algorithms, data structures, automata and formal languages in computer science. Designed to capture the spark of discovery and motivate the subsequent lines of inquiry, our projects are centered around key historical sources that led to the development of selected topics in the above fields.

  19. Multiobjective location planning for primary medical services in rural Iowa

    SciTech Connect

    Hillsman, E.L.

    1980-01-01

    Developing location plans for primary medical services is a multiobjective location problem. In rural regions, plans must consider both the ability of a location to retain needed health care professionals and the accessibility of service center locations to the rural population. Using township level population data and a model of physician attrition, these objectives were incorporated into a location-allocation model and applied to rural Iowa.

  20. Compensation for primary reflector wavefront error

    NASA Technical Reports Server (NTRS)

    Meinel, Aden B. (Inventor); Meinel, Marjorie P. (Inventor); Stacy, John E. (Inventor)

    1989-01-01

    In a telescope having primary and secondary reflectors, wherein the actual primary reflector surface deviates from an ideal primary reflector surface, such deviation is compensated for. At least one intermediate element forms an image of the primary surface onto the secondary surface, so each point on the secondary surface corresponds to a point on the primary surface. The secondary surface is formed with a deviation from an ideal secondary surface, with the piston distance of each point on the actual secondary surface equal to the piston distance of a corresponding point on the actual primary surface from the ideal primary surface. It is found that this results in electromagnetic (e.g., light) rays which strike a deviating area of the actual primary surface being brought to the same focus as if the actual primary surface did not have a deviation from an ideal primary surface.