Science.gov

Sample records for 3-year period patients

  1. Vascular Calcification in Patients with Nondialysis CKD over 3 Years

    PubMed Central

    Molina, Pablo; Cerverón, M. Jesús; Vila, Rocío; Bover, Jordi; Nieto, Javier; Barril, Guillermina; Martínez-Castelao, Alberto; Fernández, Elvira; Escudero, Verónica; Piñera, Celestino; Adragao, Teresa; Navarro-Gonzalez, Juan F.; Molinero, Luis M.; Castro-Alonso, Cristina; Pallardó, Luis M.; Jamal, Sophie A.

    2015-01-01

    Background and objectives Vascular calcification (VC) is common in CKD, but little is known about its prognostic effect on patients with nondialysis CKD. The prevalence of VC and its ability to predict death, time to hospitalization, and renal progression were assessed. Design, setting, participants, & measurements The Study of Mineral and Bone Disorders in CKD in Spain is a prospective, observational, 3-year follow-up study of 742 patients with nondialysis CKD stages 3–5 from 39 centers in Spain from April to May 2009. VC was assessed using Adragao (AS; x-ray pelvis and hands) and Kauppila (KS; x-ray lateral lumbar spine) scores from 572 and 568 patients, respectively. The primary end point was death. Secondary outcomes were hospital admissions and appearance of a combined renal end point (beginning of dialysis or drop >30% in eGFR). Factors related to VC were assessed by logistic regression analysis. Survival analysis was assessed by Cox proportional models. Results VC was present in 79% of patients and prominent in 47% (AS≥3 or KS>6). Age (odds ratio [OR], 1.05; 95% confidence interval [95% CI], 1.02 to 1.07; P<0.001), phosphorous (OR, 1.68; 95% CI, 1.28 to 2.20; P<0.001), and diabetes (OR, 2.11; 95% CI, 1.32 to 3.35; P=0.002) were independently related to AS≥3. After a median follow-up of 35 months (interquartile range=17–36), there were 70 deaths (10%). After multivariate adjustment for age, smoking, diabetes, comorbidity, renal function, and level of phosphorous, AS≥3 but not KS>6 was independently associated with all-cause (hazard ratio [HR], 2.07; 95% CI, 1.07 to 4.01; P=0.03) and cardiovascular (HR, 3.46; 95% CI, 1.27 to 9.45; P=0.02) mortality as well as a shorter hospitalization event–free period (HR, 1.14; 95% CI, 1.06 to 1.22; P<0.001). VC did not predict renal progression. Conclusions VC is highly prevalent in patients with CKD. VC assessment using AS independently predicts death and time to hospitalization. Therefore, it could be a useful

  2. Coincident 1.3-year Periodicities in the ap Geomagnetic Index and the Solar Wind

    NASA Technical Reports Server (NTRS)

    Paularena, K. I.; Szabo, A.; Richardson, J. D.

    1995-01-01

    Recent observations show an approximately 1.3-year period in the speed of the solar wind detected by the IMP 8 and Voyager 2 spacecraft. A similar period is also seen in the north-south (GSE) component of the magnetic field observed by IMP 8. Since both parameters are commonly used as input to models of geomagnetic activity, the 'ap' index (a measure of geomagnetic disturbance) is examined to look for this periodicity. The Lomb-Scargle periodogram method is used on the ap, plasma, and magnetic field data during the 1973-1994 time range. A dynamic FFT periodogram method is also used to analyze the ap data during this time, as well as to look for periods present between 1932 and 1972. A clear 1.3-year periodicity is present in the post-1986 data when the same period is observed in the plasma and field data. The V(2)B(zsm) and V(2)B(s) proxies for geomagnetic activity also show this periodicity. However, the southward (GSM) component of the magnetic field does not have a 1.3-year period, and neither do solar wind or ap data from 1973-1985. This demonstrates that the ap geomagnetic index can act as a proxy for solar wind periodicities at this time scale. Historic ap data are examined, and show that a similar periodicity in ap exists around 1942. Since auroral data show a 1.4-year periodicity, all these similar periods may result from a common underlying solar mechanism.

  3. Primary prevention in health care employees: a prospective intervention study with a 3-year training period.

    PubMed

    Löffler, Harald; Bruckner, Thomas; Diepgen, Thomas; Effendy, Isaak

    2006-04-01

    Irritant contact dermatitis is a mayor problem in health care employees. Because educational programs have shown convincing success in certain occupations (e.g. in hairdressers), this study investigates the effect of a special training program in health care trainees. 521 trainees from 14 nursing schools in Central Germany were randomly divided in 2 groups, (i) an intervention group with a regular teaching protocol regarding all aspects of primary prevention and (ii) a control group without any further teaching. Morphological changes of the hands, use of hand care creams and knowledge regarding skin care were evaluated regularly during their 3 years lasting training period (1999-2002). In the intervention group, we found at the end of the 3-year training period a significant better skin condition of the hands than in the control group: a 3-year prevalence of morphological skin changes of 66.7% versus 89.3%. The unteached trainees (control group) had an odds ratio (OR) of 4.8 [95% confidential interval (CI): 2.9-7.8] for developing any skin changes on the hands after 3 years. Besides the effect of the teaching, the history of hand dermatitis before the study start was an independent risk factor for development of further hand dermatitis [OR 1.9, 95% CI: 1.0-3.6). Age and sex showed no influence on the skin condition. Atopic constitution had an influence on the development of skin changes only at the evaluation after 18 month. The observed effect in the intervention group may best be explained by different behaviour of the trainees, e.g. the amount of hand washing was reduced, while procedure of hand disinfection remained unchanged compared with the control group. However, the amount of used skin care cream did not differ between the both groups. This study shows that primary prevention of skin disease by regularly teaching during the training period of medical employees can effectively reduce the risk of development of irritant skin changes of the hands. Therefore

  4. Living with diabetes—Development of learning patterns over a 3-year period

    PubMed Central

    Kneck, Åsa; Fagerberg, Ingegerd; Eriksson, Lars E.; Lundman, Berit

    2014-01-01

    Background Learning involves acquiring new knowledge and skills, and changing our ways of thinking, acting, and feeling. Learning in relation to living with diabetes is a lifelong process where there is limited knowledge of how it is experienced and established over time. It was considered important to explore how learning was developed over time for persons living with diabetes. Aim The aim of the study was to identify patterns in learning when living with diabetes, from recently being diagnosed, and over a 3-year period. Materials and methods A longitudinal qualitative descriptive design was used. Thirteen participants, with both type I and type II diabetes, were interviewed at three different occasions during a 3-year period. Qualitative content analysis was used in different steps in order to distinguish patterns. Findings Five main patterns of learning were identified. Two of the patterns (I and II) were characterized by gradually becoming comfortable living with diabetes, whereas for one pattern (IV) living with diabetes became gradually more difficult. For pattern V living with diabetes was making only a limited impact on life, whereas for Pattern III there was a constant management of obstacles related to illness. The different patterns in the present study showed common and different ways of learning and using different learning strategies at different timespans. Conclusion The present study showed that duration of illness is not of importance for how far a person has come in his own learning process. A person-centered care is needed to meet the different and changing needs of persons living with diabetes in relation to learning to live with a lifelong illness. PMID:25030359

  5. [3-year results of clinical and immunological monitoring of patients with multiple sclerosis treated by copaxone].

    PubMed

    Orlova, Iu Iu; Alifirova, V M; Cherdyntseva, N V; Zagrebina, I A; Bychkova, I V

    2005-01-01

    Tipe 1 T-helper cells are of importance in development of multiple sclerosis (MS). Copaxone (TEVA, Israel) is one of the preventive drugs, which modifies T-helpers activity. Thirty-three patients with MS were treated by copaxone for 2 years and 13 patients--for 3 years. Clinical and immunological parameters were examined: amount of CD3+, CD4+, CD8+, CD16+, CD22+, CD95+, CD25+ lymphocytes, HLA-D+ cells, IgG, IgA, IgM and phagocytosis. During the treatment course, mean rate of relapses decreased from the pretreatment value from 1.26 +/- 0.11 to 0.59 +/- 0.11 in the first year and 0.28 +/- 0.07 in the second one. After 3 years no relapses were observed in 13 patients. Relapse rate was the highest in the first 3-6 months. But after 3 months there was an increase of CD22+ cells that persisted for all the period of the study. After a year of the treatment, a level of IgM, IgG, IgA and CD95+ cells has raised significantly, with decreasing of a number of CD4+ and CD8+ cells. The authors suggest that immunological shift is related to mechanism of copaxone action determining its positive effect i.e. reducing of frequency of MS relapses.

  6. Molecular Diagnosis of Toxoplasmosis in Immunocompromised Patients: a 3-Year Multicenter Retrospective Study

    PubMed Central

    Sterkers, Yvon; Yera, Hélène; Accoceberry, Isabelle; Menotti, Jean; Cassaing, Sophie; Brenier-Pinchart, Marie-Pierre; Hennequin, Christophe; Delhaes, Laurence; Bonhomme, Julie; Villena, Isabelle; Scherer, Emeline; Dalle, Frédéric; Touafek, Feriel; Filisetti, Denis; Varlet-Marie, Emmanuelle; Pelloux, Hervé; Bastien, Patrick

    2015-01-01

    Toxoplasmosis is a life-threatening infection in immunocompromised patients (ICPs). The definitive diagnosis relies on parasite DNA detection, but little is known about the incidence and burden of disease in HIV-negative patients. A 3-year retrospective study was conducted in 15 reference laboratories from the network of the French National Reference Center for Toxoplasmosis, in order to record the frequency of Toxoplasma gondii DNA detection in ICPs and to review the molecular methods used for diagnosis and the prevention measures implemented in transplant patients. During the study period, of 31,640 PCRs performed on samples from ICPs, 610 were positive (323 patients). Blood (n = 337 samples), cerebrospinal fluid (n = 101 samples), and aqueous humor (n = 100 samples) were more frequently positive. Chemoprophylaxis schemes in transplant patients differed between centers. PCR follow-up of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients was implemented in 8/15 centers. Data from 180 patients (13 centers) were further analyzed regarding clinical setting and outcome. Only 68/180 (38%) patients were HIV+; the remaining 62% consisted of 72 HSCT, 14 solid organ transplant, and 26 miscellaneous immunodeficiency patients. Cerebral toxoplasmosis and disseminated toxoplasmosis were most frequently observed in HIV and transplant patients, respectively. Of 72 allo-HSCT patients with a positive PCR result, 23 were asymptomatic; all were diagnosed in centers performing systematic blood PCR follow-up, and they received specific treatment. Overall survival of allo-HSCT patients at 2 months was better in centers with PCR follow-up than in other centers (P < 0.01). This study provides updated data on the frequency of toxoplasmosis in HIV-negative ICPs and suggests that regular PCR follow-up of allo-HSCT patients could guide preemptive treatment and improve outcome. PMID:25762774

  7. Molecular diagnosis of toxoplasmosis in immunocompromised patients: a 3-year multicenter retrospective study.

    PubMed

    Robert-Gangneux, Florence; Sterkers, Yvon; Yera, Hélène; Accoceberry, Isabelle; Menotti, Jean; Cassaing, Sophie; Brenier-Pinchart, Marie-Pierre; Hennequin, Christophe; Delhaes, Laurence; Bonhomme, Julie; Villena, Isabelle; Scherer, Emeline; Dalle, Frédéric; Touafek, Feriel; Filisetti, Denis; Varlet-Marie, Emmanuelle; Pelloux, Hervé; Bastien, Patrick

    2015-05-01

    Toxoplasmosis is a life-threatening infection in immunocompromised patients (ICPs). The definitive diagnosis relies on parasite DNA detection, but little is known about the incidence and burden of disease in HIV-negative patients. A 3-year retrospective study was conducted in 15 reference laboratories from the network of the French National Reference Center for Toxoplasmosis, in order to record the frequency of Toxoplasma gondii DNA detection in ICPs and to review the molecular methods used for diagnosis and the prevention measures implemented in transplant patients. During the study period, of 31,640 PCRs performed on samples from ICPs, 610 were positive (323 patients). Blood (n = 337 samples), cerebrospinal fluid (n = 101 samples), and aqueous humor (n = 100 samples) were more frequently positive. Chemoprophylaxis schemes in transplant patients differed between centers. PCR follow-up of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients was implemented in 8/15 centers. Data from 180 patients (13 centers) were further analyzed regarding clinical setting and outcome. Only 68/180 (38%) patients were HIV(+); the remaining 62% consisted of 72 HSCT, 14 solid organ transplant, and 26 miscellaneous immunodeficiency patients. Cerebral toxoplasmosis and disseminated toxoplasmosis were most frequently observed in HIV and transplant patients, respectively. Of 72 allo-HSCT patients with a positive PCR result, 23 were asymptomatic; all were diagnosed in centers performing systematic blood PCR follow-up, and they received specific treatment. Overall survival of allo-HSCT patients at 2 months was better in centers with PCR follow-up than in other centers (P < 0.01). This study provides updated data on the frequency of toxoplasmosis in HIV-negative ICPs and suggests that regular PCR follow-up of allo-HSCT patients could guide preemptive treatment and improve outcome.

  8. Twenty years of interplanetary magnetic field variations with periods in the range of 10 days to 3 years

    SciTech Connect

    Szabo, A.; Lepping, R.P.; King, J.H.

    1995-06-01

    Twenty years of interplanetary magnetic field data collected primarily by the IMP-8 spacecraft near Earth has been analyzed by a dynamic periodogram method in search of significant periodicities in the range of 10 days to 3 years. The method has the advantage of detecting variations with time in the periodicities besides determining the power and phase of the dominant variations. It has been found that the well known periodicities near 1 year and 27 days are strongly modulated by the solar cycle. Both of these periodicities are only detected during solar minimum. During solar maximum. a number of unusual variations are observed. Special emphasis will be placed on the recently reported 1.3 year variation in solar wind parameters besides periods in the interplanetary magnetic field near 51, 73 and 154 days. Correlations with solar wind plasma and solar index variations will also be presented.

  9. Twenty years of interplanetary magnetic field variations with periods in the range of 10 days to 3 years

    NASA Technical Reports Server (NTRS)

    Szabo, A.; Lepping, R. P.; King, J. H.

    1995-01-01

    Twenty years of interplanetary magnetic field data collected primarily by the IMP-8 spacecraft near Earth has been analyzed by a dynamic periodogram method in search of significant periodicities in the range of 10 days to 3 years. The method has the advantage of detecting variations with time in the periodicities besides determining the power and phase of the dominant variations. It has been found that the well known periodicities near 1 year and 27 days are strongly modulated by the solar cycle. Both of these periodicities are only detected during solar minimum. During solar maximum. a number of unusual variations are observed. Special emphasis will be placed on the recently reported 1.3 year variation in solar wind parameters besides periods in the interplanetary magnetic field near 51, 73 and 154 days. Correlations with solar wind plasma and solar index variations will also be presented.

  10. Longitudinal association of maternal attempt to lose weight during the postpartum period and child obesity at age 3 years.

    PubMed

    Sonneville, Kendrin R; Rifas-Shiman, Sheryl L; Oken, Emily; Peterson, Karen E; Gortmaker, Steven L; Gillman, Matthew W; Taveras, Elsie M

    2011-10-01

    The effect of maternal attempt to lose weight during the postpartum period on later child weight has not been explored. Among 1,044 mother-infant pairs in Project Viva, we estimated longitudinal associations of maternal attempt to lose weight during the postpartum period with child weight and adiposity at age 3 years and examined differences in associations by type of weight loss strategy used. Using covariate-adjusted linear and logistic regression models, we estimated associations before and after adjusting for maternal weight-related variables including prepregnancy BMI. At 6 months postpartum, 53% mothers were trying to lose weight. At age 3 years, mean (s.d.) child BMI z-score was 0.44 (1.01) and 8.9% of children were obese. Children whose mothers were trying to lose weight at 6 months postpartum had higher BMI z-scores (0.30 (95% confidence interval (CI) 0.18, 0.42)) and were more likely to be obese (3.0 (95% CI 1.6, 5.8)) at 3 years of age. Addition of maternal prepregnancy BMI to the models attenuated but did not eliminate the associations seen for BMI z-score (0.24 (95% CI 0.12, 0.36) and obesity (2.4 (95% CI 1.2, 4.7)). Attempting to lose weight by exercising alone was the only weight loss strategy that consistently predicted higher child BMI z-score (0.36 (95% CI 0.14, 0.58)) and odds of obesity (6.0 (95% CI 2.2, 16.5)) at age 3 years. In conclusion, we observed an association between maternal attempt to lose weight at 6 months postpartum, particularly through exercise alone, measured using a single item and child adiposity at age 3 years. This association should be thoroughly examined in future studies.

  11. Multicenter study on the long-term (3-year) efficacy of lanthanum carbonate in dialysis patients.

    PubMed

    Ando, Ryoichi; Yama, Satomi; Ohnishi, Tsuyoshi; Iwamoto, Shunsuke; Kimura, Hitoshi; Chida, Yoshiko; Ishida, Yuji; Yamada, Kouei; Inagaki, Yuichiro; Takayama, Masanobu; Tachibana, Ken; Kikuchi, Kan; Inoue, Atsushi; Ohtsuka, Masakazu

    2014-06-01

    We previously conducted a multicenter study enrolling 101 dialysis patients with hyperphosphatemia in which lanthanum carbonate (LC) was administered for 2 years. In this study, the administration has been continued for an additional year, and we have evaluated the long-term (a total of 3 years) effects of LC. The average serum phosphorus (P) level was 6.05 mg/dL at the start and decreased to 5.84 mg/dL after 3 years, but no significant differences were observed at both points. The average serum corrected calcium (Ca) level significantly reduced after 3 years (P < 0.001). As results of evaluating the achievement rates with the management target values of serum P, Ca and intact parathyroid hormone (PTH) stated in the Japanese guideline, the achievement rates increased after 3 years. From these results, LC is considered to be a useful P binder that can be used for long-term treatment of hyperphosphatemia, without causing a Ca load.

  12. Patterns of nonfatal heroin overdose over a 3-year period: findings from the Australian treatment outcome study.

    PubMed

    Darke, Shane; Williamson, Anna; Ross, Joanne; Mills, Katherine L; Havard, Alys; Teesson, Maree

    2007-03-01

    To determine annual patterns and correlates of nonfatal heroin overdose across 3 years, data were analyzed on 387 heroin users recruited for the Australian Treatment Outcome Study (ATOS), interviewed at 12, 24, and 36 months. A heroin overdose across follow-up was reported by 18.6%, and naloxone had been administered to 11.9%. Annual rates of overdose declined between baseline and 12 months and then remained stable. Previous overdose experience was strongly related to subsequent overdose. Those with a history of overdose before ATOS were significantly more likely to overdose during the study period. In particular, there was a strong association between overdose experience in any 1 year and increased overdose risk in the subsequent year. This is the first study to examine long-term annual trends in nonfatal heroin overdose. While overdose rates declined after extensive treatment, substantial proportions continued to overdose in each year, and this was strongly associated with overdose history.

  13. Impact of Cigarette Smoking: a 3-Year Clinical Outcome of Vasospastic Angina Patients

    PubMed Central

    Choi, Byoung Geol; Park, Taeshik; Choi, Se Yeon; Byun, Jae Kyeong; Shim, Min Suk; Xu, Shaopeng; Li, Hu; Park, Sang-Ho; Park, Ji Young; Choi, Woong Gil; Cho, Yun-Hyeong; Lee, Sunki; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Jin Won; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo

    2016-01-01

    Background and Objectives Cigarette smoking is a risk significant factor in coronary artery disease (CAD) and vasospastic angina (VSA). However, it is largely unknown whether smoking adds to any long-term clinical risk in VSA patients. Subjects and Methods A total of 2797 patients without significant CAD underwent acetylcholine (Ach) provocation test between November 2004 and October 2010. Patients were divided into three groups, based on the presence of coronary artery spasm (CAS) and smoking habits (non-CAS group: n=1188, non-smoking CAS group: n=1214, smoking CAS group: n=395). All CAS patients were prescribed with anti-anginal medications for at least 6 months. The incidence of major clinical outcomes and recurrent angina of these groups were compared up to 3 years. Results There were considerable differences in the baseline clinical and angiographic characteristics among the three groups, but there was no difference in the endpoints among the three groups (including individual and composite hard endpoints) such as death, myocardial infarction, de novo percutaneous coronary intervention, cerebrovascular accident, and major adverse cardiac events. However, there was a higher incidence of recurrent angina in both the non-smoking CAS group and smoking CAS group, as compared to the non-CAS group. In multivariable adjusted Cox-proportional hazards regression analysis, smoking CAS group exhibited a higher incidence of recurrent angina compared with the non-CAS group (hazard ratio [HR]; 2.46, 95% confidence interval [CI]; 1.46-4.14, p=0.001) and non-smoking CAS group (HR; 1.76, 95% CI; 1.08-2.87, p=0.021). Conclusion Cigarette smoking CAS group exhibited higher incidence of recurrent angina during the 3-year clinical follow-up compared with both the non-CAS group and non-smoking CAS group. Quitting of smoking, paired with intensive medical therapy and close clinical follow-up, can help to prevent recurrent angina. PMID:27721853

  14. Metabolic control and complications over 3 years in patients with insulin dependent diabetes (IDDM): the Stockholm Diabetes Intervention Study (SDIS).

    PubMed

    Reichard, P; Britz, A; Carlsson, P; Cars, I; Lindblad, L; Nilsson, B Y; Rosenqvist, U

    1990-11-01

    In a planned 5-year study, 97 patients with insulin dependent diabetes mellitus (IDDM), non-proliferative retinopathy and unsatisfactory blood glucose control were monitored for 3 years. The patients were randomized to an intensified conventional treatment (ICT, n = 44) or a regular treatment (RT, n = 53) group. HbA1c (normal range 3.9-5.7%) was reduced from 9.5 +/- 0.2 (mean value +/- SEM) to 7.4 +/- 0.1% in the ICT group (P = 0.0001), and from 9.5 +/- 0.2 to 9.0 +/- 0.2% in the RT group (P = 0.004). Nerve conduction velocities in the sural and peroneal nerves (P = 0.01-0.0001) were impaired in the RT group, but not in the ICT group. Retinopathy increased in both groups. The condition of 22 ICT patients (50%, 95% confidence interval 34-66%) and 37 RT patients (73%, 61-84%) deteriorated with regard to at least one microvascular complication (retinopathy, nephropathy, neuropathy) (P = 0.024). Lower HbA1c levels during the study significantly reduced the risk of deterioration (P = 0.01). In total, 57% of the ICT patients had at least one episode of serious hypoglycaemia, compared with 23% in the RT group (P = 0.001). The patients in the ICT group also gained weight (P = 0.0001). Improved blood glucose control slowed down the progression of microangiopathy during a 3-year period in patients with non-proliferative retinopathy, but at the price of an increased frequency of serious hypoglycaemic episodes, and some gain in body weight.

  15. Immediate implants and immediate loading in periodontally compromised patients-a 3-year prospective clinical study.

    PubMed

    Alves, Celia Coutinho; Correia, Andre Ricardo; Neves, Manuel

    2010-10-01

    To avoid the necessity of a removable provisional prosthesis, and therefore preserve the patient's functional outcome, esthetics, and quality of life, a clinical protocol was developed to approach periodontally compromised patients presenting a full-arch irreversibly lost dentition: full-arch extraction and immediate replacement with a provisional acrylic resin implant-supported fixed partial denture (FPD). A total of 23 periodontally compromised patients (11 women, 12 men; 4 smokers, 4 controlled diabetics) were included in this study. Pretreatment casts were taken and vertical dimension of occlusion was determined. In most patients, 6 Straumann implants were distributed along the arch according to the surgical guide or bone availability, with the most distal ones in the maxilla slightly tilted so they could emerge more distally. A total of 168 implants (146 Straumann, 10 Nobel Biocare, 8 Biomet 3i, and 4 Lifecore) were placed (83 in the maxilla, 85 in the mandible). Of those in the maxilla, 74 were loaded immediately (implant stability quotient mentor [ISQm] > 70) and 9 placed with delayed loading (ISQm =/< 70). Of the 85 implants placed in the mandible, all were loaded immediately (ISQm > 70). If an FPD had not been fabricated already, impressions were taken during surgery to do so. The prosthesis was then adapted (cemented or screwed) to the 6 implants within the first 48 hours postsurgery. After 2 months, definitive impressions were taken, and a definitive porcelain-fused-to-metal implant-supported 12-element FPD was fabricated and cemented or screwed to all 6 implants. Of the 168 implants, 108 were immediate implants and 159 immediately loaded. Only 2 implants (1 in the mandible, 1 in the maxilla) did not osseointegrate. This yields a 3-year cumulative survival rate of 98.74% (98.65% in the maxilla, 98.82% in the mandible). From a total of 26 immediately loaded prostheses (12 in the maxilla, 14 in the mandible), 6 were cemented and 20 screw-retained. The 3

  16. Delayed Complications in Patients Surviving at Least 3 Years After Stereotactic Radiosurgery for Brain Metastases

    SciTech Connect

    Yamamoto, Masaaki; Kawabe, Takuya; Higuchi, Yoshinori; Sato, Yasunori; Nariai, Tadashi; Barfod, Bierta E.; Kasuya, Hidetoshi; Urakawa, Yoichi

    2013-01-01

    Purpose: Little is known about delayed complications after stereotactic radiosurgery in long-surviving patients with brain metastases. We studied the actual incidence and predictors of delayed complications. Patients and Methods: This was an institutional review board-approved, retrospective cohort study that used our database. Among our consecutive series of 2000 patients with brain metastases who underwent Gamma Knife radiosurgery (GKRS) from 1991-2008, 167 patients (8.4%, 89 women, 78 men, mean age 62 years [range, 19-88 years]) who survived at least 3 years after GKRS were studied. Results: Among the 167 patients, 17 (10.2%, 18 lesions) experienced delayed complications (mass lesions with or without cyst in 8, cyst alone in 8, edema in 2) occurring 24.0-121.0 months (median, 57.5 months) after GKRS. The actuarial incidences of delayed complications estimated by competing risk analysis were 4.2% and 21.2% at the 60th month and 120th month, respectively, after GKRS. Among various pre-GKRS clinical factors, univariate analysis demonstrated tumor volume-related factors: largest tumor volume (hazard ratio [HR], 1.091; 95% confidence interval [CI], 1.018-1.154; P=.0174) and tumor volume {<=}10 cc vs >10 cc (HR, 4.343; 95% CI, 1.444-12.14; P=.0108) to be the only significant predictors of delayed complications. Univariate analysis revealed no correlations between delayed complications and radiosurgical parameters (ie, radiosurgical doses, conformity and gradient indexes, and brain volumes receiving >5 Gy and >12 Gy). After GKRS, an area of prolonged enhancement at the irradiated lesion was shown to be a possible risk factor for the development of delayed complications (HR, 8.751; 95% CI, 1.785-157.9; P=.0037). Neurosurgical interventions were performed in 13 patients (14 lesions) and mass removal for 6 lesions and Ommaya reservoir placement for the other 8. The results were favorable. Conclusions: Long-term follow-up is crucial for patients with brain metastases

  17. Association between pneumonia in acute stroke stage and 3-year mortality in patients with acute first-ever ischemic stroke.

    PubMed

    Yu, Yi-Jing; Weng, Wei-Chieh; Su, Feng-Chieh; Peng, Tsung-I; Chien, Yu-Yi; Wu, Chia-Lun; Lee, Kuang-Yung; Wei, Yi-Chia; Lin, Shun-Wen; Zhu, Jun-Xiao; Huang, Wen-Yi

    2016-11-01

    The influence of pneumonia in acute stroke stage on the clinical presentation and long-term outcomes of patients with acute ischemic stroke is still controversial. We investigate the influence of pneumonia in acute stroke stage on the 3-year outcomes of patients with acute first-ever ischemic stroke. Nine-hundred and thirty-four patients with acute first-ever ischemic stroke were enrolled and had been followed for 3years. Patients were divided into two groups according to whether pneumonia occurred during acute stroke stage or not. Clinical presentations, risk factors for stroke, laboratory data, co-morbidities, and outcomes were recorded. The result showed that a total of 100 patients (10.7%) had pneumonia in acute stroke stage. The prevalence of older age, atrial fibrillation was significantly higher in patients with pneumonia in acute stroke stage. Total anterior circulation syndrome and posterior circulation syndrome occurred more frequently among patients with pneumonia in acute stroke stage (P<0.001 and P=0.009, respectively). Multivariate Cox regression revealed that pneumonia in acute stroke stage is a significant predictor of 3-year mortality (hazard ratio=6.39, 95% confidence interval=4.03-10.11, P<0.001). In conclusion, pneumonia during the acute stroke stage is associated with increased risk of 3-year mortality. Interventions to prevent pneumonia in acute stroke stage might improve ischemic stroke outcome.

  18. Effects of treatment with bimatoprost 0.03% for 3 years in patients with normal-tension glaucoma

    PubMed Central

    Inoue, Kenji; Shiokawa, Minako; Fujimoto, Takayuki; Tomita, Goji

    2014-01-01

    Purpose To evaluate the effects of bimatoprost 0.03% single treatment for 3 years on intraocular pressure (IOP) and visual field performance. Methods We monitored the IOP of 62 patients with normal-tension glaucoma every 1–3 months. The Humphrey visual field test was performed every 6 months after treatment and the results obtained were compared to those before treatment. In addition, visual field performance was evaluated using trend and event analysis. Results The mean ± standard deviation (SD) of IOP after treatment with bimatoprost for 3 years (13.6±3.1 mmHg) was significantly lower than that before treatment (16.8±2.4 mmHg, P<0.0001). No change was observed in the mean deviation and pattern SD values of the Humphrey visual field before and 3 years after treatment. Worsening of visual field performance was observed in one patient (3.0%) by using trend analysis and in four patients (12.1%) by using event analysis. Treatment was discontinued in 17 patients (27.4%) because of adverse reactions. Conclusion Bimatoprost 0.03% single treatment was effective in reducing the IOP at least during the 3 years of treatment, but visual field performance worsened by 3.0%–12.1% in patients with normal-tension glaucoma. PMID:24970996

  19. Do autistic symptoms persist across time? Evidence of substantial change in symptomatology over a 3-year period in cognitively able children with autism.

    PubMed

    Pellicano, Elizabeth

    2012-03-01

    This study investigated the extent and nature of changes in symptomatology in cognitively able children with autism over a 3-year period. Thirty-seven children diagnosed with an autism spectrum condition involved in an earlier study (M age  =  5 years, 7 months) were followed and reassessed 3 years later (M age  =  8 years, 4 months). Scores on the Social Communication Questionnaire (SCQ; M. Rutter, A. Bailey, & C. Lord, 2003 ) decreased significantly over time in all symptom domains but especially in the social domain, and correlational findings suggested the presence of 2 distinct developmental trajectories-social communication and repetitive behaviors-that interact across time. Furthermore, 7 children (19% of sample) made substantial changes to the extent that they failed to meet criteria on diagnostic instruments (the Autism Diagnostic Observation Schedule-Generic [ADOS-G; C. Lord, M. Rutter, P. C. DiLavore, & S. Risi, 1999 ] and the SCQ) 3 years later. Children showing diagnostic discontinuity were distinguishable from those who fulfilled ADOS-G criteria only in terms of the age at which they began receiving intervention. The presence of a significant proportion of children showing considerable progress over the 3-year period challenges assumptions of diagnostic continuity and highlights the potential long-term benefits of early intervention.

  20. How Many Patients Become Functionally Dependent after a Stroke? A 3-Year Population-Based Study in Joinville, Brazil

    PubMed Central

    Pontes-Neto, Octávio Marques; Mazin, Suleimy Cristina; dos Reis, Felipe Ibiapina

    2017-01-01

    The decrease in stroke mortality will increase the burden of survivors with functional dependence (FD). The aim of this study was to evaluate how many patients become functionally dependent over 3 years after an incident event in Joinville, Brazil. The proportion of FD (defined as a modified Rankin score 3 to 5) among stroke survivors from the Joinville Stroke Registry was assessed using a validated telephone interview. Incidence of FD after stroke in Joinville in one year was 23.24 per 100,000 population. The overall proportion of FD among stroke survivors at discharge was 32.7%. Of 303 patients with first-ever ischaemic stroke (IS), one-third were FD at discharge, and 12%, 9% and 8%, respectively at 1, 2 and 3 years. Among 37 patients with haemorrhagic stroke (HS), 38% were dependent at discharge, 16% after 1 and 2 years and 14% after 3. Among 27 patients with subarachnoid haemorrhage (SAH), 19% were dependent at discharge and 4% from 1 to 3 years. Among IS subtypes, cardioembolic ones had the worst risk of FD. (RR 19.8; 95% CI: 2.2 to 175.9). Our results showed that one-third of stroke survivors have FD during the first year after stroke in Brazil. Therefore, a city with half a million people might expect 120 new stroke patients with FD each year. PMID:28107401

  1. Occurrence and molecular characterization of Klebsiella pneumoniae ST37 clinical isolates producing plasmid-mediated AmpC recovered over a 3-year period.

    PubMed

    Illiaquer, Marina; Caroff, Nathalie; Bémer, Pascale; Aubin, Guillaume G; Juvin, Marie-Emmanuelle; Lepelletier, Didier; Reynaud, Alain; Corvec, Stéphane

    2012-09-01

    We investigated the clinical and microbiological epidemiology of AmpC plasmidic cephalosporinases (pAmpC) in Klebsiella pneumoniae strains resistant to ceftazidime, during a 3-year period (2007-2009). Among 1505 K. pneumoniae, 7 were pAmpC producers. Molecular characterization revealed the spread of a ST37 strain producing DHA-1 within intensive care units and the diffusion of the same plasmid among unrelated strains.

  2. Review Over a 3-Year Period of European Union Proficiency Tests for Detection of Staphylococcal Enterotoxins in Food Matrices.

    PubMed

    Nia, Yacine; Mutel, Isabelle; Assere, Adrien; Lombard, Bertrand; Auvray, Frederic; Hennekinne, Jacques-Antoine

    2016-04-13

    Staphylococcal food poisoning outbreaks are a major cause of foodborne illnesses in Europe and their notifications have been mandatory since 2005. Even though the European regulation on microbiological criteria for food defines a criterion on staphylococcal enterotoxin (SE) only in cheese and dairy products, European Food Safety Authority (EFSA) data reported that various types of food matrices are involved in staphylococcal food poisoning outbreaks. The European Screening Method (ESM) of European Union Reference Laboratory for Coagulase Positive Staphylococci (EURL CPS) was validated in 2011 for SE detection in food matrices and is currently the official method used for screening purposes in Europe. In this context, EURLCPS is annually organizing Inter-Laboratory Proficiency Testing Trials (ILPT) to evaluate the competency of the European countries' National Reference Laboratories (NRLs) to analyse SE content in food matrices. A total of 31 NRLs representing 93% of European countries participated in these ILPTs. Eight food matrices were used for ILPT over the period 2013-2015, including cheese, freeze-dried cheese, tuna, mackerel, roasted chicken, ready-to-eat food, milk, and pastry. Food samples were spiked with four SE types (i.e., SEA, SEC, SED, and SEE) at various concentrations. Homogeneity and stability studies showed that ILPT samples were both homogeneous and stable. The analysis of results obtained by participants for a total of 155 blank and 620 contaminated samples allowed for evaluation of trueness (>98%) and specificity (100%) of ESM. Further to the validation study of ESM carried out in 2011, these three ILPTs allowed for the assessment of the proficiency of the NRL network and the performance of ESM on a large variety of food matrices and samples. The ILPT design presented here will be helpful for the organization of ILPT on SE detection by NRLs or other expert laboratories.

  3. A 3-year follow-up of stroke patients: relationships between activities of daily living and personality characteristics.

    PubMed

    Elmståhl, S; Sommer, M; Hagberg, B

    1996-01-01

    The importance of some personality characteristics for improvement of activities of daily life (ADL) was studied in sixty-six stroke patients, initially admitted to geriatric rehabilitation (n=37) or the department of medicine (n=29), 3 years after stroke. Outcome measurements were activities of daily life and motor and mental functions assessed using the Activity Index (AI) by Hamrin and Wohlin (1982). Neuroticism and extroversion were measured with the Eysenck Personality Inventory Scale. Preferred coping strategies were assessed from interviews on how the patients handle difficult events. Major improvements of ADL and motor functions were seen the first year after stroke. There was no major differences between patients admitted, either to geriatric rehabilitation or traditional medical wards regarding the outcome measurements except for better eating ability in the former group 3 years later. Subjects living alone showed deteriorated ADL functions after 3 years. Extrovert personality and active coping strategy predicted improved ADL functions. Multiple regression analyses with AI as the dependent variable proved active coping to predict functional outcome. In conclusion; increased knowledge about personality characteristics can improve possibilities for a more individual rehabilitation program.

  4. Gallstone obstructive ileus 3 years post-cholecystectomy to a patient with an old ileoileal anastomosis.

    PubMed

    Papavramidis, T S; Potsi, S; Paramythiotis, D; Michalopoulos, A; Papadopoulos, V N; Douros, V; Pantoleon, A; Foutzila-Kalogera, A; Ekonomou, I; Harlaftis, N

    2009-12-01

    The present case is one of gallstone obstructive ileus due to gallstones 3 yr after laparoscopic cholecystectomy. It is interesting because of the sex of the patient, the fact that ileus occurred 3 yr after cholecystectomy and that the localization of the obstruction was an old side-to-side ileoileal anastomosis due to a diverticulectomy following intussusception of Meckels' diverticulum at the age of 3.

  5. Application of Regent mechanical valve in patients with small aortic annulus: 3-year follow-up

    PubMed Central

    2012-01-01

    Background Aortic valve replacement (AVR) with a small aortic annulus is always challenging for the cardiac surgeon. In this study, we sought to evaluate the midterm performance of implantation with a 17-mm or 19-mm St. Jude Medical Regent (SJM Regent) mechanical valve in retrospective consecutive cohort of patients with small aortic annulus (diameter ≤ 19 mm). Methods From January 2008 to April 2011, 40 patients (31 female, mean age = 47.2 ± 5.8 years) with small aortic annulus (≤19 mm in diameter) underwent aortic valve replacement with a 17-mm or 19-mm St. Jude Medical Regent (SJM Regent) mechanical valve. Preoperative mean body surface area, New York Heart Association class, and mean aortic annulus were 1.61 ± 0.26 m2, 3.2 ± 0.4, and 18 ± 1.4 mm respectively. Patients were divided into two groups, according to the implantation of 17 mm SJM Regent mechanical valve (group 1, n = 18) or 19 mm SJM Regent valve (group 2, n = 22). All patients underwent echocardiography examination preoperatively and at one year post-operation. Results There were no early deaths in either group. Follow-up time averaged 36 ± 17.6 months. The mean postoperative New York Heart Association class was 1.3 ± 0.6 (p < 0.001). By echocardiography, in group 1, the left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), and the indexed effective orifice area (EOAI) increased from 43.7% ± 11.6%, 27.3% ± 7.6%, and 0.70 ± 0.06 cm2/m2 to 69.8 ± 9.3%, 41.4 ± 8.3%, and 0.92 ± 0.10 cm2/m2 respectively (P < 0.05), while the left ventricular mass index (LVMI), and the aortic transvalvular pressure gradient decreased from 116.4 ± 25.4 g/m2, 46.1 ± 8.5 mmHg to 86.7 ± 18.2 g/m2 , 13.7 ± 5.2 mmHg respectively. In group 2, the LVEF, LVFS and EOAI increased from 45.9% ± 9.7%, 30.7% ± 8.0%, and 0.81 ± 0.09 cm2/m2 to 77.4%

  6. Off-treatment efficacy of 3-year nucleos(t)ide analogues in chronic hepatitis B patients.

    PubMed

    Lin, Ching-Chung; Bair, Ming-Jong; Chen, Chih-Jen; Lee, Keng-Han; Chen, Ming-Jen; Liu, Chia-Yuan; Chang, Chen-Wang; Hu, Kuang-Chun; Liou, Tai-Cherng; Lin, Shee-Chan; Wang, Horng-Yuan; Chu, Cheng-Hsin; Shih, Shou-Chuan; Wang, Tsang-En

    2016-01-01

    Lamivudine, telbivudine, and entecavir are the first-line drugs covered by the Taiwan National Health Insurance as 3-year treatments for patients with chronic hepatitis B virus (HBV), but the optimal treatment duration of each remains unclear. We aimed to detect HBV treatment-cessation durability, and compare the predictors in patients with and without clinical relapse. In this retrospective cohort study, 210 patients with chronic HBV who tested hepatitis B e-antigen positive or hepatitis B e-antigen negative were treated for 3 years with a nucleos(t)ide analogue. Of these, 102 patients continued therapy after 3 years, while 88 patients stopped treatment and were followed for 1 year due to financial difficulties. Efficacy was assessed in terms of alanine aminotransferase (ALT) level normalization, HBV DNA clearance, virus breakthrough, clinical relapse, and liver decompensation. The durability predictors were evaluated by host factors, HBV DNA, and drug differences. Eighty patients (14 on lamivudine, 19 on telbivudine, and 47 on entecavir) were recruited. There was no difference in clinical-relapse rate among lamivudine, telbivudine, and entecavir (35.7% vs. 36.8% vs. 31.9%, respectively; p = 0.916), and liver decompensated hepatitis was absent. In baseline clinical characteristics, there were no differences between the clinical-relapse and nonrelapse groups in age, sex, cirrhosis, prior treatment, HBV DNA, pretreatment ALT, or hepatitis B e-antigen (HBeAg). The mean 3(rd) year serum ALT level differed significantly between clinical-relapse and nonrelapse patients (37.5 U/L vs. 27.7 U/L, respectively; p = 0.044). The 3-year nucleos(t)ide analogue off-treatment in patients with chronic HBV delivered according to the Taiwan National Health Insurance guidelines had an overall 33.8% 1-year clinical-relapse rate without any decompensated hepatitis flare-ups.

  7. A large prospective European cohort study of patients treated with strontium ranelate and followed up over 3 years.

    PubMed

    Audran, M; Jakob, F J; Palacios, S; Brandi, M-L; Bröll, H; Hamdy, N A T; McCloskey, E V

    2013-09-01

    Strontium ranelate has been available as an osteoporosis treatment in Europe since 2004. This article describes a large European observational survey of the use of strontium ranelate in clinical daily practice. A retrospective observational registry included 32,446 women consulting for postmenopausal osteoporosis in seven countries. Within the registry, 12,046 women were receiving strontium ranelate and were followed up over 3 years. The baseline characteristics of the follow-up cohort were similar to those of the whole registry cohort (age, 68.9 ± 10.3 years; body mass index, 25.6 ± 4.3 kg/m(2); lumbar spine T-score, -2.57 ± 0.85 SD; femoral neck T-score, -2.11 ± 0.86 SD). At baseline, 77 % of patients had at least one risk factor for osteoporosis, and 46 % had a previous history of osteoporotic fracture. Mean duration of follow-up was 32.0 ± 9.7 months, and treatment duration was 25.2 ± 13.7 months (24,956 patient-years of treatment). Persistence with strontium ranelate was 80 % at 1 year, 68 % at 2 years, and 64 % at 32 months; most patients (about 80 %) reported rarely omitting a dose. At least one emergent adverse event was reported in 2,674 (22 %) patients, most frequently gastrointestinal side effects. The crude incidence of venous thromboembolic events was 2.1/1,000 patient-years. No cases of hypersensitivity reactions, such as drug rash with eosinophilia and systemic symptoms (DRESS), Steven-Johnson syndrome, or toxic epidermal necrolysis, were reported. During follow-up, a fracture occurred in 890 patients (7 %); 429 of the fractures were nonvertebral fractures. Our observational survey over 32 months indicated good rates of adherence with strontium ranelate and confirmed its good safety profile in the management of postmenopausal osteoporosis.

  8. Predictive Factors for Subjective Improvement in Lumbar Spinal Stenosis Patients with Nonsurgical Treatment: A 3-Year Prospective Cohort Study

    PubMed Central

    Matsudaira, Ko; Hara, Nobuhiro; Oka, Hiroyuki; Kunogi, Junichi; Yamazaki, Takashi; Takeshita, Katsushi; Atsushi, Seichi; Tanaka, Sakae

    2016-01-01

    Objective To assess the predictive factors for subjective improvement with nonsurgical treatment in consecutive patients with lumbar spinal stenosis (LSS). Materials and Methods Patients with LSS were enrolled from 17 medical centres in Japan. We followed up 274 patients (151 men; mean age, 71 ± 7.4 years) for 3 years. A multivariable logistic regression model was used to assess the predictive factors for subjective symptom improvement with nonsurgical treatment. Results In 30% of patients, conservative treatment led to a subjective improvement in the symptoms; in 70% of patients, the symptoms remained unchanged, worsened, or required surgical treatment. The multivariable analysis of predictive factors for subjective improvement with nonsurgical treatment showed that the absence of cauda equina symptoms (only radicular symptoms) had an odds ratio (OR) of 3.31 (95% confidence interval [CI]: 1.50–7.31); absence of degenerative spondylolisthesis/scoliosis had an OR of 2.53 (95% CI: 1.13–5.65); <1-year duration of illness had an OR of 3.81 (95% CI: 1.46–9.98); and hypertension had an OR of 2.09 (95% CI: 0.92–4.78). Conclusions The predictive factors for subjective symptom improvement with nonsurgical treatment in LSS patients were the presence of only radicular symptoms, absence of degenerative spondylolisthesis/scoliosis, and an illness duration of <1 year. PMID:26863214

  9. Cumulative success rates following mild IVF in unselected infertile patients: a 3-year, single-centre cohort study.

    PubMed

    Bodri, Daniel; Kawachiya, Satoshi; De Brucker, Michaël; Tournaye, Herman; Kondo, Masae; Kato, Ryutaro; Matsumoto, Tsunekazu

    2014-05-01

    A 3-year, retrospective, single-centre cohort study was conducted in a private infertility centre to determine cumulative live birth rates (LBR) per scheduled oocyte retrieval following minimal ovarian stimulation/natural-cycle IVF in unselected infertile patients. A total of 727 consecutive infertile patients were analysed who underwent 2876 (median 4) cycles with scheduled oocyte retrieval from November 2008 to December 2011. Natural-cycle IVF or clomiphene-based minimal ovarian stimulation was coupled with single-embryo transfer and increased use of delayed vitrified-warmed blastocyst transfer. Main outcome measures were crude and expected age-specific cumulative LBR per scheduled oocyte retrieval. Crude cumulative LBR were 65%, 60%, 39%, 15% and 5% in patients aged 26-34, 35-37, 38-40, 41-42 and 43-44 years, respectively. No live births occurred in patients aged ⩾ 45 years. Dropout rates per cycle were 13-25%. Success rates gradually reached a plateau, with few additional live births after six cycles. Most of the expected success rate was reached within 6 months with almost maximal rates within 15 months of the first oocyte retrieval. Acceptable cumulative LBR are reached with an exclusive minimal ovarian stimulation/single-embryo transfer policy especially in patients aged <38 years but also in intermediate aged patients (38-40 years).

  10. Risk for Sleep Disorder Measured during Students' First College Semester May Predict Institutional Retention and Grade Point Average over a 3-Year Period, with Indirect Effects through Self-Efficacy

    ERIC Educational Resources Information Center

    Gaultney, Jane F.

    2016-01-01

    The present study used a validated survey to assess freshmen college students' sleep patterns and risk for sleep disorders and then examined associations with retention and grade point average (GPA) over a 3-year period. Students at risk for a sleep disorder were more likely to leave the institution over the 3-year period, although this…

  11. Small peripheral developing odontoma of the maxilla in a 3-year-old patient depicted on cone-beam tomograms.

    PubMed

    Friedrich, Reinhard E; Fuhrmann, Andreas; Scheuer, Hanna A; Zustin, Jozef

    2010-01-01

    A 3-year-old male patient was referred to the Maxillofacial Surgery Clinic due to a painless swelling of the right palatal region. Conventional radiographs revealed no alteration of the dentition and did not delineate a lesion in the region of interest. Cone-beam tomography depicted small radiopaque, extraosseous deposits inside the palatal space. Histological examination revealed a minute mixed epithelial-mesenchymal lesion of odontogenic origin. We made the diagnosis of a peripheral developing odontoma, taking into consideration the components and arrangements of structures of the lesion. Early intervention is advisable to prevent these odontogenic lesions from eventually deforming the jaw and displacing adjacent teeth. Cone-beam tomography was a valuable pre-operative diagnostic tool to assess the lesion as being composed in part of hard tissue.

  12. Contribution of dysregulated serum magnesium to mortality in hemodialysis patients with secondary hyperparathyroidism: a 3-year cohort study

    PubMed Central

    Kurita, Noriaki; Akizawa, Tadao; Fukagawa, Masafumi; Onishi, Yoshihiro; Kurokawa, Kiyoshi; Fukuhara, Shunichi

    2015-01-01

    Background The extent of contribution of disturbed magnesium balance to mortality remains unclear among hemodialysis patients. Methods This was a cohort study involving 3276 patients on maintenance hemodialysis at 86 facilities in Japan from 2008 to 2010 who had secondary hyperparathyroidism (SHPT). Baseline serum magnesium (sMg) values were categorized into quintiles (≤2.3, >2.3–2.5, >2.5–2.7, >2.7–3.0 and >3.0 mg/dL), and the middle quintile was set as the reference. Outcome was all-cause death. Independent contribution to all-cause death was assessed via Cox regression to generate population-attributable fractions (PAFs). Results A total of 2165 patients from 68 facilities were analyzed. The lowest quintile of sMg was positively associated with lower serum potassium and albumin levels, higher C-reactive protein (CRP) levels and prevalence of atrial fibrillation and cerebrovascular disease than the other quintiles. The highest sMg quintile was positively associated with higher potassium levels, and negatively associated with lower serum albumin levels and higher intact parathyroid hormone and CRP levels and prevalence of cerebrovascular disease than the other quintiles. During a median follow-up of 3 years, the lowest and the second lowest quintiles of sMg were associated with all-cause death [adjusted hazard ratio (HR) 1.737, 95% confidence interval (95% CI) 1.200–2.512 and HR 1.675, 95% CI 1.254–2.238, respectively). Point estimates of adjusted HRs of the highest and the second highest sMg quintiles were higher than those of the middle quintile for all-cause death. Adjusted PAFs of lower sMg and of higher and lower sMg for all-cause death were 24.0% (95% CI 13.0–35.0%) and 30.7% (95% CI 14.5–46.8%), respectively. Conclusion In hemodialysis patients with SHPT, dysregulated sMg is an important contributor to all-cause death. Further studies are warranted to examine whether or not correction of sMg improves survival. PMID:26613035

  13. Monitoring and source tracking of tetracycline resistance genes in lagoons and groundwater adjacent to swine production facilities over a 3-year period

    USGS Publications Warehouse

    Koike, S.; Krapac, I.G.; Oliver, H.D.; Yannarell, A.C.; Chee-Sanford, J. C.; Aminov, R.I.; Mackie, R.I.

    2007-01-01

    To monitor the dissemination of resistance genes into the environment, we determined the occurrence of tetracycline resistance (Tcr) genes in groundwater underlying two swine confinement operations. Monitoring well networks (16 wells at site A and 6 wells at site C) were established around the lagoons at each facility. Groundwater (n = 124) and lagoon (n = 12) samples were collected from the two sites at six sampling times from 2000 through 2003. Total DNA was extracted, and PCR was used to detect seven Tcr genes [tet(M), tet(O), tet(Q), tet(W), tet(C), tet(H), and tet(Z)]. The concentration of Tcr genes was quantified by real-time quantitative PCR. To confirm the Tcr gene source in groundwater, comparative analysis of tet(W) gene sequences was performed on groundwater and lagoon samples. All seven Tcr genes were continually detected in groundwater during the 3-year monitoring period at both sites. At site A, elevated detection frequency and concentration of Tcr genes were observed in the wells located down-gradient of the lagoon. Comparative analysis of tet(W) sequences revealed that the impacted groundwater contained gene sequences almost identical (99.8% identity) to those in the lagoon, but these genes were not found in background libraries. Novel sequence clusters and unique indigenous resistance gene pools were also found in the groundwater. Thus, antibiotic resistance genes in groundwater are affected by swine manure, but they are also part of the indigenous gene pool. Copyright ?? 2007, American Society for Microbiology. All Rights Reserved.

  14. Case Study: Variation in fatty acid profiles in milk from adjacent organic and conventional dairy farms over a 3-year period

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Measuring the seasonal variability of fatty acids (FAs) in milk improves our understanding of the nutritional and health values of milk. In collaboration with the Rodale Institute, Kutztown, PA, a 3-year study evaluated the seasonal variation of FA profiles of milk obtained from two farms adjacent t...

  15. Life Stress and the Long-Term Treatment Course of Recurrent Depression: III. Nonsevere Life Events Predict Recurrence for Medicated Patients over 3 Years

    ERIC Educational Resources Information Center

    Monroe, Scott M.; Torres, Leandro D.; Guillaumot, Julien; Harkness, Kate L.; Roberts, John E.; Frank, Ellen; Kupfer, David

    2006-01-01

    Research has consistently documented the significance of severe life events for onset of major depression. Theory, however, suggests other forms of stress are relevant for depression's recurrence. Nonsevere life events were tested in relation to depression for 126 patients with recurrent depression in a 3-year randomized maintenance protocol. Life…

  16. Sex differences in the quality of life of patients with acute coronary syndrome treated with percutaneous coronary intervention after a 3-year follow-up

    PubMed Central

    Jankowska-Polańska, Beata; Uchmanowicz, Izabella; Dudek, Krzysztof; Łoboz-Grudzień, Krystyna

    2016-01-01

    Background The aims of this study were to analyze the dynamics of quality of life (QoL) changes after 36 months from the percutaneous coronary intervention (PCI) depending on sex and identify baseline predictors of the follow-up QoL of patients hospitalized for acute coronary syndrome (ACS) and subjected to PCI. Methods and results The study included 137 patients, females (n=67) and males (n=70), with ACS who underwent PCI. The QoL was assessed using the MacNew Heart Disease Health-Related Quality of Life questionnaire. The group of females scored lower in all the domains of the MacNew Heart Disease Health-Related Quality of Life questionnaire in the initial measurement (B1), in the measurement after 6 months (B2), and in the long-term follow-up measurement (36 months – B3). Despite the fact that both groups achieved improved QoL, its values were higher in the males. The average growth rate of the QoL score in the period from the sixth month to 36th month was higher in females than in males. In the univariate and multivariate analyses, significant independent predictors with a negative influence on the long-term QoL score included female sex (ρ=−0.190, β=−0.21), age >60 years (ρ=−0.255, β=−0.186), and diabetes (ρ=−0.216, β=−0.216). Conclusion In a 36-month follow-up of ACS patients treated with PCI, there were no statistically significant differences in QoL between sexes. In the entire cohort, there was improvement in QoL, which was higher in the case of the females studied. For the entire group, significant independent determinants of lower QoL 3 years after ACS included female sex, age >60 years, and diabetes. PMID:27499616

  17. Risk factors for death and the 3-year survival of patients with systemic sclerosis: the French ItinérAIR-Sclérodermie study

    PubMed Central

    Carpentier, Patrick; Gressin, Virginie; Diot, Elisabeth; Allanore, Yannick; Sibilia, Jean; Launay, David; Mouthon, Luc; Jego, Patrick; Cabane, Jean; de Groote, Pascal; Chabrol, Amélie; Lazareth, Isabelle; Guillevin, Loïc; Clerson, Pierre; Humbert, Marc

    2009-01-01

    Objectives. This longitudinal study investigated survival, risk factors and causes of death in the multicentre ItinérAIR-Sclérodermie cohort of patients with SSc without severe pulmonary fibrosis or severe left heart disease at baseline. Methods. At 3-year follow-up, vital status was obtained from investigators or French national death records. Causes of death were classified as SSc-related or otherwise. Data were censored at 37 months, time of death or loss to follow-up, whichever was earlier. Survival was estimated using the Kaplan–Meier method. Multivariate survival analyses were conducted using the Cox model. Results. In total, 546 patients were followed for a median duration of 37 months, representing 1547 patient-years. At baseline, the majority of patients were female, with lcSSc, mean age 54.9 ± 13.0 years and mean duration of SSc of 8.8 ± 8.1 years. In total, 47 patients died, giving a 3-year survival of 91.1% and cumulative mortality of 3.04 deaths per 100 patient-years; 17 deaths (32.2%) resulted from pulmonary arterial hypertension (PAH) and eight (17.1%) from cancer. Of the 47 patients with PAH at baseline, 20 died during follow-up, giving a 3-year survival of 56.3%. In a multivariate analysis, PAH [hazard ratio (HR) 7.246], age at first symptom (HR 1.052), duration of SSc (HR 1.047 per year) and Rodnan skin score (per one point) (HR 1.045) were associated with increased mortality. Conclusion. This 3-year study observed survival and mortality estimates that were comparable with previous reports. PAH increased the HR for mortality in patients with SSc, justifying yearly echocardiographic screening. PMID:19174571

  18. Water Quality Conditions Monitored at the Corps’ Garrison Project in North Dakota during the 3-Year Period 2003 through 2005

    DTIC Science & Technology

    2006-07-01

    period 2003 through 2005. Collected algae included taxa from the following seven taxonomic Divisions: Bacillariophyta (Diatioms), Chlorophyta (Green... Chlorophyta /Cryptophyta > Cyanobacteria > Pyrrophyta > Chrysophyta >> Euglenophyta. The diatoms were generally the most prevalent algae throughout the...collected at sites L1, L3, L5, and L7 during the period 2003 through 2005. Site Date Biovolume (um3) Bacillariophyta Chlorophyta Chrysophyta

  19. Establishing efficient interview periods for gonorrhea patients.

    PubMed Central

    Starcher, E T; Kramer, M A; Carlota-Orduna, B; Lundberg, D F

    1983-01-01

    From February through December 1978, venereal disease casefinders in Polk County, Iowa used an expanded interview period of at least 120 days to interview 983 gonorrhea patients for sexual partner information. We grouped patients according to sex and clinical findings and evaluated the percentage of all new cases identified by time intervals within the expanded interview period. Ninety-one per cent of all untreated, infected sexual partners of symptomatic males were identified by using an interview period which spanned the interval from date of treatment to 15 days before symptom onset. In contrast, the traditional 30-day interview period missed 23 per cent of those untreated, infected partners named by women with pelvic inflammatory disease (PID), 34 per cent of those partners named by women with uncomplicated gonorrhea, and 29 per cent of those named by asymptomatic men. The Polk County data suggest the importance of basing interview periods upon a patient's sex and clinical presentation. PMID:6638232

  20. Nitinol stent implantation for femoropopliteal disease in patients on hemodialysis: results of the 3-year retrospective multicenter APOLLON study.

    PubMed

    Fujihara, Masahiko; Higashimori, Akihiro; Kato, Yoshihiro; Taniguchi, Hiromasa; Iwasaki, Yusuke; Amano, Tomonori; Sumiyoshi, Akinori; Nishiya, Daisuke; Yokoi, Yoshiaki

    2016-09-01

    The clinical outcomes of nitinol stents for femoropopliteal arterial (FP) disease in patients on hemodialysis were assessed. Endovascular therapy (EVT) is accepted for symptomatic FP disease. However, the clinical outcomes of patients on dialysis are not well known. A multicenter retrospective study was conducted with data between November 2010 and August 2013. A total of 484 consecutive patients who successfully underwent EVT for FP disease with nitinol stents were recruited and analyzed. Patients were categorized into the hemodialysis group (N = 161) and non-hemodialysis group (N = 323). The primary measure was primary patency verified by duplex ultrasound at a rest peak systolic velocity (PSVR) of >2.5, and secondary measures were freedom from target lesion revascularization (TLR) and major amputation-free survival (AFS). Average follow-up duration was 19.5 ± 13.5 months. The primary patency rate at 3 years was significantly lower in the hemodialysis group than the non-hemodialysis group (33.8 vs. 43.7 %; p = 0.036). Freedom from TLR at 3 years was 55.0 % in the hemodialysis group and 66.1 % in the non-hemodialysis group (p = 0.032). The hemodialysis group showed a significantly lower AFS rate at 3 years than the non-hemodialysis group (86.4 vs. 58.2 %; p < 0.001). In hemodialysis patients, nitinol stent use resulted in a lower patency rate, higher TLR rate, and lower AFS rate compared to non-hemodialysis patients. These data suggest that nitinol stent implantation for FP arteries in hemodialysis patient needs to be reconsidered.

  1. 3-year results of transvaginal cystocele repair with transobturator four-arm mesh: A prospective study of 105 patients

    PubMed Central

    Kdous, Moez; Zhioua, Fethi

    2014-01-01

    Objectives To evaluate the long-term efficacy and safety of transobturator four-arm mesh for treating cystoceles. Patients and methods In this prospective study, 105 patients had a cystocele corrected between January 2004 and December 2008. All patients had a symptomatic cystocele of stage ⩾2 according to the Baden–Walker halfway stratification. We used only the transobturator four-arm mesh kit (Surgimesh®, Aspide Medical, France). All surgical procedures were carried out by the same experienced surgeon. The patients’ characteristics and surgical variables were recorded prospectively. The anatomical outcome, as measured by a physical examination and postoperative stratification of prolapse, and functional outcome, as assessed by a questionnaire derived from the French equivalents of the Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire and the Pelvic Organ Prolapse–Urinary Incontinence-Sexual Questionnaire, were considered as the primary outcome measures. Peri- and postoperative complications constituted the secondary outcome measures. Results At 36 months after surgery the anatomical success rate (stage 0 or 1) was 93%. On a functional level, all the scores of quality of life and sexuality were improved. The overall satisfaction score (visual analogue scale) was 71.4%. There were no perioperative adverse events. Mesh erosion was reported in 7.6% and mesh retraction in 5.7% of the patients. Conclusions If the guidelines and precautions are followed, vaginal prosthetic surgery for genitourinary prolapse has shown long-term benefits. It provides excellent results both anatomically and functionally. However, complications are not negligible and some are specific to prosthetic surgery. PMID:26019962

  2. Lymphoma in patients treated with anti-TNF: results of the 3-year prospective French RATIO registry

    PubMed Central

    Mariette, Xavier; Tubach, Florence; Bagheri, Haleh; Bardet, Michel; Berthelot, Jean-Marie; Gaudin, Philippe; Heresbach, Denis; Martin, Antoine; Schaeverbeke, Thierry; Salmon, Dominique; Lemann, Marc; Hermine, Olivier; Raphael, Martine; Ravaud, Philippe

    2010-01-01

    Objective To describe cases of lymphoma associated with anti-TNF therapy, identify risk factors, estimate the incidence and compare risks for different anti-TNF agents. Methods We designed a national prospective registry (RATIO) from 2004 to 2006, for collecting all cases of lymphoma in French patients receiving anti-TNF therapy, whatever the indication. We conducted a case-control analysis including two controls treated with anti-TNF per case and an incidence study of lymphoma with the French population used as reference.. Results We collected 38 cases of lymphoma, 31 non-Hodgkin’s lymphoma (NHL) (26 B-cell and 5 T-cell), 5 Hodgkin’s lymphoma (HL) and 2 Hodgkin’s-like lymphoma. Epstein-Barr virus (EBV) was detected in 2 of 2 Hodgkin’s-like lymphoma, 3 of 5 HL and one NHL. Patients receiving adalimumab or infliximab had a higher risk than those treated with etanercept: SIR = 4.1 (2.3–7.1) and 3.6 (2.3–5.6) versus 0.9 (0.4– 1.8). The exposure to adalimumab or infliximab versus etanercept was an independent risk factor for lymphoma in the case-control study: odds ratio=4.7 (1.3– 17.7) and 4.1 (1.4–12.5), respectively. The sex and age- adjusted incidence rate of lymphoma was 42.1 per 100,000 patient-years. The standardized incidence ratio (SIR) was 2.4 (95% confidence interval [CI] 1.7–3.2). Conclusion Some lymphomas associated with immunosuppression may occur in patients receiving anti TNF therapy, and the risk of lymphoma is higher with monoclonal-antibody therapy than with soluble-receptor therapy. PMID:19828563

  3. Clinical evaluation of 860 anterior and posterior lithium disilicate restorations: retrospective study with a mean follow-up of 3 years and a maximum observational period of 6 years.

    PubMed

    Fabbri, Giacomo; Zarone, Fernando; Dellificorelli, Gianluca; Cannistraro, Giorgio; De Lorenzi, Marco; Mosca, Alberto; Sorrentino, Roberto

    2014-01-01

    This study aimed to assess the clinical performance of lithium disilicate restorations supported by natural teeth or implants. Eight hundred sixty lithium disilicate adhesive restorations, including crowns on natural teeth and implant abutments, veneers, and onlays, were made in 312 patients. Parafunctional patients were included, but subjects with uncontrolled periodontitis and gingival inflammation were excluded. Veneers up to 0.5 mm thick were luted with flowable composite resin or light curing cements, while dual-curing composite systems were used with veneers up to 0.8 mm thick. Onlays up to 2 mm in thickness were luted with flowable composite resins or dual-curing composite cements. Crowns up to 1 mm in thickness were cemented with self-adhesive or dual-curing resin cements. The observational period ranged from 12 to 72 months, with a mean follow-up of 3 years. The mechanical and esthetic outcomes of the restorations were evaluated according to the modified California Dental Association (CDA) criteria. Data were analyzed with descriptive statistics. Twenty-six mechanical complications were observed: 17 porcelain chippings, 5 fractures, and 4 losses of retention. Structural drawbacks occurred mainly in posterior segments, and monolithic restorations showed the lowest number of mechanical complications. The clinical ratings of the successful restorations, both monolithic and layered, were satisfactory according to the modified CDA criteria for color match, porcelain surface, and marginal integrity. The cumulative survival rates of lithium disilicate restorations ranged from 95.46% to 100%, while cumulative success rates ranged from 95.39% to 100%. All restorations recorded very high survival and success rates. The use of lithium disilicate restorations in fixed prosthodontics proved to be effective and reliable in the short- and medium-term.

  4. Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years: A Single-center Initial Experience from China

    PubMed Central

    Xiao, Bo; Zhang, Xin; Hu, Wei-Guo; Chen, Song; Li, Yu-Hong; Tang, Yu-Zhe; Liu, Yu-Bao; Li, Jian-Xing

    2015-01-01

    Background: Urolithiasis in pediatric population is a serious problem with the incidence increased these years. In the management of larger stones (diameters >2 cm), percutaneous nephrolithotomy (PCNL) is considered to be the gold standard. This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged <3 years. Methods: We reviewed 68 patients (80 renal units) aged <3 years between August 2006 and December 2014 in Peking University People's Hospital and Beijing Tsinghua Changung Hospital, including 36 renal units with a single stone, 6 with staghorn stones, 14 with upper ureteral stones, and 24 with multiple stones. The mean age of the patients was 24.2 months (range 6–36 months), and the mean maximum stone diameter was 19.2 mm (range 10–35 mm). The puncture site selection and tract dilation were guided by Doppler ultrasonography solely. All procedures were performed using 12–16 Fr tracts. Stones were fragmented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope. Results: Fifty-six patients with unilateral stones underwent a single session procedure, and 12 patients with bilateral stones underwent two procedures. The mean time to establish access was 2.8 min (range 1.8–5.0 min), the mean operative time was 36.5 min (range 20–88 min), the mean decrease in hemoglobin concentration was 8.9 g/L (2–15 g/L), and the stone-free rate (SFR) at hospital discharge was 94.0%. The mean postoperative hospital stay was 7.1 days (range 3–13 days). Postprocedure complications included fever (>38.5°C) in five patients and reactive pleural effusion in one patient. Blood loss requiring transfusion, sepsis, adjacent organ injury, and kidney loss were not observed. Conclusions: This study indicated that ultrasound-guided mini-PCNL is feasible and safe in patients aged <3 years, without major complications or radiation exposure. PMID:26063360

  5. Extensive ameloblastic fibroma of the mandibula in a female adult patient: A case report with a follow-up of 3 years

    PubMed Central

    Tozoglu, Sinan; Hatipoglu, Mukerrem; Aytekin, Zeliha; Gurer, Elif Inanc

    2016-01-01

    Ameloblastic fibroma (AF) is rare benign odontogenic tumour which usually occurs in the first two decades of life. It can occur either the mandible or maxilla but it is most frequently found in the posterior region of the mandible. Treatment of AF in usual is a conservative approach, such as enucleation and curettage but the aggressive lesions require a radical approach. A more radical approach should be considered in older patients who have likely high recurrence tendency. This report describes a case of AF in a 38-year-old female patient identified during a routine radiographic exam. Tomographic examination through three-dimensional reconstruction indicated vestibular fenestration of the cortical bone, with involvement of lingual cortical bone as the lession extended to the posterior region. We removed the tumor under local anesthesia. In this case patient has continued to be followed frequently and has been disease-free for 3 years. PMID:27011753

  6. Treatment of Patients with Obese Type 2 Diabetes with Tantalus-DIAMOND® Gastric Electrical Stimulation: Normal Triglycerides Predict Durable Effects for at Least 3 Years.

    PubMed

    Lebovitz, H E; Ludvik, B; Yaniv, I; Schwartz, T; Zelewski, M; Gutterman, D D

    2015-06-01

    The objectives of the present work are to evaluate long-term benefit of nonexcitatory gastric electrical stimulation (GES) by the DIAMOND(®) device on glycemic control and body weight in patients with type 2 diabetes inadequately controlled with oral agents and to determine the magnitude of the modulating effects of fasting plasma triglyceride (FTG) levels on these effects of GES. Sixty one patients with type 2 diabetes [HbA1c > 7.0% (53 mmol/mol) to < 10.5% (91 mmol/mol)] were implanted with the DIAMOND(®) GES device and treated with meal-mediated antral electrical stimulation for up to 36 months. The effects of baseline HbA1c and FTG on glycemic control, body weight, and systolic blood pressure were measured. GES reduced mean HbA1c by 0.9% and body weight by 5.7%. The effects were greater in patients with normal fasting plasma triglycerides (NTG) as compared to those with hypertriglyceridemia. The mean decrease in HbA1c in patients with NTG averaged 1.1% and was durable over 3 years of follow-up. ANCOVA indicated that improvement in HbA1c was a function of both baseline FTG group (p = 0.02) and HbA1c (p = 0.001) and their interaction (p = 0.01). Marked weight loss (≥ 10%) was observed in a significant proportion of NTG patients by 12 months of treatment and persisted through the 3 years. GES improves glycemic control and reduces body weight by a triglyceride-dependent mechanism in patients with type 2 diabetes inadequately controlled on oral agents. It is postulated that this is through a gut-brain interaction that modulates effects on the liver and pancreatic islets.

  7. Changes in magnetic resonance imaging disease measures over 3 years in mildly disabled patients with relapsing-remitting multiple sclerosis receiving interferon β-1a in the COGnitive Impairment in MUltiple Sclerosis (COGIMUS) study

    PubMed Central

    2011-01-01

    Background Conventional magnetic resonance imaging (MRI) has improved the diagnosis and monitoring of multiple sclerosis (MS). In clinical trials, MRI has been found to detect treatment effects with greater sensitivity than clinical measures; however, clinical and MRI outcomes tend to correlate poorly. Methods In this observational study, patients (n = 550; 18-50 years; relapsing-remitting MS [Expanded Disability Status Scale score ≤4.0]) receiving interferon (IFN) β-1a therapy (44 or 22 µg subcutaneously [sc] three times weekly [tiw]) underwent standardized MRI, neuropsychological and quality-of-life (QoL) assessments over 3 years. In this post hoc analysis, MRI outcomes and correlations between MRI parameters and clinical and functional outcomes were analysed. Results MRI data over 3 years were available for 164 patients. T2 lesion and T1 gadolinium-enhancing (Gd+) lesion volumes, but not black hole (BH) volumes, decreased significantly from baseline to Year 3 (P < 0.0001). Percentage decreases (baseline to Year 3) were greater with the 44 μg dose than with the 22 μg dose for T2 lesion volume (-10.2% vs -4.5%, P = 0.025) and T1 BH volumes (-7.8% vs +10.3%, P = 0.002). A decrease in T2 lesion volume over 3 years predicted stable QoL over the same time period. Treatment with IFN β-1a, 44 μg sc tiw, predicted an absence of cognitive impairment at Year 3. Conclusion Subcutaneous IFN β-1a significantly decreased MRI measures of disease, with a significant benefit shown for the 44 µg over the 22 µg dose; higher-dose treatment also predicted better cognitive outcomes over 3 years. PMID:21999142

  8. Phase I clinical trial of cell therapy in patients with advanced chronic obstructive pulmonary disease: follow-up of up to 3 years

    PubMed Central

    Stessuk, Talita; Ruiz, Milton Artur; Greco, Oswaldo Tadeu; Bilaqui, Aldemir; Ribeiro-Paes, Maria José de Oliveira; Ribeiro-Paes, João Tadeu

    2013-01-01

    Background Chronic obstructive pulmonary disease is a major inflammatory disease of the airways and an enormous therapeutic challenge. Within the spectrum of chronic obstructive pulmonary disease, pulmonary emphysema is characterized by the destruction of the alveolar walls with an increase in the air spaces distal to the terminal bronchioles but without significant pulmonary fibrosis. Therapeutic options are limited and palliative since they are unable to promote morphological and functional regeneration of the alveolar tissue. In this context, new therapeutic approaches, such as cell therapy with adult stem cells, are being evaluated. Objective This article aims to describe the follow-up of up to 3 years after the beginning of a phase I clinical trial and discuss the spirometry parameters achieved by patients with advanced pulmonary emphysema treated with bone marrow mononuclear cells. Methods Four patients with advanced pulmonary emphysema were submitted to autologous infusion of bone marrow mononuclear cells. Follow-ups were performed by spirometry up to 3 years after the procedure. Results The results showed that autologous cell therapy in patients having chronic obstructive pulmonary disease is a safe procedure and free of adverse effects. There was an improvement in laboratory parameters (spirometry) and a slowing down in the process of pathological degeneration. Also, patients reported improvements in the clinical condition and quality of life. Conclusions Despite being in the initial stage and in spite of the small sample, the results of the clinical protocol of cell therapy in advanced pulmonary emphysema as proposed in this study, open new therapeutic perspectives in chronic obstructive pulmonary disease. It is worth emphasizing that this study corresponds to the first study in the literature that reports a change in the natural history of pulmonary emphysema after the use of cell therapy with a pool of bone marrow mononuclear cells. PMID:24255620

  9. The Effect of Renal Function Impairment on the Mortality of Cirrhotic Patients: A Nationwide Population-Based 3-Year Follow-up Study

    PubMed Central

    Hung, Tsung-Hsing; Lay, Chorng-Jang; Tseng, Chih-Wei; Tsai, Chih-Chun; Tsai, Chen-Chi

    2016-01-01

    Renal function impairment (RFI) contributes to poor prognosis in cirrhotic patients. However, there have been no studies that seek to identify the effect of different types of RFI on the mortality of cirrhotic patients. We used the National Health Insurance Database, derived from the Taiwan National Health Insurance Program, to identify 44365 cirrhotic patients between January 1, 2007 and December 31, 2007. RFI was identified in 2832 cirrhotic patients, including 1075 with acute renal failure (ARF) (169 with hepatorenal syndrome, HRS; 906 with non-hepatorenal syndrome, NHRS), 705 with chronic kidney disease (CKD), and 1052 with end stage renal disease (ESRD). After Cox proportional hazard regression analysis adjusted by gender, age, and comorbid disorders, the 30-day, 30 to 90-day, 90-day to 1-year, and 1 to 3-year mortality hazard ratios (HR) compared to the non-RFI group were: (ARF) 5.19 (4.70–5.74), 3.23 (2.76–3.77), 1.51 (1.26–1.81), and 1.35 (1.13–1.61), respectively; (CKD) 2.70 (2.30–3.18), 2.03 (1.66–2.49), 1.60 (1.34–1.90), and 1.26 (1.06–1.49), respectively; and (ESRD) 1.42 (1.17–1.72), 1.62 (1.35–1.94), 1.90 (1.68–2.15), and 1.67 (1.48–1.89), respectively. Compared to NHRS, the 30-day, 30 to 90-day, 90-day to 1-year, and 1 to 3-year mortality HRs of HRS were 1.03 (0.80–1.32), 2.13 (1.46–3.11), 1.58 (0.90–2.75), and 2.51 (1.41–4.48), respectively, in cirrhotic patients with ARF. These results indicate the effects of CKD and ESRD on the mortality of cirrhotic patients are distributed equally in every survival stage, whereas the effect of ARF appears only in the early stage. Compared to NHRS, HRS contributes to a higher mortality risk at the late survival stage. PMID:27631098

  10. Developmental milestones record - 3 years

    MedlinePlus

    ... years; Growth milestones for children - 3 years; Childhood growth milestones - 3 years; Well child - 3 years ... activities related to your child's interests. Encourage your child to use words to express feelings (rather than acting out).

  11. Evidence for Trait Related Theory of Mind Impairment in First Episode Psychosis Patients and Its Relationship with Processing Speed: A 3 Year Follow-up Study

    PubMed Central

    Ayesa-Arriola, Rosa; Setién-Suero, Esther; Neergaard, Karl D.; Ferro, Adele; Fatjó-Vilas, Mar; Ríos-Lago, Marcos; Otero, Soraya; Rodríguez-Sánchez, Jose M.; Crespo-Facorro, Benedicto

    2016-01-01

    This study aimed to confirm whether first-episode psychosis patients present a stable trait impairment in theory of mind (ToM) and to examine the potential relationship between ToM and clinical symptomatology and neurocognition. Patients with a first episode of psychosis (N = 160) and healthy controls (N = 159) were assessed with an extensive neuropsychological test battery, which included a mental state decoding task known as “The Reading the Mind in the Eyes” (Eyes test), at baseline and reassessed after 1 and 3 years. The clinical group performed below healthy controls on the Eyes test while not showing test-retest differences between baseline and follow-up administrations. Analyses revealed age, education and premorbid IQ as potential moderators. Poorer performance on the Eyes test was not linked to clinical symptomatology but was associated with greater neurocognitive deficit, particularly related to processing speed. The persistence of ToM deficits in patients suggests that there are trait related metalizing impairments in first episode psychosis. This study shows the influence of processing speed and moderator variables on efficient ToM. PMID:27199826

  12. Personality Disorder and Changes in Affect Consciousness: A 3-Year Follow-Up Study of Patients with Avoidant and Borderline Personality Disorder

    PubMed Central

    Johansen, Merete Selsbakk; Normann-Eide, Tone; Egeland, Jens

    2015-01-01

    Personality disorders (PDs) are highly prevalent in patients receiving psychiatric services, and are associated with significant personal and social costs. Over the past two decades, an increasing number of treatment studies have documented the effectiveness of treatment for patients with PDs, especially when it comes to reduction of symptom distress, risk taking behavior, self-harm, or suicide attempts. However, less is known about the more complex aims of improving the personality structure itself, such as identity- and interpersonal disturbances. Emotional dysfunction is closely associated with PD pathology. The present study investigated changes in affect consciousness (AC) in patients with avoidant or borderline PD, and how these changes were associated with clinical status after 3 years of follow-up. The study included 52 individuals; 79 percent were females, and mean age was 30 years. The evaluations included the Affect Consciousness Interview, Symptom Checklist-90-R, Circumplex of Interpersonal Problems, the Index of Self-Esteem, and three domains (Identity Integration, Relational Capacities, and Self-Control) of the Severity Indices of Personality Problems (SIPP-118). There was a significant increase in the Global AC and AC scores for most of the specific affects from baseline to follow-up. As the present study did not include a control group, it cannot be concluded that changes in AC are effects of psychotherapy, and the possibility of age-related maturation processes cannot be excluded. The change in Global AC contributed significantly to explained variance in the follow-up levels of Circumplex of Interpersonal Problems, and the two SIPP-118 domains Relational Capacities and Identity Integration. Improved AC was not associated with change in the Self-Control domain or the Global Severity Index of Symptom Checklist-90-R. The results suggest that AC may be altered for patients with borderline and avoidant PDs, and this is the first study to report that

  13. The long-term course of patients undergoing alternative and integrative therapy for lumbar disc herniation: 3-year results of a prospective observational study

    PubMed Central

    Shin, Joon-Shik; Lee, Jinho; Kim, Me-riong; Shin, Byung-Cheul; Lee, Myeong Soo; Ha, In-Hyuk

    2014-01-01

    Objectives This study aimed to assess the efficacy and safety of an integrative complementary and alternative medicine (CAM) approach in the management of lumbar herniated disc (LHD) with sciatic pain and investigate pain relapse, use of medical care and surgery rates in patients who actively chose non-surgical CAM treatment for LHD. Study design/Setting This prospective observational study was undertaken at a Korean medicine hospital outpatient setting in Korea. Participants A total of 128 consecutive patients with LHD with a numeric rating scale for leg pain of ≥5 completed 6 months of CAM treatment after recruitment from November 2006, and 73/128 participants (57%) attended follow-up 3 years later. Interventions 6 months of CAM treatment (herbal medicine, acupuncture, bee venom pharmacopuncture, and Chuna manipulation). Primary outcome measures Visual analogue scale (VAS) for low back and leg pain, Oswestry Disability Index (ODI), and Short Form (SF)-36 Health Survey. Secondary outcome measures Neurological impairment (muscular weakness, sensory loss, Straight Leg Raise test), MRIs, recurrence of low back pain and/or radiating pain, and use of medical care. Results 92 patients could be assessed for surgical state, of whom 4 replied that they had received surgery. 73 patients attended the 3-year follow-up. The baseline VAS of back pain (4.37±2.70) decreased after treatment (0.90±1.01; p<0.001) and was maintained at 3 years (1.12±1.64; p=0.19). The baseline VAS of leg pain (7.57±1.40) also decreased on treatment (0.82±1.18; p<0.001) and was sustained at 3 years (0.99±1.58; p=0.34). ODI scores declined from 40.74±16.15 to 9.84±9.67 (p<0.001), then decreased further to 6.30±7.19 (p<0.01). SF-36 scores increased from 34.96±13.30 to 69.20±14.96 (p<0.001), reaching 76.19±14.45 (p<0.001) at 3 years. 37 patients reported recurrence of pain and most chose CAM treatment for management of relapse symptoms. Conclusions Although the absence of a

  14. The bacteriological quality of retail-level peanut, almond, cashew, hazelnut, brazil, and mixed nut kernels produced in two Australian nut-processing facilities over a period of 3 years.

    PubMed

    Eglezos, Sofroni

    2010-07-01

    An investigation of the bacteriological quality of ready-to-eat peanuts, almonds, cashews, hazelnuts, and brazil nuts processed in two Australian nut-processing facilities was performed over a period of 3 years. A total of 564 ready-to-eat retail packs were analyzed for aerobic plate count (APC), Salmonella, coagulase-positive staphylococci, Listeria monocytogenes, and Escherichia coli. Of these samples, 343 were peanuts, 45 cashews, 42 almonds, 40 brazil nuts, 51 hazelnuts, and 43 were mixed packs containing all five types. There was no Salmonella, E. coli, or coagulase-positive staphylococci detected in any sample. L. monocytogenes was detected in two of the mixed packs after enrichment, but was not detected from samples by an alternate enumeration method (detection limit = 10/g). The APC percentages of positive samples with counts above the detection level of the plating method used (100 CFU/g) for peanuts, almonds, cashews, hazelnuts, brazil nuts, and mixed nuts were 48%, 36%, 62%, 36%, 56%, and 44%, respectively. Of the samples containing more than this detection limit, the means were 2.7, 2.4, 2.4, 2.6, 2.8, and 2.7 log CFU/g, respectively. The maximum APC was 3.9 log CFU/g. The bacteriological quality of roasted peanut, almond, cashew, hazelnut, brazil, and mixed nut kernels processed in Australian facilities does not appear to suggest a public health concern.

  15. A survey of the bacteriological quality of preroasted peanut, almond, cashew, hazelnut, and brazil nut kernels received into three Australian nut-processing facilities over a period of 3 years.

    PubMed

    Eglezos, Sofroni; Huang, Bixing; Stuttard, Ed

    2008-02-01

    There is little information about bacteriological quality of preroasted kernels available in the public domain. An investigation of the bacteriological quality of preroasted peanut, almond, cashew, hazelnut, and Brazil nut kernels received into three Australian nut-processing facilities was performed over a period of 3 years. A total of 836 samples were analyzed for aerobic plate count, and 921 samples for Salmonella and Escherichia coli. The 921 samples included 653 peanut, 100 cashew, 60 almond, 60 Brazil nut, and 48 hazelnut kernels. There was no E. coli detected in any sample. Salmonella subsp. II (Fremantle) was detected in one raw almond sample. The aerobic plate count percentages of positive samples with counts above the detection level of the plating method used (100 CFU/g) for peanuts, almonds, cashews, hazelnuts, and Brazil nuts were 84, 78, 74, 50, and 45%, respectively. Of the samples containing more than this detection limit, the means were 4.5, 4.4, 3.1, 2.5, and 3.8 log CFU/g respectively. Although roasted kernel quality was not within the scope of this survey, raw microbial bioload would be expected to reduce on roasting. The bacteriological quality of preroasted peanut, almond, cashew, hazelnut, and Brazil nut kernels received into nut-processing facilities in Australia does not appear to suggest a public health concern.

  16. Relationship of Pretreatment Rorschach Factors to Symptoms, Quality of Life, and Real-Life Functioning in a 3-Year Follow-Up of Traumatized Refugee Patients

    PubMed Central

    Opaas, Marianne; Hartmann, Ellen; Wentzel-Larsen, Tore; Varvin, Sverre

    2016-01-01

    ABSTRACT Response to mental health treatment varies highly among refugee patients. Research has not established which factors relate to differences in outcome. This study is a follow-up of Opaas and Hartmann's (2013) Rorschach Inkblot Method (RIM; Exner, 2003) pretreatment study of traumatized refugees, where 2 RIM principal components, Trauma Response and Reality Testing, were found descriptive of participants’ trauma-related personality functioning. This study's aims were to examine relationships of the RIM components with measures of anxiety, depression, posttraumatic stress, quality of life (QOL), employment, and exile language skills throughout 3 years. We found that impaired Reality Testing was related to more mental health symptoms and poorer QOL; furthermore, individuals with adequate Reality Testing improved in posttraumatic stress symptoms the first year and retained their improvement. Individuals with impaired Reality Testing deteriorated the first year and improved only slightly the next 2 years. The results of this study imply that traumatized refugee patients with impaired Reality Testing might need specific treatment approaches. Research follow-up periods should be long enough to detect changes. The reality testing impairment revealed by the RIM, mainly perceptual in quality, might not be easily detected by diagnostic interviews and self-report. PMID:26528822

  17. Multiple risk intervention in high-risk hypertensive patients. A 3-year ultrasound study of intima-media thickness and plaques in the carotid artery. Risk Intervention Study (RIS) Group.

    PubMed

    Suurküla, M; Agewall, S; Fagerberg, B; Wendelhag, I; Wikstrand, J

    1996-03-01

    than we observed is needed to favorably affect intima-media thickness during an observation period of around 3 years in high-risk hypertensive patients.

  18. Your Child's Development: 3 Years

    MedlinePlus

    ... Feeding Your 1- to 2-Year-Old Your Child’s Development: 3 Years KidsHealth > For Parents > Your Child’s Development: 3 Years A A A Kids this age ... but certain signs could indicate a delay in development. Talk to your doctor if your child: doesn't speak, or can't speak in ...

  19. Your Child's Development: 3 Years

    MedlinePlus

    ... Feeding Your 1- to 2-Year-Old Your Child’s Development: 3 Years KidsHealth > For Parents > Your Child’s Development: 3 Years Print A A A en español ... but certain signs could indicate a delay in development. Talk to your doctor if your child: doesn't speak, or can't speak in ...

  20. Application of modeling and simulation to a long-term clinical trial: a direct comparison of simulated data and data actually observed in Japanese osteoporosis patients following 3-year ibandronate treatment.

    PubMed

    Nakai, Kiyohiko; Iida, Satofumi; Tobinai, Masato; Hashimoto, Junko; Kawanishi, Takehiko

    2015-03-01

    Ibandronate, a nitrogen-containing bisphosphonate, is a bone resorption inhibitor widely used to prevent and treat osteoporosis. To optimize the design for a long-term clinical study of ibandronate, modeling and simulation (M&S) was performed based on the result of population pharmacodynamic analysis using the data of a short-term clinical study. A population pharmacodynamic model was constructed by the urinary C-terminal telopeptide of type I collagen (uCTx) and the lumbar spine bone mineral density (BMD) data obtained in clinical studies, including a phase II study of Japanese osteoporosis patients treated with ibandronate for 6 months. Changes in BMD over a period of 3 years were simulated from the population pharmacodynamic parameters of the patients in this phase II study. The relationship between uCTx and BMD was well described by this modeling. The functions of disease progression and supplemental treatment were incorporated into the model to simulate a long-term clinical study with high accuracy. A long-term clinical study with a 3-year treatment was conducted after this M&S. The percentage change from baseline in observed BMD values were found to be similar to the prospectively simulated values. This study showed that M&S could be a useful and powerful tool for designing and conducting long-term clinical studies when carried out in the following sequence: (1) conduct a short-term clinical study; (2) perform M&S; and (3) conduct the long-term clinical study. Application of this procedure to various other treatment agents will establish the usefulness of M&S for long-term clinical studies and bring further efficiencies to drug development.

  1. Lamivudine switch therapy in chronic hepatitis B patients achieving undetectable hepatitis B virus DNA after 3 years of entecavir therapy: A prospective, open-label, multicenter study.

    PubMed

    Yeh, Ming-Lun; Huang, Ching-I; Hsieh, Ming-Yen; Huang, Chung-Feng; Hsieh, Meng-Hsuan; Huang, Jee-Fu; Dai, Chia-Yen; Lin, Zu-Yau; Chen, Shinn-Chern; Yu, Ming-Lung; Chuang, Wan-Long

    2016-11-01

    The subsequent maintenance therapy in chronic hepatitis B (CHB) patients after long-term viral replication suppression is still uncertain. We aim to evaluate the efficacy of lamivudine (LAM) maintenance therapy in CHB patients achieving undetectable hepatitis B virus (HBV) DNA after 3 years of entecavir (ETV) therapy. Consecutive CHB patients who received at least 3 years of ETV and achieved HBV DNA negativity were allocated either LAM switch therapy or stopped ETV therapy in a prospective, open-label study. Another group of sex- and age-matched patients with continuous ETV therapy for at least 4 years served as historical control group. The primary outcome measurement of the study was relapse of HBV DNA (defined as serum HBV DNA level ≥ 2000 IU/mL). A total of 74 patients, including 42 of LAM switch and 32 of the nonswitch group, were enrolled. There were no significant differences in demographics, except a higher proportion of patients with positive hepatitis B envelope antigen in the nonswitch group at the initiation of ETV therapy. The LAM switch group had significantly lower 1-year relapse rate of HBV within 1 year compared to the nonswitch group (14.3% vs. 75%, p<0.001). However, none of the 48 historical control patients developed relapse of HBV, which was significantly lower than the rate in LAM switch group (p < 0.001). LAM switch was the only factor associated with HBV DNA relapse. In conclusion, continuous long-term potent nucleot(s)ide analogue therapy is mandatory for prevention of viral relapse in CHB patients.

  2. Human growth hormone replacement in adult hypopituitary patients: long-term effects on body composition and lipid status--3-year results from the HypoCCS Database.

    PubMed

    Attanasio, Andrea F; Bates, Peter C; Ho, Ken K Y; Webb, Susan M; Ross, Richard J; Strasburger, Christian J; Bouillon, Roger; Crowe, Brenda; Selander, Keith; Valle, Domenico; Lamberts, Steven W J

    2002-04-01

    The Hypopituitary Control and Complications Study is an international surveillance study evaluating efficacy and safety of GH therapy of adult GH-deficient patients in clinical practice. The present report examined baseline data from 1,123 adult onset (AO) and 362 childhood onset (CO) patients, as well as efficacy in 242 patients who had completed 3 yr of GH treatment. At study entry, mean height, body mass index, waist to hip ratio, and lean body mass were significantly (P < 0.001 for each) lower in CO compared with AO patients. After 3 yr on GH, lean body mass was significantly increased in AO males and females and CO males but not CO females, whereas fat mass was significantly decreased in AO males only. Serum total cholesterol was decreased in females (-0.32 +/- 1.00 mmol/liter; P = 0.045) and males (-0.36 +/- 0.96 mmol/liter; P = 0.004). High-density lipoprotein (HDL) cholesterol was increased for females (0.10 +/- 0.26 mmol/liter; P = 0.026) and males (0.10 +/- 0.34 mmol/liter; P = 0.022). The low-density lipoprotein/HDL ratio was decreased in AO males (-0.93 +/- 2.00; P = 0.003), AO females (-0.65 +/- 0.74; P < 0.001), and CO females (-0.69 +/- 0.76; P = 0.038), but the decrease in CO males was not significant (-0.84 +/- 2.85; P = 0.273). In AO patients, lean body mass increase from baseline was greatest in the those younger than 40 yr old, less but still significant in the middle group (40-60 yr) and unchanged in older (>60 yr) patients; conversely, decreases in the low-density lipoprotein/HDL ratio were small and not significant in the younger patients but greater and significant in the middle and older age groups. During the 3-yr treatment, 114 (7.7%) patients discontinued, including 9 (0.6%) for tumor recurrences, 9 (0.6%) for neoplasia, and 9 (0.6%) for side effects. Therefore, these observational data showed significant long-term efficacy of adult GH replacement therapy on body composition and lipid profiles and indicate that age is an important

  3. Accuracy of photodynamic diagnosis in the detection and follow-up of patients with upper urinary tract lesions: Initial 3-year experience

    PubMed Central

    Aboumarzouk, Omar M.; Ahmad, Sarfraz; Moseley, Harry; Kata, Slawomir G.

    2012-01-01

    Objective To assess the diagnostic accuracy of photodynamic diagnostic (PDD) ureterorenoscopy for detecting upper-urinary tract transitional cell carcinoma (UUT-TCC) in our initial 3 years, and compare the results with that of white light ureterorenoscopy (WLU). Patients and methods Between August 2007 and March 2010, 32 patients underwent PDD flexible ureterorenoscopy for UUT-TCC. Oral 5-aminolaevulinic acid (5-ALA) was used as the photosensitiser. The sensitivity, specificity and detection rate of PDD were calculated. Results The sensitivity, specificity, positive and negative predictive values of PDD for detecting abnormal tissue were 96%, 100%, 100% and 88%, compared to the results of WLU of 80%, 86%, 95% and 55%, respectively. PDD was able to detect 96% (24/25) of the abnormal tissue and 96% (21/22) of cancerous tissue, while WLU detected 80% (20/25) of abnormal tissue and 91% (20/22) of the tumour tissue. Three patients of the 32 (10%) developed side-effects related to 5-ALA; two patients developed a facial-skin photosensitive reaction and one developed hypotension. All were treated conservatively, with no long-term effects. Conclusion PDD can be used safely in the UUT, and with a higher sensitivity, specificity and detection rate than standard WLU for detecting UUT tumours. PMID:26558016

  4. Probabilistic modelling to assess exposure to three artificial sweeteners of young Irish patients aged 1-3 years with PKU and CMPA.

    PubMed

    O'Sullivan, Aaron J; Pigat, Sandrine; O'Mahony, Cian; Gibney, Michael J; McKevitt, Aideen I

    2016-11-01

    The choice of suitable normal foods is limited for individuals with particular medical conditions, e.g., inborn errors of metabolism (phenylketonuria - PKU) or severe cow's milk protein allergy (CMPA). Patients may have dietary restrictions and exclusive or partial replacement of specific food groups with specially formulated products to meet particular nutrition requirements. Artificial sweeteners are used to improve the appearance and palatability of such food products to avoid food refusal and ensure dietary adherence. Young children have a higher risk of exceeding acceptable daily intakes for additives than adults due to higher food intakes kg(-1) body weight. The Budget Method and EFSA's Food Additives Intake Model (FAIM) are not equipped to assess partial dietary replacement with special formulations as they are built on data from dietary surveys of consumers without special medical requirements impacting the diet. The aim of this study was to explore dietary exposure modelling as a means of estimating the intake of artificial sweeteners by young PKU and CMPA patients aged 1-3 years. An adapted validated probabilistic model (FACET) was used to assess patients' exposure to artificial sweeteners. Food consumption data were derived from the food consumption survey data of healthy young children in Ireland from the National Preschool and Nutrition Survey (NPNS, 2010-11). Specially formulated foods for special medical purposes were included in the exposure model to replace restricted foods. Inclusion was based on recommendations for adequate protein intake and dietary adherence data. Exposure assessment results indicated that young children with PKU and CMPA have higher relative average intakes of artificial sweeteners than healthy young children. The reliability and robustness of the model in the estimation of patient additive exposures was further investigated and provides the first exposure estimates for these special populations.

  5. Pathogenic molds (including Aspergillus species) in hospital water distribution systems: a 3-year prospective study and clinical implications for patients with hematologic malignancies.

    PubMed

    Anaissie, Elias J; Stratton, Shawna L; Dignani, M Cecilia; Lee, Choon-kee; Summerbell, Richard C; Rex, John H; Monson, Thomas P; Walsh, Thomas J

    2003-04-01

    The incidence of mold infections in patients with hematologic malignancies continues to increase despite the widespread use of air filtration systems, suggesting the presence of other hospital sources for these molds. Water sources are known to harbor pathogenic molds. We examined samples from water, water surfaces, air, and other environment sources from a bone marrow transplantation unit with optimal air precautions. Molds (Aspergillus species, others) were recovered in 70% of 398 water samples, in 22% of 1311 swabs from plumbing structures and environmental surfaces, and in 83% of 274 indoor air samples. Microscopic examination of the water plumbing lines revealed hyphal forms compatible with molds. Four findings suggest that indoor airborne molds were aerosolized from the water: (1) higher mean airborne concentrations of molds in bathrooms (16.1 colony-forming units [CFU]/m(3)) than in patient rooms (7 CFU/m(3)) and hallways (8.6 CFU/m(3); P =.00005); (2) a strong type and rank correlation between molds isolated from hospital water and those recovered from indoor hospital; (3) lack of seasonal correlation between the airborne mold concentration in outdoor and indoor air; and (4) molecular relatedness between a clinical strain and a water-related strain (previously reported). Hospital water distribution systems may serve as a potential indoor reservoir of Aspergillus and other molds leading to aerosolization of fungal spores and potential exposure for patients.

  6. A protocol for resuscitation of severe burn patients guided by transpulmonary thermodilution and lactate levels: a 3-year prospective cohort study

    PubMed Central

    2013-01-01

    Introduction The use of urinary output and vital signs to guide initial burn resuscitation may lead to suboptimal resuscitation. Invasive hemodynamic monitoring may result in over-resuscitation. This study aimed to evaluate the results of a goal-directed burn resuscitation protocol that used standard measures of mean arterial pressure (MAP) and urine output, plus transpulmonary thermodilution (TPTD) and lactate levels to adjust fluid therapy to achieve a minimum level of preload to allow for sufficient vital organ perfusion. Methods We conducted a three-year prospective cohort study of 132 consecutive critically burned patients. These patients underwent resuscitation guided by MAP (>65 mmHg), urinary output (0.5 to 1 ml/kg), TPTD and lactate levels. Fluid therapy was adjusted to achieve a cardiac index (CI) >2.5 L/minute/m2 and an intrathoracic blood volume index (ITBVI) >600 ml/m2, and to optimize lactate levels. Statistical analysis was performed using mixed models. We also used Pearson or Spearman methods and the Mann-Whitney U-test. Results A total of 98 men and 34 women (mean age, 48 ± 18 years) was studied. The mean total body surface area (TBSA) burned was 35% ± 22%. During the early resuscitation phase, lactate levels were elevated (2.58 ± 2.05 mmol/L) and TPTD showed initial hypovolemia by the CI (2.68 ± 1.06 L/minute/m2) and the ITBVI (709 ± 254 mL/m2). At 24 to 32 hours, the CI and lactic levels were normalized, although the ITBVI remained below the normal range (744 ± 276 ml/m2). The mean fluid rate required to achieve protocol targets in the first 8 hours was 4.05 ml/kg/TBSA burned, which slightly increased in the next 16 hours. Patients with a urine output greater than or less than 0.5 ml/kg/hour did not show differences in heart rate, mean arterial pressure, CI, ITBVI or lactate levels. Conclusions Initial hypovolemia may be detected by TPTD monitoring during the early resuscitation phase. This hypovolemia might not be reflected by blood

  7. The presence of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor on patients with rheumatoid arthritis (RA) does not interfere with the chance of clinical remission in a follow-up of 3 years.

    PubMed

    da Mota, Licia Maria Henrique; Dos Santos Neto, Leopoldo Luiz; de Carvalho, Jozélio Freire; Pereira, Ivânio Alves; Burlingame, Rufus; Ménard, Henri A; Laurindo, Ieda Maria Magalhães

    2012-12-01

    Autoantibodies in early rheumatoid arthritis (RA) have important diagnostic value. The association between the presence of autoantibodies against cyclic citrullinated peptide and the response to treatment is controversial. To prospectively evaluate a cohort of patients with early rheumatoid arthritis (<12 months of symptoms) in order to determine the association between serological markers (rheumatoid factor (RF), anti-citrullinated protein antibodies) such as anti-cyclic citrullinated peptide antibodies (anti-CCP) and citrullinated anti-vimentin (anti-Sa) with the occurrence of clinical remission, forty patients diagnosed with early RA at the time of diagnosis were evaluated and followed for 3 years, in use of standardized therapeutic treatment. Demographic and clinical data were recorded, disease activity score 28 (DAS 28), as well as serology tests (ELISA) for RF (IgM, IgG, and IgA), anti-CCP (CCP2, CCP3, and CCP3.1) and anti-Sa in the initial evaluation and at 3, 6, 12, 18, 24, and 36 months of follow-up. The outcome evaluated was the percentage of patients with clinical remission, which was defined by DAS 28 lower than 2.6. Comparisons were made through the Student t test, mixed-effects regression analysis, and analysis of variance (significance level of 5%). The mean age was 45 years, and a female predominance was observed (90%). At the time of diagnosis, RF was observed in 50% of cases (RF IgA-42%, RF IgG-30%, and RF IgM-50%), anti-CCP in 50% (no difference between CCP2, CCP3, and CCP3.1) and anti-Sa in 10%. After 3 years, no change in the RF prevalence and anti-CCP was observed, but the anti-Sa increased to 17.5% (P = 0.001). The percentage of patients in remission, low, moderate, and intense disease activity, according to the DAS 28, was of 0, 0, 7.5, and 92.5% (initial evaluation) and 22.5, 7.5, 32.5, and 37.5% (after 3 years). There were no associations of the presence of autoantibodies in baseline evaluation and in serial analysis with the percentage of

  8. Acute epididymitis in Greek children: a 3-year retrospective study.

    PubMed

    Sakellaris, George S; Charissis, Giorgos C

    2008-07-01

    The aim of the study was to compare historical features, physical examination findings, and testicular color Doppler ultrasound in pediatric patients with epididymitis compared to testicular torsion and torsion of the appendix testes. A retrospective review of the medical records of 66 boys presenting with clinical aspects of acute scrotum over a 3-year period was performed. Sixty-six patients were included in the study (29 with epididymitis, 8 with testicular torsion and 12 with torsion of the appendix testis, 4 with scrotal abscesses, 5 with scrotal swelling, and 1 with inflamed epididymal cyst). The duration of symptoms ranged from 6 h to 4 days with a peak on the second day. Urine cultures and viral testes were negative in all patients. Color Doppler ultrasound was diagnostic for epididymitis in 28 patients (96.6%). Systemic intravenous antibiotics were given in all 29 patients with epididymitis. No patient showed signs of testicular atrophy in the follow-up. The increasing incidence of epididymitis should question the policy of routine exploration of the acute scrotum in children. The history and physical examination cannot reliably identify those boys who can be managed conservatively. Color Doppler ultrasound is a useful adjunct in the evaluation of the acute scrotum when physical findings are equivocal but it can also be misleading.

  9. Periodization

    PubMed Central

    Lorenz, Daniel S.; Reiman, Michael P.; Walker, John C.

    2010-01-01

    Background: Clinicians are constantly faced with the challenge of designing training programs for injured and noninjured athletes that maximize healing and optimize performance. Periodization is a concept of systematic progression—that is, resistance training programs that follow predictable patterns of change in training variables. The strength training literature is abundant with studies comparing periodization schemes on uninjured, trained, and untrained athletes. The rehabilitation literature, however, is scarce with information about how to optimally design resistance training programs based on periodization principles for injured athletes. The purpose of this review is to discuss relevant training variables and methods of periodization, as well as periodization program outcomes. A secondary purpose is to provide an anecdotal framework regarding implementation of periodization principles into rehabilitation programs. Evidence Acquisition: A Medline search from 1979 to 2009 was implemented with the keywords periodization, strength training, rehabilitation, endurance, power, hypertrophy, and resistance training with the Boolean term AND in all possible combinations in the English language. Each author also undertook independent hand searching of article references used in this review. Results: Based on the studies researched, periodized strength training regimens demonstrate improved outcomes as compared to nonperiodized programs. Conclusions: Despite the evidence in the strength training literature supporting periodization programs, there is a considerable lack of data in the rehabilitation literature about program design and successful implementation of periodization into rehabilitation programs. PMID:23015982

  10. How Grammatical Are 3-Year-Olds?

    ERIC Educational Resources Information Center

    Eisenberg, Sarita L.; Guo, Ling-Yu; Germezia, Mor

    2012-01-01

    Purpose: This study investigated the level of grammatical accuracy in typically developing 3-year-olds and the types of errors they produce. Method: Twenty-two 3-year-olds participated in a picture description task. The percentage of grammatical utterances was computed and error types were analyzed. Results: The mean level of grammatical accuracy…

  11. Profile of inflammatory mediators in tonsils of patients with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome.

    PubMed

    Valenzuela, Patricia M; Araya, Andrea; Pérez, Claudio I; Maul, Ximena; Serrano, Carolina; Beltrán, Constanza; Harris, Paul R; Talesnik, Eduardo

    2013-12-01

    The purpose of this study was to analyze the levels of white blood cells and profile of proinflammatory Th1, Th2, Th17, and T regulatory tissue cytokines in the tonsils of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) patients to contribute to the pathophysiological understanding of the PFAPA syndrome. A cohort of PFAPA patients who had tonsillectomy during 2010 and 2011 was included and compared to control patients who had tonsillectomy for tonsillar hypertrophy. White blood cell counts were measured during flares in PFAPA patients and before tonsillectomy in the control group. Cytokine gene expression was analyzed in removed tonsils by real-time PCR. Nine PFAPA patients with a median age of 5.3 years (1.7-8 years) and 17 hypertrophic tonsils of patients with a median age of 4.8 years (2.3-8.4 years) participated in this study. Tonsillectomy was performed during afebrile period between PFAPA flares. Three of the nine patients had recurrent episodes of aphthous stomatitis without fever after tonsillectomy. Leukocyte and neutrophil counts were higher in PFAPA patients compared to controls (p < 0.05). Eosinophil counts were lower in PFAPA patients during flares (p = 0.006). IL-1β, TNF-α, TGF-β, IL-17, and IFN-γ levels were similar in the tonsils of patients and controls. IL-4 gene expression in the tonsils was lower in PFAPA patients compared to those of the controls (p = 0.04). Proinflammatory, effector, and regulatory cytokine gene expression in tonsil tissue of PFAPA children removed in a noninflammatory asymptomatic interval and in control patients were similar. However, IL-4 cytokine gene expression in the tonsils and peripheral blood eosinophils were lower in the PFAPA patients suggesting a potential pathogenesis pathway based on an inhibition of Th2 responses.

  12. [Periodic fever: a description of twelve patients with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA)].

    PubMed

    De Cunto, Carmen; Britos, María; Eymann, Alfredo; Deltetto, Noelia; Liberatore, Diana

    2010-10-01

    PFAPA is a periodic fever syndrome characterized by: fever, aphthous stomatitis, pharyngitis and cervical adenitis. It is one of the autoinflammatory syndromes, but yet of unknown etiology. Our aim is to report our experience, describe clinical manifestations, laboratory findings, relapses occurrence and response to treatment. We present 12 PFAPA patients. Median age at onset: 1.15 years, mean duration of febrile episodes: 4 days, and relapses at regular intervals. All children received prednisone (1-2 mg/kg/dose) one to two doses, 9 patients responded immediately after the first dose and all experienced a lower periodicity of attacks. PFAPA is the most frequent periodic fever syndrome. To our knowledge, there are no other local series of PFAPA patients published. Recognizing this syndrome will prevent from ordering unnecessary studies and will favor family coping.

  13. [Selected ethical problems of oncologic patients during the terminal period].

    PubMed

    Iwaszczyszyn, J; Kwiecińska, A

    2001-01-01

    Patient suffering from terminal disease is depended on his environment more than any other one. He often suffers from nervous break down, anxiety and fear and he is usually unprotected from the environment. Fast development of medical science and its technicisation can lead towards dehumanization and lack of psychological and spiritual care, which should be based on clear ethical principles. Main lines of ethical principles of Health Service which are included in Deontological Code of Physicians and Collection of ethical principles for a qualified nurse are the main rules how to proceed as to fulfill the rule: "benefit of a patient is the superior law." According to its speciality Palliative Medicine introduces also four general ethical principles: 1. Patient will is a rule of treatment. 2. The principle of proportion--benefits from the treatment should be higher than losses and suffering from iatrogenic acting. 3. The principle of equality--stop taking a cure does not differ from not undertaking treatment. 4. The principle of relativity--life is not an absolute good, death is not an absolute evil. Holistic acts of Palliative Medicine determines also specific ethical attitudes, especially in the following: 1. Communication between a therapist and a patient and his family (interpersonal attitudes). 2. Procedures how to lessen suffering and its interpretation according to culture, tradition and religion ("nonsense and significance of suffering"). 3. Negation of euthanasia. 4. Spiritual, psychological and social care of patients.

  14. Pipeline for uncoilable or failed aneurysms: 3-year follow-up results.

    PubMed

    Becske, Tibor; Potts, Matthew B; Shapiro, Maksim; Kallmes, David F; Brinjikji, Waleed; Saatci, Isil; McDougall, Cameron G; Szikora, István; Lanzino, Giuseppe; Moran, Christopher J; Woo, Henry H; Lopes, Demetrius K; Berez, Aaron L; Cher, Daniel J; Siddiqui, Adnan H; Levy, Elad I; Albuquerque, Felipe C; Fiorella, David J; Berentei, Zsolt; Marosföi, Miklós; Cekirge, Saruhan H; Nelson, Peter K

    2016-10-14

    late-onset hemorrhagic or ischemic cerebrovascular events or neurological deaths were observed in the 6-month through 3-year posttreatment period. Among 103 surviving patients, 85 underwent functional outcome assessment in which modified Rankin Scale scores of 0-1 were demonstrated in 80 subjects. CONCLUSIONS Pipeline embolization is safe and effective in the treatment of complex large and giant aneurysms of the intracranial internal carotid artery. Unlike more traditional endovascular treatments, flow diversion results in progressive vascular remodeling that leads to complete aneurysm obliteration over longer-term follow-up without delayed aneurysm recanalization and/or growth. Clinical trial registration no.: NCT00777088 ( clinicaltrials.gov ).

  15. Radiological evaluation of the Cresco system in combination with Osseospeed implants: a preliminary 3-year report

    PubMed Central

    BALDINI, N.; DE SANCTIS, M.; CAGIDIACO, M.C.; BALLERI, P.; VIGNOLETTI, F.; GORACCI, C.; FERRARI, M.

    2014-01-01

    SUMMARY Aim. In this preliminary study, the 3-year radiological outcomes of Osseospeed implant-supported fixed complete or partial prostheses made with two different laboratory protocols were compared. Methods. A convenience sample of 34 patients, who were either partially or completely edentulous in either jaw, were randomly assigned to two groups, of 17 patients each, using either a traditional laboratory protocol (control group) or the Cresco one (test group). The study’s objective was an assessment of marginal bone loss around implants, measured on intraoral radiographs at 3-year follow-up. Results. None of the implants inserted was lost during the study and radiological measurements of marginal bone level changes revealed that the mean marginal bone loss was respectively 0,73±0,33mm for test group and 0,88±1,13mm for control group. The differences between test and control groups were not statistically significant. Conclusion. This preliminary study did not demonstrate statistically significant differences in marginal bone loss around implant-prostheses prepared with the two different laboratory protocols, over the 3-year observational period. PMID:25694796

  16. [Dermatobia hominis infection in a 3-year-old child].

    PubMed

    Meissner, M; Kippenberger, S; Valesky, E M; Kaufmann, R

    2012-04-01

    In the context of increasing travel to the tropics, outpatient services are more frequently confronted with non-domestic diseases in Europe. A 3-year old child presented with a painful tumor of the scalp. After incision of the furuncle-like lesion, we extracted a larva of the botfly Dermatobia hominis. Botflies are mainly encountered in Central and South America; they should be considered if patients demonstrate a furuncle-like lesion and have returned from a holiday in these endemic regions.

  17. AID awards 3-year Guatemala contract.

    PubMed

    1984-01-01

    The US Agency for International Development (USAID) has awarded a 3-year US$593,036 grant to the Los Angeles firm of Juarez and Associates, Inc. to help implement a contraceptive social marketing project in Guatemala. The firm will provide marketing assistance to the for-profit organization. Importadora de Productos Farmaceuticos (PROFA), an offshoot of the nonprofit International Planned Parenthood Federation affiliate, Asociacion Pro-Bienestar de la Familia de Guatemala (APROFAM), created specifically to conduct the social marketing project. Juarez and Associates has previous market research experience in family planning in Guatemala. Contraceptive social marketing sales are projected to begin in early 1985.

  18. Health Blogging and Social Support: A 3-Year Panel Study.

    PubMed

    Keating, David M; Rains, Stephen A

    2015-01-01

    The reported study explored the implications of informal computer-mediated social support for the well-being of individuals coping with illness over the course of 3 years. A panel study was conducted in which respondents--bloggers writing about their experiences living with a health condition--reported on their perceptions of social support and well-being during 2010 and again during 2013. Among respondents who completed both questionnaires (n = 49), increases in support availability from family and friends were related to improvements in bloggers' health self-efficacy as well as improvements in bloggers' loneliness, particularly among those who also experienced increased support availability from blog readers. Increased blog reader support availability was associated with improvements in bloggers' health-related uncertainty. Among respondents who completed the initial questionnaire (N = 121), a survival analysis showed that neither support available from family and friends nor support from blog readers predicted continued health blogging over the 3-year period.

  19. Algerian Eddies lifetime can near 3 years

    NASA Astrophysics Data System (ADS)

    Puillat, I.; Taupier-Letage, I.; Millot, C.

    2002-01-01

    The Algerian Current (AC) is unstable and generates mesoscale meanders and eddies. Only anticyclonic eddies can develop and reach diameters over 200 km with vertical extents down to the bottom (˜3000 m). Algerian Eddies (AEs) first propagate eastward along the Algerian slope at few kilometers per day. In the vicinity of the Channel of Sardinia, a few AEs detach from the Algerian slope and propagate along the Sardinian one. It was hypothesized that AEs then followed a counter-clockwise circuit in the eastern part of the basin. Maximum recorded lifetimes were known to exceed 9 months. Within the framework of the 1-year Eddies and Leddies Interdisciplinary Study off Algeria (ELISA) experiment (1997-1998), we exhaustively tracked two AEs, using mainly an ˜3-year time series of NOAA/AVHRR satellite images. We show that AEs lifetimes can near 3 years, exceeding 33 months at least. We also confirm the long-lived AEs preferential circuit in the eastern part of the Algerian Basin, and specify that it may include several loops (at least three).

  20. A bioactive dental luting cement--its retentive properties and 3-year clinical findings.

    PubMed

    Jefferies, Steven R; Pameijer, Cornelis H; Appleby, David C; Boston, Daniel; Lööf, Jesper

    2013-02-01

    A clinical validation study was conducted to determine the performance of a new bioactive dental cement (Ceramir C&B, Doxa Dental AB) for permanent cementation. The cement is a new formulation class, which is a hybrid material comprised of calcium aluminate and glass-ionomer components. A total of 38 crowns and bridges were cemented in 17 patients; 31 of the abutment teeth were vital and seven were non-vital. Six restorations were bridges with a total of 14 abutment teeth (12 vital/ two non-vital). One fixed splint comprising two abutment teeth was also included. Preparation parameters were recorded, as well as cement characteristics such as working time, setting time, seating characteristics, and ease of cement removal. Baseline data were recorded for the handling of the cement, gingival inflammation, and pre-cementation sensitivity. Post-cementation parameters included post-cementation sensitivity, gingival tissue reaction, marginal integrity, and discoloration. All patients were seen for recall examinations at 30 days and 6 months. Fifteen of 17 subjects and 13 of 17 patients were also available for subsequent comprehensive 1- and 2-year recall examination, and 13 patients were available for a 3-year recall examination. Restorations available for the 3-year recall examination included 14 single-unit full-coverage crown restorations, four three-unit bridges comprising eight abutments, and one two-unit splint. Three-year recall data yielded no loss of retention, no secondary caries, no marginal discolorations, and no subjective sensitivity. All restorations rated excellent for marginal integrity. Average visual analogue scale (VAS) score for tooth sensitivity decreased from 7.63 mm at baseline to 0.44 mm at 6-month recall, 0.20 mm at 1-year recall, and 0.00 mm at 2- and 3-year recall. Average gingival index (GI) score for gingival inflammation decreased from 0.56 at baseline to 0.11 at 6-month recall, 0.16 at 1-year recall, 0.21 at 2-year recall, and 0.07 at 3

  1. 78 FR 40485 - Lung Cancer Patient-Focused Drug Development; Extension of Comment Period

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ... HUMAN SERVICES Food and Drug Administration Lung Cancer Patient-Focused Drug Development; Extension of... lung cancer patient-focused drug development. In the Federal Register of June 5, 2013 (78 FR 33581... comment on lung cancer patient- focused drug development and explained that the comment period would...

  2. Endogenous insulin fluctuations during glucose-induced paralysis in patients with familial periodic hypokalemia.

    PubMed

    Johnsen, T

    1977-11-01

    Endogenous insulin production in patients with familial periodic hypokalemia has not previously been studied during induced attacks. The serum insulin, serum potassium, and blood glucose concentrations were measured in six patients with familial periodic hypokalemia during six attacks of paralysis induced by long-lasting glucose stimulation. The same parameters were measured in four normal subjects under the same conditions. There was no difference in insulin response or in blood glucose between the two groups. Basal insulin levels showed no difference. There was no correlation between the occurrence of the attack and the serum insulin level in the patients. All the patients responded by severe paralysis and hypokalemia.

  3. Clinical outcomes of 3-year experience of targeted temperature management in patients with out-of-hospital cardiac arrest at Songklanagarind Hospital in Southern Thailand: an analysis of the MICU-TTM registry

    PubMed Central

    Vattanavanit, Veerapong; Bhurayanontachai, Rungsun

    2016-01-01

    Background Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of intensive care unit admission, which results in high hospital mortality. Targeted temperature management (TTM) was introduced several years ago and is considered to improve neurological and mortality outcomes. This management process was implemented in our hospital in 2012, which was expected to improve the standard of care in OHCA patients. Purpose We aimed to report the clinical and mortality outcomes after TTM was introduced to our hospital in 2012. Patients and methods An analysis of data from the Medical Intensive Care Unit-TTM registry between 2012 and 2015 was performed. After successful cardiopulmonary resuscitation, TTM was applied to all OHCA patients regardless of causes if there was no contraindication. The Cerebral Performance Category scale score and other clinical outcomes were recorded and analyzed. Results Out of 23 patients, 87% were male and the mean age was 54.5±18.1 years. The causes of OHCA from cardiac etiology comprised 52.2%. The most common initial cardiac rhythm was ventricular fibrillation (47.8%). The survival rate to hospital discharge was 47.8% (11/23), but neurological outcomes were in a persistent vegetative state (8/11, 72.7%). The group with poor neurological outcomes had a significantly higher Acute Physiologic Assessment and Chronic Health Evaluation II score than the group with good neurological outcomes (22.9±4.2 vs 16.0±3.6, P=0.01). In the multivariate analysis, initial shockable rhythm was associated with survival at hospital discharge (odds ratio 10.1, 95% confidence interval 1.1–94.3, P=0.04). Conclusion TTM in OHCA patients gave better mortality benefits compared to our previous records, despite poor neurological outcomes. Ventilator-associated pneumonia was the major complication of TTM. Therefore, TTM should be considered in OHCA patients, especially in shockable rhythms, after return of spontaneous circulation. PMID:27660500

  4. “I Wasted 3 Years, Thinking It’s Not a Problem”: Patient and Health System Delays in Diagnosis of Leprosy in India: A Mixed-Methods Study

    PubMed Central

    Govindarajulu, Srinivas; Isaakidis, Petros; Shewade, Hemant Deepak; Rokade, Vasudev; Singh, Rajbir; Kamble, Sanjeev

    2017-01-01

    Background Worldwide, leprosy is one of the major causes of preventable disability. India contributes to 60% of global leprosy burden. With increasing numbers of leprosy with grade 2 disability (visible disability) at diagnosis, we aimed to determine risk factors associated with grade 2 disability among new cases and explore patients and providers’ perspectives into reasons for late presentation. Methodology/Principal Findings This was an explanatory mixed-methods study where the quantitative component, a matched case-control design, was followed by a qualitative component. A total of 70 cases (grade 2 disability) and 140 controls (grade 0) matched for age and sex were randomly sampled from new patients registered between January 2013-January 2015 in three districts of Maharashtra (Mumbai, Thane and Amaravati) and interviewed using a structured close ended questionnaire. Eight public health care providers involved in leprosy care and 7 leprosy patients were purposively selected (maximum variation sampling) and interviewed using a structured open-ended interview schedule. Among cases, overall median (IQR) diagnosis delay in months was 17.9(7–30); patient and health system delay was 7(4–16.5) and 5.5(0.9–12.5) respectively; this was significantly higher than the delay in controls. Reasons for delayed presentation identified by the quantitative and qualitative data were: poor awareness of leprosy symptoms, first health care provider visited being private practitioners who were not aware about provision of free leprosy treatment at public health care facilities, reduced engagement and capacity of the general health care system in leprosy control. Conclusions Raising awareness in communities and health care providers regarding early leprosy symptoms, engagement of private health care provider in early leprosy diagnosis and increasing capacity of general health system staff, especially targeting high endemic areas that are hotspots for leprosy transmission may

  5. Foreign matter salpingitis 3 years after typhlitis.

    PubMed

    Rossbach, H C; Mastry, M; Barnes, J; Chamizo, W; Davis, L; Grana, N H; Barbosa, J L

    2001-05-01

    This case suggests that typhlitis may cause delayed abdominal pathology. A history of this condition should be considered in the work-up of any patient with gastrointestinal or genitourinary pathology.

  6. Blowout Fracture in a 3-Year-Old

    PubMed Central

    Pluijmers, Britt I.; Koudstaal, Maarten J.; Paridaens, Dion; van der Wal, Karel G.H.

    2013-01-01

    A 3-year-old patient was referred to the oral and maxillofacial department with a fracture of the orbital floor. Due to the lack of clinical symptoms, a conservative approach was chosen. After 3 weeks, an enophthalmos developed. The orbital floor reconstruction was successfully performed through a transconjunctival approach. This case highlights the rarity of pure blowout fractures in young children. The specific presentation and diagnostics of orbital floor fractures in children and the related surgical planning and intervention are discussed. PMID:24436749

  7. Pulmonary nocardiosis in a 3-year-old child

    PubMed Central

    Holdaway, M. D.; Kennedy, J.; Ashcroft, T.; Kay-Butler, J. J.

    1967-01-01

    Until 1960, 179 cases of infection with Nocardia asteroides had been described in the world literature. Seventeen cases in children were reported by 1963. The organism is a common saprophyte in nature with probably a world-wide distribution. Infection can be primary but is more common in patients with underlying malignancy, auto-immune disease or preceding tuberculosis. Sulphonamides, particularly sulphadiazine, are the drugs of choice in treatment; the value of antibiotics is less clearly established. The indications for surgical treatment have not yet been defined. We record a further case of primary pulmonary nocardiosis in a 3-year-old child. Images PMID:6035802

  8. Clinicopathological features and surgical outcome of patients with fibrolamellar hepatocellular carcinoma (experience with 22 patients over a 15-year period)

    PubMed Central

    Wahab, Mohamed Abdel; El Hanafy, Ehab; El Nakeeb, Ayman; Ali, Mahmoud Abdelwahab

    2017-01-01

    AIM To evaluate the clinicopathological features and the surgical outcomes of patients with fibrolamellar hepatocellular carcinoma (FL-HCC) over a 15-year period. METHODS This is a retrospective study including 22 patients with a pathologic diagnosis of FL-HCC who underwent hepatectomy over a 15-year period. Tumor characteristics, survival and recurrence were evaluated. RESULTS There were 11 male and 11 female with a median age of 29 years (range from 21 to 58 years). Two (9%) patients had hepatitis C viral infection and only 2 (9%) patients had alpha-fetoprotein level > 200 ng/mL. The median size of the tumors was 12 cm (range from 5-20 cm). Vascular invasion was detected in 5 (23%) patients. Four (18%) patients had lymph node metastases. The median follow up period was 42 mo and the 5-year survival was 65%. Five (23%) patients had a recurrent disease, 4 of them had a second surgery with 36 mo median time interval. Vascular invasion is the only significant negative prognostic factor CONCLUSION FL-HCC has a favorable prognosis than common HCC and should be suspected in young patients with non cirrhotic liver. Aggressive surgical resection should be done for all patients. Repeated hepatectomy should be considered for these patients as it has a relatively indolent course. PMID:28289511

  9. Factors influencing the survival period in Japanese patients with sporadic Creutzfeldt-Jakob disease.

    PubMed

    Iwasaki, Yasushi; Akagi, Akio; Mimuro, Maya; Kitamoto, Tetsuyuki; Yoshida, Mari

    2015-10-15

    Although Japanese cases of sporadic Creutzfeldt-Jakob disease (sCJD) generally involve longer survival periods compared to those from other countries, details regarding the factors influencing survival are unclear. To determine the influence of certain factors on survival, we retrospectively assessed 51 Japanese MM1-type sCJD patients with respect to background, clinical course, and disease management. No significant differences were found between men and women, tracheotomy and nontracheotomy patients, or patients treated in public and other types of hospitals. Although the survival period of tube-fed patients was significantly longer than that of patients who were not tube fed, survival of patients fed via a nasal tube did not differ significantly from that of gastrostomy-fed patients. The proportion of tube-fed patients was 68.6% (35/51). Disease duration was not significantly associated with age or year of onset. However, it was associated with time from onset to first recognition of myoclonus, first recognition of periodic sharp-wave complexes on electroencephalogram, and progression to the akinetic mutism state. Mechanical ventilation was not performed for any patient. Because the total disease duration increased in cases with a slowly progressive clinical course as a natural outcome, we concluded that the most crucial factor contributing to the prolonged survival of Japanese sCJD patients was tube feeding once the akinetic mutism state had been reached.

  10. Analysis of heart rate variability during auditory stimulation periods in patients with schizophrenia.

    PubMed

    Akar, Saime Akdemir; Kara, Sadık; Latifoğlu, Fatma; Bilgiç, Vedat

    2015-02-01

    The vulnerability-stress model is a hypothesis for symptom development in schizophrenia patients who are generally characterized by cardiac autonomic dysfunction. Therefore, measures of heart rate variability (HRV) have been widely used in schizophrenics for assessing altered cardiac autonomic regulations. The goal of this study was to analyze HRV of schizophrenia patients and healthy control subjects with exposure to auditory stimuli. More specifically, this study examines whether schizophrenia patients may exhibit distinctive time and frequency domain parameters of HRV from control subjects during at rest and auditory stimulation periods. Photoplethysmographic signals were used in the analysis of HRV. Nineteen schizophrenic patients and twenty healthy control subjects were examined during rest periods, while exposed to periods of white noise (WN) and relaxing music. Results indicate that HRV in patients was lower than that of control subjects indicating autonomic dysfunction throughout the entire experiment. In comparison with control subjects, patients with schizophrenia exhibited lower high-frequency power and a higher low-frequency to high-frequency ratio. Moreover, while WN stimulus decreased parasympathetic activity in healthy subjects, no significant changes in heart rate and frequency-domain HRV parameters were observed between the auditory stimulation and rest periods in schizophrenia patients. We can conclude that HRV can be used as a sensitive index of emotion-related sympathetic activity in schizophrenia patients.

  11. [Nursing practice of care to patients undergoing elective surgery in the immediate preoperative period].

    PubMed

    de Sena, Adnairdes Cabral; do Nascimento, Eliane Regina Pereira; Maia, Ana Rosete Camargo Rodrigues

    2013-09-01

    Research that aimed to analyze the care of nurses to patients, in the daily professional practice, provided in the preoperative period for patients undergoing elective surgery. It is a descriptive research with a qualitative approach that involved 15 nurses from Surgical Units and two nurses from the Surgical Centre of a hospital in the southern region of Brazil. Data was collected in semi-structured interviews conducted from April to July 2011. Data was analyzed using the Collective Subject Discourse (CSD) technique. The information obtained generated three CDS focused on the following ideas: administrative care, instruction in the preoperative period and surgical care in the immediate preoperative period. The results showed that caring consists mostly of giving instructions to the patient in the preoperative period. It is concluded that the care was directed to the physical aspects to the detriment of the psychological, in disagreement with the assistance methodology adopted in the hospital, supported by the Theory of Basic Human Needs.

  12. Periodic Fever: A Review on Clinical, Management and Guideline for Iranian Patients - Part I

    PubMed Central

    Ahmadinejad, Zahra; Mansori, Sedigeh; Ziaee, Vahid; Alijani, Neda; Aghighi, Yahya; Parvaneh, Nima; Mordinejad, Mohammad-Hassan

    2014-01-01

    Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. The first manifestation of these disorders are present in childhood and adolescence, but infrequently it may be presented in young and middle ages. Genetic base has been known for all types of periodic fever syndromes except periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). Common periodic fever disorders are Familial Mediterranean fever (FMF) and PFAPA. In each patient with periodic fever, acquired infection with chronic and periodic nature should be ruled out. It depends on epidemiology of infectious diseases. Some of them such as Familial Mediterranean fever and PFAPA are common in Iran. In Iran and other Middle East countries, brucellosis, malaria and infectious mononucleosis should be considered in differential diagnosis of periodic fever disorders especially with fever and arthritis manifestation. In children, urinary tract infection may be presented as periodic disorder, urine analysis and culture is necessary in each child with periodic symptoms. Some malignancies such as leukemia and tumoral lesions should be excluded in patients with periodic syndrome and weight loss in any age. After excluding infection, malignancy and cyclic neutropenia, FMF and PFAPA are the most common periodic fever disorders. Similar to other countries, Hyper IgD, Chronic Infantile Neurologic Cutaneous and Articular, TRAPS and other auto-inflammatory syndromes are rare causes of periodic fever in Iranian system registry. In part 1 of this paper we reviewed the prevalence of FMF and PFAPA in Iran. In part 2, some uncommon auto-inflammatory disorders such as TRAPS, Hyper IgD sydrome and cryopyrin associated periodic syndromes will be reviewed. PMID:25793039

  13. Periodic Fever: a review on clinical, management and guideline for Iranian patients - part I.

    PubMed

    Ahmadinejad, Zahra; Mansori, Sedigeh; Ziaee, Vahid; Alijani, Neda; Aghighi, Yahya; Parvaneh, Nima; Mordinejad, Mohammad-Hassan

    2014-02-01

    Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. The first manifestation of these disorders are present in childhood and adolescence, but infrequently it may be presented in young and middle ages. Genetic base has been known for all types of periodic fever syndromes except periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). Common periodic fever disorders are Familial Mediterranean fever (FMF) and PFAPA. In each patient with periodic fever, acquired infection with chronic and periodic nature should be ruled out. It depends on epidemiology of infectious diseases. Some of them such as Familial Mediterranean fever and PFAPA are common in Iran. In Iran and other Middle East countries, brucellosis, malaria and infectious mononucleosis should be considered in differential diagnosis of periodic fever disorders especially with fever and arthritis manifestation. In children, urinary tract infection may be presented as periodic disorder, urine analysis and culture is necessary in each child with periodic symptoms. Some malignancies such as leukemia and tumoral lesions should be excluded in patients with periodic syndrome and weight loss in any age. After excluding infection, malignancy and cyclic neutropenia, FMF and PFAPA are the most common periodic fever disorders. Similar to other countries, Hyper IgD, Chronic Infantile Neurologic Cutaneous and Articular, TRAPS and other auto-inflammatory syndromes are rare causes of periodic fever in Iranian system registry. In part 1 of this paper we reviewed the prevalence of FMF and PFAPA in Iran. In part 2, some uncommon auto-inflammatory disorders such as TRAPS, Hyper IgD sydrome and cryopyrin associated periodic syndromes will be reviewed.

  14. Periodic Fever: A Review on Clinical, Management and Guideline for Iranian Patients - Part II

    PubMed Central

    Ahmadinejad, Zahra; Mansouri, Sedigeh; Ziaee, Vahid; Aghighi, Yahya; Moradinejad, Mohammad-Hassan; Fereshteh-Mehregan, Fatemeh

    2014-01-01

    Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. In the first part of this paper, we presented a guideline for approaching patients with periodic fever and reviewed two common disorders with periodic fever in Iranian patients including familial Mediterranean fever (FMF) and periodic fever syndromes except for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). In this part, we review other autoinflammatory disorders including hyper IgD, tumor necrosis factor receptor–associated periodic syndrome (TRAPS), cryopyrin associated periodic syndromes, autoinflammatory bone disorders and some other rare autoinflammatory disorders such as Sweet’s and Blau syndromes. In cryopyrin associated periodic syndromes group, we discussed chronic infantile neurologic cutaneous and articular (CINCA) syndrome, Muckle-Wells syndrome and familial cold autoinflammatory syndrome. Autoinflammatory bone disorders are categorized to monogenic disorders such as pyogenic arthritis, pyoderma ;gangraenosum and acne (PAPA) syndrome, the deficiency of interleukine-1 receptor antagonist (DIRA) and Majeed syndrome and polygenic background or sporadic group such as chronic recurrent multifocal osteomyelitis (CRMO) or synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome are classified in sporadic group. Other autoinflammatory syndromes are rare causes of periodic fever in Iranian system registry. PMID:25562014

  15. Periodic Fever: A Review on Clinical, Management and Guideline for Iranian Patients - Part II.

    PubMed

    Ahmadinejad, Zahra; Mansouri, Sedigeh; Ziaee, Vahid; Aghighi, Yahya; Moradinejad, Mohammad-Hassan; Fereshteh-Mehregan, Fatemeh

    2014-06-01

    Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. In the first part of this paper, we presented a guideline for approaching patients with periodic fever and reviewed two common disorders with periodic fever in Iranian patients including familial Mediterranean fever (FMF) and periodic fever syndromes except for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). In this part, we review other autoinflammatory disorders including hyper IgD, tumor necrosis factor receptor-associated periodic syndrome (TRAPS), cryopyrin associated periodic syndromes, autoinflammatory bone disorders and some other rare autoinflammatory disorders such as Sweet's and Blau syndromes. In cryopyrin associated periodic syndromes group, we discussed chronic infantile neurologic cutaneous and articular (CINCA) syndrome, Muckle-Wells syndrome and familial cold autoinflammatory syndrome. Autoinflammatory bone disorders are categorized to monogenic disorders such as pyogenic arthritis, pyoderma ;gangraenosum and acne (PAPA) syndrome, the deficiency of interleukine-1 receptor antagonist (DIRA) and Majeed syndrome and polygenic background or sporadic group such as chronic recurrent multifocal osteomyelitis (CRMO) or synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome are classified in sporadic group. Other autoinflammatory syndromes are rare causes of periodic fever in Iranian system registry.

  16. Patient notification exercise following a dentist's admission of the periodic use of unsterilized equipment.

    PubMed

    Roy, K M; Ahmed, S; Cameron, S O; Shaw, L; Yirrell, D; Goldberg, D

    2005-06-01

    During 2001, Greater Glasgow National Health Service (NHS) Board undertook a patient notification exercise in a Glasgow dental practice following the admission, by the dentist, of the use of unsterilized dental equipment on patients. Four thousand and eighty-nine exposed patients were identified; of these, 1696 contacted the NHS helpline and 1005 were counselled and screened for hepatitis C virus (HCV), hepatitis B virus (HBV) and human immunodeficiency virus. One patient showed evidence of previous HBV infection and 13 had antibodies to HCV. Molecular investigation of the HCV isolates indicated no significant associations. The investigation found no evidence of patient-to-patient transmission of HCV among patients attending the practice of a dentist who admitted periodically using unsterilized equipment.

  17. [The period of dialysis and nutritional habits of patients with the end stage renal disease].

    PubMed

    Wyszomierska, Agnieszka; Puka, Janusz; Myszkowska-Ryciak, Joanna; Narojek, Lucyna

    2009-01-01

    The influence of dialysis's period on energy and selected nutrients intake was examined on 38 patients with end stage renal disease. The longer period of dialysis caused higher energy and protein content in daily food rations. Furthermore lower intake of energy, protein, iron and calcium were observed as well as too high level of saturated fatty acids comparing to recommendations. Our data strongly suggest that constant dietician care might be essential to correct nutrients intake and prevent possible deficiencies among patients with the end stage renal disease.

  18. Modular stem fixed-bearing total ankle replacement: prospective results of 23 consecutive cases with 3-year follow-up.

    PubMed

    Brigido, Stephen A; Galli, Melissa M; Bleazey, Scott T; Protzman, Nicole M

    2014-01-01

    In the present report, the 3-year outcomes of 23 consecutive patients treated with a modular stem fixed-bearing total ankle replacement are described. Pain, functional impairment, and disability were assessed annually using a visual analog scale. Complications and additional procedures also were recorded. Compared with preoperative pain (8.4 ± 1.4), functional impairment (8.7 ± 2.3), and disability (3.0 ± 2.5), there were statistically significant postoperative improvements at 1 year (pain, 2.6 ± 1.6; functional impairment, 3.1 ± 2.1; disability, 0.9 ± 1.2), 2 years (pain, 1.5 ± 1.3; functional impairment, 1.9 ± 1.4; disability, 0.6 ± 1.4), and 3 years (pain, 1.3 ± 1.3; functional impairment, 1.9 ± 1.9; disability, 0.4 ± 0.9; p ≤ .001). Pain, function, and disability significantly improved postoperatively from 1 to 2 years (p ≤ .008) and from 1 to 3 years (p ≤ .008). The reductions in pain, functional impairment, and disability were maintained from 2 to 3 years (p ≥ .08). Nine complications (39.1%) were encountered: 1 deep infection, 2 pulmonary embolisms, 3 wounds, 1 ectopic bone formation, 1 stiff joint, and 1 talar subsidence. In the 3-year follow-up period, 3 patients (13.0%) required additional procedures after the immediate postoperative phase. Our results have demonstrated that modular stem fixed-bearing prostheses can be implanted in a predictable and consistent fashion with resultant improvements in pain, function, and disability. Future studies evaluating the clinical outcomes after modular stem fixed-bearing total ankle replacement are warranted.

  19. The Clinical Utility of a Comprehensive Periodic Assessment Form for the Geriatric Rehabilitation Patient.

    ERIC Educational Resources Information Center

    Yew, Elizabeth; And Others

    1989-01-01

    The Comprehensive Periodic Assessment Form is an innovative way to document a patient's rehabilitation progress. This nonnarrative, semi-graphical form digests onto one page many sheets of progress notes. Mobility, Activities of Daily Living (ADL), mental, and medical status over time can be ascertained at a glance. Useful for the aged patient…

  20. Thyrotoxic periodic paralysis: reports of seven patients presenting with weakness in an Asian emergency department

    PubMed Central

    Goh, S

    2002-01-01

    Methods: Seven male patients were enlisted who presented to the emergency department over a period of three years with weakness and paralysis in the morning. Results: Initial electrolyte studies revealed hypokalaemia in these patients, and later thyroid function tests confirmed thyrotoxicosis for all. Only two of these patients had clinical symptoms and signs of thyrotoxicosis, the others being asymptomatic. Conclusions: Early morning paralysis can be the first manifestation of hyperthyroidism in Asian men, without the other more typical symptoms of weight loss, increased appetite, excitability, sweaty palms or goitre. Treatment to a euthyroid state will ameliorate the syndrome. PMID:11777887

  1. Up-to-date and precise estimates of cancer patient survival: model-based period analysis.

    PubMed

    Brenner, Hermann; Hakulinen, Timo

    2006-10-01

    Monitoring of progress in cancer patient survival by cancer registries should be as up-to-date as possible. Period analysis has been shown to provide more up-to-date survival estimates than do traditional methods of survival analysis. However, there is a trade-off between up-to-dateness and the precision of period estimates, in that increasing the up-to-dateness of survival estimates by restricting the analysis to a relatively short, recent time period, such as the most recent calendar year for which cancer registry data are available, goes along with a loss of precision. The authors propose a model-based approach to maximize the up-to-dateness of period estimates at minimal loss of precision. The approach is illustrated for monitoring of 5-year relative survival of patients diagnosed with one of 20 common forms of cancer in Finland between 1953 and 2002 by use of data from the nationwide Finnish Cancer Registry. It is shown that the model-based approach provides survival estimates that are as up-to-date as the most up-to-date conventional period estimates and at the same time much more precise than the latter. The modeling approach may further enhance the use of period analysis for deriving up-to-date cancer survival rates.

  2. Sleep structure in patients with periodic limb movements and obstructive sleep apnea syndrome.

    PubMed

    Iriarte, Jorge; Murie-Fernandez, Manuel; Toledo, Estefania; Urrestarazu, Elena; Alegre, Manuel; Viteri, Cesar; Salvador, Javier; Baptista, Peter; Alcaide, Belen; Artieda, Julio

    2009-08-01

    Periodic limb movements (PLM) and obstructive sleep apnea syndrome (OSAS) are two frequent sleep disorders which often occur in the same patient. The goal of this study was to know the influence of the presence of PLM in the sleep architecture in patients with and without OSAS. Two hundred twenty consecutive patients (69 women and 151 men) participated in this transversal study. They were patients with clinical suspicion of dysomnia, including snoring, OSAS, and PLM. All of them underwent a full polysomnography and were interviewed using questionnaires about the sleep quality. The sleep parameters (percentage of sleep stages, rapid eye movement latency, sleep efficiency, awakenings, PLM presence, apnea-hypopnea index) were calculated and compared between groups. Descriptive statistics and nonparametric distribution techniques were used for the analysis. Patients with PLM when compared with patients with OSAS had lower sleep efficiency and less rapid eye movement percentage. The presence of PLM in patients with sleep apnea was less relevant being responsible only for an increase in the rapid eye movement latency and a decrease in the duration of the three to four sleep stages. However, the presence of OSAS was related to a better sleep efficiency (patients with PLM plus OSAS had a better sleep efficiency than patients with only PLM). PLM alters the structure of sleep. In patients with sleep apnea, the presence of PLM is less relevant.

  3. [Nursing diagnoses of patients in immediate postoperative period of laparoscopic cholecystectomy].

    PubMed

    Dalri, Cristina Camargo; Rossi, Lídia Aparecida; Dalri, Maria Célia Barcellos

    2006-01-01

    The aim of this study was to identify and analyze the nursing diagnoses for patients in the immediate postoperative period of laparoscopic cholecystectomy. We elaborated and validated an instrument for data collection and registration. Fifteen 15 adult patients were evaluated in the immediate postoperative period of laparoscopic cholecystectomy, four men and 11 women, with average age of 45 years. Identified nursing diagnoses were: Impaired Skin Integrity (100%), Risk for Infection (100%), Sensory/Perceptual Alterations (100%), Risk for aspiration (100%), Risk for Ineffective Breathing Pattern (80%), Hypothermia (60%), Risk for Altered Body Temperature (40%), Altered nutrition: more than body requirements (33,3%) and Acute pain (26,7%). All patients were admitted in ambulatory regimen and were discharged from Post anesthesia Care Unit, still presenting the nursing diagnoses of Impaired Skin Integrity and Risk for infection.

  4. Evaluation of Nutritional Biochemical Parameters in Haemodialysis Patients over a Ten-year Period

    PubMed Central

    Alfonso, AIQ; Castillo, RF; Jimenez, FJ Gomez; Negrillo, AM Nuñez

    2015-01-01

    ABSTRACT Aim: Protein-energy malnutrition as well as systemic inflammation and metabolic disorders are common in patients with chronic kidney failure who require renal replacement therapy (haemodialysis). Such malnutrition is a factor that significantly contributes to their morbidity and mortality. This study evaluated the nutritional status of haemodialysis patients by assessing biochemical and anthropometric parameters in order to determine whether these patients suffered disorders reflecting nutritional deterioration directly related to time on haemodialysis. Subjects and Method: This research comprised 90 patients of both genders with chronic kidney failure, who regularly received haemodialysis at our unit over a period of ten years. The patients' blood was tested quarterly for plasma albumin, total cholesterol and total proteins, and tested monthly for transferrin. The patients' weight, height and body mass index (BMI) were monitored. Body mass index was calculated using the formula: weight (kg)/height (m2) and classified in one of the following categories defined in the World Health Organization (WHO) Global Database on Body Mass Index: (i) underweight [BMI < 18.50], (ii) normal [BMI 18.50 – 24.99], (iii) overweight [BMI 25 – 29.99], (iv) obese [BMI ≥ 30]. Results: In the ten-year period of the study, the patients experienced a substantial decline in their biochemical parameters. Nevertheless, their BMI did not show any significant changes despite the patients' state of malnutrition. Conclusions: The prevalence of malnutrition in haemodialysis patients was evident. Nevertheless, the BMI of the subjects did not correspond to the biochemical parameters measured. Consequently, the results showed that the nutritional deterioration of these patients was mainly reflected in their biochemical parameters rather than in their anthropometric measurements. PMID:26426172

  5. [Functional characteristics of gait and standing posture in poststroke patients in residual period].

    PubMed

    Batysheva, T T; Rusina, L R; Skvortsov, D V; Boĭko, A N

    2004-01-01

    Using biomechanic method, gait and standing posture were studied in 17 stroke patients in a remote poststroke period. The locomotor system was found to have non-specific compensatory changes to optimize motor functions and reduce functional disturbances. Symptoms of the triceps surae muscle insufficiency as well as a balance deficit at standing posture and displacement of the center of pressure towards the non-affected side were characteristic of the given stage of rehabilitation stroke period that should be taken into account during the rehabilitation treatment.

  6. Patient prognosis based on feature extraction, selection and classification of EEG periodic activity.

    PubMed

    Sánchez-González, Alain; García-Zapirain, Begoña; Maestro Saiz, Iratxe; Yurrebaso Santamaría, Izaskun

    2015-01-01

    Periodic activity in electroencephalography (PA-EEG) is shown as comprising a series of repetitive wave patterns that may appear in different cerebral regions and are due to many different pathologies. The diagnosis based on PA-EEG is an arduous task for experts in Clinical Neurophysiology, being mainly based on other clinical features of patients. Considering this difficulty in the diagnosis it is also very complicated to establish the prognosis of patients who present PA-EEG. The goal of this paper is to propose a method capable of determining patient prognosis based on characteristics of the PA-EEG activity. The approach, based on a parallel classification architecture and a majority vote system has proven successful by obtaining a success rate of 81.94% in the classification of patient prognosis of our database.

  7. Characterization of Common Measures of Heart Period Variability in Healthy Human Subjects: Implications for Patient Monitoring

    DTIC Science & Technology

    2010-01-01

    RRI) variability preceded other signs of fetal distress [1], heart period variability has been extensively reported in the literature, with consid...application of these metrics to patient monitoring must take into account the impact of other external stimuli, such as pain , anxiety and activity status...Lee ST. Electronic evaluation of the fetal heart rate VIII. Patterns preceding fetal death, further observations. Am J Obstet Gynecol 1963; 87: 814

  8. Tissue integration of one-stage ITI implants: 3-year results of a longitudinal study with Hollow-Cylinder and Hollow-Screw implants.

    PubMed

    Buser, D; Weber, H P; Bragger, U; Balsiger, C

    1991-01-01

    This study examined the tissue integration of one-stage, nonsubmerged ITI implants over a period of 3 years. Fifty-four implants were placed in 38 partially edentulous patients. Following healing (at least 3 months), all 54 implants were free of peri-implant infections and revealed no detectable mobility. Radiographs showed no signs of peri-implant radiolucencies, and the implants were in favorable positions for prosthetic restoration. Following incorporation of fixed partial dentures, patients were enrolled in a hygiene recall program with 3-month intervals and were examined once a year. Based on predefined criteria, each implant was classified as successful or failing. After the 3-year observation period, 51 of 53 implants (96.2%) were considered successfully integrated. (One patient with one implant dropped out of the study.) Two implants exhibited recurrent peri-implant infections and were classified as late failures. These results indicate that one-stage ITI implants can achieve successful tissue integration on a predictable basis and that it can be maintained over a period of at least 3 years.

  9. Evaluation of Stress Intensity and Anxiety Level in Preoperative Period of Cardiac Patients

    PubMed Central

    Rosiek, Anna; Kornatowski, Tomasz; Rosiek-Kryszewska, Aleksandra; Leksowski, Łukasz; Leksowski, Krzysztof

    2016-01-01

    Introduction. The stress related to patient's stay in a hospital increases when it is necessary to perform a surgery. Therefore, the study of the phenomenon of stress intensity in hospitalized patients has become an important issue for public health. Material and Method. The study was conducted in University Hospital No. 1 in the cardiosurgery clinic. The study involved 58 patients who were admitted as planned to the hospital. The study used a standardized questionnaire measuring intensity of the stress and also deepened interviews with patients about stress and anxiety felt before the surgery. Results. The greater the patient's anxiety resulting from his state of health, the greater the intensity of stress in the preoperative period. This relationship is linear. The results of the study also made it possible to see intrapersonal factors (pain, illness, and suffering) and extrapersonal factors (anesthesia, surgery, and complications after surgery), which are causes of anxiety before surgery. Conclusion. The research showed high (negative) results of anxiety and stress associated with the disease, surgery, and complications after cardiac surgery. Active involvement in hospitalization elements, such as patient education before surgery, psychological support, and medical care organization taking into account patient's preferences, reduces the impact of stressors. PMID:27042655

  10. Amyloid arthropathy in patients undergoing periodical haemodialysis for chronic renal failure: a new complication.

    PubMed Central

    Muñoz-Gómez, J; Bergadá-Barado, E; Gómez-Pérez, R; Llopart-Buisán, E; Subías-Sobrevía, E; Rotés-Querol, J; Solé-Arqués, M

    1985-01-01

    Seven patients (five male and two female) with chronic renal failure (CRF) treated by periodical haemodialysis presented with swelling and effusion of more than three months' duration in knees (four bilateral), shoulders (two, one of them bilateral), elbow (one), and ankle (one). Four had a carpal tunnel syndrome both clinically and electromyographically (three bilateral). All patients had hyperparathyroidism secondary to their CRF, which was not due to amyloidosis in any of them. The dialysis duration period varied from five to 14 years, with an average of 8.6 years. Amyloid deposits (Congo red positive areas with green birefringence under polarising microscopy) were shown in six of the seven synovial biopsy specimens of the knee, in five of the sediments of the synovial fluids, and in specimens removed during carpal tunnel syndrome surgery. No amyloid was found in the biopsy specimen of abdominal fat of six of the patients. The finding of amyloid only in the synovial membrane and fluid, and carpal tunnel, its absence in abdominal fat, and the lack of other manifestations of generalised amyloidosis (cardiomyopathy, malabsorption syndrome, macroglossia, etc.) and of Bence Jones myeloma (protein immunoelectrophoresis normal) raises the possibility that this is a form of amyloidosis which is peculiar to CRF treated by periodical haemodialysis. Images PMID:4062386

  11. The protective and hemodynamic effects of dexmedetomidine on hypertensive cerebral hemorrhage patients in the perioperative period

    PubMed Central

    Zhao, Junhui; Zhou, Chuixian

    2016-01-01

    The aim of the present study was to analyze the protective and hemodynamic effects of dexmedetomidine in hypertensive cerebral hemorrhage (HCH) patients during perioperative period. In total, 50 HCH patients were selected and randomly divided into two groups, one group was administered with dexmedetomidine and the other groups with midazolam. The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2) were monitored in the two groups of patients before and during the operation. The MAP, HR, SpO2 and PETCO2 recorded 5 min after admission into the operation room was considered T1, the same parameters recorded 10 min after drug administration were considered T2, just after starting the operation were considered T3 and 30 min after start of operation were considered T4. The preoperative sedation and analgesia were evaluated by the Ramsay scoring method and the neuron-specific enolase (NSE) and S100 protein (S100β) were estimated using ELISA. The patients of the midazolam group experienced mild respiratory depression during the period of sedation. Levels of, MAP, HR and PETCO2 were significantly increased whereas SPO2 was decreased (P<0.05). The MAP, HR, SPO2 and PETCO2 were stable during the period of sedation (P>0.05). The plasma concentrations of epinephrine and norepinephrine at T1 were similar in the two groups (P>0.05), but decreased after drug administration. This decrease was more prominent in the dexmedetomidine group patients (P<0.05) than midazolam group patients. The epinephrine and norepinephrine concentrations just after starting operation (T3) were higher than the basal level (T1) in the midazolam group, but close to the basal level in the dexmedetomidine group (P<0.05). The serum concentration of NSE and S100β in the two groups showed no difference (P>0.05) at the end of operation (T5), but after 24 h of operation (T7) NSE and S100β in the dexmedetomidine group were significantly lower compared to the midazolam group (P<0

  12. A hepatic cancer patient with Guillain-Barré syndrome during the perioperative period of partial hepatectomy: a case report

    PubMed Central

    Zeng, Su-Dan; Ye, Bin; Liang, Zhi-Jian

    2015-01-01

    We reported a case of hepatic cancer patient with Guillain-Barré syndrome during the perioperative period of partial hepatectomy in the present study. We analyzed the clinical data and described the characteristics of this patient. PMID:26550403

  13. Postoperative Mortality after Hip Fracture Surgery: A 3 Years Follow Up

    PubMed Central

    Un, Canan; Sacan, Ozlem; Gamli, Mehmet; Baskan, Semih; Baydar, Mustafa

    2016-01-01

    Background and Aims To determine mortality rates and predisposing factors in patients operated for a hip fracture in a 3-year follow-up period. Methods The study included patients who underwent primary surgery for a hip fracture.The inclusion criteria were traumatic, non-traumatic, osteoporotic and pathological hip fractures requiring surgery in all age groups and both genders. Patients with periprosthetic fractures or previous contralateral hip fracture surgery and patients who could not be contacted by telephone were excluded. At 36 months after surgery, evaluation was made using a structured telephone interview and a detailed examination of the hospital medical records, especially the documents written during anesthesia by the anesthesiologists and the documents written at the time of follow-up visits by the orthopaedic surgeons. A total of 124 cases were analyzed and 4 patients were excluded due to exclusion criteria. The collected data included demographics, type of fracture, co-morbidities, American Society of Anesthesiologists (ASA) scores, anesthesia techniques, operation type (intramedullary nailing or arthroplasty; cemented-noncemented), peroperative complications, refracture during the follow-up period, survival period and mortality causes. Results The total 120 patients evaluated comprised 74 females(61.7%) and 46 males(38.3%) with a mean age of 76.9±12.8 years (range 23–95 years). The ASA scores were ASA I (0.8%), ASA II (21.7%), ASA III (53.3%) and ASA IV (24.2%). Mortality was seen in 44 patients (36.7%) and 76 patients (63.3%) survived during the 36-month follow-up period. Of the surviving patients, 59.1% were female and 40.9% were male.The survival period ranged between 1–1190 days. The cumulative mortality rate in the first, second and third years were 29.17%, 33.33% and 36.67% respectively. The factors associated with mortality were determined as increasing age, high ASA score, coronary artery disease, congestive heart failure, Alzheimer

  14. Influence of Kinesitherapy on Gait in Patients with Ischemic Stroke in the Chronic Period

    PubMed Central

    Vasileva, Danche; Lubenova, Daniela; Mihova, Marija; Dimitrova, Antoaneta; Grigorova-Petrova, Kristin

    2015-01-01

    AIM: The study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on gait in patients with ischemic stroke in the chronic period (ISChP). MATERIAL AND METHODS: The study was conducted with 56 patients with ISChP (duration of the disease up to 1 year). For determining changes in gait before and after the treatment a cadence of gait and maximum movement speed were taken into consideration. To determine the cadence, steps are counted for covering 6 meters and 10 meters respectively. The maximum speed of the gait is determined in m / min by dividing undergone distance (m) and time (min). RESULTS: Patients were found to significantly normalize the parameters of gait. Compared to the initial data, there is a significant reduction in the number of steps on 6 and 10 meters and a tendency to increase the speed of gait, with the significant change during the 1st month with a level of significance of p <0.001. CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as exercise program at home, which significantly improved gait cadence and speed of movement in patients with ischemic stroke in the chronic period and is with a supportive prolonged exposure. PMID:27275297

  15. Growth and Your 2- to 3-Year-Old

    MedlinePlus

    ... 1- to 2-Year-Old Growth and Your 2- to 3-Year-Old KidsHealth > For Parents > Growth and Your 2- to 3-Year-Old Print A A A ... 4 pounds (1.8 kilograms) and grow about 2 to 3 inches (5 to 8 centimeters). They' ...

  16. Fitness and Your 2- to 3-Year-Old

    MedlinePlus

    ... 1- to 2-Year-Old Fitness and Your 2- to 3-Year-Old KidsHealth > For Parents > Fitness and Your 2- to 3-Year-Old A A A Kids ... skills are appropriate for this age. By age 2, toddlers should be able to walk and run ...

  17. [Analgesic effect of TES therapy in the early postoperative period in patients who underwent tonsillectomy].

    PubMed

    Semënov, F V; Kade, A Kh; Banashek-Meshchiarkova, T V; Vartanian, M S

    2013-01-01

    The objective of the present work was to study peculiarities of the analgesic action of therapeutic electrical stimulation (TES therapy) in the early postoperative period in the patients who underwent tonsillectomy. A total of 60 patients admitted for this surgery to the specialized otorhinolaryngological department were available for observation. They were divided into two groups depending on the pain relief strategy. The patients of the study group (n=30) underwent courses of transcranial electrical stimulation on a daily basis (from the onset of hospitalization) in addition to the administration of a standard analgetic. The standard dose of tramadol (2.0 ml) was given to the patients of the control group (n=30) who complained of strong pain. The results of the objective and subjective estimations indicate that the degree of pharyngeal pain in the patients treated with TES therapy and the standard analgetic was significantly different. The patients receiving TES therapy could sooner resume their habitual diet and required smaller amounts of the analgetic which makes this modality a cost-effective supplement to the standard postoperative treatment.

  18. A 3-year follow-up study of various types of orthodontic canine-to-canine retainers.

    PubMed

    Artun, J; Spadafora, A T; Shapiro, P A

    1997-10-01

    The present study was performed to test the tendency for plaque and calculus build-up along the wire of different types of bonded orthodontic canine-to-canine retainers, whether the presence of such retainers causes any damage to the teeth involved, the failure rate of the retainers, and any changes in incisor alignment during a 3-year period of retention. The four test groups received either retainers made of thick plain wire bonded only to the canines (n = 11); thick spiral wire bonded only to the canines (n = 13); thin, flexible spiral wire bonded to each tooth (n = 11); or removable retainers (n = 14). Accumulation of plaque and calculus along the gingival margin, gingival inflammation and probing attachment level were scored in lingual areas from canine to canine at the time of fixed appliance removal and again 3 years after retainer insertion. Incisor irregularity was measured on plaster models made at the same time periods. Accumulation of plaque and calculus and development of caries along the wire were scored at follow-up. Retainer failures were recorded whenever they occurred. The results revealed no intergroup differences in changes between baseline and follow-up examinations or status along the retainer wire for any of the variables. Gingival inflammation and plaque accumulation were scored less frequently after 3 years in retention than at the time of debonding. No signs of caries were seen adjacent to the wire. Failures were observed of one, four and three of the fixed retainer types, respectively. These patients showed a greater increase in incisor irregularity than the other patients.

  19. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up.

    PubMed

    Tunchel, Samy; Blay, Alberto; Kolerman, Roni; Mijiritsky, Eitan; Shibli, Jamil Awad

    2016-01-01

    This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26-67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results.

  20. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up

    PubMed Central

    2016-01-01

    This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26–67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results. PMID:27313616

  1. Iron Status and Febrile Seizure- A Case Control Study in Children Less Than 3 Years

    PubMed Central

    SADEGHZADEH, Mansour; KHOSHNEVIS ASL, Parisa; MAHBOUBI, Esrafil

    2012-01-01

    Objective Febrile seizure is one of the most common neurological conditions of childhood. Several theories, such as iron deficiency anemia have been proposed as the pathogenesis of this condition. The aim of this study was to find the association between iron deficiency anemia and febrile seizures in children aged 6 months to 3 years admitted in Valie Asr hospital in Zanjan. Materials &Methods Hemoglobin (Hb), mean corpuscular volume (MCV), serum iron (SI), total iron binding capacity (TIBC) and SI/TIBC ratio were assessed in one hundred children with febrile seizures and compared to the values of one hundred healthy children presenting in a heath care center in the same period as the control group. Results A total of 6% of cases had iron deficiency anemia which was similar to the control group. In the case group SI/TIBC ratio below 12% was seen in 58% of children which was significantly higher than that of the control group (29%). Conclusion The results of this study suggest that although anemia was not common among febrile seizure patients, iron deficiency was more frequent in these patients. PMID:24665277

  2. Silent periods in the abductor pollicis brevis muscle in patients with Parkinson's disease.

    PubMed

    Nakashima, K; Takahashi, K

    1992-01-01

    Silent periods in the abductor pollicis brevis muscle, produced by electrical stimulation of the median nerve at the wrist or the palmar side of the index finger, were studied in 14 patients with Parkinson's disease (PD) and eight control subjects. Prior to the stimulation, background electromyographic activity showed no differences between normal subjects and patients with PD. Following the H-reflex after median nerve stimulation, two suppressive phases were observed: early (SP1) and late (SP2). Electrical stimulation of the palmar side of the index finger elicited two suppressive phases at almost the same latencies. The latency and duration of SP1 and SP2 and the degree of SP1, produced by electrical stimulation of the median nerve and the palmar side of the index finger in patients with PD, were normal. The degree of SP2 produced by electrical stimulation of the palmar side of the index finger in patients with PD was lower than that in normal subjects, although the degree of SP2 produced by median nerve stimulation in patients with PD did not differ from that in normal subjects. Suppression produced by cutaneous stimulation in the Parkinsonian hand may be low.

  3. Lessons learned from muscle fatigue: implications for treatment of patients with hyperkalemic periodic paralysis.

    PubMed

    Renaud, Jean-Marc; Hayward, Lawrence J

    2012-12-01

    Hyperkalemic periodic paralysis (HyperKPP) is a disease characterized by periods of myotonic discharges and paralytic attacks causing weakness, the latter associated with increases in plasma [K(+)]. The myotonic discharge is due to increased Na(+) influx through defective Na(+) channels that triggers generation of several action potentials. The subsequent increase in extracellular K(+) concentration causes excessive membrane depolarization that inactivates Na(+) channels triggering the paralysis. None of the available treatments is fully effective. This paper reviews the capacity of Na(+) K(+)ATPase pumps, KATP and ClC-1 Cl(-) channels in improving membrane excitability during muscle activity and how using these three membrane components we can study future and more effective treatments for HyperKPP patients. The review of current patents related to HyperKPP reinforces the need of novel approaches for the treatment of this channelopathy.

  4. Predictors of Reading Development in Deaf Children: A 3-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Kyle, Fiona E.; Harris, Margaret

    2010-01-01

    The development of reading ability in a group of deaf children was followed over a 3-year period. A total of 29 deaf children (7-8 years of age at the first assessment) participated in the study, and every 12 months they were given a battery of literacy, cognitive, and language tasks. Earlier vocabulary and speechreading skills predicted…

  5. Leadership Coaching in an Induction Program for Novice Principals: A 3-Year Study

    ERIC Educational Resources Information Center

    Lochmiller, Chad R.

    2014-01-01

    This article presents results from a study of leadership coaches who worked with novice principals in a university-based induction program for a 3-year period. The qualitative case study describes how the support the coaches provided to the novice principals changed over time. The study reveals that coaches adapted their leadership coaching…

  6. [Remodelling of right heart chambers in patients with occupational respiratory diseases in post-contact period].

    PubMed

    2011-01-01

    Clinical manifestations of occupational respiratory diseases and functional cardiorespiratory state in workers were studied in thorough examination of 329 workers including main occupations of refractory metals alloys production, who are exposed to polymetallic highly dispersed aerosols in concentrations exceeding the MACs. The data obtained prove changes in intracardial hemodynamics, lower myocardial contractility and lung hypertension even at early stages of the process, progressing in the advanced disease and in post-contact period. Heart remodelling underlies frequent cardiac arrhythmias in occupational respiratory diseases. With that, intensity of the changes reliably increases with higher degree of bronchial obstruction in the patients and could serve as a marker of respiratory failure severity.

  7. Acute Corneal Hydrops 3 Years after Intra-corneal Ring Segments and Corneal Collagen Cross-linking

    PubMed Central

    Antonios, Rafic; Dirani, Ali; Fadlallah, Ali; Chelala, Elias; Hamadeh, Adib; Jarade, Elias

    2016-01-01

    This case report describes a 15-year-old male with allergic conjunctivitis and keratoconus, who underwent uneventful intra-corneal ring segment (ICRS) implantation and corneal collagen cross-linking (CXL) in the right eye. During the follow-up periods, the patient was noted to have several episodes of allergic conjunctivitis that were treated accordingly. At the 2 years postoperatively, he presented with another episode of allergic conjunctivitis and progression of keratoconus was suspected on topography. However, the patient was lost to follow-up, until he presented with acute hydrops at 3 years postoperatively. There are no reported cases of acute corneal hydrops in cross-linked corneas. We suspect the young age, allergic conjunctivitis and eye rubbing may be a risk factors associated with possible progression of keratoconus after CXL. Prolonged follow-up and aggressive control of the allergy might be necessary in similar cases. PMID:26957859

  8. Actigraphic assessment of periodic leg movements in patients with restless legs syndrome.

    PubMed

    Cippà, Maria A T; Baumann, Christian R; Siccoli, Massimiliano M; Bassetti, Claudio L; Poryazova, Rositsa; Werth, Esther

    2013-10-01

    The diagnosis of restless legs syndrome (RLS) relies upon diagnostic criteria which are based on history only, and dopaminergic treatment is not normally the first choice of treatment for all patients. It would be worthwhile to identify patients non-responsive to dopaminergic treatment beforehand, because they may suffer from a restless legs-like syndrome and may require alternative treatment. We included retrospectively 24 adult patients fulfilling the four essential criteria for restless legs and 12 age-matched healthy controls. They were investigated by ambulatory actigraphy from both legs over three nights, and patients started treatment with dopamine agonists after this diagnostic work-up. We examined 12 responders to dopaminergic treatment and 12 non-responders and studied the association between response to dopaminergic treatment and the periodic limb movement index (PLMI) as assessed with actigraphy. Demographic characteristics, excessive daytime sleepiness and fatigue at baseline were similar in all three groups. Baseline RLS severity was similar between responders and non-responders [International Restless Legs Severity Scale (IRLS): 25 ± 9 and 24 ± 8]. Group comparisons of PLMI before treatment initiation showed significant differences between the three groups. Post-hoc pairwise comparisons revealed that healthy controls had significantly lower PLMI (4.9 ± 4.5) than responders (29.3 ± 22.7) and non-responders (13.3 ± 11.2). Similarly, the PLMI in responders was lower than in non-responders. PLMI day-to-day variability did not differ between responders and non-responders and there was no correlation between treatment effect, as assessed by the decrease of the IRLS and baseline PLMI. Our retrospective study indicates that actigraphy to assess periodic limb movements may contribute to a better diagnosis of dopamine-responsive restless legs syndrome.

  9. Growth and Your 2- to 3-Year-Old

    MedlinePlus

    ... effective in significantly increasing their final adult height. Constitutional growth delay (delayed puberty). Although they are usually ... about age 2 or 3 years, kids with constitutional growth delay will grow at a normal childhood ...

  10. Influence of Kinesitherapy on Balance Reactions in Patients with Ischemic Stroke in the Chronic Period

    PubMed Central

    Vasileva, Danche; Lubenova, Daniela; Mihova, Marija; Dimitrova, Antoaneta; Grigorova-Petrova, Kristin

    2015-01-01

    AIM: The study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on balance reactions in patients with ischemic stroke in the chronic period (ISChP). MATERIAL AND METHODS: A prospective, multicenter study with 56 patients with ISChP. Evaluation of balance reactions using Berg Balance Scale - BBS, includes implementation of 14 tasks with increasing difficulty reflecting the usual activities of everyday life. The first 5 assignments are used to assess the main balance potential and the remaining 9 (6th to 14th task) include more sophisticated balance tasks. RESULTS: The patients were found with a significant improvement in balance opportunities, according to the scale of Berg. Compared to initial data there is a significant increase in the number of points in the measured indicators for functional and static balance. In absolute terms, positive change is most pronounced during the 1st month with a level of significance of p <0.001. CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as adapted exercise program at home, and significantly improved equilibrium reactions in patients with postural disorders because of ischemic stroke and is with a supportive prolonged exposure. PMID:27275294

  11. Changes in retinal vessel diameters in migraine patients during attack-free period

    PubMed Central

    Unlu, Metin; Sevim, Duygu Gulmez; Gultekin, Murat; Baydemir, Recep; Karaca, Cagatay; Oner, Ayse

    2017-01-01

    AIM To evaluate the retinal vessel diameters in patients with migraine by optical coherence tomography (OCT). METHODS In this cross-sectional study, 124 eyes of 62 patients with a diagnosis of unilateral migraine during attack-free period and 42 age- and sex-matched control subjects were included. Migraine patients were divided into the ≤2 migraine attacks per month group and the ≥5 migraine attacks per month group. All subjects underwent complete ophthalmological and neurological examinations before measurements. Retinal vessel diameters and choroidal thickness were examined with the Spectralis OCT. RESULTS The mean diameters of the arteries in the eyes on the headache side of control group, ≥5 migraine attacks per month and ≤2 migraine attacks per month group at 480 µm from the optic disk (Raster 3) were 119.54±46.69, 136.68±25.93 and 119.34±31.75 µm respectively with a steady decline to 105.57±32.15, 118.18±31.87 and 108.05±38.77 µm at 1440 µm (Raster 7), the last measurement point, respectively. The retinal artery diameter measurements were significantly increased in ≥5 migraine attacks per month patients at four out of five measured points compared to control group (P<0.05). There were no statistical differences at any of the points of vein measurements. The choroidal thickness measurements were significantly decreased in ≥5 migraine attacks per month patients at all measured points compared to control group (P<0.05). CONCLUSION The retinal artery diameter is found to increase significantly and the choroidal thickness is found to decrease in the eyes on the headache side in ≥5 migraine attacks per month patients compared to control group. PMID:28393037

  12. Bone Mineral Density as a Marker of Cumulative Estrogen Exposure in Psychotic Disorder: A 3 Year Follow-Up Study

    PubMed Central

    van der Leeuw, Christine; Peeters, Sanne; Domen, Patrick; van Kroonenburgh, Marinus; van Os, Jim; Marcelis, Machteld

    2015-01-01

    Altered estrogen-induced neuroprotection has been implicated in the etiology of psychotic disorders. Using bone mineral density as a marker of lifetime estrogen exposure, a longitudinal family study was conducted to discriminate between etiological mechanisms and secondary effects of disease and treatment. Dual X-ray absorptiometry scans were acquired twice, with an interval of 3 years, in 30 patients with psychotic disorder (male (M)/female (F): 24/6, mean age of 32 years at second measurement), 44 non-psychotic siblings of patients with a psychotic disorder (M/F: 26/18, mean age 32) and 27 controls (M/F: 7/20, mean age 35). Total bone mineral density, Z-scores and T-scores were measured in the lumbar spine and proximal femur. Associations between group and bone mineral density changes were investigated with multilevel random regression analyses. The effect of prolactin-raising antipsychotic medication was evaluated. (Increased risk of) psychotic disorder was not associated with disproportionate bone mineral density loss over a three year period. Instead, femoral bone mineral density measures appeared to decrease less in the patient versus control comparison (total BMD: B = 0.026, 95% CI 0.002 to 0.050, p = 0.037; Z-score: B = 0.224, 95% CI 0.035 to 0.412, p = 0.020; and T-score: B = 0.193, 95% CI 0.003 to 0.382, p = 0.046). Current or past use of a prolactin-raising antipsychotic medication was not associated with bone mineral density changes. In this small longitudinal study, there was no evidence of ongoing estrogen deficiency in psychotic disorder as there was no excessive loss of bone mineral density over a 3-year period in patients using antipsychotic medication. PMID:26309037

  13. Nutrition for the pediatric surgical patient: approach in the peri-operative period.

    PubMed

    Falcão, Mário Cícero; Tannuri, Uenis

    2002-01-01

    Nutrition is essential for maintenance of physiologic homeostasis and growth. Hypermetabolic states lead to a depletion of body stores, with decreased immunocompetence and increased morbidity and mortality. The purpose of this paper is to provide an update regarding the provision of appropriate nutrition for the pediatric surgical patient, emphasizing the preoperative and postoperative periods. Modern nutritional support for the surgical patient comprises numerous stages, including assessment of nutritional status, nutritional requirements, and nutritional therapy. Nutritional assessment is performed utilizing the clinical history, clinical examination, anthropometry, and biochemical evaluation. Anthropometric parameters include body weight, height, arm and head circumference, and skinfold thickness measurements. The biochemical evaluation is conducted using determinations of plasma levels of proteins, including album, pre-albumin, transferrin, and retinol-binding protein. These parameters are subject to error and are influenced by the rapid changes in body composition in the peri-operative period. Nutritional therapy includes enteral and/or parenteral nutrition. Enteral feeding is the first choice for nutritional therapy. If enteral feeding is not indicated, parenteral nutrition must be utilized. In all cases, an individualized, adequate diet (enteral formula or parenteral solution) is obligatory to decrease the occurrence of overfeeding and its undesirable consequences.

  14. Sera from cancer patients contain two oscillating ECTO-NOX activities with different period lengths

    NASA Technical Reports Server (NTRS)

    Wang, Sui; Morre, Dorothy M.; Morre, D. James

    2003-01-01

    ECTO-NOX protein's are cell surface-associated and growth-related hydroquinone oxidases with both protein disulfide-thiol interchange activity and the capacity to oxidize NAD(P)H. The activities of these ECTO-NOX proteins are not steady state but fluctuate to create a repeating pattern of oscillations. Two forms of ECTO-NOX activities have been distinguished. The constitutive ECTO-NOX (CNOX), is hormone responsive and refractory to quinone-site inhibitors. A tumor-associated NOX (tNOX) is unregulated, refractory to hormones and growth factors and responds to quinone-site inhibitors. CNOX proteins are widely distributed and exhibit oscillations in enzymatic activity with a period length of 24 min. tNOX proteins are cancer specific and exhibit oscillations with a period length of about 22 min. Our findings now demonstrate the presence of the novel oscillating tNOX activity in sera of patients with cancer whereas the constitutive NOX of non-cancer cells is present in sera of both cancer patients and healthy volunteers. We conclude that ECTO-NOX proteins in sera exhibit oscillatory characteristics similar to those of ECTO-NOX forms of the cell surface.

  15. A levodopa dry powder inhaler for the treatment of Parkinson's disease patients in off periods.

    PubMed

    Luinstra, Marianne; Grasmeijer, Floris; Hagedoorn, Paul; Moes, Jan Reindert; Frijlink, Henderik W; de Boer, Anne H

    2015-11-01

    Adequate treatment of Parkinson's patients in off periods with orally administered levodopa is hindered by a poor bioavailability and a slow onset of action. Hence, there is a need for a fast and reliable alternative as for instance via pulmonary administration of the drug. We developed a levodopa containing powder formulation for pulmonary delivery by a recently presented high dose dry powder inhaler (Cyclops). The objective was to produce the drug formulation by means of simple techniques such as micronization, either as pure active substance or with a minimum amount of excipients. After an initial screening on dispersion behaviour, the most promising formulation in the Cyclops was characterized in vitro over a range of pressure drops (2-6 kPa) and doses (20, 30 and 40 mg), representative of those to be expected in practice. A co-micronized levodopa formulation with 2% L-leucine appeared to yield the best aerosol properties for inhalation and highest delivered dose reproducibility. The combination of this particular formulation and the Cyclops inhaler seems to meet the basic requirements for satisfactory deposition in the airways. This formulation is therefore expected to be a promising candidate for the treatment of Parkinson's patients in an off period.

  16. Serum pentosidine levels after 3 years of bisphosphonate treatment in post-menopausal osteoporotic women.

    PubMed

    Hashidate, Hiroyuki; Kamimura, Mikio; Ikegami, Shota; Mukaiyama, Keijiro; Uchiyama, Shigeharu; Nakamura, Yukio; Kato, Hiroyuki

    2015-01-01

    The present study measured changes in plasma pentosidine and bone turnover markers in elderly patients with osteoporosis treated using bisphosphonate. The relationship between pentosidine and bone turnover markers and bone mineral density (BMD) was investigated. This study consisted of post-menopausal osteoporotic women who could be treated using bisphosphonate for 3 years were included in the present analysis. The study population consisted of 58 cases, all women, ranging in age from 53 to 86 years (mean, 67.1 years). Bisphosphonate treatment significantly increased BMD of the lumbar spine to 0.914 ± 0.141 g/cm(2) and BMD of the femoral neck to 0.708 ± 0.086 g/cm(2) after 3 years (p < 0.001 versus baseline). The mean BAP level was 27.3 ± 8.3 U/L in patients at baseline. After bisphosphonate treatment, BAP significantly decreased to 18.1 ± 7.2 U/L at 3 years (p < 0.001). Urinary NTX also decreased after bisphosphonate treatment. After 3 years of treatment, urinary NTX significantly decreased from 50.0 ± 19.0 nmol BCE/mmol Cr to 24.6 ± 10.2 nmol BCE/mmol Cr at 3 years (p < 0.001). Serum pentosidine levels were 0.0413 ± 0.0094 μg/mL at baseline and 0.0413 ± 0.0122 μg/mL after 3 years. They were not significantly changed by bisphosphonate treatment. Serum pentosidine levels were not changed by treatment with bisphosphonates. Thus, serum pentosidine may not be suitable as a marker of bone quality after 3 years of bisphosphonate treatment.

  17. Lisuride reduces involuntary periodic leg movements in spinocerebellar ataxia type 2 patients.

    PubMed

    Velázquez-Pérez, Luis; Rodríguez-Labrada, Roberto; Álvarez-González, Lázaro; Aguilera-Rodríguez, Raúl; Álvarez Sánchez, Mario; Canales-Ochoa, Nalia; Galicia Polo, Lourdes; Haro-Valencia, Reyes; Medrano-Montero, Jacqueline; Vázquez-Mojena, Yaimeé; Peña-Acosta, Arnoy; Estupiñán-Rodríguez, Annelié; Rodríguez Pupo, Noemí

    2012-12-01

    Periodic leg movements (PLMs) are a common sleep disorder in spinocerebellar ataxia type 2 (SCA2) being associated to higher disease severity and altered sleep patterns. To assess the efficacy and safety of lisuride for the treatment of PLMs in SCA2 patients, an open-label clinical trial was conducted in 12 SCA2 patients suffering from PLMs associated to other subjective sleep complaints. All subjects received 0.1 mg of oral lisuride daily for 4 weeks. Primary outcome measure was the change of PLMs index. Changes in the subjective sleep quality, other polysomnographical sleep parameters, Scale for the Assessment and Rating of Ataxia score, and saccadic velocity were assessed as secondary outcome parameters. Safety assessments included hemoglobin, hematocrit, cholesterol, creatinine, and TGP. A significant decrease in both the PLMs index and R stage latency were observed during the treatment, associated to subjective improvement of frequent awakenings, early insomnia, restless leg syndrome, and nocturnal limb paresthesias in most cases. Ataxia score and saccadic pathology were unchanged. No significantly adverse events were observed. Our study suggests the efficacy of dopamine agonist therapy in the treatment of PLMs in SCA2, improving various subjective sleep complaints. These findings serve to promote the adequate management of sleep-related disorders in SCA2, which could improve the life quality of the patients.

  18. Canakinumab in patients with cryopyrin-associated periodic syndrome: an update for clinicians.

    PubMed

    Kuemmerle-Deschner, Jasmin B; Haug, Iris

    2013-12-01

    The cryopyrin-associated periodic syndrome (CAPS) is a very rare disease. It is estimated that there are 1-2 cases for every 1 million people in the US and 1 in every 360,000 in France. However, many patients are diagnosed very late or not at all, meaning the real prevalence is likely to be higher. CAPS encompasses the three entities of familial cold auto-inflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (NOMID)/chronic infantile neurologic, cutaneous and articular (CINCA) syndrome. They have in common a causative mutation in the NLRP3 gene. The altered gene product cryopyrin leads to activation of the inflammasome which in turn is responsible for excessive production of interleukin (IL)-1β. IL-1β causes the inflammatory manifestations in CAPS. These appear as systemic inflammation including fever, headache or fatigue, rash, eye disease, progressive sensorineural hearing loss, musculoskeletal manifestations and central nervous system (CNS) symptoms (NOMID/CINCA only). With the advent of IL-1 Inhibitors, safe and effective therapeutic options became available for this devastating disease. To prevent severe and possible life-threatening disease sequelae, early and correct diagnosis and immediate initiation of therapy are mandatory in most patients. Canakinumab is a fully human monoclonal IgG1 anti-IL-1β antibody. It provides selective and prolonged IL-1β blockade and has demonstrated a rapid (within hours), complete and sustained response in most CAPS patients without any consistent pattern of side effects. Long-term follow-up trials have demonstrated sustained efficacy, safety and tolerability. Canakinumab is approved by the US Food and Drug Administration for FCAS and MWS and by European Medicines Agency for treatment of all three phenotypes of CAPS.

  19. Similarity Predicts Liking in 3-Year-Old Children

    ERIC Educational Resources Information Center

    Fawcett, Christine A.; Markson, Lori

    2010-01-01

    Two studies examined the influence of similarity on 3-year-old children's initial liking of their peers. Children were presented with pairs of childlike puppets who were either similar or dissimilar to them on a specified dimension and then were asked to choose one of the puppets to play with as a measure of liking. Children selected the puppet…

  20. Developing Dialogic Argumentation Skills: A 3-Year Intervention Study

    ERIC Educational Resources Information Center

    Crowell, Amanda; Kuhn, Deanna

    2014-01-01

    Argumentation is increasingly recognized as a fundamental intellectual skill, but evidence suggests that few adolescents or adults are skilled arguers. This article reports on an extended (3-year, twice weekly) intervention designed to afford dense practice in dialogic argumentation to middle-school students from traditionally academically…

  1. Maxillary overdentures supported by four splinted direct metal laser sintering implants: a 3-year prospective clinical study.

    PubMed

    Mangano, Francesco; Luongo, Fabrizia; Shibli, Jamil Awad; Anil, Sukumaran; Mangano, Carlo

    2014-01-01

    Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS) technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females) to support bar-retained maxillary overdentures (ODs). Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB). Results. The 3-year implant survival rate was 97.4% (implant-based) and 92.9% (patient-based). Three implants failed. The incidence of biological complication was 3.5% (implant-based) and 7.1% (patient-based). The incidence of prosthetic complication was 17.8% (patient-based). No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results.

  2. Maxillary Overdentures Supported by Four Splinted Direct Metal Laser Sintering Implants: A 3-Year Prospective Clinical Study

    PubMed Central

    Mangano, Francesco; Shibli, Jamil Awad; Anil, Sukumaran

    2014-01-01

    Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS) technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females) to support bar-retained maxillary overdentures (ODs). Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB). Results. The 3-year implant survival rate was 97.4% (implant-based) and 92.9% (patient-based). Three implants failed. The incidence of biological complication was 3.5% (implant-based) and 7.1% (patient-based). The incidence of prosthetic complication was 17.8% (patient-based). No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results. PMID:25580124

  3. Socio-demographic Characteristics of Patients with Diagnosis of Leukemia in Bosnia and Herzegovina During Six-year Period

    PubMed Central

    Hasanbegovic, Edo; Begic, Nedim; Hasanbegovic, Snijezana; Begic, Zijo

    2016-01-01

    Introduction: Malignancies in children are second most frequent cause of death after accidents in pediatric age, while leukemias represents 30% of all malignancies of children age. Aim: To present the social and demographic characteristics of patients with a diagnosis of leukemia in Bosnia and Herzegovina during six years period. Patients and Methods: The study included 97 patients (from birth to 18 years old) with diagnosis of acute leukemia. Results: During the aforementioned period at the Pediatric Clinic of University Clinical Centre Sarajevo, 244 patients with the diagnosis of malignancy were treated (99 children were with leukemia (40.6%). Acute leukemia’s were diagnosed in 97 patients and chronic in 2 patients. Out of 97 treated patients with acute leukemia, they almost of all cantons of Federation of Bosnia and Herzegovina, Brcko District and the Republic Srpska. Patients were usually coming from the Tuzla Canton Federation of Bosnia and Herzegovina (28 patients). Based on the cytomorphological diagnosis of patients according to the FAB classification, the most was a present ALL-L1 type of acute leukemia’s. Mortality of patients with ALL was 15,3%, while mortality of patient with AML was 36,8%. Conclusion: In Bosnia and Herzegovina, during six year period, the largest number of patients with leukaemia came from Tuzla Canton. The most common age of patients was preschool and school ages. Male sex was dominant in patients with diagnosis AML. According to the FAB classification, ALL-L1 type of acute leukemia was the most common. PMID:28144203

  4. Anakinra use during pregnancy in patients with cryopyrin-associated periodic syndromes (CAPS).

    PubMed

    Chang, Zenas; Spong, Catherine Y; Jesus, Adriana A; Davis, Michael A; Plass, Nicole; Stone, Deborah L; Chapelle, Dawn; Hoffmann, Patrycja; Kastner, Daniel L; Barron, Karyl; Goldbach-Mansky, Raphaela T; Stratton, Pamela

    2014-11-01

    Objective: To describe the pregnancy course and outcome, and use of anakinra, a recombinant selective IL-1 receptor blocker, during pregnancy in patients with cryopyrin-associated periodic syndromes (CAPS), including familial cold auto-inflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS) and neonatal onset multi-system inflammatory disease (NOMID). Methods: Women currently enrolled in natural history protocols (NCT00059748, and/or NCT00069329 under IND) who have been pregnant were included. Subjects underwent a structured, standardized interview with regards to maternal health, pregnancy and fetal outcomes. Medical records were reviewed. Results: Nine women (four with FCAS, one with MWS and four with NOMID) reported one to four pregnancies, each resulting in a total of fifteen FCAS, three MWS, and six NOMID pregnancies. Six births from FCAS mothers and three births from NOMID mothers occurred while patients were receiving anakinra. If a woman became pregnant while taking anakinra, the pre-pregnancy anakinra dose was continued. Anakinra dose was increased during one twin pregnancy. No preterm births or serious complications of pregnancy were observed. One fetus of the twin pregnancy had renal agenesis and suffered fetal demise. Genetic testing showed the deceased twin carried the same NLRP3 c.785T>C, p.V262A mutation as the mother. The other twin is healthy and mutation negative. Conclusions: Anakinra was continued during pregnancy in women with CAPS and provided significant, persistent CAPS symptom relief while continuing to prevent the long-term sequelae of CAPS. Anakinra was well tolerated. Although a causal relation between anakinra and renal agenesis seems unlikely, further safety data are needed.

  5. International Staging System predicts prognosis of Chinese patients with multiple myeloma across different calendar periods with application of novel agents.

    PubMed

    Yang, Sheng-Hsiang; Teng, Hao-Wei; Hong, Ying-Chung; Liu, Chun-Yu; Yu, Yuan-Bin; Yang, Ching-Fen; Gau, Jyh-Pyng; Liu, Jin-Hwang; Chang, Tai-Jay; Yen, Jeffrey J Y; Chen, Po-Min; Chiou, Tzeon-Jye; Tzeng, Cheng-Hwai; Hsiao, Liang-Tsai

    2012-01-01

    The applicability of the International Staging System (ISS) for Chinese patients with multiple myeloma (MM) has not been demonstrated, especially with respect to treatments with novel agents. Newly diagnosed MM patients at Taipei Veterans General Hospital were enrolled between 1996 and 2007. Data regarding clinical features, laboratory tests, and outcome at last follow-up were collected. A total of 389 MM patients (71% male) were enrolled, with median age of 71 years. At diagnosis, 72.7% had Durie-Salmon (DS) stage III disease, 56.2% had ISS stage III disease, and 34% had serum creatinine ≧2.0 mg/dL. Compared with patients diagnosed in the first calendar period 1996-2001, the patients of the second calendar period 2002-2007 were older and more of these patients had received novel agents, especially thalidomide. The median overall survival period was 20.5 months, with a significant increase of patients in the second calendar period (15.3 and 28.2 months, respectively; P = 0.002), especially for those with ISS stages I and II. In the Cox proportion model, elevated serum β(2) microglobulin at diagnosis (≧3.5 mg/L), old age (≧65 years), and impaired renal function were found to be independently associated with poor survival. Over the entire period, the ISS was found to be effective in providing an accurate prognosis with respect to different ages and calendar periods. This is the first study to show the applicability of ISS for Chinese patients with MM, especially for those who had received thalidomide.

  6. The structure of executive function in 3-year-olds.

    PubMed

    Wiebe, Sandra A; Sheffield, Tiffany; Nelson, Jennifer Mize; Clark, Caron A C; Chevalier, Nicolas; Espy, Kimberly Andrews

    2011-03-01

    Although the structure of executive function (EF) during adulthood is characterized by both unity and diversity, recent evidence suggests that preschool EF may be best described by a single factor. The latent structure of EF was examined in 228 3-year-olds using confirmatory factor analysis. Children completed a battery of executive tasks that differed in format and response requirements and in putative working memory and inhibitory control demands. Tasks appeared to be age appropriate, with adequate sensitivity across the range of performance and without floor or ceiling effects. Tests of the relative fit of several alternative models supported a single latent EF construct. Measurement invariance testing revealed less proficient EF in children at higher sociodemographic risk relative to those at lower risk and no differences between boys and girls. At 3years of age, when EF skills are emerging, EF appears to be a unitary, more domain-general process.

  7. Periodic fever in MVK deficiency: a patient initially diagnosed with incomplete Kawasaki disease.

    PubMed

    Thors, Valtyr S; Vastert, Sebastiaan J; Wulffraat, Nico; van Royen, Annet; Frenkel, Joost; de Sain-van der Velden, Monique; de Koning, Tom J

    2014-02-01

    Mevalonate kinase deficiency (MKD) is a rare autosomal recessive disorder causing 1 of 2 phenotypes, hyperimmunoglobulin D syndrome and mevalonic aciduria, presenting with recurrent fever episodes, often starting in infancy, and sometimes evoked by stress or vaccinations. This autoinflammatory disease is caused by mutations encoding the mevalonate kinase (MVK) gene and is classified in the group of periodic fever syndromes. There is often a considerable delay in the diagnosis among pediatric patients with recurrent episodes of fever. We present a case of an 8-week-old girl with fever of unknown origin and a marked systemic inflammatory response. After excluding infections, a tentative diagnosis of incomplete Kawasaki syndrome was made, based on the finding of dilated coronary arteries on cardiac ultrasound and fever, and she was treated accordingly. However, the episodes of fever recurred, and alternative diagnoses were considered, which eventually led to the finding of increased excretion of mevalonic acid in urine. The diagnosis of MKD was confirmed by mutation analysis of the MVK gene. This case shows that the initial presentation of MKD can be indistinguishable from incomplete Kawasaki syndrome. When fever recurs in Kawasaki syndrome, other (auto-)inflammatory diseases must be ruled out to avoid inappropriate diagnostic procedures, ineffective interventions, and treatment delay.

  8. Screening for inborn errors of metabolism in high-risk children: a 3-year pilot study in Zhejiang Province, China

    PubMed Central

    2012-01-01

    Background Tandem mass spectrometry (MS/MS) has been available in China for 8 years. This technique makes it possible to screen for a wide range of previously unscreened inborn errors of metabolism (IEM) using a single test. This 3-year pilot study investigated the screening, diagnosis, treatment and outcomes of IEM in symptomatic infants and children. Methods All children encountered in the Newborn Screening Center of Zhejiang Province during a 3-year period with symptoms suspicious for IEM were screened for metabolic diseases. Dried blood spots were collected and analyzed by tandem mass spectrometry. The diagnoses were further confirmed by clinical symptoms and biochemical analysis. Neonatal intrahepatic cholestasis caused by citrin deficiency, ornithine transcarbamylase deficiency and primary carnitine deficiency were confirmed by DNA analysis. Results A total of 11,060 symptomatic patients (6,720 boys, 4,340 girls) with a median age of 28.8 months (range: 0.04-168.2 months) were screened. Among these, 62 were diagnosed with IEM, with a detection rate of 0.56%. Thirty-five were males and 27 females and the median age was 3.55 months (range 0.07-143.9 months). Of the 62 patients, 27 (43.5%) had aminoacidemias, 26 (41.9%) had organic acidemias and nine (14.5%) had fatty acid oxidation disorders. Conclusions Because most symptomatic patients are diagnosed at an older age, mental retardation and motor delay are difficult to reverse. Additionally, poor medication compliance reduces the efficacy of treatment. More extensive newborn screening is thus imperative for ensuring early diagnosis and enhancing the treatment efficacy of IEM. PMID:22364411

  9. A 35-month prospective study on onset of scabies in a psychiatric hospital: discussion on patient transfer and incubation period.

    PubMed

    Makigami, Kuniko; Ohtaki, Noriko; Yasumura, Seiji

    2012-02-01

    This study was conducted to evaluate the risk factors of scabies introduction into a hospital. We addressed the following question: Do patients transferred from other institutions pose a higher risk than patients from the community? From July 2003 to May 2006, a trained physician surveyed the inpatients and staff of a psychiatric hospital (six wards, 300 beds) on a monthly basis. During the study period, specific infection control measures beyond standard precautions, such as prophylactic treatment, were not adopted. There were 333 newly-admitted patients during the study period and among them, 122 were transferred from other institutions. Seven patients were diagnosed with scabies. Two of these patients were infected while in the hospital (secondary infection), thus the number of introduced scabies cases (index cases) was five. Four of the index cases were transferred from other institutions (three from psychiatric hospitals and one from a nursing home). The source of infection for one index case was unexplained. The rate of scabies infection among transferred patients was 3.3% while the infection rate among patients from the community was 0.5%. Therefore, transferred patients pose a higher risk than those from the community. The average time from admission to diagnosis of scabies was 141 days (range 34-313 days). The hospital personnel checked the skin condition of all patients at admission and none of the four patients showed symptoms of scabies.

  10. A 3-Year Review of Cranial Nerve Palsies from the University of Port Harcourt Teaching Hospital Eye Clinic, Nigeria

    PubMed Central

    Pedro-Egbe, Chinyere Nnenne; Fiebai, Bassey; Awoyesuku, Elizabeth Akon

    2014-01-01

    Purpose: To provide the types, frequency and clinical information on common cranial nerve palsies seen at the Eye Clinic at the University of Port Harcourt Teaching Hospital. Materials and Methods: A chart review was performed of patients who presented with cranial nerve palsy at the Eye Clinic over a 3-year period (January 2009-December 2011). Data were collected on age, sex, type of cranial nerve palsy, a history of systemic disease such as diabetes mellitus (DM), hypertension and cerebrovascular disease. Exclusion criteria included medical charts with incomplete data. Data was analyzed using Epi-info Version 6.04D. Statistical significance was indicated by P < 0.05. Results: Twenty-four patients had cranial nerve palsies. There were 11 males and 13 females with a mean age of 34.50 ± 18.41 years. Four patients (26.6%) had exotropia while three patients (20%) had esotropia. Complete ophthalmoplegia was noted in two patients (13.3%). The 3rd and 6th cranial nerves were affected in seven patients each (29.2%) and five patients (20.8%) had 7th cranial nerve palsy. Approximately 38% of patients with cranial nerve palsies had systemic disorders (16.7% systemic hypertension; 12.5% DM). The relationship between cranial nerve palsy and systemic disorder was statistically significant (P < 0.01). Conclusion: This is the first study in the literature on ocular cranial nerve palsies in Southern Nigeria. Third and sixth cranial nerve palsies were the most common cases to present to the University of Port Harcourt Teaching Hospital Eye Clinic. There was a statistically significant association to systemic disorders such as hypertension and DM and majority of cases with 6th cranial nerve palsy. PMID:24791110

  11. Rare Perilunate Injury as a Result of Chronic Trauma in 3-Year-Old Girl

    PubMed Central

    Tomaszewski, Ryszard

    2015-01-01

    A 3-year-old girl was reported to have perilunate dislocation. The child had suffered, approximately 18 months before, a repetitive wrist injury by means of frequent pulling and bending of the hand by the father who may have physically abused the child for approximately 2 months. At the age of 3 years and 4 months, we performed the reduction of the perilunate dislocation and the plasty of the dorsal scapholunate ligament using the capsular flap prepared from the extensor retinaculum. The wrist was immobilized for 6 weeks. Two months after surgery, patient started the physiotherapy for 3 months. The patient could flex up the wrist to 40 degrees and extend up to 45 degrees (mobility of the healthy wrist was 60, 50 degrees) during the examination 24 months' post-op. Only the surgical treatment of the perilunate dislocation can lead to obtain the good surgical result. PMID:26788457

  12. Sleep-stage sequencing of sleep-onset REM periods in MSLT predicts treatment response in patients with narcolepsy.

    PubMed

    Drakatos, Panagis; Patel, Kishankumar; Thakrar, Chiraag; Williams, Adrian J; Kent, Brian D; Leschziner, Guy D

    2016-04-01

    Current treatment recommendations for narcolepsy suggest that modafinil should be used as a first-line treatment ahead of conventional stimulants or sodium oxybate. In this study, performed in a tertiary sleep disorders centre, treatment responses were examined following these recommendations, and the ability of sleep-stage sequencing of sleep-onset rapid eye movement periods in the multiple sleep latency test to predict treatment response. Over a 3.5-year period, 255 patients were retrospectively identified in the authors' database as patients diagnosed with narcolepsy, type 1 (with cataplexy) or type 2 (without) using clinical and polysomnographic criteria. Eligible patients were examined in detail, sleep study data were abstracted and sleep-stage sequencing of sleep-onset rapid eye movement periods were analysed. Response to treatment was graded utilizing an internally developed scale. Seventy-five patients were included (39% males). Forty (53%) were diagnosed with type 1 narcolepsy with a mean follow-up of 2.37 ± 1.35 years. Ninety-seven percent of the patients were initially started on modafinil, and overall 59% reported complete response on the last follow-up. Twenty-nine patients (39%) had the sequence of sleep stage 1 or wake to rapid eye movement in all of their sleep-onset rapid eye movement periods, with most of these diagnosed as narcolepsy type 1 (72%). The presence of this specific sleep-stage sequence in all sleep-onset rapid eye movement periods was associated with worse treatment response (P = 0.0023). Sleep-stage sequence analysis of sleep-onset rapid eye movement periods in the multiple sleep latency test may aid the prediction of treatment response in narcoleptics and provide a useful prognostic tool in clinical practice, above and beyond their classification as narcolepsy type 1 or 2.

  13. COMPLETE STEROID AVOIDANCE IS EFFECTIVE AND SAFE IN CHILDREN WITH RENAL TRANSPLANTS: A MULTICENTER RANDOMIZED TRIAL WITH 3 YEAR FOLLOW UP

    PubMed Central

    Sarwal, Minnie M.; Ettenger, Robert; Dharnidharka, Vikas; Benfield, Mark; Mathias, Robert; Portale, Anthony; McDonald, Ruth; Harmon, William; Kershaw, David; Vehaskari, V. Matti; Kamil, Elaine; Baluarte, H. Jorge; Warady, Bradley; Tang, Lily; Liu, Jun; Li, Li; Naesens, Maarten; Sigdel, Tara; Waskerwitz, Janie; Salvatierra, Oscar

    2012-01-01

    To determine whether steroid avoidance in pediatric kidney transplantation is safe and efficacious, a randomized, multicenter trial was performed in 12 pediatric kidney transplant centers. One hundred thirty children receiving primary kidney transplants were randomized to steroid-free (SF) or steroid-based (SB) immunosuppression, with concomitant tacrolimus, mycophenolate, and standard dose daclizumab (SB group) or extended dose daclizumab (SF group). Follow-up was 3 years post-transplant. Standardized height Z score change after 3 years follow-up was −0.99±2.20 in SF vs. −0.93±1.11 in SB; p=0.825. In subgroup analysis, recipients under 5 years of age showed improved linear growth with SF compared to SB treatment (change in standardized height Z score at 3 years −0.43±1.15 vs. −1.07±1.14; p=0.019). There were no differences in the rates of biopsy-proven acute rejection at 3 years after transplantation (16.7% in SF vs. 17.1% in SB; p=0.94). Patient survival was 100% in both arms; graft survival was 95% in the SF and 90% in the SB arms (p=0.30) at 3 years follow-up. Over the three year follow-up period, the SF group showed lower systolic BP (p=0.017) and lower cholesterol levels (p=0.034). In conclusion, complete steroid avoidance is safe and effective in unsensitized children receiving primary kidney transplants. PMID:22694755

  14. [Superficial mycoses in patients from Anzoátegui state, Venezuela, period 2002-2012].

    PubMed

    Lemus-Espinoza, Druvic; Teresa Maniscalchi, María; Villarroel, Oskarina; Bónoli, Stefano B; Wahab, Fadi; García, Oswaldo

    2014-12-01

    Superficial fungal diseases that affect the skin and its appendages are frequently seen in basic triage and in dermatology services. These diseases are distributed in Venezuela with an incidence of 92.9%. The aim of this study was to determine the genera and species that cause dermatomycoses in residents of Anzoátegui state, Venezuela, during the period 2002-2012. A total of 4257 patients with a presumptive diagnosis of superficial mycoses were studied, with ages from 7 months to 79 years. The overall prevalence was 30.9%. The most frequent were dermatophytosis (44.7%). M. canis produced 148 cases of tinea capitis. Three dermatophytic agents represented 95% of all cases, with a significant predominance of T. mentagrophytes with 50%. Candidosis occurred in 28.4%. C. albicans, and the C. parapsilosis complex, were responsible for 80% of the cases. The other species identified were C. tropicalis (n = 41, 11.0%), C. glabrata (n = 10, 2.7%), C. guilliermondii (n = 6, 1.6%), C. krusei (n = 4, 1.1%). Pityriasis versicolor occurred in 22.4% of the cases studied, and less frequently were present onychomycosis produced by a non dermatophytic mold: Fusarium oxysporum (n = 34, 65.4%), Aspergillus terreus (n=16, 30.8%) and Scytalidium dimidiatum (n=2; 3.8%). Rare cases of Trichosporon onychomycosis (0.5%) and one case of black tinea were also found. Health education in the population is recommended to promote measures to prevent transmission of these fungi and prevent the spread of this silent public health problem.

  15. Systemic and pulmonary screening of patients with Behçet's disease during periodic follow-up.

    PubMed

    Bilgin, Gulden; Sungur, Gulten; Kucukterzi, Vildan

    2013-03-01

    Behçet's disease (BD) is a multisystemic disease that may involve all systems, the most common symptoms being oral and genital ulcerations and ocular involvement. Pulmonary involvement is not usually investigated in BD unless there is a specific complaint. In this study, pulmonary parameters and findings were investigated in BD patients at periodic follow-ups. A total of 112 subjects with a definitive diagnosis of BD from the Ocular Diseases Polyclinic, Behçet Disease Center, Ankara Training and Research Hospital and who had been referred to the Thoracic Diseases Polyclinic between January-October 2010 were evaluated. In the patients, the absence of active smoking, pregnancy, lactation and systemic steroid use were especially considered. A total of 112 patients between 14 and 61 years-old (53 male, 59 female) were enrolled in the study. The duration of follow-up varied between 1 and 22 years. The most commonly encountered symptom was hemoptysis observed in 18 subjects. 43 patients had mild obstruction, 9 patients had moderate obstruction, 4 patients had advanced obstruction and 4 patients showed restrictive alterations. Thoracic CT was normal for 83 subjects. Pulmonary involvement was observed as a pulmonary artery aneurysm in 4 patients and was treated. In BD, although anyone of PFT and CT values is normal, others may show pathological values. We believe that it would be useful in the follow-up to keep a regular record of the patient data and to perform PFT and, if possible, CT periodically.

  16. Patterns of paediatric facial fractures in a hospital of São Paulo, Brazil: a retrospective study of 3 years.

    PubMed

    Nardis, Amanda da Costa; Costa, Sabrina Araújo Pinho; da Silva, Rogério Almeida; Kaba, Shajadi Carlos Pardo

    2013-04-01

    The objective of this study is to analyze patterns of facial fractures in children treated at the Service of Oral and Maxillofacial Surgery of the Vila Penteado General Hospital (HGVP), in São Paulo, Brazil, in a period of 3 years. Between May 2008 and April 2011 the authors reviewed 110 records of patients under 12 years old with facial fractures. The following parameters were evaluated: age and sex distribution, aetiology of trauma, incidence and type of fractures, monthly distribution and treatment modality. Male-to-female ratio was 1.8:1, and the mean age was 8.13. The majority of the involved patients were aged between 6 and 12 years. The most prevalent cause was fall (58%) and nasal fractures were the most common type of fracture (69%). Monthly distribution was similar in all seasons. Of 110 patients, 69 (62%) were treated conservatively. The incidence of facial fractures in the area of study is high. The high incidence of nasal fractures should be a warning to maxillofacial surgeons, so that they are not overlooked. Safety programs should be installed in Brazil to increase public awareness and to decrease morbidity resulting from paediatric trauma.

  17. Prevalence and Characteristics of Periodic Limb Movements during Sleep in Korean Adult Patients with Restless Legs Syndrome

    PubMed Central

    Shin, Jung-won; Koo, Yong Seo; Lee, Byeong Uk; Shin, Won Chul; Lee, Sang Kun; Cho, Yong Won; Jung, Ki-Young

    2016-01-01

    Study Objectives: The aim of this study was to investigate the prevalence and characteristics of periodic limb movements during sleep (PLMS) in Korean patients with restless legs syndrome (RLS). Methods: Unmedicated adult patients with idiopathic RLS (n = 354) who underwent polysomnography at three major sleep centers in tertiary hospitals were included. Characteristics of PLMS in RLS were analyzed using the time structure of polysomnographically recorded leg movements and periodicity indices (PIs). RLS severity and subjective sleep quality were assessed. Results: Out of 354 patients with idiopathic RLS (mean age: 52.9 ± 12.0 years), 150 patients (42.3%) had RLS with a PLMS index greater than 15 events/h, and 204 (57.9%) had a PLMS index greater than 5 events/h. The distribution of inter-LM intervals was bimodal, and high PIs (0.86 ± 0.10) were observed in patients with RLS and PLMS (PLMS index > 15 events/h). The PLMS index was positively correlated with age (r = 0.228; p < 0.001), the periodic limb movements in wakefulness index (r = 0.455, p < 0.001) and arousal index (r = 0.174, p = 0.014), but not with RLS severity and parameters of sleep quality. In multivariate analysis, age and male gender were independently associated with PLMS > 15 events/h. Conclusions: The prevalence of PLMS in Korean patients with RLS was lower than that observed in Western countries, but the characteristics of PLMS were not different. Ethnic differences and/or different genetic backgrounds may contribute to the varying prevalence of PLMS in RLS. Citation: Shin JW, Koo YS, Lee BU, Shin WC, Lee SK, Cho YW, Jung KY. Prevalence and characteristics of periodic limb movements during sleep in Korean adult patients with restless legs syndrome. J Clin Sleep Med 2016;12(8):1089–1097. PMID:27306390

  18. Transition from acute to chronic hypercapnia in patients with periodic breathing: predictions from a computer model.

    PubMed

    Norman, Robert G; Goldring, Roberta M; Clain, Jeremy M; Oppenheimer, Beno W; Charney, Alan N; Rapoport, David M; Berger, Kenneth I

    2006-05-01

    Acute hypercapnia may develop during periodic breathing from an imbalance between abnormal ventilatory patterns during apnea and/or hypopnea and compensatory ventilatory response in the interevent periods. However, transition of this acute hypercapnia into chronic sustained hypercapnia during wakefulness remains unexplained. We hypothesized that respiratory-renal interactions would play a critical role in this transition. Because this transition cannot be readily addressed clinically, we modified a previously published model of whole-body CO2 kinetics by adding respiratory control and renal bicarbonate kinetics. We enforced a pattern of 8 h of periodic breathing (sleep) and 16 h of regular ventilation (wakefulness) repeated for 20 days. Interventions included varying the initial awake respiratory CO2 response and varying the rate of renal bicarbonate excretion within the physiological range. The results showed that acute hypercapnia during periodic breathing could transition into chronic sustained hypercapnia during wakefulness. Although acute hypercapnia could be attributed to periodic breathing alone, transition from acute to chronic hypercapnia required either slowing of renal bicarbonate kinetics, reduction of ventilatory CO2 responsiveness, or both. Thus the model showed that the interaction between the time constant for bicarbonate excretion and respiratory control results in both failure of bicarbonate concentration to fully normalize before the next period of sleep and persistence of hypercapnia through blunting of ventilatory drive. These respiratory-renal interactions create a cumulative effect over subsequent periods of sleep that eventually results in a self-perpetuating state of chronic hypercapnia.

  19. [Possibilities of magnetic-laser therapy in comprehensive treatment of patients with brain concussion in acute period].

    PubMed

    Zubkova, O V; Samosiuk, I Z; Polishchuk, O V; Shul'ga, N M; Samosiuk, N I

    2012-01-01

    The efficacy of magnetic-laser therapy used according to the method developed by us was studied in patients having the brain concussion (BC) in an acute period. The study was based on the dynamics of values of the evoked vestibular potentials and the disease clinical course. It was shown that following the magnetic-laser therapy in combination with traditional pharmacotherapy in BC acute period, the statistically significant positive changes were registered in the quantitative characteristics of the evoked vestibular brain potentials that correlated with the dynamics of the disease clinical course. The data obtained substantiate the possibility of using the magnetic-laser therapy in patients with a mild craniocereblal injury in an acute period.

  20. Effects of socioeconomic status on physical and mental health of hemodialysis patients in Japan: differences by age, period, and cohort

    PubMed Central

    Sugisawa, Hidehiro; Shimizu, Yumiko; Kumagai, Tamaki; Sugisaki, Hiroaki; Ohira, Seiji; Shinoda, Toshio

    2016-01-01

    Study purpose Whether or not socioeconomic status (SES)-related differences in the health of hemodialysis patients differ by age, period, and birth cohort remains unclear. We examined whether SES-related gaps in physical and mental health change with age, period, and birth cohort for hemodialysis patients. Methods Data were obtained from repeated cross-sectional surveys conducted in 1996, 2001, 2006, and 2011, with members of a national patients’ association as participants. We used raking adjustment to create a database which had similar characteristics to the total sample of dialysis patients in Japan. SES was assessed using family size-adjusted income levels. We divided patients into three groups based on their income levels: below the first quartile, over the second quartile and under the third quartile, and over the fourth quartile. We used the number of dialysis complications as a physical health indicator and depressive symptoms as a mental health indicator. We used a cross-classified random-effects model that estimated fixed effects of age categories and period as level-1 factors, and random effects of birth cohort as level-2 factors. Results Relative risk of dialysis complications in respondents below the first quartile compared with ones over the fourth quartile was reduced in age categories >60 years. Mean differences in depressive symptoms between respondents below the first quartile and ones over the fourth quartile peaked in the 50- to 59-year-old age group, and were reduced in age groups >60 years. In addition, mean differences varied across periods, widening from 1996 to 2006. There were no significant birth cohort effects on income differences for dialysis complications or depressive symptoms. Conclusion The number of dialysis complications and depressive symptoms in dialysis patients were affected by income differences, and the degree of these differences changed with age category and period. PMID:27471405

  1. Class V lesions restored with four different tooth-colored materials--3-year results.

    PubMed

    Folwaczny, M; Loher, C; Mehl, A; Kunzelmann, K H; Hickel, R

    2001-03-01

    The aim of this study was to compare the treatment results using four different types of tooth colored materials for restoring class V lesions. A total of 197 class V restorations (n = 197) were placed by one dentist in 37 patients on incisors, canines and premolars. The fillings were placed due to different indications: erosion/non-carious cervical defects (n = 69), primary carious lesions (n = 57), and for replacing defective existing fillings (n = 71). The teeth were assigned on a random basis to four groups for restoration with either a composite (group 1: n = 36; Tetric, Vivadent), or a polyacid-modified resin composite (group 2: n = 79; Dyract, Dentsply), or one of two different resin-modified glass ionomer cements (group 3: n = 51, Fuji II LC,GC; group 4: n = 31, Photac-Fil, Espe). The restorations were evaluated by a single-blind design, according to a modified USPHS system 36 months following placement. Statistical analysis was completed with the Pearson Chi-square test for comparing the results of the four groups (P < 0.05). Additionally, the survival rates were analyzed with the Kaplan-Meier estimator and the Log-rank test (P < 0.05). The Alpha ratings were as follows (Tetric/Dyract/Fuji II LC/Photac Fil): shade match (86%/77%/58%/40%), surface texture (81%/83%/16%/9%), marginal integrity (enamel) (73%/67%/61%/61%), marginal integrity (dentin) (86%/70%/55%/61%), marginal discoloration (enamel) (59%/44%/58%/52%), marginal discoloration (dentin) (82%/84%/71%/48%), anatomic contours (91%/83%/39%/35%). One Tetric restoration, five Dyract restorations, two Fuji II LC restorations and three Photac restorations were dislodged within the study period. The retention of the restorations showed no significant difference among the four materials. However, the clinical performance of the restorations retained over the 3-year period showed distinct differences for the four materials. The best clinical performance was observed for the resin composite, whereas the

  2. GRB 030329: 3 years of radio afterglow monitoring.

    PubMed

    van der Horst, A J; Kamble, A; Wijers, R A M J; Resmi, L; Bhattacharya, D; Rol, E; Strom, R; Kouveliotou, C; Oosterloo, T; Ishwara-Chandra, C H

    2007-05-15

    Radio observations of gamma-ray burst (GRB) afterglows are essential for our understanding of the physics of relativistic blast waves, as they enable us to follow the evolution of GRB explosions much longer than the afterglows in any other wave band. We have performed a 3-year monitoring campaign of GRB 030329 with the Westerbork Synthesis Radio Telescopes and the Giant Metrewave Radio Telescope. Our observations, combined with observations at other wavelengths, have allowed us to determine the GRB blast wave physical parameters, such as the total burst energy and the ambient medium density, as well as to investigate the jet nature of the relativistic outflow. Further, by modelling the late-time radio light curve of GRB 030329, we predict that the Low-Frequency Array (30-240 MHz) will be able to observe afterglows of similar GRBs, and constrain the physics of the blast wave during its non-relativistic phase.

  3. ISS ECLSS: 3 Years of Logistics for Maintenance

    NASA Technical Reports Server (NTRS)

    Shkedi, Brienne; Thompson, Dean

    2004-01-01

    The International Space Station (ISS) Environmental Control and Life Support System (ECLSS) is designed to be maintainable. During the 3 years since the ISS US Lab became operational, there have been numerous ECLSS Orbital Replacement Units (ORUs) launched and returned to Maintain the ECLSS operation in the US segments. The maintenance logistics have provided tools for maintenance, replaced limited life ORUs and failed ORUs, upgraded ECLSS hardware to improve reliability and placed critical spares onboard prior to need. In most cases, the removed ORUs have been returned for either failure analysis and repair or refurbishment. This paper describes the ECLSS manifesting history and maintenance events and quantifies the numbers of ECLSS items, weights, and volumes.

  4. Extrinsic Rewards Diminish Costly Sharing in 3-Year-Olds.

    PubMed

    Ulber, Julia; Hamann, Katharina; Tomasello, Michael

    2016-07-01

    Two studies investigated the influence of external rewards and social praise in young children's fairness-related behavior. The motivation of ninety-six 3-year-olds' to equalize unfair resource allocations was measured in three scenarios (collaboration, windfall, and dictator game) following three different treatments (material reward, verbal praise, and neutral response). In all scenarios, children's willingness to engage in costly sharing was negatively influenced when they had received a reward for equal sharing during treatment than when they had received praise or no reward. The negative effect of material rewards was not due to subjects responding in kind to their partner's termination of rewards. These results provide new evidence for the intrinsic motivation of prosociality-in this case, costly sharing behavior-in preschool children.

  5. A 3 Year-Old Male Child Ingested Approximately 750 Grams of Elemental Mercury

    PubMed Central

    Uysalol, Metin; Parlakgül, Güneş; Yılmaz, Yasin; Çıtak, Agop; Uzel, Nedret

    2016-01-01

    Background: The oral ingestion of elemental mercury is unlikely to cause systemic toxicity, as it is poorly absorbed through the gastrointestinal system. However, abnormal gastrointestinal function or anatomy may allow elemental mercury into the bloodstream and the peritoneal space. Systemic effects of massive oral intake of mercury have rarely been reported. Case Report: In this paper, we are presenting the highest single oral intake of elemental mercury by a child aged 3 years. A Libyan boy aged 3 years ingested approximately 750 grams of elemental mercury and was still asymptomatic. Conclusion: The patient had no existing disease or abnormal gastrointestinal function or anatomy. The physical examination was normal. His serum mercury level was 91 µg/L (normal: <5 µg/L), and he showed no clinical manifestations. Exposure to mercury in children through different circumstances remains a likely occurrence. PMID:27606146

  6. Pharyngoesophageal perforation 3 years after anterior cervical spine surgery: a rare case report and literature review.

    PubMed

    Yin, Dan-Hui; Yang, Xin-Ming; Huang, Qi; Yang, Mi; Tang, Qin-Lai; Wang, Shu-Hui; Wang, Shuang; Liu, Jia-Jia; Yang, Tao; Li, Shi-Sheng

    2015-08-01

    Pharyngoesophageal perforation after anterior cervical spine surgery is rare and the delayed cases were more rarely reported but potentially life-threatening. We report a case of pharyngoesophageal perforation 3 years after anterior cervical spine surgery. The patient presented with dysphagia, fever, left cervical mass and developing dyspnea 3 years after cervical spine surgery for trauma. After careful examinations, he underwent an emergency tracheostomy, neck exploration, hardware removal, abscess drainage and infected tissue debridement. 14 days after surgery, CT of the neck with oral contrast demonstrated no contrast extravasation from the esophagus. Upon review of literature, only 14 cases of pharyngoesophageal perforation more than 1 year after anterior cervical spine surgery were found. We discussed possible etiology, diagnosis and management and concluded that in cases of dysphagia, dyspnea, cervical pain, swelling and edema of the cervical area even long time after anterior cervical spine surgery, potential pharyngoesophageal damage should be considered.

  7. A comprehensive comparison between pediatric and adult patients with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenopathy (PFAPA) syndrome.

    PubMed

    Rigante, Donato; Vitale, Antonio; Natale, Marco Francesco; Lopalco, Giuseppe; Andreozzi, Laura; Frediani, Bruno; D'Errico, Francesca; Iannone, Florenzo; Cantarini, Luca

    2017-02-01

    Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenopathy (PFAPA) syndrome is a mysterious disorder characterized by periodically recurrent fevers, oropharyngeal inflammation, and adenitis, which mainly affects children, though in very recent times, it has been also recognized in adulthood. We enrolled 115 unrelated pediatric and adult patients with history of periodic fevers who fulfilled the current diagnostic criteria for PFAPA syndrome in three Italian referral centers and highlighted differences between children and adults. Eighty-five children and 30 adults were evaluated: the frequency of flares was significantly higher in pediatric cases, while febrile attack duration was significantly longer in adults. Clockwork periodicity of fever and recurrent pharyngitis were more frequently observed in childhood, but no differences were identified for aphthosis and cervical adenopathy. Conversely, joint symptoms, myalgia, headache, fatigue, ocular signs, and rashes were more common in adults. The simultaneous occurrence of two or three cardinal PFAPA signs did not show any statistical difference between the groups, while the occurrence of only one cardinal manifestation was more frequent in adults. Corticosteroids were effective in 98.82 % of children and 88.2 % of adults. Tonsillectomy was rarely performed, resulting effective in only two patients. Our data illustrate the clinical overlap between pediatric and adult cases of PFAPA syndrome. Adults are characterized by a wider repertoire of inflammatory signs, suggesting that onset in adulthood might leave the disease misdiagnosed. Clinicians, not only pediatricians, should take into account this clinical entity in every patient of whatever age suffering from recurrent fevers of unknown origin.

  8. Development of temporomandibular disorder symptoms: a 3-year cohort study of university students.

    PubMed

    Akhter, R; Morita, M; Esaki, M; Nakamura, K; Kanehira, T

    2011-06-01

    The aims of this study were to examine the incidence of temporomandibular disorders (TMDs) over a 3-year period and to evaluate the risk of self-reported TMDs among university students in Japan. The study population comprised 2374 university students examined at the start of their undergraduate course and 492 students re-examined after 3 years using questionnaires on symptoms of TMD and experiences of jaw injury, stress, orthodontic treatment and parafunctional habits. Cumulative incidence (%) and relative risks were calculated overall. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to determine the degree of risks of these variables for symptoms of TMDs using logistic regression. Results of logistic regression analysis showed that male subjects with experience of jaw injury had a 3·54 (CI=1·45-8·68, P<0·01)-fold higher risk of temporomandibular joint (TMJ) pain than that for those who did not. Female subjects who reported experiencing stress and bruxism had 10·56 (CI=1·28-87·54, P<0·05)- and 5·00 (CI=1·21-20·71, P<0·05)-fold higher risks of TMJ sound, respectively, than the risk for female subjects who had not experienced stress or bruxism. The results indicated that experiences of jaw injury, stress and bruxism were significantly associated with increased risks of development of TMJ disorders in a 3-year cohort.

  9. A Relationship between Periodic Limb Movements in Sleep and High Nocturnal Blood Pressure Values in Patients with Insomnia

    PubMed Central

    Sieminski, Mariusz; Partinen, Markku

    2016-01-01

    Study Objectives: Insomnia, which is the most common sleep disorder, is a significant public health burden. Growing evidence suggests the existence of a relationship between insomnia and hypertension. The aim of this study was to verify the hypothesis that periodic limb movements in sleep (PLMS) are related to increased nocturnal blood pressure (BP) values in patients with insomnia. Methods: We retrospectively analyzed polysomnographic recordings of patients with insomnia who were seen in our clinic from January to December 2012. Patients were divided into two groups based on their nocturnal BP values: group I had normal nocturnal BP values (n = 27) and group II (n = 29) had elevated nocturnal BP values. The sleep architecture of the groups was compared. Results: The groups did not differ in terms of age, sex, or the prevalence of cardiovascular disorders. However, we found that the number of PLMS was significantly higher in group II than in group I (PLMS index: 18.8 vs. 6.5; p = 0.01). Conclusions: Our results suggest that PLMS are related to increased nocturnal BP values in patients with insomnia, which may partly explain the relationship between insomnia and hypertension. Therefore, it is possible that treatment of PLMS may normalize nocturnal BP in patients with insomnia. Citation: Sieminski M, Partinen M. A relationship between periodic limb movements in sleep and high nocturnal blood pressure values in patients with insomnia. J Clin Sleep Med 2016;12(6):865–869. PMID:27070247

  10. SMOS Instrument Performance and Calibration after 3 Years in Orbit

    NASA Astrophysics Data System (ADS)

    Martin-Neira, Manuel; Corbella, Ignasi; Torres, Francesc; Kainulainen, Juha; Oliva, Roger; Closa, Josep; Cabot, François; Castro, Rita; Barbosa, Jose; Gutierrez, Antonio; Anterrieu, Eric; Tenerelli, Joe; Martin-Porqueras, Fernando; Buenadicha, Guillermo; Delwart, Steven; Crapolicchio, Raffaele; Suess, Martin

    2013-04-01

    ESA's Soil Moisture and Ocean Salinity (SMOS) mission has been in orbit for already over 3 years which has allowed the calibration and data processing team consolidating both the calibration strategy and the Level-1 processor which transforms the raw visibility samples into polarimetric brightness temperature images. The payload on board SMOS, MIRAS, is quite unique in that it is the first microwave radiometer in space ever capable to generate wide field of view images at every snapshot measurement. This means that most of the calibration as well as image processing techniques are being developed for the first time with little heritage from any previous space mission. Issues intrinsically attached to its wide field of view such as spatial ripples across the snapshot images are particular to MIRAS and to no other earlier radiometer. Even the fundamental theory behind the instrument was put at test, first on ground inside an electromagnetic compatibility chamber, and now in orbit when imaging the Cosmic Microwave Background Radiation of the cold sky. A groundbreaking effort is being carried out by the SMOS project team to understand and master all calibration and image reconstruction issues of this novel microwave interferometer payload. MIRAS in-orbit performance is driven by the amplitude of spatial ripples across the image and orbital and seasonal radiometer stability. Spatial ripples are unique to interferometric radiometers and are produced by (a) a limited knowledge of the antenna patterns and, in general, of the model of the instrument, (b) some fundamental limitations related to the inverse problem of image reconstruction in undetermined conditions and (c) subtle data processing inconsistencies which are discovered and corrected. To reduce the spatial ripples sea surface salinity retrievals are performed by first removing the brightness temperature spatial errors using a uniform region of the Pacific Ocean. However soil moisture retrievals cannot benefit of

  11. Psychological Analysis of Oral Cancer Patients during Pre-operative Period in South Indian Population: A Prospective, Quantitative, Multicentre Study

    PubMed Central

    Kamatchinathan, Prabhusankar; Muthuraman, Varun; Antharaju, Yuvaraj; Kumar, Mahendra; Varadharajan, Usha

    2016-01-01

    Introduction Oral cancer is prevalent worldwide with high incidence of mortality and morbidity. It is associated with poor prognosis and low survival rate. Moreover, patients affected are more likely to develop psychological issues and thus, addressing psychological needs of such patients is crucial. Aim The aim of our study was to assess the quality of life of oral cancer patients in the pre-operative period, thereby providing them with the necessary psychological support. Materials and Methods A total of 206 patients, scheduled to undergo treatment for oral cancer were selected from various cancer centres in South India. After informed consent, 171 patients were finally analysed for their quality of life using Functional Assessment of Cancer Therapy-General (FACT-G) version 4; and Functional Assessment of Cancer Therapy Head and Neck (FACT-H&N), as a Quality of Life (QOL) survey. Result Most of the patients had poor quality of life and were found to be emotionally distressed pre-operatively as they did not have proper emotional support from society. Conclusion From the study it was observed that catering to the psychological needs of oral cancer patients is important and psychological counselling should be a part of a comprehensive treatment plan for such patients. PMID:27891463

  12. Intestinal stoma in patients with colorectal cancer from the perspective of 20-year period of clinical observation

    PubMed Central

    Banaszkiewicz, Zbigniew; Woda, Łukasz P.; Tojek, Krzysztof; Jarmocik, Paweł; Jawień, Arkadiusz

    2015-01-01

    Introduction Intestinal stoma is a procedure most often performed in patients with colorectal cancer. Aim To identify the percentage of patients with colorectal cancer in which the intestinal stoma was performed. Material and methods We retrospectively analysed 443 patients treated during a 20-year period (1994–2013) due to colorectal cancer, in which the intestinal stoma was made during the first surgical intervention. Results In the second analysed decade, a significant decrease in the percentage of created stomas, definitive stomas in particular, was observed. Stomas were made significantly more often in patients with a tumour located in the rectum, the left half of the colon, and in patients undergoing urgent surgeries. An increased incidence of intestinal stomas was associated with a higher severity of illness and higher proportion of unresectable and non-radical procedures. The definitive stomas were significantly more often made in men and in patients with tumours located in the rectum, whereas temporary stomas were created significantly more often in patients undergoing urgent operations. Conclusions In the last decade (2004–2013) the number of intestinal stomas in patients operated due to colorectal cancer was significantly reduced. PMID:25960811

  13. Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period

    PubMed Central

    Gomez-Reino, Juan J; Carmona, Loreto

    2006-01-01

    The objective of this work is to analyze the survival of infliximab, etanercept and adalimumab in patients who have switched among tumor necrosis factor (TNF) antagonists for the treatment of chronic arthritis. BIOBADASER is a national registry of patients with different forms of chronic arthritis who are treated with biologics. Using this registry, we have analyzed patient switching of TNF antagonists. The cumulative discontinuation rate was calculated using the actuarial method. The log-rank test was used to compare survival curves, and Cox regression models were used to assess independent factors associated with discontinuing medication. Between February 2000 and September 2004, 4,706 patients were registered in BIOBADASER, of whom 68% had rheumatoid arthritis, 11% ankylosing spondylitis, 10% psoriatic arthritis, and 11% other forms of chronic arthritis. One- and two-year drug survival rates of the TNF antagonist were 0.83 and 0.75, respectively. There were 488 patients treated with more than one TNF antagonist. In this situation, survival of the second TNF antagonist decreased to 0.68 and 0.60 at 1 and 2 years, respectively. Survival was better in patients replacing the first TNF antagonist because of adverse events (hazard ratio (HR) for discontinuation 0.55 (95% confidence interval (CI), 0.34–0.84)), and worse in patients older than 60 years (HR 1.10 (95% CI 0.97–2.49)) or who were treated with infliximab (HR 3.22 (95% CI 2.13–4.87)). In summary, in patients who require continuous therapy and have failed to respond to a TNF antagonist, replacement with a different TNF antagonist may be of use under certain situations. This issue will deserve continuous reassessment with the arrival of new medications. PMID:16507128

  14. [Content of C-reactive protein in patients in an acute period of a ruptured intracranial aneurysm].

    PubMed

    Globa, M V; Lisyanyi, M I; Tsimeyko, A; Litvak, S O

    2015-03-01

    A content of C-reactive protein (CRP) in the blood serum was determined in 36 patients in acute period of a ruptured intracranial arterial aneurysm (AA). It was significantly more, than in a control group, and have exceeded 10 mg/I in 1 - 4th day of the disease. The level of CRP have had differ, depending on severity of cerebral vasospasm (CVS), determined in accordance to the ultrasound investigation data. In a pronounced CVS in majority of patients the level of CRP in the blood serum have had exceed 10 mg/l, and have secured elevated in a spinal liquor on the 7 - 10th day of the disease, differing from this index in patients with moderately pronounced CVS or without it. In patients with severe invalidization or those, who have died, the level of CRP was trust-worthy higher.

  15. [Metabolic monitoring of heart surgery patients during the immediate postoperative period].

    PubMed

    Smirnova, V I; Machulin, A V; Pulina, N N; Solopova, G V

    1991-01-01

    The situation of aggression is accompanied by metabolic alterations with an important neuro-endocrinal context. Extracorporeal surgery is an especially aggressive situation which involves both surgery and the added metabolic state of hypothermia. In 48 patients subjected to extracorporeal circulation with hypothermia, the metabolic parameters of Oxygen Consumption (VO2), Production of carbon dioxide (VCO2), Respiratory Quotient (RQ) and Energy Expenditure (GE) were studied. It was observed that the patients could be divided into two subgroups, depending on their metabolic response. Studying the RQ parameter, it was seen that this divided patients into two subgroups depending on their posterior evolution. Patients in whom RQ did not exceed 0.8 showed more favourable evolution than those in whom RQ was higher than 0.8. The correct metabolic response was regarded as a parameter indicative of the evolution, directly correlated to the hemodynamic parameters studied. In one patient, creatine phosphate was infused at a dosage of 30 mg/kg for 60 min, and an improvement was noted in GE and Cardiac Index. It was concluded that the intravenous intake of creatine phosphate in patients undergoing extracorporeal surgery improved both metabolic parameters and the myocardiac function.

  16. Spontaneous analog number representations in 3-year-old children.

    PubMed

    Cantlon, Jessica F; Safford, Kelley E; Brannon, Elizabeth M

    2010-03-01

    When enumerating small sets of elements nonverbally, human infants often show a set-size limitation whereby they are unable to represent sets larger than three elements. This finding has been interpreted as evidence that infants spontaneously represent small numbers with an object-file system instead of an analog magnitude system (Feigenson, Dehaene & Spelke, 2004). In contrast, non-human animals and adult humans have been shown to rely on analog magnitudes for representing both small and large numbers (Brannon & Terrace, 1998; Cantlon & Brannon, 2007; Cordes, Gelman, Gallistel & Whalen, 2001). Here we demonstrate that, like adults and non-human animals, children as young as 3 years of age spontaneously employ analog magnitude representations to enumerate both small and large sets. Moreover, we show that children spontaneously attend to numerical value in lieu of cumulative surface area. These findings provide evidence of young children's greater sensitivity to number relative to other quantities and demonstrate continuity in the process they spontaneously recruit to judge small and large values.

  17. A 3-year follow-up of hypertension in Delhi.

    PubMed Central

    Gopinath, N.; Chadha, S. L.; Shekhawat, S.; Tandon, R.

    1994-01-01

    A follow-up study of hypertension was carried out among adults in Delhi 3 years after an initial community-based epidemiological survey of the same population. The treatment and the severity status of 1115 out of 1749 individuals with hypertension detected in the initial survey were compared with those observed in the follow-up. The proportion of treated cases with controlled blood pressure rose from 10.8% to 60.8%. Among the cohort of 3611 subjects aged 25-64 years who were normotensive in the initial survey, 132 new cases of hypertension, were detected. The annual incidence of hypertension was the same in men and women (12.2 per 1000). Diabetes and regular alcohol consumption were significant risk factors for hypertension, being present in 13 and 7 cases, respectively. Electrocardiograms (ECGs) were recorded for 871 of the 1115 cases of hypertension. Abnormal ECGs were exhibited by 307 cases (35.2%), of which 24 (2.7%) had had myocardial infarction, 133 (15.3%) had ischaemic ST-T changes, 54 (6.2%) had left ventricular hypertrophy, and 96 (11.0%) had conduction defects and arrhythmias. PMID:7955019

  18. Long-term evaluation of teeth and implants during the periodic maintenance in patients with viral liver disease

    PubMed Central

    2016-01-01

    PURPOSE This study was designed to investigate the maintenance of teeth and implants in patients with viral liver disease. MATERIALS AND METHODS 316 patients without any significant systemic disease were selected as a control group. Liver disease group was consisted of 230 patients. Necessary data were collected using clinical records and panoramic radiographs. Then, the patients were subdivided into 2 groups based on the type of active dental therapy received before maintenance period (Pre-Tx). Analysis for finding statistically significant difference was performed based on the need for re-treatment of active dental therapy (Re-Tx) and change in the number of teeth (N-teeth) and implants (N-implants). RESULTS Comparing to control group, the patients with liver disease showed higher value on N-teeth, N-implants, and Re-Tx. Statistically significant differences were found on N-teeth (P=.000) and Re-Tx (P=.000) in patients with non-surgical Pre-Tx. Analysis based on severity of liver disease showed that N-teeth and Re-Tx were directly related to severity of liver disease regardless of received type of Pre-Tx. Significant differences were found on N-teeth (P=.003) and Re-Tx (P=.044) in patients with non-surgical Pre-Tx. CONCLUSION In this study, it was concluded that liver disease might influence the loss of teeth and cause the relapse of dental disease during maintenance period in patients. A significant positive relationship between tooth and implant loss and severity of liver disease seems to exist. PMID:27555902

  19. Patient subjective experience and satisfaction during the perioperative period in the day surgery setting: a systematic review.

    PubMed

    Rhodes, Lenore; Miles, Gail; Pearson, Alan

    2006-08-01

    This systematic review used the Joanna Briggs Institute Qualitative Assessment and Review Instrument to manage, appraise, analyse and synthesize textual data in order to present the best available information in relation to how patients experience nursing interventions and care during the perioperative period in the day surgery setting. Some of the significant findings that emerged from the systematic review include the importance of pre-admission contact, provision of relevant, specific education and information, improving communication skills and maintaining patient privacy throughout their continuum of care.

  20. [Clinical features and course of schizophrenia developing in patients during remote periods following cranio-cerebral injuries].

    PubMed

    Kornilov, A A

    1980-01-01

    By means of clinical and follow up studies 340 patients were examined in the late period of brain trauma. Among this group 90 patients were distinguished who had an increasing endogenization of psychotic conditions and transformation of post-traumatic personality changes with emerging negative disorders, inherent to schizophrenia. In analysing the psychotic attacks attention was drawn to the depressive content of verbal hallucinosis, the rudimentary ideas fof self-accusation in an acute paranoid state, to the elements of the Kandinsky-Clerambault syndrome in delirious states, to the prevalence of low energy level in depressions and to the short psychotic episodes in remissions of the schizoaffective psychosis.

  1. [Pulmonary metabolism of beta-endorphin in asthmatic patients in asymptomatic periods and after bronchospasm induced by methacholine].

    PubMed

    Bottino, G; Antognozzi, G; Degrandi, R; Augeri, C; Bogliolo, G; Zoccali, P

    1995-01-01

    Blood concentration of endogenous beta-endorphines can change during the clinical evolution of chronic bronchopneumopathies. The authors assessed the beta-endorphine concentrations in the pulmonary arterial and systemic arterial blood in 8 asthmatic patients during a symptom-free period and after methacholine-induced bronchospasm. The beta-endorphine analysis was performed in duplicate dor each sample, by means of a RIA assay. There is not difference in the systemic arterial blood concentration of beta-endorphines between asthmatic patients and normal subjects. Furthermore, there is no change in the beta-endorphine blood concentration during the passage through the pulmonary tissue after methacoline-induced bronchospasm.

  2. Different presentations in patients with tumor necrosis factor receptor-associated periodic syndrome mutations: report of two cases.

    PubMed

    Celebi-Tayfur, Aslı; Bilginer, Yelda; Finetti, Martina; Gattorno, Marco; Ozen, Seza

    2013-01-01

    Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is an autosomal dominant autoinflammatory disorder caused by mutations in the TNFRSF1A gene encoding the 55-kDa receptor for tumor necrosis factor (TNF)-α. It is characterized by recurrent prolonged episodes of fever accompanied by abdominal pain, pleuritis, migratory skin rashes, fasciitis, headache, conjunctivitis, and periorbital edema. We report two children, one with a severe mutation in the TNFRSF1A gene causing the typical phenotype. The second patient had a homozygous R92Q-type mutation and displayed a periodic fever with aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome-like phenotype. In the eastern Mediterranean region, TRAPS is probably underdiagnosed because of the overwhelming frequency of familial Mediterranean fever (FMF). However, TRAPS should be sought for in patients with atypical symptoms for FMF.

  3. Qualitative Feasibility of Using Three Accelerometers With 2-3-Year-Old Children and Both Parents

    ERIC Educational Resources Information Center

    Costa, Silvia; Barber, Sally E.; Griffiths, Paula L.; Cameron, Noël; Clemes, Stacy A.

    2013-01-01

    Purpose: This study assessed mothers' opinions about the feasibility and acceptability of using the ActiGraph GT3X+, Actiheart, and activPAL3 with their 2- to 3-year-old children, as well as with themselves and their husbands/partners, for an 8-day period. Method: Six focus groups were run with Pakistani and White British mothers ("n" =…

  4. Intergenerational Transmission of Warm-Sensitive-Stimulating Parenting: A Prospective Study of Mothers and Fathers of 3-Year-Olds

    ERIC Educational Resources Information Center

    Belsky, Jay; Jaffee, Sara R.; Sligo, Judith; Woodward, Lianne; Silva, Phil A.

    2005-01-01

    More than 200 New Zealand men and women studied repeatedly since age 3 were videotaped interacting with their own 3-year-old children to determine (a) whether childrearing and family climate experienced in 3 distinct developmental periods while growing up (i.e., early childhood, middle childhood, early adolescence) predicted parenting and (b)…

  5. Effect of Lifestyle on Asthma Control in Japanese Patients: Importance of Periodical Exercise and Raw Vegetable Diet

    PubMed Central

    Iikura, Motoyasu; Yi, Siyan; Ichimura, Yasunori; Hori, Ai; Izumi, Shinyu; Sugiyama, Haruhito; Kudo, Koichiro; Mizoue, Tetsuya; Kobayashi, Nobuyuki

    2013-01-01

    Background The avoidance of inhaled allergens or tobacco smoke has been known to have favorable effects on asthma control. However, it remains unclear whether other lifestyle-related factors are also related to asthma control. Therefore, a comprehensive study to examine the associations between various lifestyle factors and asthma control was conducted in Japanese asthmatic patients. Methods The study subjects included 437 stable asthmatic patients recruited from our outpatient clinic over a one-year period. A written, informed consent was obtained from each participant. Asthma control was assessed using the asthma control test (ACT), and a structured questionnaire was administered to obtain information regarding lifestyle factors, including tobacco smoking, alcohol drinking, physical exercise, and diet. Both bivariate and multivariate analyses were conducted. Results The proportions of total control (ACT = 25), well controlled (ACT = 20-24), and poorly controlled (ACT < 20) were 27.5%, 48.1%, and 24.5%, respectively. The proportions of patients in the asthma treatment steps as measured by Global Initiative for Asthma 2007 in step 1, step 2, step 3, step 4, and step 5 were 5.5%, 17.4%, 7.6%, 60.2%, and 9.4%, respectively. Body mass index, direct tobacco smoking status and alcohol drinking were not associated with asthma control. On the other hand, younger age (< 65 years old), passive smoking, periodical exercise (> 3 metabolic equivalents-h/week), and raw vegetable intake (> 5 units/week) were significantly associated with good asthma control by bivariate analysis. Younger age, periodical exercise, and raw vegetable intake were significantly associated with good asthma control by multiple linear regression analysis. Conclusions Periodical exercise and raw vegetable intake are associated with good asthma control in Japanese patients. PMID:23874577

  6. Relationship between the brain natriuretic peptide (BNP) level and remission of diabetic nephropathy with microalbuminuria: a 3-year follow-up study.

    PubMed

    Seki, N; Matsumoto, T; Fukazawa, M

    2015-02-01

    The aim of the study was to examine the relationship between the brain natriuretic peptide (BNP) level and progression or remission of diabetic nephropathy with microalbuminuria for 3 years. The subjects were 100 Japanese type 2 diabetes mellitus outpatients with microalbuminuria. Associations between metabolic parameters at baseline [HbA1c, systolic blood pressure (SBP), urine albumin-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), and BNP] and the progression or remission of diabetic nephropathy were examined for 3 years. A total of 83 patients were examined at the end of the 3-year period, including 17 with remission to normoalbuminuria, 47 with continuing microalbuminuria, and 19 with progression to macroalbuminuria. HbA1c, ACR, and BNP differed significantly among the 3 groups (p=0.024, p<0.001, p=0.002, respectively). Among baseline factors, HbA1c and BNP were significant predictors of the percentage increase in ACR for 3 years in multiple linear regression analysis (β=0.259, p=0.02; β=0.299, p=0.007, respectively). In multivariate logistic regression analysis, HbA1c and ACR were independently associated with progression of diabetic nephropathy (p=0.008, p=0.023, respectively), and ACR and BNP were independently associated with remission of diabetic nephropathy (p=0.029, p=0.012, respectively). ROC curve analysis gave a cutoff value for BNP of 14.9 pg/ml for prediction of remission of diabetic nephropathy (p=0.016). The BNP level has a relationship with diabetic nephropathy and a low BNP level predicts remission of diabetic nephropathy. Therefore, monitoring of BNP can play an important role in management of diabetic nephropathy.

  7. 3-year study of donepezil therapy in Alzheimer's disease: effects of early and continuous therapy.

    PubMed

    Winblad, B; Wimo, A; Engedal, K; Soininen, H; Verhey, F; Waldemar, G; Wetterholm, A-L; Haglund, A; Zhang, R; Schindler, R

    2006-01-01

    Delays in the diagnosis of Alzheimer's disease, and, therefore, delays in treatment, may have a detrimental effect on a patient's long-term well-being. This study assessed the effects of postponing donepezil treatment for 1 year by comparing patients treated continuously for 3 years with those who received placebo for 1 year followed by open-label donepezil for 2 years. Patients (n = 286) with possible or probable Alzheimer's disease (according to DSM-IV, NINCDS-ADRDA, and Mini-Mental State Examination criteria; see text) were randomized to receive donepezil (5 mg/day for 4 weeks, 10 mg/day thereafter) or placebo (delayed-start group) for 1 year. Of the 192 completers, 157 began a 2-year, open-label phase of donepezil treatment. Outcome measures were the Gottfries-Bråne-Steen scale, the Mini-Mental State Examination, the Global Deterioration Scale, the Progressive Deterioration Scale, the Neuropsychiatric Inventory, and safety (adverse events). Mixed regression analysis was used to compare changes between the groups over 3 years on the efficacy measures. There was a trend for patients receiving continuous therapy to have less global deterioration (Gottfries-Bråne-Steen scale) than those who had delayed treatment (p = 0.056). Small but statistically significant differences between the groups were observed for the secondary measures of cognitive function (Mini-Mental State Examination; p = 0.004) and cognitive and functional abilities (Global Deterioration Scale; p = 0.0231) in favor of continuous donepezil therapy. Over 90% of the patients in both cohorts experienced one treatment-emergent adverse event; most were considered mild or moderate. In conclusion, patients in whom the start of treatment is delayed may demonstrate slightly reduced benefits as compared with those seen in patients starting donepezil therapy early in the course of Alzheimer's disease. These data support the long-term efficacy and safety of donepezil.

  8. [THE RISK FACTORS OF LETHAL COMPLICATIONS IN EARLY POSTOPERATIVE PERIOD IN PATIENTS, SUFFERING GASTROESOPHAGEAL ZONE MALIGNANCIES].

    PubMed

    Dumanskiy, Yu V; Stepko, V A; Sinyachenko, O V

    2016-02-01

    Abstract The factors, determining possibility of early postoperative morbidity occurrence in patients, suffering gastro-esophageal zone cancer, were analyzed. After radical operation performance (gastrectomy, gastric and esophageal resection) 5.7% patients died. Insufficience of the anastomosis sutures with peritonitis occurrence, an acute hepato-renal insufficience, an acute coronary syndrome, pulmonary thromboembolism, pneumonia, the brain insult, pancreonecrosis and mesenterial thrombosis constituted the main morbidities. The complications occurrence depends upon the tumoral process course severity, morphological variant of cancer, presence of concomitant diaphragmatic hernia and the blood rheological properties. Initially high indices of the blood sera present a rheological properties of blood serum may serve as a prognostic criterion of the postoperative complications occurrence in the patients.

  9. A clinical study of kuru patients with long incubation periods at the end of the epidemic in Papua New Guinea

    PubMed Central

    Collinge, John; Whitfield, Jerome; McKintosh, Edward; Frosh, Adam; Mead, Simon; Hill, Andrew F.; Brandner, Sebastian; Thomas, Dafydd; Alpers, Michael P.

    2008-01-01

    Kuru is so far the principal human epidemic prion disease. While its incidence has steadily declined since the cessation of its route of transmission, endocannibalism, in Papua New Guinea in the 1950s, the arrival of variant Creutzfeldt–Jakob disease (vCJD), also thought to be transmitted by dietary prion exposure, has given kuru a new global relevance. We investigated all suspected cases of kuru from July 1996 to June 2004 and identified 11 kuru patients. There were four females and seven males, with an age range of 46–63 years at the onset of disease, in marked contrast to the age and sex distribution when kuru was first investigated 50 years ago. We obtained detailed histories of residence and exposure to mortuary feasts and performed serial neurological examination and genetic studies where possible. All patients were born a significant period before the mortuary practice of transumption ceased and their estimated incubation periods in some cases exceeded 50 years. The principal clinical features of kuru in the studied patients showed the same progressive cerebellar syndrome that had been previously described. Two patients showed marked cognitive impairment well before preterminal stages, in contrast to earlier clinical descriptions. In these patients, the mean clinical duration of 17 months was longer than the overall average in kuru but similar to that previously reported for the same age group, and this may relate to the effects of both patient age and PRNP codon 129 genotype. Importantly, no evidence for lymphoreticular colonization with prions, seen uniformly in vCJD, was observed in a patient with kuru at tonsil biopsy. PMID:18849289

  10. Conjunctival Splendore-Hoeppli phenomenon in a 3-year-old child.

    PubMed

    Orhan, Diclehan; Kiratli, Hayyam; Kocabeyoğlu, Sibel

    2006-01-01

    A case of benign granulomas of the conjunctiva in a 3-year-old girl is reported. Histologic features of the excised conjunctival lesions were consistent with Splendore-Hoeppli phenomenon. This phenomenon is thought to be a granulomatous reaction to an antigen-antibody precipitate related to parasites or fungi. No causative agent is identified in our patient. Immunohistochemical analysis showed no immunoreactivity for immunoglobulin G (IgG), IgM, IgA, or the C3 component of the complement. We propose that the presence of small amelanotic nodular conjunctival tumors should arouse suspicion related to the Splendore-Hoeppli phenomenon even in early childhood.

  11. Chronic paroxysmal hemicrania in a 3-year, 10-month-old female.

    PubMed

    Talvik, Inga; Koch, Kadri; Kolk, Anneli; Talvik, Tiina

    2006-03-01

    This is the report of a 3-year, 10-month-old female with classical symptoms of chronic paroxysmal hemicrania and favorable response to indomethacin therapy. The patient was admitted because of frequent episodes of severe unilateral headaches during the day and nighttime as well as agitation. During the episodes, she complained of severe pains on the left orbital and supraorbital region. Subsequent lacrimation from the left eye was also documented. Initially, focal epileptic attack was diagnosed and during the following 10 months several antiepileptic drugs were used without effect. After 10 months, chronic paroxysmal hemicrania was diagnosed because of the typical symptoms along with a favorable response to indomethacin therapy.

  12. [Methods of the use of ketorolac tromethamine in patients during the early postoperative period].

    PubMed

    Lebedeva, R N; Maiachkin, R B; Nikoda, V V; Rusina, O V; Broun, N K; Molochnikov, I O

    1997-01-01

    Analgesia with nonsteroid antiinflammatory drugs (NSAID) becomes a pressing problem today. One such drug is ketorolak tromethamine (KT), characterized by expressed analgesic activity comparable with that of opioid analgesics morphine or promedol. Our purpose was to assess KT efficacy in analgesia performed by different methods, including analgesia controlled by the patient (ACP) after surgery. In medium severe and strong pain KT was used in group I (n = 60) "as needed" in a dose of 30 mg up to 3-4 times a day, in group 2 (n = 12) by the ACP method, in group 3 (n = 16) KT was incessantly infused in a daily dose of up to 120 mg, and in group 4 (n = 11) KT was injected 3-4 times a day in a dose of 30 mg in combination with morphine ACP. The results indicate a high efficacy of KT: 83% after a single injection. Combined use of KT and promedol decreased the dose by 40-50%. Side effects were observed in 15% of patients: most often it was a sense of fever and sweating (in 4% of patients), nausea and vomiting (in 2%), insomnia (in 2%). ACP and planned injections in a daily dose of 90-120 mg is the optimal method of analgesia in patients after extensive surgical interventions.

  13. Working Memory and Response Inhibition in Patients With Bipolar I Disorder During Euthymic Period

    PubMed Central

    Farahmand, Zahra; Tehrani-Doost, Mehdi; Amini, Homayoun; Mohammadi, Abolfazl; Mirzaei, Mosleh; Mohamadzadeh, Azar

    2015-01-01

    Background: Several cognitive domains, including attention, memory, and executive functions are impaired in bipolar disorder. Objectives: This study aimed to investigate two executive functions (working memory and response inhibition) in patients with bipolar I disorder during remission of the symptoms. Patients and Methods: In this case-control design, 30 bipolar I patients (18 to 45 years old) were matched with 30 ones in the control group in terms of age, gender, and education. The patients were selected from Roozbeh Psychiatric Hospital (a hospital affiliated to Tehran University of Medical Sciences) from May to October 2013. They were evaluated and contrasted using working memory (Spatial Span and Spatial Working Memory (SSP and SWM)) and response inhibition (Stop Signal Task (SST)) tests. Results: We used independent t-tests for comparing and contrasting 2 groups on total and sub-scales scores of these 3 tests. In terms of SWM test there was a significant difference in between-group error between the two groups (P = 0.05); there was also a meaningful difference between the strategies used by two groups (P = 0.05). In SSP test, a significant difference appeared between averages of span length of the two groups. In the first and last item delays, there was also a clear difference, but the total error index was not noticeably different. In SST test, the direction error indicator in start-stop trials indicated a major difference, while in successful stops ratio, the case group had a lower ratio. In addition, reaction time to stop signs in bipolar group was meaningfully lower than the control group. Conclusion: In conclusion, even during remission phase, executive dysfunction is detectable at least in some areas in patients with bipolar disorder. PMID:26251656

  14. Choice of fluid therapy in patients of craniopharyngioma in the perioperative period: A hospital-based preliminary study

    PubMed Central

    Mukherjee, K. K.; Dutta, Pinaki; Singh, Apinderpreet; Gupta, Prakamya; Srinivasan, Anand; Bhagat, Hemant; Mathuriya, S. N.; Shah, Viral N.; Bhansali, Anil

    2014-01-01

    Background: Electrolyte imbalance and acute diabetes insipidus (DI) are the most common complications in patients undergoing craniopharyngioma surgery. Improper management of water and electrolyte imbalance is common cause of morbidity and mortality. Data is sparse and controversial regarding the choice of fluid therapy in this population during perioperative period. Methods: In this retrospective-prospective study involving 73 patients (58 retrospective), the type of fluid therapy was correlated with occurrence of hypernatremia, hyponatremia, DI, morbidity, and mortality. In the retrospective study, 48 patients received normal saline and 10 received mixed fluids as per the prevailing practice. In the prospective group, five patients each received normal saline, half normal saline, and 5% dextrose randomly. Results: The sodium values were significantly higher in first 48 h in the group that received normal saline compared with other groups (P < 0.001). The use of normal saline was associated with higher incidence of hypernatremia, DI, and mortality (P = 0.05), while the group that received 5% dextrose was associated with hyponatremia, hypoglycemia, and seizures. There was no perioperative hypotension with use of any of the fluids. Conclusion: Our results indicate half normal saline was fluid of choice with diminished incidence of water and electrolyte abnormalities without increase in mortality during postoperative period. PMID:25101200

  15. [Clinical-electrophysiological characteristics of the cognitive sphere in patients in the acute period of the first cerebral ischemic stroke].

    PubMed

    Kispaeva, T T; Kichuk, I V; Shetova, I M; Memetova, D Sh; Gudkova, V V; Ivanova, G E; Skvortsova, V I

    2011-01-01

    A neuropsychological and neurophysiological study using computed EEG was carried out in 31 stroke patients who did not have a cognitive impairment according to MMSE. Thirty age-matched patients with the same risk factors without a history of stroke were included into the control group. The examination of the control group was performed only once. The examination of stroke patients was performed on days 1, 7 and 21. It was shown that cognitive neurodynamic disturbances (memory disorders and the visual memory decrease) and bioelectrical brain activity disturbances (the decrease in a- and beta band activities and the increase of theta-band power) occurred from the first day and lasted during the acute stroke period even after the improvement of neurological status.

  16. The effect of inhalation aromatherapy on anxiety level of the patients in preoperative period

    PubMed Central

    Fayazi, Sadigheh; Babashahi, Monireh; Rezaei, Mehdi

    2011-01-01

    BACKGROUND: Anxiety is the one of the most common problems before the surgery. Its prevalence rate ranged from 11 to 80 percent in all the adult patients. Delay in wound healing and increasing use of narcotics and anesthetics are some of the other accompanying problems. Aromatherapy is one of the complementary medicine components. It is applied by special type of oil extracted from aromatic plants for medical objectives. This study aimed to investigate the effects of inhalation aromatherapy on anxiety level in preoperative patients. METHODS: This was a clinical study done on 72 patients candidate for heart and abdominal surgery admitted in Golestan and Imam Khomeini hospitals. The patients were selected according to our study objectives and inclusion criteria. Then, they were divided in two case and control groups. The Spielberger scale was used for evaluating the anxiety level. Twenty minute of inhalation with handkerchief containing lavandula was used in the case group and placebo also (water) in the control group. RESULTS: The average of anxiety level in inhalation aromatherapy group decreased from 51.00 to 38.61 from before to after the intervention. This average in the inhalation group with placebo was 50.67 before the intervention and decreased to 49.53 after the intervention. The results of independent t-test statistically showed a significant difference between the two groups after the intervention. CONCLUSIONS: The findings showed that inhalation aromatherapy was effective on reduction of anxiety level and this method can be applied as a complementary medicine on the clinic. PMID:23449862

  17. Lobotomy at a state mental hospital in Sweden. A survey of patients operated on during the period 1947-1958.

    PubMed

    Ogren, Kenneth; Sandlund, Mikael

    2007-01-01

    This retrospective survey aims at describing patients subjected to prefrontal lobotomies and the general treatment conditions at Umedalen State Mental Hospital during the period 1947-1958. Data collected from psychiatric and surgical medical records was analysed using quantitative and qualitative content analysis. A total of 771 patients subjected to lobotomy during the years 1947-1958 were identified. From these, a sample of 105 patients was selected for the purpose of obtaining detailed data on socio-economic status, diagnosis, symptomatology, other psychiatric treatments applied before the pre-frontal lobotomy operation, time spent in hospital before operation, praxis of consent and mortality. The diagnosis of schizophrenia was found in 84% of the 771 lobotomized patients. The post-operative mortality was 7.4% (57 deaths), with the highest rate in 1949 (17%). The mean age of the patient at the time of operation was 44.8 years for females and 39.5 years for male patients. The average length of pre-operative time in hospital for females was 10.7 years and for males 3.5 years. It remains unclear why this mental hospital conducted the lobotomy operation to such a comparatively great extent. Factors such as overcrowding of wards and its status as a modern mental hospital may have contributed.

  18. Level of anxiety versus self-care in the preoperative and postoperative periods of total laryngectomy patients 1

    PubMed Central

    Almonacid, Clara Inés Flórez; Ramos, Alfredo Jurado; Rodríguez-Borrego, María-Aurora

    2016-01-01

    Abstract Objective: estimate the prevalence of anxiety in laryngectomy patients in the pre and postoperative periods and its relation with the self-care level. Method: observational research of 40 patients with stage IV laryngeal cancer. Three observations took place: in the preoperative phase, at seven and at 14 days after the surgery; between June 2010 and December 2012. Two self-care levels were defined: self-sufficient and needing help for activities of daily living and treatment-related activities. To assess the anxiety levels, Zigmond's hospital anxiety scale (1983) was used. Results: in the preoperative and postoperative phases, the patients presented high levels of anxiety. Concerning self-care, on average, self-sufficient patients presented lower levels of anxiety than patients who needed help to accomplish activities of daily living and activities deriving from the surgery, without significant differences. Conclusion: anxiety is present at all times in laryngectomy patients and the reduction of the self-care deficit seems to decrease it, without putting a permanent end to it. PMID:27305181

  19. Deep Space 1 Ion Engine Completed a 3-Year Journey

    NASA Technical Reports Server (NTRS)

    Sovey, James S.; Patterson, Michael J.; Rawlin, Vincent K.; Hamley, John A.

    2001-01-01

    A xenon ion engine and power processor system, which was developed by the NASA Glenn Research Center in partnership with the Jet Propulsion Laboratory and Boeing Electron Dynamic Devices, completed nearly 3 years of operation aboard the Deep Space 1 spacecraft. The 2.3-kW ion engine, which provided primary propulsion and two-axis attitude control, thrusted for more than 16,000 hr and consumed more than 70 kg of xenon propellant. The Deep Space 1 spacecraft was launched on October 24, 1998, to validate 12 futuristic technologies, including the ion-propulsion system. After the technology validation process was successfully completed, the Deep Space 1 spacecraft flew by the small asteroid Braille on July 29, 1999. The final objective of this mission was to encounter the active comet Borrelly, which is about 6 miles long. The ion engine was on a thrusting schedule to navigate the Deep Space 1 spacecraft to within 1400 miles of the comet. Since the hydrazine used for spacecraft attitude control was in short supply, the ion engine also provided two-axis attitude control to conserve the hydrazine supply for the Borrelly encounter. The comet encounter took place on September 22, 2001. Dr. Marc Rayman, project manager of Deep Space 1 at the Jet Propulsion Laboratory said, "Deep Space 1 plunged into the heart of the comet Borrelly and has lived to tell every detail of its spinetingling adventure! The images are even better than the impressive images of comet Halley taken by Europe's Giotto spacecraft in 1986." The Deep Space 1 mission, which successfully tested the 12 high-risk, advanced technologies and captured the best images ever taken of a comet, was voluntarily terminated on December 18, 2001. The successful demonstration of the 2-kW-class ion propulsion system technology is now providing mission planners with off-the-shelf flight hardware. Higher power, next generation ion propulsion systems are being developed for large flagship missions, such as outer planet

  20. Clinical outcomes of guided tissue regeneration with Atrisorb membrane in the treatment of intrabony defects: a 3-year follow-up study.

    PubMed

    Sakallioglu, Umur; Yavuz, Umit; Lütfioglu, Müge; Keskiner, Ilker; Açikgöz, Gökhan

    2007-02-01

    In this controlled clinical trial, initial and long-term treatment outcomes of guided tissue regeneration (GTR) were investigated for a synthetic absorbable membrane (Atrisorb) in intrabony defects. Eighteen defects in 16 patients received GTR with Atrisorb (test), with the membrane applied by an indirect method, and 15 defects in 15 patients were treated with open flap debridement (control). Probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), and linear alveolar bone level (ABL) were recorded at baseline and at 1 and 3 years following the treatment procedures and were assessed as the therapeutic outcome parameters. Both groups demonstrated significant PPD reduction and CAL and ABL gain after 1 year. Among these parameters, alterations in PPD and CAL were statistically significantly greater in the test group than the control group 1 year postsurgery. No significant changes were noted in the parameters of the first year between and within the study groups after 3 years. The results suggest that GTR performed with Atrisorb membrane via an indirect application method may provide favorable clinical outcomes for intrabony defects, and these outcomes may be maintained at least as well as open flap debridement over an extended period.

  1. Frequency of thyroid cancer in patients operated at Cantonal Hospital Zenica, Bosnia and Herzegovina, in the period 2007-2014.

    PubMed

    Hrnčić, Nermin; Goga, Amna; Hrnčić, Selma; Filipovska-Mušanović, Marijana; Hatibović, Haris; Hodžić, Ðenad

    2016-08-01

    Aim To determine frequency and type of thyroid cancer (TC) as well as gender and age distribution of patients operated at the Department of Ear, Nose and Throat (ENT), Cantonal Hospital Zenica, Bosnia and Herzegovina. Methods A retrospective analysis of data obtained from an operating protocol and disease history of patients operated in the eightyear period (2007- 2014) was made according to the frequency and type of thyroid cancer, as well as age and gender of the patients. χ2 test was used for statistical with p<0.05. Results A total of 818 surgeries of the thyroid gland were conducted, in 714 (87.29%) female and 104 (12.71%) male patients. Malignancies were diagnosed in 74 (9.05%) patients, of whom 64 (86.49%) were females and 10 (13.51%) were males, resulting in the gender prevalence of 8.96% and 9.62%, respectively. The most often presented type was papillary carcinoma, in 48(out of 74, 64.86%) patients, followed by follicular carcinoma in 10 (13.51%), medullary carcinoma in four (5.41%), Hurthle cell carcinoma in four (5.41%) patients, while anaplastic carcinoma was found in one (1.35%) patient. The number of diagnosed malignancy varied from 0% (in 2007) to 13.91% (in 2014) (p=0.05). Conclusion The prevalence of thyroid cancer is low, but has an increasing trend. A large number of unnecessary surgeries on thyroid gland was performed. Preoperative diagnostic procedures for diseases of the thyroid gland in Cantonal Hospital Zenica should be improved in order to avoid unessential surgeries.

  2. PRIS may be diagnosed before ICU period for patients undergoing cardiopulmonary bypass.

    PubMed

    Şahin, Türker

    2016-05-01

    There are many published articles on the clinical manifestations of propofol-related infusion syndrome (PRIS), but they are not the same in each case.(1)Moreover, PRIS is only encountered infrequently and, therefore, it may create a diagnostic challenge. Nearly all of the published articles on PRIS are related to the use of long-term (> 48 hour) propofol infusion with a dose range of at least 4-5 mg/kg/h. In this case, not only a short duration, but also a low-dose propofol administration seems to induce PRIS. A 73-year-old male patient under cardiopulmonary bypass (CPB) suffered from some clinical symptoms of PRIS, such as hyperlactatemia and persistent low metabolic acidosis which promptly resolved on the discontinuation of propofol. Therefore, we suggest that any propofol administration (bolus or infusion) may result in such clinical symptoms, which may be the earliest indicators of PRIS. When those symptoms are observed on propofol administration during cardiopulmonary bypass (CPB), the perfusionist must alert both the anaesthesiologist and the surgeon to stop the propofol in order to prevent the patient from further adverse effects of PRIS.

  3. Nationwide peritoneal dialysis nurse training in Thailand: 3-year experience.

    PubMed

    Thaiyuenwong, Jutiporn; Mahatanan, Nanta; Jiravaranun, Somsong; Boonyakarn, Achara; Rodpai, Somrak; Eiam-Ong, Somchai; Tungsanga, Kriang; Dhanakijcharoen, Prateep; Kanjanabuch, Talerngsak

    2011-09-01

    Peritoneal dialysis (PD) center is not possible to operate if there is no availability of dedicated PD nurse. Generally, the nurse has to play many roles, including educator coordinator, and sometimes leader. As professionalism, the PD nurses need to have both theoretical and practical skills. With the tremendous leap of PD population after the launch of "PD First" policy in Thailand, the shortage of skillful PD nurse is concerned. Hence, the nationwide PD nurse training course was established with the collaborations of many organizations and institutes. Until now, 3 generations of 225 PD nurses are the productions of the course. This number represents 80 percent of PD nurses distributed throughout the whole nation. The survey operated in the year 2010 demonstrated that the output of the course was acceptable in terms of quality since most of the trained PD nurses had a confidence in taking care of PD patients. The quality of patient care is good as indicated by KPIs.

  4. [An approach to the patients with cryopyrin-associated periodic syndrome (CAPS) : a new biologic response modifier, canakinumab].

    PubMed

    Yokota, Shumpei; Kikuchi, Masako; Nozawa, Tomo; Kizawa, Toshiatsu; Kanetaka, Taichi; Miyamae, Takako; Mori, Masa-aki; Nishikomori, Ryohta; Takata, Hidetoshi; Heike, Toshio; Hara, Toshiro; Imagawa, Tomoyuki

    2012-01-01

    Cryopyrin-associated periodic syndrome (CAPS) comprises a group of rare, but severe, autoinflammatory syndrome, and includes 3 distinct conditions, familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (MONID). These syndromes are characterized by urticarial-like rash, periodic fever, central nervous system inflammation, an arthropathy, and the risk of amyloidosis. About 20% die by age 20 years in the most severe cases. The disease is associated with mutations in the NLRP3 gene that encodes for the protein cryopyrin, a component of the inflammasome complex that regulates the production and secretion of IL-1β. Canakinumab is a human IgG monoclonal antibody targeting IL-1β. The clinical trials of canakinumab for patients with CAPS in both western countries and Japan were well-tolerated in most patients, and provided significant advantages over existing competitive therapies. Although no serious adverse effects have been reported, the frequencies of common infectious diseases including nasopharyngitis, upper respiratory tract infections, and gastroenteritis were reported presumably due to the blockade of proinflammatory cytokine, IL-1β. For us pediatrician, it will be important to be more careful for infectious diseases to provide the maximum safety of canakinumab for these patients.

  5. [Retention period for patient data: the health council of the Netherlands pleads for a change in the law].

    PubMed

    Dondorp, W J; Legemaate, J; van de Klippe, C J

    2004-04-10

    According to the Dutch Medical Treatment Act (WGBO), patient data must be retained for at least 10 years or as much longer as required for the provision of good medical care. In practice, patient data are often destroyed after 10 years. This may lead to problems, for example if a treatment turns out to have long-term consequences. A committee of the Health Council of the Netherlands has now recommended a change in the law. They propose a longer retention period for the care of the patient, a statutory regulation governing retention for research purposes and supplementary provisions that make it possible to retain hereditary data in the interest of relatives. Until the necessary changes in the law have been made, further destruction of medical data must be prevented. This can be accomplished by revising the existing transition provision in the WGBO, while extending it by 5 years. The scientific societies can use this time to develop guidelines for the longer storage of data in specific areas of care and for the periodic cleaning up of the files.

  6. A novel TNFRSF1A gene mutation in a patient with tumor necrosis factor receptor-associated periodic syndrome.

    PubMed

    Khabazi, Alireza; Maralani, Mahafarin; Andalib, Sasan; Sakhinia, Ebrahim

    2016-10-19

    Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is a periodic fever syndrome inherited in an autosomal dominant fashion. It stems from mutations in the TNFRSF1A (accession number: NM_001065) gene expressing the receptor for tumor necrosis factor α. A patient with TRAPS may present with prolonged episodes of fever attacks, abdominal pain, severe myalgia, and painful erythema on the trunk or extremities. Here, we report an 8-year-old boy with febrile attacks occurring every 1-2months and continuing for 3-4days. The patient experienced 40°C-fever attacks without chills. Approximately 80% of fever attacks were accompanied by abdominal manifestations. Direct sequencing analysis was used to assess the genomic DNA of the patient, and a heterozygous R426L mutation in exon 10 of the TNFRSF1A gene in an autosomal dominant inheritance fashion was identified. Further genetic analyses were also carried out on his parents. Due to the fact that the mutation was not inherited from the parents, it was likely that R426L was a de novo and novel mutation in the TNFRSF1A gene, which can trigger TRAPS or TRAPS-like symptoms.

  7. Qualitative Approach and Treatment of Patients with Prostate Cancer in Cantonal Hospital Bihac During Two Years Period

    PubMed Central

    Kardasevic, Amel; Delic-Redzepagic, Ervin

    2014-01-01

    Introduction: Prostate cancer is an important cause of morbidity and mortality in human pathology. In recent years there has been an increase in the number of new cases. Material and methods: In this article, we want to show the number of patients diagnosed and treated due to prostate cancer in the Cantonal Hospital Bihac, Bosnia and Herzegovina, over a two year period. After examining the medical records, we selected 70 patients diagnosed with prostate cancer. Average age was 70.9 years (51-91 years). The total PSA ranged from 1.6 to 3332 ng/ml. For each patient is determined the PSA ratio f/t PSA, with an average value of 0.13 (0.02 to 0.627). Results: From the data analysis, we concluded that nearly half of the patients (30 patients), came to the urology clinic with advanced disease. The stage of the disease is well correlated with PSA value. Conclusion: The PSA can be considered as a reliable marker in the diagnosis and treatment of prostate cancer. Regardless of the current controversy on the issue of screening on prostate cancer using the PSA analysis, we believe that the use of this simple test in selected populations is justified for the purpose of early disease detection. PMID:24757406

  8. [Primary pulmonary artery sarcoma in 36-year-old women: 3-years follow-up after partial resection and radiotherapy].

    PubMed

    Drożdż, Jarosław; Warchoł, Ewa; Fijuth, Jacek; Filipiak, Krzysztof; Spych, Michał; Maciejewski, Marek; Piestrzeniewicz, Katarzyna; Ludomir, Stafańczyk; Janaszek-Sitkowska, Hanna; Januszewicz, Andrzej; Zembala, Marian

    2013-01-01

    Intimal sarcoma of the heart and pulmonary artery is a very rare, malignant, primary tumour. The prognosis in patients with primary sarcoma of the pulmonary artery, including intimal sarcoma, is poor. We present the case and 3-years follow-up of 36-year-old woman who was successfully treated with surgical, partial resection of the tumour followed by radiotherapy.

  9. Experience and outcome of 3 years of a European EQA scheme for genetic testing of the spinocerebellar ataxias.

    PubMed

    Seneca, Sara; Morris, Michael A; Patton, Simon; Elles, Rob; Sequeiros, Jorge

    2008-08-01

    The European Molecular Genetics Quality Network (EMQN) has been organizing an external quality assessment (EQA) scheme for molecular genetic testing of trinucleotide repeat mutations in the spinocerebellar ataxias (SCAs) since 2004. DNA samples were validated by at least two independent labs and two different methods. Together with mock clinical case descriptions and requests for specific SCA gene analyses, these were sent to registered participants each year. Laboratories were asked to use their routine procedures and protocols. A panel of assessors reviewed the final returns, including genotype results and reports, to assess the quality of (1) genotyping and (2) interpretation and reporting. A description of methods and raw data were also requested and were very useful for the final analysis. Altogether, during 3 years, 239 reports were received from the laboratories. Overall genotype error rate ranged 1.1-5.2%, a significant cause of concern. Scores for interpretation and reporting also showed that there is still much room for progress, although performance has improved over this period of assessment. The consequences of suboptimal laboratory practices, genotyping errors and misdiagnosis and of incorrect or incomplete interpretation and reporting have wide implications for patient lives, as well as for health management and counselling of relatives. EQA schemes are an important part of quality assurance in molecular genetic laboratories, and their use should become a routine part of laboratory diagnostic practice. Current evidence shows also that it is important that laboratories participate on a yearly basis and that this becomes mandatory for reference laboratories.

  10. [Pain scale: implementation for patients in the immediate postoperative period of cardiac surgery].

    PubMed

    Keller, Clarissa; Paixão, Adriana; Moraes, Maria Antonieta; Rabelo, Eneida Rejane; Goldmeier, Silvia

    2013-06-01

    A clinical intervention study was developed in a hospital specialized in cardiology in Porto Alegre, RS, Brazil, with the objective of evaluating the implementation of the pain scale in post-operative cardiac surgery patients. It was developed in four steps: pre-test on pain, training lecture for nursing staff, and, reapplication of the pre-test at 30 and 60 days. The test consisted of ten questions weighing one point each. Scores > or =7 were determined to represent satisfactory knowledge in using the pain scale. The sample consisted of 57 nursing professionals. The scores ranged from 6.12 +/- 1.65 in the pre-test to 7.73 +/- 1.05 and 8.18 +/- 0.99 after 30 and 60 days, respectively (p<0.005). Pain intensity was correlated to medication standardized by protocol. The training improved the knowledge of the team and the type of analgesia administered in relation to pain intensity.

  11. Evolution of multiple cell clones over a 29-year period of a CLL patient

    PubMed Central

    Zhao, Zhikun; Goldin, Lynn; Liu, Shiping; Wu, Liang; Zhou, Weiyin; Lou, Hong; Yu, Qichao; Tsang, Shirley X.; Jiang, Miaomiao; Li, Fuqiang; McMaster, MaryLou; Li, Yang; Lin, Xinxin; Wang, Zhifeng; Xu, Liqin; Marti, Gerald; Li, Guibo; Wu, Kui; Yeager, Meredith; Yang, Huanming; Xu, Xun; Chanock, Stephen J.; Li, Bo; Hou, Yong; Caporaso, Neil; Dean, Michael

    2016-01-01

    Chronic lymphocytic leukaemia (CLL) is a frequent B-cell malignancy, characterized by recurrent somatic chromosome alterations and a low level of point mutations. Here we present single-nucleotide polymorphism microarray analyses of a single CLL patient over 29 years of observation and treatment, and transcriptome and whole-genome sequencing at selected time points. We identify chromosome alterations 13q14−, 6q− and 12q+ in early cell clones, elimination of clonal populations following therapy, and subsequent appearance of a clone containing trisomy 12 and chromosome 10 copy-neutral loss of heterogeneity that marks a major population dominant at death. Serial single-cell RNA sequencing reveals an expression pattern with high FOS, JUN and KLF4 at disease acceleration, which resolves following therapy, but reoccurs following relapse and death. Transcriptome evolution indicates complex changes in expression occur over time. In conclusion, CLL can evolve gradually during indolent phases, and undergo rapid changes following therapy. PMID:27982015

  12. State estimation and optimal long period clinical treatment of HIV seropositive patients.

    PubMed

    Grégio, Juliana M; Caetano, Marco A L; Yoneyama, Takashi

    2009-03-01

    Optimal control theory provides a very interesting quantitative method that can be used to assist the decision making process in several areas of application, such as engineering, biology, economics and sociology. The main idea is to determine the values of the manipulated variables, such as drug doses, so that some cost function is minimized, subject to physical constraints. In this work, the cost function reflects the number of CD4+T cells, viral particles and the drug doses. It is worth noticing that high drug doses are related to more intense side-effects, apart from the impact on the actual cost of the treatment. In a previous paper by the authors, the LQR - Linear Quadratic Regulator approach was proposed for the computation of long period maintenance doses for the drugs, which turns out to be of state feedback form. However, it is not practical to determine all the components of the state vector, due to the fact that infected and uninfected CD4+T cells are not microscopically distinguishable. In order to overcome this difficulty, this work proposes the use of Extended Kalman Filter to estimate the state, even though, because of the nonlinear nature of the involved state equations, the separation principle may not be valid. Extensive simulations were then carried out to investigate numerically if the control strategy consisting of the feedback of estimated states yielded satisfactory clinical results.

  13. Lower Limb Loading during Gait in Patients Long Period after Total Hip Arthroplasty Revision

    PubMed Central

    Kubonova, Eliska; Janura, Miroslav; Duskova, Sarka

    2016-01-01

    The aim of the study was to assess lower limb loading during walking after unilateral total hip arthroplasty (THA) revision. Twenty-three THA revision subjects (12 men, 11 women) were divided into three groups according to time since surgery as 1 to 6 years, 6 to 11 years, and over 11 years. Two force plates were used to measure the ground reaction force during the stance phase. On the operated limb, compared to nonoperated limb, we found lower first vertical peak in the group of 1 to 6 years after revision and lower propulsion peak in the group of 6 to 11 years since revision. In the group of 11 years since THA revision, no significant difference was found. With advancing years after surgery, the stance phase duration got reduced and propulsion peak increased in the operated limb; minimal vertical force decreased and the time of minimal vertical force increased in the nonoperated limb. The study findings suggest the tendency to a more gradual and safer weight acceptance on the operated limb during the first years after THA revision, followed by limitation of foot propulsion. Despite this fact, lower limb loading can be considered as symmetrical across the whole measured period. PMID:27579321

  14. [The complex approach to the rehabilitation of post-stroke patients with movement disorders in the early rehabilitation period].

    PubMed

    Khabirov, F A; Khaĭbullin, T I; Grigor'eva, O V

    2011-01-01

    We studied 110 patients, aged 34-71 years, in the early rehabilitation period after stroke who were admitted to a rehabilitation neurologic department of Kazan. The rehabilitation approach was based on the combination of several methods: kinesitherapy, transcranial magnetic stimulation and cerebrolysin treatment. This complex reanimation allowed to achieve the marked functional restoration of movement abilities in many cases that was correlated with the normalization of brain bioelectric activity (the increase of alpha-rhythm spectral power, the decrease of slow-wave EEG components). The combined use of these three methods was more effective than a combination of any two of them.

  15. [Sodium cromoglycate in the treatment of food hypersensitivity in children under 3 years of age].

    PubMed

    Zur, E; Kaczmarski, M

    2001-09-01

    Dietary elimination is a treatment of first choice in food hypersensitivity. Such therapy is not always enough to stop the disease and introduction of pharmacological treatment is necessary. In prevention and long term treatment antiallergic drugs are recommended. The aim of the study was to assess efficacy and safety of oral sodium cromoglycate in treatment of food hypersensitivity in the youngest children. In our study we examined: the group of 25 children aged 6 months-3 years treated with oral cromolyn sodium during the period 4-20 weeks and 29 children aged 6 months-3 years treated with ketotifen. Symptoms from skin, digestive and respiratory tract, behaviour status were evaluated for drugs efficacy. Cromolyn and ketotifen effected a significant decrease in total symptoms score. The treatment was well tolerated. No serious side effects were noted. The incidents of skin rash, disquiet during the night, diarrhoea and urticaria were only 8 percent. Sodium cromoglycate is safe and effective drug in treatment of food allergy in children; specially in symptoms from gastrointestinal tract and multi-organs allergy.

  16. [Notification of incidents related to patient safety in hospitals in Catalonia, Spain during the period 2010-2013].

    PubMed

    Oliva, Glòria; Alava, Fernando; Navarro, Laura; Esquerra, Miquel; Lushchenkova, Oksana; Davins, Josep; Vallès, Roser

    2014-07-01

    The aim of this paper is to discover the aggregated results of a general notification system for incidents related to patient safety implemented in Catalan hospitals from 2010 to 2013. Observational study describing the incidents notified from January 2010 to December 2013 from all hospitals in Catalonia forming part of the project to create operational patient safety management units. The Patient Safety Notification and Learning System (SiNASP) was used. This makes it possible to classify incidents depending on the area where they occur, the type of incident notified, the consequences, the seriousness according to the Severity Assessment Code (SAC) and the profession of the notifying party, as the principal variables. The system was accessed via the Internet (SiNASP portal). Access was voluntary and anonymous or with a name given and later removed. During the study period, notification of a total of 5,948 incidents came from 22-29 hospitals. 5,244 of the incidents were handled by the centres and these are the ones analysed in the study. 64% (3,380) affected patients, 18% (950) created a situation capable of causing an incident and 18% (914) did not affect patients. 26% of incidents that affected patients (864) caused some kind of harm. Most incidents occurred during hospitalisation (54%) and in casualty (15%), followed by the ICU (9%) and the surgical block (8%). The most frequent notifying parties were nurses (71%) followed by doctors (15%) and pharmacists (9%). In terms of severity, most incidents were classified as low-risk (37%) or incidents that did not affect the patient (36%). However, 40 cases (0.76%) of extreme risk should be highlighted. In terms of the types of incident notified, most were due to a medication error (26.8%), followed by falls (16.3%) and patient identification (10.6%). The majority of notifications were incidents that affected patients and, of these, 26% caused harm. In general, they occurred in hospitalisation units and notification was

  17. Clinical outcome following DIAM implantation for symptomatic lumbar internal disk disruption: a 3-year retrospective analysis

    PubMed Central

    Lu, Kang; Liliang, Po-Chou; Wang, Hao-Kuang; Chen, Jui-Sheng; Chen, Te-Yuan; Huang, Ruyi; Chen, Han-Jung

    2016-01-01

    Background/objective Internal disk disruption (IDD), an early event of lumbar disk degeneration, is the most common cause of low back pain. Since increased intradiskal pressure (IDP) is associated with symptoms and progression of disk degeneration, unloading a painful disk with an interspinous process device (IPD) is a rational treatment option. The goal of this study was to evaluate the effectiveness of dynamic stabilization with an IPD in the treatment of symptomatic IDD of the lumbar spine. Patients and methods Patients with symptomatic IDD were treated with implantation of an IPD, the device for intervertebral assisted motion (DIAM). Diagnosis of IDD was based on typical MRI finding of posterior annular high-intensity zone and positive provocative test on discography. IDP was analyzed intraoperatively. Axial back and leg pain was evaluated with visual analog scale, functional status with Oswestry Disability Index, and final clinical outcomes with Odom criteria. Data from 34 patients followed up for at least 3 years were collected. Results DIAM implantation significantly reduced IDP (n=11, P<0.0001). All 34 patients reported symptom relief. Thirty-one patients (91%) remained symptom free until the last followups. Three patients (9%) experienced recurrence of pain, of which the causes were unrelated to the IDD or surgery. Disk status at the DIAM-implanted segments remained stable. Segmental flexion/extension mobility was preserved in 27 of 30 patients with preoperative mobility. No proximal or distal adjacent segment degeneration was observed. The final clinical outcomes were excellent/good in 31 and fair/poor in three patients. Conclusion For patients with symptomatic IDD, dynamic stabilization with DIAM provides pain relief and functional improvement. The implantation maintains disk status and prevents progression of disk degeneration, without compromising segmental flexion/extension mobility or causing adjacent segment degeneration. PMID:27826214

  18. Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study.

    PubMed

    Mayou, R A; Ehlers, A; Bryant, B

    2002-06-01

    The paper presents a 3-year follow-up of a prospective longitudinal study of posttraumatic stress disorder (PTSD) after motor vehicle accidents (J. Abnormal Psychol., 107 (1998) 508). Participants were 546 patients who had been assessed when attending an emergency clinic shortly after a motor vehicle accident, and at 3 months and 1 year afterwards. The prevalence of posttraumatic stress disorder PTSD at 3 years was 11%. Maintaining psychological factors, i.e. negative interpretation of intrusions, rumination, thought suppression and anger cognitions, were important in predicting the persistence of PTSD at 3 years, as were persistent health and financial problems after the accident. Other predictors were female sex, hospital admission for injuries, perceived threat and dissociation during the accident, and litigation.

  19. The Bactec FX Blood Culture System Detects Brucella melitensis Bacteremia in Adult Patients within the Routine 1-Week Incubation Period.

    PubMed

    Sagi, Moshe; Nesher, Lior; Yagupsky, Pablo

    2017-03-01

    The performance of the Bactec FX blood culture system for detecting Brucella bacteremia within the routine 1-week incubation period was assessed in a prospective study conducted in an area in southern Israel in which Brucella melitensis is endemic. Aerobic vials (BD Bactec Plus Aerobic/F medium) inoculated with blood specimens obtained from adult patients with positive Rose-Bengal screening test results were monitored for 4 consecutive weeks, and blind subcultures of negative vials were performed on solid media on days 7 and 28. During a 16-month period, a total of 31 (35.2%) of 88 cultures, obtained from 19 (38.0%) of 50 patients, were positive for Brucella melitensis The blood culture instrument identified 30 (96.8%) of 31 positive vials within 7 days of incubation; the single positive vial that was missed by the automated readings was detected only by the blind subculture performed on day 28. It is concluded that the Bactec FX system is able to detect the vast majority of episodes of Brucella bacteremia within the 1-week incubation protocol instituted in most clinical microbiology laboratories and without the need to perform blind subcultures of negative vials, enabling early diagnosis and saving labor and incubation time and space.

  20. Women's Heart Advantage Program: the impact 3 years later.

    PubMed

    Gombeski, William R; Kramer, R Kyle; Freed, Lisa; Foody, JoAnne; Parkosewich, Janet; Wilson, Tammi; Wack, Jeffery T; D'Onofrio, Gail

    2005-01-01

    Yale-New Haven Hospital, in partnership with Voluntary Hospital Association (VHA Inc), launched the Women's Heart Advantage program in March 2001. Major program components implemented include (1) a comprehensive initial and ongoing internal communication program; (2) a health promotion initiative including a 24-hour, 7-days-a-week women's heart line staffed by nurses and an Internet health question-and-answer forum; (3) significant ongoing communication with nurses and physicians; (4) a community outreach effort to educate poor and minority women; and (5) an aggressive effort to secure financial partners to underwrite the cost of the program. Before launching the program, a telephone survey of 300 randomly selected New Haven County women ages 40 to 70 years was initiated in January 2001 and repeated in January 2002, 2003, and 2004. Findings include (1) the percentage of women who recognize heart disease as the number-one killer of women their age increased from 26% in 2001 to 59% in 2004, (2) the percentage of women who would call 9-1-1 or go directly to a hospital emergency department increased from 63% in 2002 to 83% in 2004, and (3) the percentage of women aware of recent Women's Heart Advantage program promotion grew from 33% in 2002 to 50% in 2004. Perhaps most importantly, the number of women with heart problems admitted through the hospital's emergency department increased from 1528 per year in 2001 to 1870 per year in 2004 (7.5% annual increase), whereas the number of men with heart problems admitted through the emergency department during the same time period has been relatively low (0.8% annual increase). By linking clinical, public health, and marketing expertise along with finding ways to partner with other organizations, the Women's Heart Advantage program has contributed to remarkable changes in women's awareness, knowledge, and behaviors, suggesting a model for approaching similar health-related problems.

  1. Urinary interleukin-6 as a predictor of radiographic progression in rheumatoid arthritis: A 3-year evaluation

    PubMed Central

    Park, Yune-Jung; Yoo, Seung-Ah; Kim, Ga-Ram; Cho, Chul-Soo; Kim, Wan-Uk

    2016-01-01

    Previously, we demonstrated that the urine proteome signature of patients with rheumatoid arthritis (RA) reflects inflammation-related cellular processes. Here, we measured interleukin (IL)-6, IL-8, and chemokine ligand 2 (CCL2) concentrations in the urine of RA patients and prospectively investigated their role in predicting RA activity and prognosis. One hundred seventy-three RA patients and 62 non-RA controls were recruited. Urinary IL-6, CCL2, and IL-8 levels were elevated in RA patients and correlated well with disease activity. Urinary IL-6 level at presentation was an independent risk factor of radiographic progression at 1 and 3 years. High urinary IL-6 level increased the risk ratio of radiographic progression by 2.9-fold, which was comparable to high serum CRP. Moreover, combination of urinary IL-6 and serum CRP measures synergistically increased the predictability of radiographic progression. In a subgroup with normal ESR, patients with the highest tertile of urinary IL-6 were at 6.4-fold greater risk of radiographic progression. Conclusively, high urinary IL-6 level at presentation is an independent risk factor for radiographic progression of RA, reflecting disease activity. Urinary IL-6 in combination with serum CRP may be a useful parameter for estimating RA prognosis. PMID:27731382

  2. Periodontal status and subgingival microbiota of insulin-dependent juvenile diabetics: a 3-year longitudinal study.

    PubMed

    Sbordone, L; Ramaglia, L; Barone, A; Ciaglia, R N; Iacono, V J

    1998-02-01

    This study examined for 3 years the changes in periodontal status and the possible correlations with selected subgingival microbiota and diabetic conditions in a group of 16 insulin-dependent diabetes mellitus (IDDM, JD) patients as compared with their 16 healthy cohabiting siblings (HS). JD patients were monitored every 3 months for levels of glycosylated hemoglobin (HbA1C). Clinical and microbiological parameters were measured 6 weeks before drawing blood to determine levels of HbA1C. Periodontal parameters were measured at baseline (TO), year 2 (T2), year 3 (T3) and included: probing depth (PD), attachment level (AL), sulcus bleeding index (SBI), and plaque index (PI). Two sites in each patient were selected for microbial samples: a mesio-facial aspect of the maxillary right first molar (defined as constant site, CS) and a site with the greatest probing depth (defined as deepest site, DS). Microbial samples were analyzed by culture techniques. No significant differences in clinical parameters were found between diabetics and healthy siblings at any examination. The SBI in the non-diabetic group at T2 and at T3 was significantly lower than at baseline. PD and AL of constant sites in the diabetic group at T3 were significantly higher than baseline. There was a significant increase in Prevotella intermedia at T3 as compared with baseline for deepest sites in the diabetic group. Cluster analysis revealed, in a former study, two clusters (IV and V) at baseline which were significantly different from the overall mean regarding composition of Porphyromonas gingivalis and Capnocytophaga spp. They were not significantly different for periodontal parameters from TO to T3. These data would suggest no significant differences in clinical parameters between the diabetics and non-diabetic siblings throughout this 3-year longitudinal study.

  3. Home parenteral nutrition--a 3-year analysis of clinical and laboratory monitoring.

    PubMed

    Burnes, J U; O'Keefe, S J; Fleming, C R; Devine, R M; Berkner, S; Herrick, L

    1992-01-01

    We report a 3-year analysis (1986 to 1989) of the management of 63 home parenteral nutrition patients, 40 with short-bowel syndrome and 23 with chronic intestinal obstruction with or without intestinal resection. Intravenous fluid requirements varied from 0.9 to 6 L/day, and the content of glucose varied between 46 and 531 g/day, protein varied from .0 to 85 g/day, fat from .0 to 100 g/day, sodium from 37 to 695 mEq/day, potassium from 30 to 220 mEq/day, chloride from 60 to 760 mEq/day, and acetate from 0 to 200 mEq/day. Body weight was normalized and well maintained in the majority of patients, but using the strict definition of deficiency as the presence of one abnormal value during 3 years, more than half had abnormal plasma chloride, glucose, alkaline phosphatase, serum glutamic oxaloacetic transaminase, total protein, albumin, selenium, and iron concentrations, and more than a third had low calcium, magnesium, vitamin D, and vitamin C levels. Normochromic anemia was seen in 73% and high blood creatinine associated with low urine volumes in 42%. Most (78%) returned to relatively normal lifestyles, but employability was occasionally impaired by loss of third-party insurance coverage resulting from a therapy that may cost $100,000 per year. Overall mortality was low (5% per year), but 73% needed readmission to hospital, mainly for suspected catheter sepsis. The results indicate that home parenteral nutrition has allowed many patients to survive gut failure and return to work but problems with chronic fluid, electrolyte and micronutrient deficiencies, catheter sepsis, and insurance coverage often restrict optimal rehabilitation.

  4. Cerebrospinal Fluid Biomarkers in the Diagnosis of Creutzfeldt-Jakob Disease in Slovak Patients: over 10-Year Period Review.

    PubMed

    Koscova, Silvia; Zakova Slivarichova, Dana; Tomeckova, Ivana; Melicherova, Katarina; Stelzer, Martin; Janakova, Alzbeta; Kosorinova, Dana; Belay, Girma; Mitrova, Eva

    2016-09-24

    Creutzfeldt-Jakob disease is a rare, but rapidly progressive, up to now untreatable and fatal neurodegenerative disorder. Clinical diagnosis of Creutzfeldt-Jakob disease (CJD) is difficult; however, it can be facilitated by suitable biomarkers. Aim of the present study is to compare levels of cerebrospinal fluid biomarkers (total tau protein, phosphorylated-tau protein, protein 14-3-3 and amyloid beta) in Slovak population of CJD suspect cases, retrospectively in over a 10-year period. One thousand three hundred sixty-four CSF samples from patients with suspect CJD, forming a homogenous group in terms of geographical as well as of equal transport conditions, storage and laboratory processing, were analysed. Definite diagnosis of Creutzfeldt-Jakob disease was confirmed in 101 patients with genetic form, and 60 patients with its sporadic form of the disease. Specificity of protein 14-3-3 and total tau in both forms CJD was similar (87 % for P14-3-3/85 % for total tau), sensitivity to P 14-3-3 and total tau was higher in sporadic Creutzfeldt-Jakob disease (sCJD) (90/95 %) than in genetic Creutzfeldt-Jakob disease (gCJD) (89/74 %). As expected, the total tau levels were significantly higher in CJD patients than in controls, but there was also significant difference between gCJD and sCJD (levels in gCJD were lower; p = 0.003). There was no significant difference in p-tau and Aβ 1-42 levels neither between both CJD forms nor between CJD patients and control group.

  5. Change in messa di voce characteristics during 3 years of classical singing training at the tertiary level.

    PubMed

    Ferguson, Sam; Kenny, Dianna T; Mitchell, Helen F; Ryan, Maree; Cabrera, Densil

    2013-07-01

    A 3-year longitudinal study was conducted to investigate changes in vocal quality as a result of singing training at a tertiary level conservatorium in Australia. Singers performed a messa di voce (MDV) at intervals of 6 months over the 3-year period of training. The study investigated the evolving acoustic features of the singers' voices exhibited during the MDV, including sound pressure level (SPL), short-term energy ratio (STER), duration, and vibrato parameters of the fundamental frequency (F0), SPL, and STER. The maximum SPL exhibited a marginal systematic increase over the training period, but the maximum STER did not systematically change. F0 vibrato extent increased significantly, whereas the extent of SPL and STER vibrato did not change significantly.

  6. Significant survival improvement of patients with recurrent breast cancer in the periods 2001-2008 vs. 1992-2000

    PubMed Central

    2011-01-01

    Background It is unclear whether individualized treatments based on biological factors have improved the prognosis of recurrent breast cancer. The purpose of this study is to evaluate the survival improvement of patients with recurrent breast cancer after the introduction of third generation aromatase inhibitors (AIs) and trastuzumab. Methods A total of 407 patients who received first diagnosis of recurrent breast cancer and treatment at National Kyushu Cancer Center between 1992 and 2008 were retrospectively evaluated. As AIs and trastuzumab were approved for clinical use in Japan in 2001, the patients were divided into two time cohorts depending on whether the cancer recurred before or after 2001. Cohort A: 170 patients who were diagnosed between 1992 and 2000. Cohort B: 237 patients who were diagnosed between 2001 and 2008. Tumor characteristics, treatments, and outcome were compared. Results Fourteen percent of cohort A and 76% of cohort B received AIs and/or trastuzumab (P < 0.001). The median overall survival (OS) times after breast cancer recurrence were 1.7 years and 4.2 years for these respective cohorts (P < 0.001). Both the time period and treatment of AIs and/or trastuzumab for recurrent disease were significant prognostic factors in multivariate analysis (cohort B vs. cohort A: HR = 0.70, P = 0.01; AIs and/or trastuzumab for recurrent disease: yes vs. no: HR = 0.46, P < 0.001). When patients were categorized into 4 subgroups by the expression of hormone receptor (HR) and HER-2 status, the median OS times of the HR-positive/HER-2-negative, HR-positive/HER-2-positive, HR-negative/HER-2-positive, and HR-negative/HER-2-negative subtypes were 2.2, 2.4, 1.6, and 1.0 years in cohort A and 4.5, 5.1, 5.0, and 1.4 years in cohort B. Conclusions The prognosis of patients with recurrent breast cancer was improved over time following the introduction of AIs and trastuzumab and the survival improvement was apparent in HR- and/or HER-2-positive tumors. PMID:21453503

  7. Pyridoxine-dependent convulsions among children with refractory seizures: A 3-year follow-up study

    PubMed Central

    Chandra, Sadanandavalli Retnaswami; Issac, Thomas Gregor; Deepak, Sai; Teja, Ravi; Kuruthukulangara, Seby

    2016-01-01

    Introduction: Epilepsy accounts for 1% of the global disease burden and about 8–10 million epilepsy patients live in India. About 30–40% of these patients become drug-resistant and land up with palliative or disease-modifying surgeries. This is a situation causing great concern in view of the psychosocial and economic burden on the patient and the family apart from severe cognitive and motor consequences, especially in children. Therefore, it is mandatory to have an insight into the wide spectrum of causes with reference to refractoriness to antiepileptic medications in children with epilepsy. Patients and Methods: Children admitted under our team with refractory epilepsy as per the International League Against Epilepsy (ILAE) criteria in the last 3 years were included in the study. Results: Refractory epilepsy constituted 13.3% of inpatients in the pediatric group. Males dominated with 68.9% of these patients. Nearly 34.4% of these patients were found to suffer from various neurometabolic diseases. Almost 3.5% were due to pyridoxine-dependent convulsions. This group of patients showed an excellent response to dietary manipulation, disease-modifying treatment for the metabolic disorder, and supportive small-dose anticonvulsants. During follow-up, they showed very good response with reference to global development and seizure control. Conclusion: Pyridoxine-dependent convulsions are relatively rare forming about 3.5% of refractory epilepsies in this series. With initiation of appropriate therapy, results with reference to seizure control as well as neurodevelopment became evident within 2 weeks, and at 1-year follow-up, complete independence for majority of the needed activities is achieved with minimum cost, almost zero side effects, and absolute elimination of the need for palliative surgery. PMID:27857784

  8. Cryoplasty Versus Conventional Angioplasty in Femoropopliteal Arterial Recanalization: 3-Year Analysis of Reintervention-Free Survival by Treatment Received

    SciTech Connect

    Diaz, Maria Lourdes; Urtasun, Fermin Barberena, Javier; Aranzadi, Carlos; Guillen-Grima, Francisco; Bilbao, Jose Ignacio

    2011-10-15

    Purpose: To compare long-term efficacy of cryoplasty therapy versus conventional angioplasty in the treatment of peripheral arterial atherosclerotic stenosis on the basis of our 3-year clinical experience. Materials and Methods: From January 2006 to December 2008, a total of 155 patients with 192 lesions of the femoropopliteal sector were randomized to receive either cryoplasty or conventional balloon angioplasty. The primary study end point was lesion target patency. Follow-up with clinical evaluation of patient's symptoms, ankle-brachial index, and Doppler ultrasound was scheduled at 1, 6, 9, 12, 24, and 36 months. Results: For the cryoplasty group (n = 86), technical immediate success was achieved in 74.4% of lesions. Rate of significant dissection was 13.5% and rate of stent placement of 22%. In the long term, target lesion patency rate at 6 months was 59.4%, with rates of 55.9, 52.6, and 49.1% at 1, 2, and 3 years, respectively. For the conventional angioplasty group (n = 69), the immediate technical success rate was 83.7%. Rate of significant dissection was 19%, and rate of stent placement was 72.9%. Patency rates at 6 months and at 1, 2, and 3 years were 71.5, 61.2, 60, and 56%, respectively. Conclusion: Compared with conventional angioplasty, cryoplasty showed good immediate success rates with lower stent placement rates. During the 3-year follow-up, patency rates tended to equalize between the two modalities.

  9. Use of Feldspathic Porcelain Veneers to Improve Smile Harmony: A 3-Year Follow-up Report.

    PubMed

    Federizzi, Leonardo; Gomes, Érica Alves; Báratro, Samantha Schaffer Pugilato; Baratto-Filho, Flares; Bacchi, Ataís; Spazzin, Aloísio Oro

    2016-01-01

    This case report describes an esthetic treatment to improve the shape and alignment of the anterior teeth, reestablishing smile harmony, using feldspathic porcelain veneers. Results of clinical follow up after 36 months are also presented. The advantages, disadvantages and limitations of the technique are detailed with reference to the relevant literature. This suggests that the success of treatment depends on adequate conditions of bonding between the veneers and the tooth complex, which involves parameters such as the strength and durability of the bond interface. Therefore, the clinical success of feldspathic porcelain veneers depends on the accurate selection of cases and correct execution of clinical and laboratory procedures. The rehabilitation involved from first right premolar to the left with feldspathic porcelain veneers made on refractory dies. After the 3-year follow up, excellent clinical results and patient satisfaction were achieved.

  10. [Effects of combined action of radon baths and transcranial magnetotherapy on cerebral circulation in patients in an intermediate period of a mild craniocerebral trauma].

    PubMed

    Moliavchikova, O V; Cherevashchenko, L A; Grinzaĭd, Iu M; Aĭvazov, V N; Zhuravlev, M E

    2007-01-01

    The authors propose combined therapy improving cerebral circulation in patients in an intermediate period of a mild craniocerebral trauma. The combination consists of radon baths and transcranial magnetotherapy which raise blood volume filling, relieve vascular resistance, improve venous outflow.

  11. [Bevacizumab as first-line therapy in metastatic renal cell carcinoma: Progression-free survival for 3 years].

    PubMed

    Pichler, R; Horninger, W; Aigner, F; Heidegger, I

    2016-03-01

    We report the case of a 72-year-old woman who was diagnosed in 2006 with renal cell cancer (RCC) and had undergone consecutive tumor nephrectomy (clear-cell RCC, Fuhrmann grade II, stage pT3a, R0). Over the years, the patient underwent several surgical and radiological interventions due to various metastatic lesions. This case report describes the 3-year progression-free survival in a patient who underwent first-line therapy with the monoclonal antibody bevacizumab. Except for hypertension, the patient does not suffer currently from any other side effects of bevacizumab therapy.

  12. Rates of mutation and host transmission for an Escherichia coli clone over 3 years.

    PubMed

    Reeves, Peter R; Liu, Bin; Zhou, Zhemin; Li, Dan; Guo, Dan; Ren, Yan; Clabots, Connie; Lan, Ruiting; Johnson, James R; Wang, Lei

    2011-01-01

    Although over 50 complete Escherichia coli/Shigella genome sequences are available, it is only for closely related strains, for example the O55:H7 and O157:H7 clones of E. coli, that we can assign differences to individual evolutionary events along specific lineages. Here we sequence the genomes of 14 isolates of a uropathogenic E. coli clone that persisted for 3 years within a household, including a dog, causing a urinary tract infection (UTI) in the dog after 2 years. The 20 mutations observed fit a single tree that allows us to estimate the mutation rate to be about 1.1 per genome per year, with minimal evidence for adaptive change, including in relation to the UTI episode. The host data also imply at least 6 host transfer events over the 3 years, with 2 lineages present over much of that period. To our knowledge, these are the first direct measurements for a clone in a well-defined host community that includes rates of mutation and host transmission. There is a concentration of non-synonymous mutations associated with 2 transfers to the dog, suggesting some selection pressure from the change of host. However, there are no changes to which we can attribute the UTI event in the dog, which suggests that this occurrence after 2 years of the clone being in the household may have been due to chance, or some unknown change in the host or environment. The ability of a UTI strain to persist for 2 years and also to transfer readily within a household has implications for epidemiology, diagnosis, and clinical intervention.

  13. Successful Medical Treatment of Adult Nesidioblastosis With Pasireotide over 3 Years

    PubMed Central

    Schwetz, Verena; Horvath, Karl; Kump, Patrizia; Lackner, Carolin; Perren, Aurel; Forrer, Flavio; Pieber, Thomas R.; Treiber, Gerlies; Sourij, Harald; Mader, Julia K.

    2016-01-01

    Abstract Nesidioblastosis is a rare cause of endogenous hyperinsulinemic hypoglycemia in adults. Diagnosis is often challenging and therapeutic options are scarce. In 2009, a 46-year-old female patient presented with recurrent severe hypoglycemia and immediate recovery after glucose ingestion. Although 72-h-fasting test was positive, various imaging technologies (sonography, computed tomography, somatostatin receptor scintigraphy, dopamine receptor positron emission tomography [DOPA-PET]) were negative. Endoscopic ultrasound revealed a lesion in the pancreatic corpus, whereas selective arterial calcium stimulation test, portal venous sampling and GLP-1-receptor scintigraphy were indicative of a lesion in the pancreatic tail, which was surgically removed. The histopathologic examination revealed beta cell hyperplasia and microadenomas expressing glucagon. After surgery, the patient was free of symptoms for 6 months, after which hypoglycemic episodes recurred. After unsuccessful treatment with corticosteroids and somatostatin analogs, treatment with pasireotide, a novel somatostatin analog with high affinity to somatostatin receptor 5 and a possible side effect of hyperglycemia, was initiated (0.6 mg BID). To date, our patient has been free of severe hypoglycemic episodes ever since. Yearly repeated imaging procedures have shown no abnormities over the last 3 years. We report for the first time that pasireotide was successfully used in the treatment of adult nesidioblastosis. PMID:27057885

  14. [Influence of immunotropic preparation cycloferon and phytopreparations of Cynara scolimus L. on blood cytokines profile of the patients with chronic viral hepatitis C in medical rehabilitation period].

    PubMed

    Frolov, V M; Sotskaia, Ia A; Kruglova, O V

    2012-01-01

    The effect of the immunotropic drug cycloferon and herbal medicine resources on the basis of Cynara scolimus L. on the blood cytokine profile in the patients with chronic viral hepatitis C (CVHC) in medical rehabilitation (MR) period. Established that prior to MR period in the patients with CVHC was noted significantly increased levels of proinflammatory cytokines (CK) at the blood serum, and the level of antiinflammatory CK changed significantly. The use of cycloferon and herbal medicine resources on the basis of Cynara scolimus L. in the MR complex provided to normalize the studied CK concentration in the serum of the patients with CVHC.

  15. Prediction of Mesiodistal Width of Unerupted Lateral Incisors, Canines and Premolars in Orthodontic Patients in Early Mixed Dentition Period

    PubMed Central

    Toodehzaeim, Mohammad Hossein; Haerian, Alireza

    2016-01-01

    Objectives: Proper diagnosis and prevention of malocclusion are superior to treatment. Discrepancy between arch length and tooth size in mixed dentition period is a condition requiring timely diagnosis. Estimating the mesiodistal width of unerupted teeth according to the size of erupted ones can lead to earlier diagnosis of malocclusion. On the other hand, the best timing for serial extractions is before the eruption of lateral incisors. The aim of this study was to present prediction formulas for mesiodistal width of unerupted lateral incisors, canines and premolars in an Iranian population based on the width of erupted permanent mandibular central incisors and maxillary first molars. Materials and Methods: A total of 120 dental models (60 males, 60 females) of orthodontic patients between 11–25 years were evaluated in Yazd city. The measurements were made by a digital caliper on the widest mesiodistal width of teeth at the interproximal contacts. Data were analyzed to calculate the prediction equation. Results: The prediction equation in the upper jaw was y=0.57x+10.82 for males, y=0.7x+6.37 for females and y=0.64x+8.46 for both sexes. The equation for the lower jaw was y=0.76x+2.86 for males, y=0.74x+3.53 for females and y=0.77x+2.7 for both sexes. Conclusions: The prediction equations suggested in this study can predict the mesiodistal width of unerupted lateral incisors, canines and premolars in an Iranian population in early mixed dentition period without taking radiographs. PMID:28243298

  16. Toxicological findings in cases of alleged drug-facilitated sexual assault in the United Kingdom over a 3-year period.

    PubMed

    Scott-Ham, Michael; Burton, Fiona C

    2005-08-01

    This paper outlines the toxicology results from 1014 cases of claimed drug-facilitated sexual assault (DFSA) analysed at the Forensic Science Service, London Laboratory between January 2000 and December 2002. Where appropriate, either a whole blood sample and/or a urine sample was analysed for alcohol, common drugs of abuse and potentially stupefying drugs. The results were interpreted with respect to the number of drugs detected and an attempt was made to distinguish between voluntary and involuntary ingestion from information supplied. Alcohol (either alone or with an illicit and/or medicinal drug) was detected in 470 of all cases (46%). Illicit drugs were detected in 344 cases (34%), with cannabis being the most commonly detected (26% of cases), followed by cocaine (11%). In 21 cases (2%), a sedative or disinhibiting drug was detected which had not been admitted and could therefore be an instance of deliberate spiking. This included three cases in which complainants were allegedly given Ecstasy (MDMA) without their knowledge. Other drugs detected included gammahydroxybutyrate (GHB) and the benzodiazepine drugs diazepam and temazepam. Another nine cases (1%) involved the complainant being either given or forced to ingest pharmaceutical tablets or an illicit drug.

  17. Acquired unilateral pulmonary vein atresia in a 3-year-old boy.

    PubMed

    Firdouse, Mohammed; Agarwal, Arnav; Grosse-Wortmann, Lars; Mondal, Tapas K

    2015-03-01

    While unilateral pulmonary venous atresia (UPVA) most commonly presents as an extremely rare late embryological defect resulting in complete occlusion or absence of the PV pathway, it may also be an acquired pathology. We present a 3-year-old boy who presented with mild respiratory distress. Neonatal echocardiographic investigations revealed normal mediastinal anatomy and pulmonary vasculature with a bicuspid aortic valve. However, follow-up Doppler investigation revealed a pulmonary artery size difference with minimal forward flow and reverse flow during diastole. Absence of the left pulmonary veins and the presence of collaterals draining to the innominate vein confirmed the diagnosis of acquired UPVA. Our case represents the first case of acquired UPVA in conjunction with a normally functioning bicuspid aortic valve. The Doppler flow patterns discussed might be of significant interest to pediatricians, cardiologists and imaging specialists. These findings suggest that acquired UPVA should be considered in the differential diagnosis of such patients when radiographic and echocardiographic findings may rule out other more common diagnoses. While the management of such a condition remains unclear and conservative management was agreed upon for our patient, the vulnerability of such cases warrants timely diagnosis and routine monitoring.

  18. A 3-year evolution of linguistic disorders in aphasia after stroke.

    PubMed

    El Hachioui, Hanane; van de Sandt-Koenderman, Mieke W M E; Dippel, Diederik W J; Koudstaal, Peter J; Visch-Brink, Evy G

    2011-09-01

    Aphasia recovery after stroke has been the subject of several studies, but in none the deficits on the various linguistic levels were examined, even though in the diagnosis and treatment of aphasia the emphasis lays more and more on these linguistic level disorders. In this observational prospective follow-up study, we explored whether it is meaningful to investigate the recovery of semantics, phonology, and syntax separately. Fifteen patients with aphasia poststroke were assessed at 3 and 10 days, 7 weeks, 4 and 7 months, and 3 years postonset with the ScreeLing, a linguistic level test, the Aphasia Severity Rating Scale (spontaneous speech) and the Token Test. Group results showed improvement for the overall ScreeLing (P<0.01) and its subparts semantics (P<0.01) and syntax (P<0.01) up to 7 weeks, just as the Token Test (P<0.01). Phonology improved up to 4 months (P<0.05) and spontaneous speech up to 7 months (P<0.05). The recovery pattern of the three linguistic levels did not follow a parallel course, with a great deal of variability in linguistic recovery curves between and within patients. These results suggest that it is meaningful to assess the recovery of the linguistic levels separately, starting from the acute stage poststroke.

  19. Recurrence rate of stress urinary incontinence in females with initial cure after transobturator tape procedure at 3-year follow-up

    PubMed Central

    Jun, Taeyong; Yoon, Hyun Sik; Kim, Hyung Suk; Lee, Jeong Woo; Bae, Jungbum

    2017-01-01

    Purpose To assess recurrence rates of urinary incontinence in women with initial cure after transobturator tape (TOT) procedure at 3-year follow-up. Materials and Methods Between June 2006 and May 2013, a total of 402 consecutive patients underwent the TOT procedure for female stress urinary incontinence (SUI) at Dongguk University Ilsan Hospital. Of the 402 patients, 223 had sufficient medical records for analysis. Therefore, they were followed-up for 3 years postoperatively. Patient characteristics, urinary symptoms, physical examination, and urodynamic parameters were evaluated. The primary end point of “cure” was defined as the absence of any complaint of urinary leakage without needing pads for usual activities. Results Of the 223 patients, 196 patients (87.9%) were initially cured within 6 months postoperatively. Of the 196 patients, 70 (35.7%) had recurrent urinary incontinence at 3 years postoperatively, 51 (26.0%) had SUI, 16 (8.2%) had urgency urinary incontinence, and 3 (1.5%) had mixed urinary incontinence. In univariate analysis, preoperative urinary obstructive symptom was found to significant contributor to the recurrence of urinary incontinence at 3-year postoperatively (p=0.004). Conclusions In our study, 35.7% of the women with initial cure after TOT experienced the recurrence of urinary leakage during the 3-year follow-up. The cure rate of TOT was decreased as time went by, although the initial cure rate was high. PMID:28097269

  20. Missed Opportunities: Evolution of Patients Leaving without Being Seen or against Medical Advice during a Six-Year Period in a Swiss Tertiary Hospital Emergency Department

    PubMed Central

    Carron, Pierre-Nicolas; Yersin, Bertrand; Trueb, Lionel; Gonin, Philippe; Hugli, Olivier

    2014-01-01

    Aim. The study aimed at describing the evolution over a 6-year period of patients leaving the emergency department (ED) before being seen (“left without being seen” or LWBS) or against medical advice (“left against medical advice” or LAMA) and at describing their characteristics. Methods. A retrospective database analysis of all adult patients who are admitted to the ED, between 2005 and 2010, and who left before being evaluated or against medical advice, in a tertiary university hospital. Results. During the study period, among the 307,716 patients who were registered in the ED, 1,157 LWBS (0.4%) and 1,853 LAMA (0.9%) patients were identified. These proportions remained stable over the period. The patients had an average age of 38.5 ± 15.9 years for LWBS and 41.9 ± 17.4 years for LAMA. The median time spent in the ED before leaving was 102.4 minutes for the LWBS patients and 226 minutes for LAMA patients. The most frequent reason for LAMA was related to the excessive length of stay. Conclusion. The rates of LWBS and LAMA patients were low and remained stable. The patients shared similar characteristics and reasons for leaving were largely related to the length of stay or waiting time. PMID:25013794

  1. Disability multilevel modelling in first episodes of psychosis at 3-year follow-up.

    PubMed

    Mellor-Marsá, Blanca; Caballero, Francisco Félix; Cabello, María; Ayuso-Mateos, José Luis; Setién-Suero, Esther; Vázquez-Bourgon, Javier; Crespo-Facorro, Benedicto; Ayesa-Arriola, Rosa

    2017-01-03

    The description of longitudinal bio-psycho-social profiles in FEP samples may be useful for the prediction of disability trajectories. This study aimed to describe the differences between disability status of FEP patients at baseline and their change over time, analysing how variables associated to the psychological status, and the environment of the patient can affect his or her disability trajectory, once the influence of health condition and socio-demographic variables has been controlled for. Using data from a 3-year follow-up study on early psychosis (PAFIP), a multilevel structure in which the longitudinal measurements (within level) were nested within the individuals (between level), was modeled. The contribution of the different time-varying and time-invariant variables to the patients' disability outcomes was tested through eight nested models. Consecutive models, that successively added health related, socio-demographic, psychological and environmental variables to the unconditional model were estimated, by means of deviance and fit statistics. The present work revealed the importance of psychological and environmental factors in the explanation of disability changes in the context of FEP. We may conclude that longitudinal assessments of time-varying predictors - living situation (b=-0.10, p<0.05), economic support (b=0.11, p<0.01) and insight (b=-0.08, p<0.05) - explain a relevant amount of disability variation over time, independently from symptoms' severity, duration of untreated psychosis, age, gender and years of education. Additionally, the level of premorbid adjustment (b=0.05, p<0.001) was associated to differences in disability outcomes among FEP patients.

  2. Usefulness of Routine Periodic Fasting to Lower Risk of Coronary Artery Disease among Patients Undergoing Coronary Angiography

    PubMed Central

    Horne, Benjamin D.; May, Heidi T.; Anderson, Jeffrey L.; Kfoury, Abdallah G.; Bailey, Beau M.; McClure, Brian S.; Renlund, Dale G.; Lappé, Donald L.; Carlquist, John F.; Fisher, Patrick W.; Pearson, Robert R.; Bair, Tami L.; Adams, Ted D.; Muhlestein, Joseph B.

    2008-01-01

    Coronary artery disease (CAD) is common and multi-factorial. Members of the Church of Jesus Christ of Latter-day Saints (LDS, or Mormons) in Utah may have lower cardiac mortality than other Utahns and the US population. While the LDS proscription of smoking likely contributes to lower cardiac risk, it is unknown whether other shared behaviors also contribute. This study evaluated potential CAD-associated effects of fasting. Patients (N1=4,629) enrolled in the Intermountain Heart Collaborative Study registry (1994-2002) were evaluated for association of religious preference with CAD diagnosis (≥70% coronary stenosis on angiography) or no CAD (normal coronaries, <10% stenosis). Consequently, another set of patients (N2=448) were surveyed (2004-2006) for association of behavioral factors with CAD, with the primary variable being routine fasting (i.e., abstinence from food and drink). Secondary survey measures included proscription of alcohol, tea, and coffee, social support, and religious worship patterns. In population 1 (initial), 61% of LDS and 66% of all others had CAD (adjusted [including for smoking]: odds ratio [OR]=0.81; p=0.009). In population 2 (survey), fasting was associated with lower risk of CAD (64% vs. 76% CAD; OR=0.55, CI=0.35, 0.87; p=0.010) and this remained after adjustment for traditional risk factors (OR=0.46, CI=0.27, 0.81; p=0.007). Fasting was also associated with lower diabetes prevalence (p=0.048). In regression models entering other secondary behavioral measures, fasting remained significant with similar effect size. In conclusion, not only proscription of tobacco, but also routine periodic fasting was associated with lower risk of CAD. PMID:18805103

  3. Usefulness of routine periodic fasting to lower risk of coronary artery disease in patients undergoing coronary angiography.

    PubMed

    Horne, Benjamin D; May, Heidi T; Anderson, Jeffrey L; Kfoury, Abdallah G; Bailey, Beau M; McClure, Brian S; Renlund, Dale G; Lappé, Donald L; Carlquist, John F; Fisher, Patrick W; Pearson, Robert R; Bair, Tami L; Adams, Ted D; Muhlestein, Joseph B

    2008-10-01

    Coronary artery disease (CAD) is common and multifactorial. Members of the Church of Jesus Christ of Latter-day Saints (LDS, or Mormons) in Utah may have lower cardiac mortality than other Utahns and the US population. Although the LDS proscription of smoking likely contributes to lower cardiac risk, it is unknown whether other shared behaviors also contribute. This study evaluated potential CAD-associated effects of fasting. Patients (n(1) = 4,629) enrolled in the Intermountain Heart Collaborative Study registry (1994 to 2002) were evaluated for the association of religious preference with CAD diagnosis (> or = 70% coronary stenosis using angiography) or no CAD (normal coronaries, <10% stenosis). Consequently, another set of patients (n(2) = 448) were surveyed (2004 to 2006) for the association of behavioral factors with CAD, with routine fasting (i.e., abstinence from food and drink) as the primary variable. Secondary survey measures included proscription of alcohol, tea, and coffee; social support; and religious worship patterns. In population 1 (initial), 61% of LDS and 66% of all others had CAD (adjusted [including for smoking] odds ratio [OR] 0.81, p = 0.009). In population 2 (survey), fasting was associated with lower risk of CAD (64% vs 76% CAD; OR 0.55, 95% confidence interval 0.35 to 0.87, p = 0.010), and this remained after adjustment for traditional risk factors (OR 0.46, 95% confidence interval 0.27 to 0.81, p = 0.007). Fasting was also associated with lower diabetes prevalence (p = 0.048). In regression models entering other secondary behavioral measures, fasting remained significant with a similar effect size. In conclusion, not only proscription of tobacco, but also routine periodic fasting was associated with lower risk of CAD.

  4. Time, frequency and information domain analysis of heart period and QT variability in asymptomatic long QT syndrome type 2 patients.

    PubMed

    Bari, Vlasta; Girardengo, Giulia; Marchi, Andrea; De Maria, Beatrice; Brink, Paul A; Crotti, Lia; Schwartz, Peter J; Porta, Alberto

    2015-01-01

    This study was designed to characterize in time, frequency and information domains heart period (HP) and QT interval variabilities in asymptomatic (ASYMP) long QT syndrome type 2 (LQT2) subjects. HP, approximated as the temporal distance between two consecutive R-wave peaks, and QT, approximated as the temporal distance between the R-wave peak and the T-wave offset, were automatically derived from 24h Holter recordings in 10 ASYMP LQT2 patients and 13 healthy non mutation carriers (NMC) subjects. All analyses were carried out during DAY (from 2 to 6 PM) and NIGHT (from 12 to 4 AM). Mean, variance, spectral power and complexity indices at short, medium and long time scales were assessed over HP and QT beat-to-beat series. Circadian rhythmicity was evident in both NMC and ASYMP LQT2 but ASYMP LQT2 subjects were characterized by higher HP, QT interval and HP variability during both DAY and NIGHT. In addition, multiscale complexity analysis was able to differentiate the groups by showing a higher HP complexity and a lower QT complexity at long time scales in ASYMP LQT2 during DAY. ASYMP LQT2 exhibited a different autonomic control compared to NMC and such a differentiation could be protective and assure them a lower risk profile.

  5. Gender-specific factors associated with shorter sleep duration at age 3 years.

    PubMed

    Plancoulaine, Sabine; Lioret, Sandrine; Regnault, Nolwenn; Heude, Barbara; Charles, Marie-Aline

    2015-12-01

    Total sleep duration has been decreasing among children in the last decades. Short sleep duration (SSD) has been associated with deleterious health consequences, such as excess weight/obesity. Risk factors for SSD have already been studied among school-aged children and adolescents, but inconsistent results have been reported regarding possible gender differences. Studies reporting such relationships are scarce in preschoolers, despite the importance of this period for adopting healthy behaviour. We aimed to investigate factors associated with SSD in 3-year-old boys (n = 546) and girls (n = 482) in a French Mother-Child Cohort (EDEN Study). Children were born between 2003 and 2006 in two French university hospitals. Clinical examinations and parent self-reported questionnaires allowed us to collect sociodemographic (e.g. income, education, family situation, child-minding system), maternal [e.g. body mass index (BMI), parity, depression, breastfeeding duration] and child's characteristics (e.g. gender, birth weight, term, physical activity and TV viewing duration, food consumption, usual sleep time). Sleep duration/24-h period was calculated and SSD was defined as <12 h. Analyses were performed using logistic regression. The mean sleep duration was 12 h 35 ± 56 min, with 91% of the children napping. Patterns of risk factors associated with SSD differed according to gender. In addition to parental presence when falling asleep, short sleep duration was associated strongly positively with high BMI Z-score and TV viewing duration among boys and with familial home child-minding and lower scores on the 'fruits and vegetables' dietary pattern among girls. These results suggest either a patterning of parental behaviours that differs according to gender, or a gender-specific sleep physiology, or both.

  6. NASA IKONOS Multispectral Radiometric Calibration and 3-Year Temporal Stability Assessment

    NASA Technical Reports Server (NTRS)

    Pagnutti, Mary; Carver, David; Holekamp, Kara; Ryan, Robert; Zanoni, Vicki; Thome, Kurtis; Schiller, Stephen; Aaran, David

    2003-01-01

    Radiometric calibration of commercial imaging satellite products is required to ensure that science and application communities can place confidence in the imagery they use and can fully understand its properties. Inaccurate radiometric calibrations can lead to erroneous decisions and invalid conclusions and can limit intercomparisons with other system. In addition, the user community has little or no insight into the design and operation of commercial sensors or into the methods involved in generating commercial products. To address this calibration need, the NASA Stennis Space Center (SSC) Earth Science Applications (ESA) Directorate established a commercial satellite imaging radiometric calibration team consisting of three independent groups: NASA, SSC,ESA, the University of Arizona Remote Sensing Group, and South Dacota State University. Each group determined the absolute radiometric calibration coefficients of the Space Imaging IKONOS 4-band, 4 m multispectral product covering the visible through near-infrared spectral region. For a three year period beginning in 2000, each team employed some variant of a reflectance-based vicarious calibration approach, requiring ground-based measurements coincident with IKONOS image acquisitions and radiative transfer calculations. Several study sites throughout the United States were employed that covered nearly the entire dynamic range of the IKONOS sensor. IKONOS at-sensor radiance values were compared to those estimated by each independent group to determine the IKONOS sensor's radiometric accuracy and stability. Over 10 individual vicariously determined at-sensor radiance estimates were used each year. When combined, these estimates provided a high-precision radiometric gain calibration coefficient. No significant calibration offset was observed. The results of this evaluation provide the scientific community with an independent assessment of the IKONOS sensor's absolute calibration and temporal stability over the 3

  7. Ability of intermittent androgen suppression to selectively create a non-trivial periodic orbit for a type of prostate cancer patients.

    PubMed

    Hirata, Yoshito; Aihara, Kazuyuki

    2015-11-07

    Intermittent androgen suppression is becoming a standard clinical option for patients who suffer from recurrence after an initial treatment of prostate cancer such as radiation therapy and radical prostatectomy. In the first mathematical model of intermittent androgen suppression (Ideta et al., 2008), the authors tried to control the trajectory of the model to a periodic orbit to enable patients to coexist with prostate cancer, even if it cannot be eradicated. Recently, we proposed a mathematical model capable of improving the quantitative reproduction of the behavior of prostate cancer under intermittent androgen suppression (Hirata et al., 2010a). Here we examine whether such a stable periodic orbit can be created for patients who eventually will have to experience the relapse of cancer at a later stage. By using a mathematical analysis, we found that the above model of Hirata et al. does not contain a non-zero periodic orbit that can be targeted for such patients, namely patients of type (ii) or type (iii) for whom intermittent androgen suppression cannot stabilize the origin where no cancer cells exist. This result might suggest that the patients must seek to delay the relapse as much as possible if the cancer cannot be eradicated. We further classify type (i) into subclasses where such a non-zero periodic orbit can either be stabilized or asymptotically stabilized.

  8. Modified Pfannenstiel approach for radical retropubic prostatectomy: a 3-year experience.

    PubMed

    Manoharan, M; Ayyathurai, R; Nieder, A M; Soloway, M S

    2008-01-01

    A modified Pfannenstiel approach for radical retropubic prostatectomy (RRP) has been described previously. We present our experience with this approach for performing a RRP over the past 3 years. Between January 2003 and July 2006, 544 consecutive RRPs by modified Pfannenstiel approach between January 2003 and July 2006 were performed. We analyzed blood loss, transfusions, use of drain, pain score, analgesia and hospital stay. Patients were followed up at 6 weeks, three monthly for a year and six monthly thereafter. All clinical and operative variables were entered into a database and analyzed. A total of 544 men underwent RRP with median follow-up of 11 (s.d.+/-10.5) months. The mean age was 60 (s.d.+/-7) years. About 83, 91 and 95% of patients had nerve sparing, bladder neck preservation and a lymph node dissection, respectively. Fifty-three patients had a concurrent inguinal hernia repair through the same incision. Mean estimated blood loss was 431 (s.d.+/-267) ml. The pathological staging distribution was T2, 82%; T3a, 9%; and T3b, 9%. The mean pain score at days 1 and 7 were 3.7 (s.d.+/-2.5) and 3.3 (s.d.+/-3), respectively. The median hospital stay was 36 h (s.d.+/-24). About 5.5% have had biochemical recurrence. At 12 months 97% were continent and 46% potent. RRP using a modified Pfannenstiel approach offers safety and efficacy. It facilitates repair of associated inguinal hernia through the same incision.

  9. The Development of Reading and Spelling Abilities in the First 3 Years of Learning Arabic

    ERIC Educational Resources Information Center

    Mohamed, Wessam; Elbert, Thomas; Landerl, Karin

    2011-01-01

    In a cross-sectional study, we investigated the development of fluent reading and spelling in the first 3 years of learning Arabic. The goals of our study were to: (1) validate suitable measures for fluent reading and spelling in the first 3 years of learning Arabic; (2) trace the developmental course of the relationship between fluent reading and…

  10. Changes in Strength Abilities of Adolescent Girls: The Effect of a 3-Year Physical Education Curriculum

    ERIC Educational Resources Information Center

    Czarniecka, Renata; Milde, Katarzyna; Tomaszewski, Pawel

    2012-01-01

    Study aim: To evaluate changes in strength abilities of adolescent girls that underwent a 3-year physical education curriculum. Material and methods: The research participants comprised 141 girls aged 13.3 plus or minus 0.35 years who participated in a 3-year physical education curriculum (PEC). Evaluation was based on the following EUROFIT…

  11. Hospital Organization and Importance of an Interventional Radiology Inpatient Admitting Service: Italian Single-Center 3-Year Experience

    SciTech Connect

    Simonetti, Giovanni; Bollero, Enrico; Ciarrapico, Anna Micaela; Gandini, Roberto; Konda, Daniel Bartolucci, Alberto; Di Primio, Massimiliano; Mammucari, Matteo; Chiocchi, Marcello; D'Alba, Fabrizio; Masala, Salvatore

    2009-03-15

    In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly higher for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p < 0.05). The results of the 3-year activity show that the activation of a COUIR with an inpatient admitting service, and the better organization of the patient pathway that came with it, evidenced more efficient use of resources, with the possibility for the hospital to save money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of Euro 1,009,095.35. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.

  12. Clinical recommendations in the management of the patient with type 1 diabetes on insulin pump therapy in the perioperative period: a primer for the anaesthetist.

    PubMed

    Partridge, H; Perkins, B; Mathieu, S; Nicholls, A; Adeniji, K

    2016-01-01

    Insulin pump therapy is increasingly common in patients with type 1 diabetes. Many of these patients will require surgery at some point in their lifetime. Few doctors will have experience of managing these patients, and little evidence exists to assist in the development of guidelines for patients with insulin pump therapy, undergoing surgery.It is clear that during emergency surgery insulin pump therapy is not appropriate and should be discontinued, but patients undergoing some elective surgery can and should continue insulin pump therapy, without any adverse effect on their blood sugar control, or on the outcome of their surgery. Individual hospitals need to formalize guidance on the management of patients receiving continuous subcutaneous insulin therapy, to allow patients the choice to continue their therapy during surgery. This expert opinion presents anaesthetists with a suggested clinical framework to help facilitate continued insulin pump therapy, during elective surgery and into the postoperative period.

  13. Impact of a 3-year pet management program on pet population and owner's perception.

    PubMed

    Dias Costa, Esther; Martins, Camila Marinelli; Cunha, Graziela Ribeiro; Catapan, Dariane Cristina; Ferreira, Fernando; Oliveira, Simone Tostes; Garcia, Rita de Cassia Maria; Biondo, Alexander Welker

    2017-04-01

    Although pet population management programs have been established worldwide, few reports on program evaluation have been carried out to date. Accordingly, a 3-year longitudinal study has been carried out in a 4000 household neighborhood located within the metropolitan area of Curitiba, the eighth most populated city of Brazil. Visits were conducted and questionnaires completed to estimate and characterize the local pet population (animal sex, reproductive and vaccination status, street access). Care provided by owners, community perception on stray dog management and the possible changes were compared in these variables over time (2010 and 2013) were evaluated, after the establishment of a city pet population management program. In addition, associations between having children, owning dogs and cats, responsible pet ownership education and owner's perception on stray dogs were statistically tested. A total of 354/4000 (8.9%) household families were interviewed in 2010 and 70/354 (19.8%) of the same families again in 2013. No significant changes were found in overall number of dogs and cats and average pet age, animal care and owner's perception on stray dogs following the 3-year population management program. In 2010, an average of 1.6 dogs and 0.3 cats were found per family, with slightly more females (51.3% dogs and 51.1% cats), adults (4.0±3.5years for dogs and 2.1±2.4 for cats), intact (not neutered; 94.2% dogs and 84.0% cats) and lacking regular visit to veterinarian (71.6%). Although more families (53.1%) had children under 12 years old, no association was found between having children and having dogs and cats. Questionnaires revealed that owners perceived neutering/spaying to be the best pet population control method (42.4%), with "society" (50%) and "government" (49.4%) as responsible for pet population management. A significant positive association has been found between education level and the best way to control stray dogs (p=0.03), between having dogs

  14. [Anatomical repair of transposition of the great vessels in the neonatal period. 5 years' experience. 246 patients].

    PubMed

    Planche, C; Bruniaux, J; Lacour-Gayet, F; Binet, J P

    1989-01-01

    In the period between april 1984 and march 1989, 246 newborn children with transposition of the great vessels benefited from anatomical repair of their heart disease. 221 children had simple transposition with normal interventricular septa. These were aged 2 to 23 days (mean age 7.8 +/- 3.5 standard deviation). 25 had transposition of the great vessels associated with a large interventricular septum defect. These were aged 7 to 30 days (mean age 18 +/- 8.3 S.D.). Associated lesions included a small interventricular septum defect in 20 cases which was not treated at the time of the operation; tricuspid insufficiency in 3 cases; and isthmic coarctation of the aorta in 10 cases. According to Yacoub's classification relative to the anatomical distribution of the coronary arteries, all the children fell into the following groups: type A, 172 cases; type B, 8 cases; type C, 12 cases; type D, 40 cases; type E, 14 cases. Preoperative catheterization was carried out in all the children. 96% benefited from Rashkin's atrioseptostomy, 90% had a prostaglandin infusion continuing through surgery. The surgical technique included the use of continuous extracorporal circulation at 20 degrees C, without circulatory arrest. Protection of the myocardium was ensured during aortic clamping by injecting of a crystalloid cardioplegia-inducing solution. The main steps of surgical repair were repositioning of the coronary arteries onto the ancient aortic stump and reconstruction of a pulmonary shunt. Repositioning of the coronary arteries was carried out in accordance with Yacoub's technique in all cases except for the 10 first patients.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Intestinal Obstruction in a 3-Year-Old Girl by Ascaris lumbricoides Infestation

    PubMed Central

    Andrade, Angel Medina; Perez, Yeudiel; Lopez, Cecilia; Collazos, Stephanie Serrano; Andrade, Alejandro Medina; Ramirez, Grecia Ortiz; Andrade, Laura Medina

    2015-01-01

    Abstract Ascaris lumbricoides infection affects approximately 1.5 billion people globally. Children with environmental and socio-economic risk factors are more susceptible to infestation, with serious complications such as intestinal obstruction (IO), volvulus, intussusception, and intestinal necrosis. We present the case of a 3-year-old girl who arrived at emergency department with abdominal pain and diarrhea for the last 3 days. The previous day she took an unspecified anthelmintic. Symptoms worsened with vomiting and diarrhea, with expulsion of roundworms through mouth and anus. Physical examination revealed bloating, absence of bowel sounds, abdominal tenderness, and a palpable mass in right hemi-abdomen. Abdominal radiographs showed air-fluid levels with mild bowel distention and shadows of roundworms. The diagnosis of IO by A lumbricoides. infestation was established and surgical approach scheduled. During exploratory laparotomy an intraluminal bolus of roundworms from jejunum to ascendant colon was evident. An ileum enterotomy was performed and worms were removed. Fluid therapy and antibiotics for 72 hours were administered, with posterior albendazol treatment for 3 days. Patient was uneventfully discharged on the tenth day. Reduction in parasitic load by means of improvements in sanitation, health education, and anthelmintic treatment must be implemented in endemic zones to prevent serious life-threatening complications by A lumbricoides. infestation, because some of them require urgent surgical treatment. PMID:25906092

  16. The Harris-Galante cementless acetabular component: results in 190 cases with at least 3 years follow-up.

    PubMed

    Claus, B; Van Innis, B; De Witte, E; Van Overschelde, J; Magotteaux, B; Fatemi, F; Vandepaer, F

    1993-01-01

    The results of 190 primary total hip arthroplasties with a Harris-Galante cementless acetabular cup were reviewed. All patients had a minimum follow-up of 3 years (range, 3 to 5.5 years, mean 46 months). Clinical and radiographical analysis was performed. Inguinal pain was recorded in five cases. We noted a fracture of a screw in four cases without further implications. There was no evidence of acetabular loosening. There was no migration of the acetabular cup. No acetabular component showed measurable wear of the polyethylene liner. Non-progressive radiolucent lines were recorded in 14% of the patients: among these patients, radiolucent lines were noted in zone 1 in 46%, in zone 2 in 4% and in zone 3 in 86%. Two socket revisions became necessary. One patient suffered a deep-seated infection. Another revision was necessary because of recurrent dislocation.

  17. Sleep apnea and the subsequent risk of Parkinson’s disease: a 3-year nationwide population-based study

    PubMed Central

    Chou, Ping-Song; Lai, Chiou-Lian; Chou, Yii-Her; Chang, Wei-Pin

    2017-01-01

    Purpose Sleep apnea (SA)-induced chronic intermittent hypoxia increases oxidative stress and inflammation, which may contribute to the pathophysiology of Parkinson’s disease (PD). This study evaluated the risk of PD following SA diagnosis. Patients and methods This was a 3-year nationwide population-based matched cohort study using claims data from the National Health Insurance Research Database (NHIRD), Taiwan. We analyzed 1,944 patients diagnosed as having SA between 1997 and 2005 and a matched cohort of 9,720 non-SA patients from the NHIRD. Patients with a history of PD were excluded. Each patient was followed up for 3 years to evaluate subsequent PD development. Results Of the 11,664 patients, 17 (0.9%) and 38 (0.4%) from the SA and matched non-SA cohorts, respectively, were subsequently diagnosed as having PD during follow-up. After adjustments for potential confounders, the SA cohort had a 1.85-fold higher risk of PD than the non-SA cohort (95% confidence interval [CI] =1.02–3.35; P=0.042). After age and sex stratification, PD development was independently associated with SA only in men (adjusted hazard ratio [HR], 2.26; 95% CI =1.11–4.63; P<0.05) and in patients aged ≥60 years (adjusted HR, 1.93; 95% CI =1.01–3.71; P<0.05). Conclusion Our study suggests that patients with SA are at an increased longitudinal risk of PD. Furthermore, age and male sex are independently associated with the risk of PD.

  18. Acute undifferentiated febrile illness in rural Cambodia: a 3-year prospective observational study.

    PubMed

    Mueller, Tara C; Siv, Sovannaroth; Khim, Nimol; Kim, Saorin; Fleischmann, Erna; Ariey, Frédéric; Buchy, Philippe; Guillard, Bertrand; González, Iveth J; Christophel, Eva-Maria; Abdur, Rashid; von Sonnenburg, Frank; Bell, David; Menard, Didier

    2014-01-01

    In the past decade, malaria control has been successfully implemented in Cambodia, leading to a substantial decrease in reported cases. Wide-spread use of malaria rapid diagnostic tests (RDTs) has revealed a large burden of malaria-negative fever cases, for which no clinical management guidelines exist at peripheral level health facilities. As a first step towards developing such guidelines, a 3-year cross-sectional prospective observational study was designed to investigate the causes of acute malaria-negative febrile illness in Cambodia. From January 2008 to December 2010, 1193 febrile patients and 282 non-febrile individuals were recruited from three health centers in eastern and western Cambodia. Malaria RDTs and routine clinical examination were performed on site by health center staff. Venous samples and nasopharyngeal throat swabs were collected and analysed by molecular diagnostic tests. Blood cultures and blood smears were also taken from all febrile individuals. Molecular testing was applied for malaria parasites, Leptospira, Rickettsia, O. tsutsugamushi, Dengue- and Influenza virus. At least one pathogen was identified in 73.3% (874/1193) of febrile patient samples. Most frequent pathogens detected were P. vivax (33.4%), P. falciparum (26.5%), pathogenic Leptospira (9.4%), Influenza viruses (8.9%), Dengue viruses (6.3%), O. tsutsugamushi (3.9%), Rickettsia (0.2%), and P. knowlesi (0.1%). In the control group, a potential pathogen was identified in 40.4%, most commonly malaria parasites and Leptospira. Clinic-based diagnosis of malaria RDT-negative cases was poorly predictive for pathogen and appropriate treatment. Additional investigations are needed to understand their impact on clinical disease and epidemiology, and the possible role of therapies such as doxycycline, since many of these pathogens were seen in non-febrile subjects.

  19. Acute Undifferentiated Febrile Illness in Rural Cambodia: A 3-Year Prospective Observational Study

    PubMed Central

    Mueller, Tara C.; Siv, Sovannaroth; Khim, Nimol; Kim, Saorin; Fleischmann, Erna; Ariey, Frédéric; Buchy, Philippe; Guillard, Bertrand; González, Iveth J.; Christophel, Eva-Maria; Abdur, Rashid; von Sonnenburg, Frank; Bell, David; Menard, Didier

    2014-01-01

    In the past decade, malaria control has been successfully implemented in Cambodia, leading to a substantial decrease in reported cases. Wide-spread use of malaria rapid diagnostic tests (RDTs) has revealed a large burden of malaria-negative fever cases, for which no clinical management guidelines exist at peripheral level health facilities. As a first step towards developing such guidelines, a 3-year cross-sectional prospective observational study was designed to investigate the causes of acute malaria-negative febrile illness in Cambodia. From January 2008 to December 2010, 1193 febrile patients and 282 non-febrile individuals were recruited from three health centers in eastern and western Cambodia. Malaria RDTs and routine clinical examination were performed on site by health center staff. Venous samples and nasopharyngeal throat swabs were collected and analysed by molecular diagnostic tests. Blood cultures and blood smears were also taken from all febrile individuals. Molecular testing was applied for malaria parasites, Leptospira, Rickettsia, O. tsutsugamushi, Dengue- and Influenza virus. At least one pathogen was identified in 73.3% (874/1193) of febrile patient samples. Most frequent pathogens detected were P. vivax (33.4%), P. falciparum (26.5%), pathogenic Leptospira (9.4%), Influenza viruses (8.9%), Dengue viruses (6.3%), O. tsutsugamushi (3.9%), Rickettsia (0.2%), and P. knowlesi (0.1%). In the control group, a potential pathogen was identified in 40.4%, most commonly malaria parasites and Leptospira. Clinic-based diagnosis of malaria RDT-negative cases was poorly predictive for pathogen and appropriate treatment. Additional investigations are needed to understand their impact on clinical disease and epidemiology, and the possible role of therapies such as doxycycline, since many of these pathogens were seen in non-febrile subjects. PMID:24755844

  20. Early childhood severe scalds in a developing country: A 3-year retrospective study.

    PubMed

    Agbenorku, Pius

    2013-01-01

    The burns intensive care unit (BICU) staff observed an increasing number of pediatric scald burn admissions as a result of increase injuries associated with the scald burns. A retrospective study was conducted to identify scalds demographics, etiologies, and mortality risk factors. This descriptive study comprised a total of 166 patients aged 0-5 years, who were admitted to the BICU of the Reconstructive Plastic Surgery and Burns Unit (RPSBU) through the Accident and Emergency (A and E) Centre of the Komfo Anokye Teaching Hospital (KATH)from May 1(st) 2009 to April 30(th) 2012. Source of information was the BICU Computerized Database System. Data extracted included demographics as well as treatment methods and outcomes. The study population was 166; 92 (55.4%) males and 74 (44.6%) females. Scalds admissions were 141 (84.9%); 13 (9.2%) of them died, 83 (58.9%) discharged, and 45 (31.9%) transferred-out to another burn ward and pediatric surgery ward in the hospital. Scald patients' demographics included 78 males (55.3%) and 63 females (44.7%); mean age was 2.18 years. Mortality risk factors identified were age <3 years (P = 0.044); scalds from hot water (P = 0.033), total burns surface area >30% (P = 0.017), and multiple body parts affected (P = 0.049). The current study showed age, hot water, and Total Burns Surface Area (TBSA) as risk factors of early childhood scalds. Education on scalds prevention targeting mothers/caregivers is needed to create awareness of the frequency, severity, and danger associated with pediatric scalds.

  1. Bidirectional Relations between Parenting Practices and Child Externalizing Behavior: A Cross-Lagged Panel Analysis in the Context of a Psychosocial Treatment and 3-Year Follow-up

    ERIC Educational Resources Information Center

    Shaffer, Anne; Lindhiem, Oliver; Kolko, David J.; Trentacosta, Christopher J.

    2013-01-01

    In the current study, we examined longitudinal changes in, and bidirectional effects between, parenting practices and child behavior problems in the context of a psychosocial treatment and 3-year follow-up period. The sample comprised 139 parent-child dyads (child ages 6-11) who participated in a modular treatment protocol for early-onset ODD or…

  2. Success Rate of MTA Pulpotomy on Vital Pulp of Primary Molars: A 3-Year Observational Study

    PubMed Central

    Tyagi, Rishi

    2016-01-01

    Introduction Vital pulp therapy is a major contributor in the preservation of primary dentition after caries affliction. Introduction of mineral trioxide aggregate (MTA) has revolutionized such treatment. Aim The aim of our study was to evaluate and correlate the effects of MTA clinically and radiographically on pulpotomized primary molars till their exfoliation or extraction followed by histological evaluation. Study design This is an observational study. Materials and methods A total of 25 teeth were selected from 5- to 8-year-old children requiring pulp therapy on the basis of inclusion and exclusion criterion. The teeth were treated by conventional pulpotomy technique under aseptic conditions using MTA and were immediately restored with stainless steel crown. The teeth were assessed postoperatively till 36 months. The exfoliated or extracted teeth were examined histologically. Results The pulpotomized teeth were vital with no adverse clinical findings during the observation period. After 3 months, one tooth showed internal resorption, but the same was not observed after 12 months. Pulp canal obliteration was seen in three cases. At the end of the study, five teeth were exfoliated and one tooth was extracted for maintaining arch symmetry. The histological examination of extracted tooth revealed the presence of healthy pulp and the area of true calcification. Remaining exfoliated teeth presented dentin bridge formation. Statistics Frequencies and percentages were used for descriptive statistics. Fisher’s exact tests were used to see the difference between clinical and radiological findings. The probability value was fixed at 5% level of significance. Conclusion The response of pulp in primary teeth to MTA was favorable in all cases from clinical and radiographic perspective, and histological evaluation confirmed the observation. How to cite this article Godhi B, Tyagi R. Success Rate of MTA Pulpotomy on Vital Pulp of Primary Molars: A 3-Year Observational Study

  3. Food insufficiency and women's mental health: findings from a 3-year panel of welfare recipients.

    PubMed

    Heflin, Colleen M; Siefert, Kristine; Williams, David R

    2005-11-01

    Household food insufficiency is a significant problem in the United States, and has been associated with poor outcomes on mental health indicators among low-income women. However, it is difficult to disentangle the mental health consequences of household food insufficiency from poverty and other shared risk factors. Drawing on theories of the social production of health and disease, research evidence linking food insufficiency with poor mental health, and high rates of food insufficiency among welfare recipients, we examined whether a change in household food insufficiency is associated with a change in women's self-reported mental health in a sample of current and recent welfare recipients over a 3-year period of time, controlling for common risk factors. Data were obtained from a prospective survey of women who were welfare recipients in an urban Michigan county in February 1997 (n=753). We estimated fixed effect models for changes in mental health status that make use of information on household food insufficiency gathered in the fall of 1997, 1998, and 1999. The relationship between household food insufficiency and respondents' meeting the diagnostic screening criteria for major depression remained highly significant even when controlling for factors known to confer increased risk of depression and time invariant unobserved heterogeneity. These findings add to growing evidence that household food insufficiency has potentially serious consequences for low-income women's mental health. If confirmed by further research, they suggest that the public health burden of depression in welfare recipients and other low-income women could be reduced by policy-level interventions to reduce their exposure to household food insufficiency.

  4. Aphasic status epilepticus with periodic lateralized epileptiform discharges in a bilingual patient as a presenting sign of "AIDS-toxoplasmosis complex".

    PubMed

    Ozkaya, Gülşen; Kurne, Asli; Unal, Serhat; Oğuz, Kader Karli; Karabudak, Rana; Saygi, Serap

    2006-08-01

    We describe an HIV-infected, bilingual patient presenting with Wernicke's aphasia due to partial status epilepticus with periodic lateralized epileptiform discharges, as the first sign of AIDS-toxoplasmosis complex. The localization of the native and secondary language centers in the brain and the possible role of recurrent seizures in the fluctuating course of Wernicke's aphasia in this patient are discussed. The clinical course of this patient supports the belief that a second language area for a second language learned in the later stages of life is located in an area different from that for the native language but still in close proximity to it.

  5. Evaluation of bacteremias in a Turkish university hospital: 3-year outcomes.

    PubMed

    Demirdal, Tuna; Demirturk, Nese; Cetinkaya, Zafer; Tufan, Gulnihal

    2007-01-01

    In this retrospective study, the investigators examined blood cultures from patients that had been diagnosed with bacteremias over a 3-y period. The study was conduced at Kocatepe University Hospital (Middle Anatolia, Turkey). Blood samples that arrived at the university's microbiology laboratory between 2002 and 2005 were evaluated retrospectively. These samples were classified as contamination, false positivity, community-acquired bacteremia (CAB), or hospital-acquired bacteremia (HAB). Patient age and sex, foci of bacteremia, present comorbidities, predisposing factors, pathogens, and mortality rates were evaluated. A total of 1783 blood cultures that had been drawn from 1441 patients during this 3-y period were examined retrospectively. Of 354 positive isolates, 61 (17.2%) were CABs and 293 (82.8%) were HABs. In HABs, the most commonly isolated microorganisms were Staphylococcus aureus (37.5%), coagulase-negative staphylococci (29.7%), and Escherichia coli (10.2%); in CABs, the most commonly isolated microorganisms were S aureus (29.5%), Brucella spp (26.2%), and E coli (24.6%). Crude mortality rates were determined to be 15.2% for HABs and 12.7% for CABs. This study yielded data on the most common foci of bacteremia, microbiologic factors, and the epidemiology associated with HABs and CABs. It is hoped that these data will enhance empirical antibiotic therapeutic approaches, thereby preventing delays in treatment and decreasing mortality rates associated with bacteremias.

  6. Parental Styles and Religious Values among Teenagers: A 3-Year Prospective Analysis

    ERIC Educational Resources Information Center

    Heaven, Patrick C. L.; Ciarrochi, Joseph; Leeson, Peter

    2010-01-01

    The authors examined the effect of Grade 7 parental styles on Grade 10 religious values. The authors surveyed 784 participants (382 boys, 394 girls; 8 unreported) in Grade 7. The mean age of the group at Time 1 was 12.3 years (SD = 0.5 years). Time 2 occurred 3 years later when students were in Grade 10 (372 boys, 375 girls). In addition to…

  7. The role of body image integrity and posttraumatic growth in kidney transplantation: A 3-year longitudinal study.

    PubMed

    Látos, Melinda; Devecsery, Ágnes; Lázár, György; Horváth, Zoltán; Szederkényi, Edit; Szenohradszky, Pál; Csabai, Márta

    2015-01-01

    The aim of this study was to explore the role of body image, posttraumatic growth, and emotional state in recovery after transplantation. A total of 53 kidney transplant patients were assessed using our Self-Test and Organ Drawing Test, the Spielberger Anxiety Inventory, the Beck Depression Inventory, and the Posttraumatic Growth Inventory in a 3-year follow-up. Logistic regression analysis showed that lower levels of integrity of the body image and posttraumatic growth, and higher pre-discharge serum creatinine levels were significant predictors of graft rejection. Our results suggest that the integrity of the body image and posttraumatic growth might contribute to better health outcomes in organ transplantation.

  8. Valproate-associated reversible encephalopathy in a 3-year-old girl with Pallister-Killian syndrome.

    PubMed

    Gerstner, Thorsten; Bell, Nellie; Koenig, Stephan A

    2008-06-01

    Valproic acid (VPA) is considered to be a drug of first choice for the therapy of generalized and focal epilepsies, including special epileptic syndromes. The drug is usually well tolerated, rare serious complications may occur in some patients, including hemorrhagic pancreatitis, coagulapathies, bone marrow suppression, VPA-induced hepatotoxicity and encephalopathy. We report a case of VPA-associated encephalopathy without hyperammonemia in a 3-year-old girl with Pallister-Killian-Syndrom, combined with a mild hepatopathy and thrombopathy. After withdrawal of VPA, the clinical symptoms and the electroencephalography-alterations vanished rapidly.

  9. Valproate-associated reversible encephalopathy in a 3-year-old girl with Pallister-Killian syndrome

    PubMed Central

    Gerstner, Thorsten; Bell, Nellie; Koenig, Stephan A

    2008-01-01

    Valproic acid (VPA) is considered to be a drug of first choice for the therapy of generalized and focal epilepsies, including special epileptic syndromes. The drug is usually well tolerated, rare serious complications may occur in some patients, including hemorrhagic pancreatitis, coagulapathies, bone marrow suppression, VPA-induced hepatotoxicity and encephalopathy. We report a case of VPA-associated encephalopathy without hyperammonemia in a 3-year-old girl with Pallister-Killian-Syndrom, combined with a mild hepatopathy and thrombopathy. After withdrawal of VPA, the clinical symptoms and the electroencephalography-alterations vanished rapidly. PMID:18827862

  10. 46,XY/47,XYY/48,XYYY karyotype in a 3-year-old boy ascertained because of radioulnar synostosis

    SciTech Connect

    James, C.; Robson, L.; Jackson, J.

    1995-05-08

    Chromosome analysis was performed on a 3-year-old boy because of bilateral radioulnar synostosis and demonstrated a mosaic karyotype 46,XY/47,XYY/48,XYYY. He had minor facial anomalies and mild intellectual delay. He appears to be the youngest patient reported with this rare chromosome complement. His father, mother, and brother had normal chromosomes. Fluorescence in situ hybridization (FISH) was performed on the propositus and his father with the Y chromosome heterochromatic probe (pHY3.4) to add to the evaluation of mosaicism. 17 refs., 3 figs., 2 tabs.

  11. Clinical and Demographic Characteristics of Patients with Molluscum Contagiosum Treated at the University Dermatology Clinic Maribor in a 5-year period.

    PubMed

    Trčko, Katarina; Poljak, Mario; Križmarić, Miljenko; Miljković, Jovan

    2016-06-01

    Molluscum contagiosum virus (MCV) is a common skin pathogen in both adults and children. In this prospective study, we clinically evaluated consecutive patients with molluscum contagiosum (MC) who had been examined during a 5-year period at the second-largest dermatology clinic in Slovenia and described their main demographic and clinical characteristics, concomitant diseases, and treatment success. The study included 188 patients, of which 121 (64%) were men and 67 (36%) were women. A total of 135 (72%) patients were adults, with lesions that were most commonly located in the anogenital region (98%) and were probably sexually acquired. Two adult patients were diagnosed with concurrent human immunodeficiency virus (HIV) infection. Fifty-three (28%) patients were children with a mean age of 5.7 years, most commonly presenting with lesions on the torso and extremities (85%). In adults, the infection most commonly occurred in male patients, while in children it was slightly more common in female patients. At presentation, 58% of patients had more than 5 MC lesions. A total of 30% of the included children had concomitant atopic dermatitis. We did not observe an increased occurrence of MCV infection in patients with atopic dermatitis. All patients were treated with curettage of the lesions. The cure rate at the first follow-up visit after 2 months was relatively high (63%), and recurrences were not associated with the number or site of lesions at presentation or with concomitant atopic dermatitis.

  12. A prospective 3-year follow-up trial of implantation of two trabecular microbypass stents in open-angle glaucoma

    PubMed Central

    Donnenfeld, Eric D; Solomon, Kerry D; Voskanyan, Lilit; Chang, David F; Samuelson, Thomas W; Ahmed, Iqbal Ike K; Katz, L Jay

    2015-01-01

    Purpose To evaluate 3-year safety and intraocular pressure (IOP) following two trabecular microbypass stents in phakic and pseudophakic subjects with open-angle glaucoma (OAG) not controlled on preoperative medication. Patients and methods In this prospective pilot study, phakic or pseudophakic subjects with OAG and IOP between 18 mmHg and 30 mmHg on one preoperative topical ocular hypotensive medication underwent medication washout. Thirty-nine qualified subjects with preoperative unmedicated IOP ≥22 mmHg and ≤38 mmHg received two stents. Postoperative examinations were scheduled at Day 1, Week 1, Months 1, 3, 6, and 12, and semiannually through Month 60. Ocular hypotensive medication was considered if postoperative IOP exceeded 21 mmHg. IOP, medication use, and safety were assessed at each visit. Subject follow-up through Month 36 was completed. Results Thirty-six eyes (92.3%; 95% confidence interval [CI] 79.1%, 98.4%) achieved the primary efficacy end point of Month 12 reduction in IOP ≥20% from baseline (unmedicated IOP) without ocular hypotensive medication. Four subjects required medication during the Month 36 follow-up period. Mean IOP at 36 months for subjects not taking medication was 15.2 mmHg. At 36 months, subjects sustained mean IOP decrease of 9.1±2.7 mmHg (95% CI 8.0 mmHg, 10.14 mmHg), or 37% IOP reduction, from unmedicated baseline IOP. Compared to preoperative medicated IOP, subjects had mean reduction at Month 36 of 5.5±2.7 mmHg (95% CI 4.5 mmHg, 6.6 mmHg), or 26% reduction. Both measures of IOP reduction were highly significant (P<0.001). Other than one case of early postoperative hyphema that resolved at 1 week, no postoperative adverse events were attributed to stent implantation. Conclusion In a pilot study, two trabecular microbypass stents to treat OAG subjects on one preoperative medication provided statistically significant, sustained, and safe reduction of IOP to ≤15 mmHg without medication through 36 months. PMID:26604675

  13. [Characteristics of cerebral hemodynamics and psychological adaptation of patients with myocardial infarction during period of rehabilitation and convalescence].

    PubMed

    Stashkevich, V P; Savchenko, N A; Babitskiĭ, V L; Toropchin, V I; Tereshchenko, V V; Strukov, V V

    2005-06-01

    Cerebral circulation and psychological state of 93 myocardial infarction patients aged from 29 to 60 years have been studied. The comparison of data concerning cerebral circulation with psychological profile of these patients enables us to make a conclusion that there is interrelation between the state of cerebral hemodynamics which ensures brain homeostasis and psychological adaptation of patients with myocardial infarction at different stages of the disease

  14. Long-term effectiveness of four pulpotomy techniques: 3-year randomised controlled trial.

    PubMed

    Huth, Karin Christine; Hajek-Al-Khatar, Niran; Wolf, Petra; Ilie, Nicoleta; Hickel, Reinhard; Paschos, Ekaterini

    2012-08-01

    A pulpotomy is the therapy for management of pulp exposures due to caries in symptom-free primary molars. The aim was to longitudinally compare the relative effectiveness of the Er:YAG laser, calcium hydroxide and ferric sulphate techniques with dilute formocresol in retaining symptom-free molars. Two hundred primary molars in 107 healthy children were included and randomly allocated to one technique. The treated teeth were blindly reevaluated after 6, 12, 18, 24 and 36 months. Descriptive data analysis and logistic regression analysis accounting for multiple observations per patient by generalised estimating equation were used. Additionally, various influences including tooth type, upper and lower jaws, type of anaesthesia, operator and the final restoration on treatment success were evaluated (Wald chi-square test). After 36 months, the following total (considering clinical and clinically symptom-free radiographic failures) and clinical success rates were determined (in percent): Formocresol 72 (92), laser 73 (89), calcium hydroxide 46 (75), ferric sulphate 76 (97). No significant differences were detected between formocresol and any other technique after 36 months. However, the odds ratio of failure appeared to be three times higher for calcium hydroxide than for formocresol. No significant differences in total success rates were seen regarding the aforementioned influencing clinical parameters. The correct diagnosis of the pulpal status, bleeding control and the specific technique are highly important for long-term success of pulpotomies in primary molars. According to the presented long-term data, pulpotomies using ferric sulphate revealed the best treatment outcome among the used techniques, while calcium hydroxide resulted in the lowest success rates after 3 years. Therefore, we can recommend ferric sulphate for easy and successful treatment of primary molars with caries-exposed pulps.

  15. ISOLATION OF THE GENOME SEQUENCE STRAIN MYCOBACTERIUM AVIUM 104 FROM MULTIPLE PATIENTS OVER A 17-YEAR PERIOD

    EPA Science Inventory

    The genome sequence strain 104 of the opportunistic pathogen Mycobacterium avium was isolated form an adult AIDS patient in Southern California in 1983. Isolates of non-paratuberculosis M. avium from 207 other patients in Southern California and elsewhere were examined for genoty...

  16. Automated peritoneal dialysis as the modality of choice: a single-center, 3-year experience with 458 children in Mexico.

    PubMed

    Fabian Velasco, Rosaura; Lagunas Muñoz, Jesus; Sanchez Saavedra, Veronica; Mena Brito Trejo, Jorge E; Qureshi, Abdul Rashid; García-López, Elvia; Divino Filho, Jose C

    2008-03-01

    Automated peritoneal dialysis (APD) has been considered as the ideal dialysis modality for pediatric patients. This study reports the 3-year APD experience with 458 end-stage renal disease (ESRD) children who started APD in a single pediatric center in Mexico City between June 2003 and June 2006. By June 2003, there were 310 patients being treated with continuous ambulatory peritoneal dialysis (CAPD). At that time, these patients were gradually switched to APD, with priority being given to those prescribed more than four exchanges per day, younger than 6 years of age, or presenting complications [hernias or decreased ultrafiltration (UF)]. An improvement of daily UF was observed when the patients were switched from CAPD (590 +/- 340 ml/day) to APD (846 +/- 335 ml/day). The presence of edema decreased (from 67% to 8%) as well as the percentage of patients requiring antihypertensive drugs (from 83% to 38%), the peritonitis rate improved from one episode every 35 patient/month to one episode every 47 patient/month, the total number of hospitalizations decreased (from 384 to 51), and 85% of children attended school. While waiting for renal transplant, APD is the dialysis modality of choice for ESRD children at the La Raza Medical Center in Mexico City.

  17. Parental Involvement in Cognitive Behavior Therapy for Children with Anxiety Disorders: 3-Year Follow-Up.

    PubMed

    Walczak, Monika; Esbjørn, Barbara H; Breinholst, Sonja; Reinholdt-Dunne, Marie Louise

    2016-07-12

    Parental factors have been linked to childhood anxiety, hence, parental involvement in cognitive behavioral therapy (CBT) for anxious children has been examined. However, findings do not consistently show added effects of parent-enhanced CBT, longitudinal investigations are scarce and long-term effects unclear. In the present study, 40 out of 54 families who, 3 years previously, completed one of two types of CBT treatment: with limited or active parental involvement, were assessed using semi-structured diagnostic interviews. Diagnostic status at 3-years follow-up was compared between groups. Changes in diagnostic status across assessment points: posttreatment, 6-month and 3-year follow-up were analyzed within groups. Diagnostic change from 6-month to 3-year follow-up was compared between groups. Intent-to-treat analyses revealed no significant difference in diagnostic status between groups at 3-year follow-up. Nonetheless, children whose parents actively participated in treatment showed significantly more remission from 6-month to 3-year follow-up than children with limited parental participation.

  18. Dietary energy density and body weight changes after 3 years in the PREDIMED study.

    PubMed

    Razquin, Cristina; Sanchez-Tainta, Ana; Salas-Salvadó, Jordi; Buil-Cosiales, Pilar; Corella, Dolores; Fito, Montserrat; Ros, Emilio; Estruch, Ramón; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Serra-Majem, Luis; Pinto, Xavier; Schröder, Helmut; Tur, Josep; Sorlí, José V; Lamuela-Raventós, Rosa M; Bulló, Mónica; Bes-Rastrollo, Maira; Martinez-Gonzalez, Miguel A

    2017-03-06

    The association of dietary energy density (ED) and overweight is not clear in the literature. Our aim was to study in 4259 of the PREDIMED trial whether an increase in dietary ED based on a higher adherence to a Mediterranean dietary pattern was associated with 3-year weight gain. A validated 137-item food-frequency questionnaire was administered. Multivariable-adjusted models were used to analyze the association between 3-year ED change and the subsequent 3-year body weight change. The most important weight reduction after 3-year follow-up was observed in the two lowest quintiles and the highest quintile of ED change. The highest ED increase was characterized by an increased intake of extra virgin olive oil (EVOO) and nuts and a decreased intake of other oils, vegetable and fruit consumption (p < .001). In conclusion, increased 3-year ED in the PREDIMED study, associated with a higher EVOO and nuts consumption, was not associated with weight gain.

  19. Change in Antimicrobial Susceptibility of Skin-Colonizing Staphylococcus aureus in Korean Patients with Atopic Dermatitis during Ten-Year Period

    PubMed Central

    Park, Jung-Min; Jo, Ju-Hyun; Jin, Hyunju; Ko, Hyun-Chang; Kim, Moon-Bum; Kim, Jung-Min; Kim, Do-Won; Jang, Ho-Sun

    2016-01-01

    Background A small subset of adolescents atopic dermatitis (AD) tends to persist. This also leads to get more antibiotics exposure with advancing years. Antibiotic resistance has been regarded as a serious problem during Staphylococcus aureus treatment, especially methicillin-resistant S. aureus (MRSA). Objective It was investigated the S. aureus colonization frequency in the skin lesions and anterior nares of adolescent AD patients and evaluated the changes in S. aureus antimicrobial susceptibility for years. Methods Patients who visited our clinic from September 2003 to August 2005 were classified into group A, and patients who visited from August 2010 to March 2012 were classified into group B. To investigate the differences with regard to patients' age and disease duration, the patients were subdivided into groups according to age. Lesional and nasal specimens were examined. Results Among the 295 AD patients, the total S. aureus colonization rate in skin lesions was 66.9% (95/142) for group A and 78.4% (120/153) for group B. No significant changes in the systemic antimicrobial susceptibilities of S. aureus strains isolated from adolescent AD patients were observed during about 10-year period. The increased trend of MRSA isolation in recent adolescent AD outpatients suggest that the community including school could be the source of S. aureus antibiotic resistance and higher fusidic acid resistance rates provides evidence of imprudent topical use. Conclusion Relatively high MRSA isolation and fusidic acid resistance rates in recent AD patients suggest that the community harbors antibiotic-resistant S. aureus. PMID:27489430

  20. The Predictive Value of Cognitive Impairments Measured at the Start of Clinical Rehabilitation for Health Status 1 Year and 3 Years Poststroke

    ERIC Educational Resources Information Center

    Verhoeven, Clara L.; Schepers, Vera P.; Post, Marcel W.; van Heugten, Caroline M.

    2011-01-01

    The objective of this study was to investigate the value of screening for cognitive functions at the start of an inpatient rehabilitation programme to predict the health status 1 and 3 years poststroke. In this longitudinal cohort study of stroke patients in inpatient rehabilitation data of 134 participants were analysed. Cognitive and clinical…

  1. Survival improvement in patients with pancreatic cancer by decade: A period analysis of the SEER database, 1981–2010

    PubMed Central

    Sun, Huanhuan; Ma, Haiqing; Hong, Guobin; Sun, Hongliu; Wang, Jin

    2014-01-01

    Pancreatic cancer (PaCa) is an aggressive malignancy with a high mortality rate and a poor prognosis. To evaluate treatment outcomes of patients with pancreatic cancer over the past three decades, data from the Surveillance, Epidemiology, and End Results (SEER) registries were used to assess the survival of patients with PaCa. A total of 63,530 patients diagnosed with pancreatic cancer between 1981 and 2010 were identified from nine original SEER registries. The 1-year relative survival rates (RSRs) improved each decade, from 17.0% to 19.9% to 28.2% (p < 0.0001), with a larger increase during the third decade than during the second decade. However, the long-term survival rates have remained very low. The 5-year RSRs increased from 3.1% to 4.4% to 6.9% over these three decades—i.e., still only few patients with PaCa survive more than 5 years. Furthermore, our analysis demonstrated that the survival rates for all the patients with pancreatic cancer were lower in patients of lower socioeconomic status and black race. These results will help predict future trends in PaCa incidence and survival, contribute to better-designed clinical trials by eliminating disparities that may affect the results, and thereby improve the clinical management and outcomes of PaCa. PMID:25339498

  2. Impacts of 3 years of elevated atmospheric CO2 on rhizosphere carbon flow and microbial community dynamics.

    PubMed

    Drigo, Barbara; Kowalchuk, George A; Knapp, Brigitte A; Pijl, Agata S; Boschker, Henricus T S; van Veen, Johannes A

    2013-02-01

    Carbon (C) uptake by terrestrial ecosystems represents an important option for partially mitigating anthropogenic CO2 emissions. Short-term atmospheric elevated CO2 exposure has been shown to create major shifts in C flow routes and diversity of the active soil-borne microbial community. Long-term increases in CO2 have been hypothesized to have subtle effects due to the potential adaptation of soil microorganism to the increased flow of organic C. Here, we studied the effects of prolonged elevated atmospheric CO2 exposure on microbial C flow and microbial communities in the rhizosphere. Carex arenaria (a nonmycorrhizal plant species) and Festuca rubra (a mycorrhizal plant species) were grown at defined atmospheric conditions differing in CO2 concentration (350 and 700 ppm) for 3 years. During this period, C flow was assessed repeatedly (after 6 months, 1, 2, and 3 years) by (13) C pulse-chase experiments, and label was tracked through the rhizosphere bacterial, general fungal, and arbuscular mycorrhizal fungal (AMF) communities. Fatty acid biomarker analyses and RNA-stable isotope probing (RNA-SIP), in combination with real-time PCR and PCR-DGGE, were used to examine microbial community dynamics and abundance. Throughout the experiment the influence of elevated CO2 was highly plant dependent, with the mycorrhizal plant exerting a greater influence on both bacterial and fungal communities. Biomarker data confirmed that rhizodeposited C was first processed by AMF and subsequently transferred to bacterial and fungal communities in the rhizosphere soil. Over the course of 3 years, elevated CO2 caused a continuous increase in the (13) C enrichment retained in AMF and an increasing delay in the transfer of C to the bacterial community. These results show that, not only do elevated atmospheric CO2 conditions induce changes in rhizosphere C flow and dynamics but also continue to develop over multiple seasons, thereby affecting terrestrial ecosystems C utilization processes.

  3. Molecular characterization of acinetobacter isolates collected in intensive care units of six hospitals in Florence, Italy, during a 3-year surveillance program: a population structure analysis.

    PubMed

    Donnarumma, Francesca; Sergi, Simona; Indorato, Cristina; Mastromei, Giorgio; Monnanni, Roberto; Nicoletti, Pieluigi; Pecile, Patrizia; Cecconi, Daniela; Mannino, Roberta; Bencini, Sara; Fanci, Rosa; Bosi, Alberto; Casalone, Enrico

    2010-04-01

    The strain diversity and the population structure of nosocomial Acinetobacter isolated from patients admitted to different hospitals in Florence, Italy, during a 3-year surveillance program, were investigated by amplified fragment length polymorphism (AFLP). The majority of isolates (84.5%) were identified as A. baumannii, confirming this species as the most common hospital Acinetobacter. Three very distinct A. baumannii clonal groups (A1, A2, and A3) were defined. The A1 isolates appeared to be genetically related to the well-characterized European EU II clone. A2 was responsible for three outbreaks which occurred in two intensive care units. Space/time population dynamic analysis showed that A1 and A2 were successful nosocomial clones. Most of the A. baumannnii isolates were imipenem resistant. The genetic determinants of carbapenem resistance were investigated by multiplex PCR, showing that resistance, independently of hospital origin, period of isolation, or clonal group, was associated with the presence of a bla (OXA-58-like) gene and with ISAba2 and ISAba3 elements flanking this gene. bla (OXA-58) appeared to be horizontally transferred. This study showed that the high discriminatory power of AFLP is useful for identification and typing of nosocomial Acinetobacter isolates. Moreover the use of AFLP in a real-time surveillance program allowed us the recognition of clinically relevant and widespread clones and their monitoring in hospital settings. The correlation between clone diffusion, imipenem resistance, and the presence of the bla(OXA-58-like) gene is discussed.

  4. Full-mouth rehabilitation with monolithic CAD/CAM-fabricated hybrid and all-ceramic materials: A case report and 3-year follow up.

    PubMed

    Selz, Christian F; Vuck, Alexander; Guess, Petra C

    2016-02-01

    Esthetic full-mouth rehabilitation represents a great challenge for clinicians and dental technicians. Computer-aided design/ computer-assisted manufacture (CAD/CAM) technology and novel ceramic materials in combination with adhesive cementation provide a reliable, predictable, and economic workflow. Polychromatic feldspathic CAD/CAM ceramics that are specifically designed for anterior indications result in superior esthetics, whereas novel CAD/CAM hybrid ceramics provide sufficient fracture resistance and adsorption of the occlusal load in posterior areas. Screw-retained monolithic CAD/CAM lithium disilicate crowns (ie, hybrid abutment crowns) represent a reliable and time- and cost-efficient prosthetic implant solution. This case report details a CAD/CAM approach to the full-arch rehabilitation of a 65-year-old patient with toothand implant-supported restorations and provides an overview of the applied CAD/CAM materials and the utilized chairside intraoral scanner. The esthetics, functional occlusion, and gingival and peri-implant tissues remained stable over a follow-up period of 3 years. No signs of fractures within the restorations were observed.

  5. Renal transplantation promptly restores excretory function but disturbed L-arginine metabolism persists in patients during the early period after surgery.

    PubMed

    Žunić, Gordana; Vučević, Dragana; Tomić, Aleksandar; Drašković-Pavlović, Biljana; Majstorović, Ivana; Spasić, Slavica

    2015-01-30

    The synthesis and whole body metabolism of L-arginine (Arg) are disturbed in renal diseases. Renal transplantation represents the best therapy in the end-stage of these diseases. In the present we compared alterations of plasma Arg and related compounds with renal excretory function in patients with end-stage renal disease, before and after kidney transplantation. Arg, asymmetric dimethylarginine (ADMA), citrulline (Cit), glutamine (Gln), ornithine (Orn), phenylalanine (Phe), tyrosine (Tyr), urea, creatinine, albumin, and nitrate were analyzed in patients before, immediately after (0-time) and 1, 2, 3, 7 and 14 days following living donors kidney transplantation. Healthy subjects were controls. Glomerular filtration rate (GFR) and amino acid molar ratios were calculated. Before transplantation creatinine, urea, Cit, Gln, ADMA, and nitrate were above, while GFR and Arg were below controls, confirming disturbed excretory and metabolic renal functions in patients with renal disease. Renal transplantation promptly normalized creatinine, urea, GFR, Cit, and nitrate. However, regardless of increased molar Phe/Tyr ratios, indicating increased net protein catabolism in peripheral tissues, low Arg and elevated ADMA concentrations persisted throughout the examined period. Alterations of other amino acids also suggest similarly disturbed Arg metabolism in patients after kidney transplantation. In conclusion, renal transplant promptly restored its excretory function, but increased net protein catabolism, disturbed Arg metabolism and endothelial dysfunction in entire body of these patients were not improved throughout the early period after the operation. That has to be considered in their therapy.

  6. Cysteamine in renal transplantation: A report of two patients with nephropathic cystinosis and the successful re-initiation of cysteamine therapy during the immediate post-transplant period.

    PubMed

    Berryhill, Allison; Bhamre, Suvarna; Chaudhuri, Abanti; Concepcion, Waldo; Grimm, Paul C

    2016-02-01

    Nephropathic cystinosis is a rare disorder causing the accumulation of intracellular cystine crystals in tissues. The damage to the proximal tubules of the kidneys results in Fanconi syndrome, and patients with cystinosis experience the progression of chronic kidney disease, resulting in the need for kidney transplantation. Treatment of cystinosis with cysteamine has proven to be effective; however, it has many gastrointestinal side effects that are concerning for transplant specialists during the immediate post-transplant period. Transplant specialists routinely discontinue cysteamine therapy for up to six weeks to ensure proper immunosuppressant absorption. This practice is worrisome because it communicates the acceptability of lapses of cysteamine treatment to patients. It may be better to re-initiate cysteamine therapy shortly after transplantation while the patient is followed more closely by the transplant team. This report presents two pediatric patients with nephropathic cystinosis who successfully restarted cysteamine therapy in the immediate post-transplant period without issue in regard to immunosuppression absorption or gastrointestinal side effects. These cases challenge current practice of discontinuing cysteamine therapy during kidney transplantation, and immediate re-initiation of cysteamine therapy in cystinosis patients post-transplant should be considered.

  7. Development and implementation of the Clinical Tooth Shade Differentiation Course – an evaluation over 3 years

    PubMed Central

    Olms, Constanze; Haak, Rainer; Jakstat, Holger A.

    2016-01-01

    Objective: Tooth shade differentiation concerns the identification and classification of tooth shades. The objective of this project was to implement the Clinical Tooth Shade Differentiation Course in the preclinical stage of studies and to evaluate the students' perspective over a period of 3 years. Methodology: The course is planned for a duration of 10 weeks with two 45-minute sessions per semester week. The entire attendance time was 10:15 h. 2 lectures of 90 minutes each, 2 seminars of 60 min each and 2 teaching units with the phantom head and role playing took place. In addition to the various parameters of tooth shade, changes in tooth shade and the basics of dental esthetics, clinical procedures for manual and digital tooth shade determination were explained and practiced. 96% (69 of 72) of the students participated in the first evaluation in 2012/2013 (T1), and 68% of these were women. In the following year, 2013/2014 (T2), 92% (45 of 48 students) took part; 62% of these were women and 38% men. The 2014/2015 evaluation (T3) comprised 94% (45 of 48 students). Of these, 67% were women. Results: In the evaluation, the students gave the course a positive grade. The questions in "General/Organization" were given a mean (M) of 1.5 (SD=0.7) in T1 and T2 , and 1.2 (SD=0.3) in T3. The "Overall Assessment" yielded MT1=1.6 (SD=0.6), MT2=1.5 (SD=0.5) and MT3=1.1 (SD=0.3). In T1 and T2, the item "The instructor actively involved the students in the course" was given a mean of 2.1 (SD=0.9), and in T3 a mean of 1.2 (SD=0.5). Conclusions: The course presented here conceptually shows how practical dental skills can be taught in a theoretical and clinical context. Educational objectives from the role of a dental expert were taken from the national competence-based catalog of educational objectives for dentistry and can also be supplemented. The objectives can be transferred to other dental faculties. PMID:26958650

  8. The prevalence of vitamin D deficiency in consecutive new patients seen over a 6-month period in general rheumatology clinics.

    PubMed

    Haroon, Muhammad; Bond, Ursula; Quillinan, Niamh; Phelan, Mark J; Regan, Michael J

    2011-06-01

    The objectives of this study are to assess: (a) the prevalence of vitamin D deficiency among new patients attending rheumatology outpatient departments, (b) the age profile of these low vitamin D patients and (c) whether any diagnostic category had a particularly high number of vitamin D-deficient patients. All new patients seen consecutively in general rheumatology clinics between January to June 2007 inclusive were eligible to partake in this study, and 231 out of 264 consented to do so. Parathyroid hormone, 25-hydroxyvitamin D, creatinine, calcium, phosphate, albumin and alkaline phosphatase levels were measured. We defined vitamin D deficiency as ≤53 nmol/l and severe deficiency as ≤25 nmol/l. Overall, 70% of 231 patients had vitamin D deficiency, and 26% had severe deficiency. Sixty-five percent of patients aged ≥65 and 78% of patients aged ≤30 years had low vitamin D levels. Vitamin D deficiency in each diagnostic category was as follows: (a) inflammatory joint diseases/connective tissue diseases (IJD/CTD), 69%; (b) soft tissue rheumatism, 77%; (c) osteoarthritis, 62%; (d) non-specific musculoskeletal back pain, 75% and (e) osteoporosis, 71%. Seasonal variation of vitamin D levels was noted in all diagnostic groups apart from IJD/CTD group, where the degree of vitamin D deficiency persisted from late winter to peak summer. Very high prevalence of vitamin D deficiency was noted in all diagnostic categories (p = 0.006), and it was independent of age (p = 0.297). The results suggest vitamin D deficiency as a possible modifiable risk factor in different rheumatologic conditions, and its role in IJD/CTD warrants further attention.

  9. Evapotranspiration over a Japanese cypress forest. I. Eddy covariance fluxes and surface conductance characteristics for 3 years

    NASA Astrophysics Data System (ADS)

    Kosugi, Yoshiko; Takanashi, Satoru; Tanaka, Hiroki; Ohkubo, Shinjiro; Tani, Makoto; Yano, Masato; Katayama, Tatsuya

    2007-04-01

    SummaryEvapotranspiration above a Japanese cypress ( Chamaecyparis obtusa Sieb. et Zucc.) forest with complex topography in central Japan were observed for 3 years using the eddy covariance method. The observations describe the magnitude and seasonal and inter-annual variations in sensible and latent heat fluxes, evapotranspiration and the parameters describing bulk canopy characteristics. Average annual evapotranspiration over the period was approximately 735 mm. Despite large fluctuations in precipitation (1179-1971 mm) during the 3 years, inter-annual fluctuations in evapotranspiration were small. Midday average dry canopy surface conductance was 6.7 mm s -1 during midseason and decreased in winter. The midday average dry canopy decoupling factor ( Ω) was 0.21 during midseason and decreased in winter. This forest is characterized by relatively small values of surface conductance and decoupling factor compared to other forests. However, several other coniferous forests show smaller values. Surface conductance, and thus stomatal regulation, is important in controlling dry-canopy transpiration in this forest. Inter-annual fluctuations of bulk parameters were small; surface conductance characteristics affected by soil moisture did not vary between dry and wet years.

  10. Fatigue analysis in the masseters and temporalis muscles in patients with temporomandibular disorder during short period of mastication.

    PubMed

    Caria, Paulo H F; Bigaton, Delaine R; de Oliveira, Anamaria S; Bérzin, Fausto

    2009-01-01

    The purpose of this experiment was to look for signals of muscle fatigue in volunteers with Temporomandibular Disorders (TMD) during short period of mastication. Twenty female volunteers selected by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) participated, 10 with myogenic TMD (experimental) and 10 clinically normal (control). The Masseter and Temporalis muscles were evaluated electromyographically with active differential surface electrodes. The masticatory activity was recorded for 15 seconds and the signals were normalized by 4 seconds of teeth clenching. Three complete masticatory cycles were taken to calculating the median frequency (MF) and electromyographic amplitude (RMS). The data were submitted to statistics analysis and non-parametric tests. The results showed that RMS and median frequency did not change during the mastication period analyzed, indicating the absence of muscle fatigue, for the Masseter and Temporalis muscles in both groups (p> 0.05). These results confirm the absence of signals of muscle fatigue in masticatory muscles during short period of mastication even in individuals with TMD, possibly due to increased of blood flow, consequence of dynamic muscle contraction and the individual characteristics of muscle fiber composition and recruitment.

  11. Homeopathic treatment of elderly patients - a prospective observational study with follow-up over a two year period

    PubMed Central

    2010-01-01

    Background Very little is known about the range of diagnoses, course of treatment and long-term outcome in elderly patients who choose to receive homeopathic medical treatment. We investigated homeopathic practice in an industrialised country under everyday conditions. The aim of the study was to determine the spectrum of diagnoses and treatments, as well as to describe the course of illness over time among older patients who chose to receive homeopathic treatment. Methods In this subgroup analysis of a prospective, multicentre cohort study totally including 3981 patients treated by homeopathic physicians in primary care practices in Germany and Switzerland, data was analysed from all patients > 70 years consulting the physician for the first time. The main outcome measures were: assessment by patient of the severity of complaints (numeric rating scales) and quality of life (SF-36) and by the physician of the severity of diagnoses (numeric rating scales) at baseline, and after 3, 12, and 24 months. Results A total of 83 patients were included in the subgroup analysis (41% men, mean age 73.2 ± (SD) 3.1 years; 59% women, 74.3 ± 3.8 years). 98.6 percent of all diagnoses were chronic with an average duration of 11.5 ± 11.5 years. 82 percent of the patients were taking medication at baseline. The most frequent diagnoses were hypertension (20.5%, 11.1 ± 7.5 years) and sleep disturbances (15.7%, 22.1 ± 25.8 years). The severity of complaints decreased significantly between baseline and 24 months in both patients (from 6.3 (95%CI: 5.7-6.8) to 4.6 (4.0-5.1), p < 0.001) and physicians' assessments (from 6.6 (6.0-7.1) to 3.7 (3.2-4.3), p < 0.001); quality of life (SF 36) and the number of medicines taken did not significantly change. Conclusion The severity of disease showed marked and sustained improvements under homeopathic treatment, but this did not lead to an improvement of quality of life. Our findings might indicate that homeopathic medical therapy may play a

  12. Effect of transsphenoidal surgery and standard care on fertility related indicators of patients with prolactinomas during child-bearing period

    PubMed Central

    Yan, Zhiyue; Wang, Yiming; Shou, Xuefei; Su, Jianguang; Lang, Liwei

    2015-01-01

    Objective: To explore the surgical therapeutic effects in the endocrine and reproductive system of women with prolactinoma at child-bearing age, and to investigate the potential influencing factors for therapeutic outcome. Methods: This retrospective study was performed using the medical records of 99 cases of female patients with pituitary PRL adenomas at child-bearing age, who underwent transsphenoidal surgery and took standard perioperative care from January, 2013 to June, 2013 in Huashan hospital, in which micro adenoma (≤1 cm) of 68 cases, large adenomas (> 1 cm) of 31 cases, 88 cases were total resection, 9 cases were subtotal resection, and 2 cases were massive resection. Retrospective study on the preoperative serum level of PRL, menstruation, galactorrhea and reproductive function, etc. Patients were followed up in 1, 3, 6 and 12 months after operation for endocrine indicators, the situation of menstruation and pregnancy. Results: Overall, 88.9%, 9.1%, and 2% patients underwent total, subtotal, and massive resection of prolactinoma in 99 cases of patients. Before accepting transsphenoidal surgery and standard care, all 99 cases with serum PRL level higher than normal 25 ng/ml, 71.7% (71 cases, all total resection) patients had their serum PRL < 25 ng/ml on the first day after surgery, and micro adenomas remission rate of 80.9% (55 cases) was significantly higher than 51.6% of large adenomas (16 cases) (P < 0.05); the postoperative PRL of 11 cases of total or massive resection in patients were not back to normal, Chi-square test results showed that the PRL remission rate after total resection were significantly higher than that of subtotal or massive resection (P < 0.01). 67.3% (66/98) irregular menstruation patients had menstruation recovery after surgery, in addition, total resection of the tumor, micro- adenoma, preoperative PRL < 200 ng/ml and first day of postoperative PRL ≤25 ng/ml were favorable factors for menstrual improvement (P < 0.05). 83

  13. [The function of the coagulation hemostatic and fibrinolytic processes in the postoperative period in patients with complicated chronic pancreatitis].

    PubMed

    Shishlov, V I

    1999-01-01

    Intravenous infusion of modified amino acid cocktail (AC), based of the "Aminosyn PF" composition with addition of glutamine, methyonine and selenium was applied in the complex of treatment of patients with complicated chronic pancreatitis. After AC infusion during 3 days after the operation the coagulation indexes restoration was noted while after conventional treatment in these terms the signs of thrombohemorrhagic syndrome were registered.

  14. Comparative analysis of the effects of two chest physical therapy interventions in patients with bronchiolitis during hospitalization period

    PubMed Central

    Remondini, Renata; dos Santos, Adriana Zamprônio; de Castro, Giselle; do Prado, Cristiane; da Silva, Luiz Vicente Ribeiro Ferreira

    2014-01-01

    Objective To evaluate and compare the effects of two chest physiotherapy interventions in patients hospitalized due to acute bronchiolitis. Methods Prospective randomized study with a sample of 83 calls for 29 patients aged between 3 months and 1 year hospitalized for acute bronchiolitis. Patients were distributed randomly into two groups: Group 1, submitted to postural drainage, tapping and tracheal aspiration; and Group 2, submitted to postural drainage, expiratory acceleration flow and tracheal aspiration. Assessments were made before and 10 and 60 minutes after the end of therapy. Patients also underwent drug treatment. The endpoint was to compare two physical therapy interventions as to clinical improvement in infants with acute bronchiolitis by means of oxygen saturation and the Respiratory Distress Assessment Instrument score. The parents/guardians was requested to answer a questionnaire about the treatment applied before the last evaluation in order to measure their satisfaction related to the interventions made. Results The groups were similar regarding the use of antibiotics and bronchodilators. A greater number of patients used corticosteroids in Group 2. A relevant improvement was observed on Respiratory Distress Assessment Instrument score with physical therapy, with reduction of the score 10 minutes after interventions, and the same score 60 minutes later, with no differences between techniques applied. There was no significant variation of pulse oximetry after chest physiotherapy. Most items assessed by the questionnaire had satisfactory answers. Conclusion No differences were observed between groups regarding the items assessed (time required to discharge from study, pulse oximetry in room air and disease severity according to the Respiratory Distress Assessment Instrument score). Parents answered positively about the effects of therapy in the majority of items in the questionnaire, both for the expiratory acceleration flow technique and for tapping

  15. Final Report for 3-year grant no. DE-FG05-85ER40226. Investigations in Elementary Particle Theory.

    SciTech Connect

    Kephart, Thomas W.; Scherrer, Robert J.; Weiler, Thomas J.

    2014-11-23

    The research interests of our three Co-PI’s complement each other very well. Kephart works mainly on models of particle unification in four or higher dimensions, on aspects of gravity such as inflation, black-holes, and the very early Universe, and on applications of knot theory and topology to various physical systems (including gluon dynamics). Scherrer works mainly on aspects of the intermediate-aged Universe, including dark matter and dark energy, and particle physics in the early Universe. Weiler works mainly on neutrino physics, dark matter signatures, and extreme particle-astrophysics in the late Universe, including origins of the highest-energy cosmic-rays and gamma-rays, and the future potential of neutrino astrophysics. Kephart and Weiler have lately devoted some research attention to the LHC and its reach for probing physics beyond the Standard Model. During the 3-year funding period, our grant supported one postdoc (Chiu Man Ho) and partially supported two students, Peter Denton and Lingjun Fu. Chiu Man collaborated with all three of the Co-PI’s during the 3-year funding period and published 16 refereed papers. Chiu Man has gone on to a postdoc with Steve Hsu at Michigan State University. Denton and Fu will both receive their PhDs during the 2014-15 academic year. The total number of our papers published in refereed journals by the three co-PIs during the period of this grant (2011-present) is 54. The total number of talks given by the group members during this time period, including seminars, colloquia, and conference presentations, is 47. Some details of the accomplishments of our DOE funded researchers during the grant period include Weiler being named a Simons Fellow in 2013. He presented an invited TEDx talk in 2012. His paper on closed timelike curves (2013) garnered a great deal of national publicity. Scherrer’s paper on the “little rip” (2011) fostered a new area of cosmological research, and the name “little rip” has now entered

  16. Effect of a field program based on systematic plaque control on caries and gingivitis in schoolchildren after 3 years.

    PubMed

    Hamp, S E; Lindhe, J; Fornell, J; Johansson, L A; Karlsson, R

    1978-01-01

    The effect of a field program, based on systematic plaque control, on caries and gingivitis was tested during a 3-year period on 1,100 schoolchildren. Once every 3rd week the children were given oral hygiene instructions, professional toothcleaning and fluorides topically delivered by specially trained dental nurses. The children of a control group of approximately the same number of pupils, participated in a preventive program consisting of mouthrinsings once every 2nd week with a 0.2% sodium fluoride solution. The children of the third and fourth grades were, at the start of the experiment, selected as reference groups and then continuously examined once every year. At the end of the trial the mean reduction of surfaces haboring plaque and units with gingival inflammation was 59% and 73%, respectively. The reduction in caries increment was 51%.

  17. Early Intervention for Children With Autism Spectrum Disorder Under 3 Years of Age: Recommendations for Practice and Research.

    PubMed

    Zwaigenbaum, Lonnie; Bauman, Margaret L; Choueiri, Roula; Kasari, Connie; Carter, Alice; Granpeesheh, Doreen; Mailloux, Zoe; Smith Roley, Susanne; Wagner, Sheldon; Fein, Deborah; Pierce, Karen; Buie, Timothy; Davis, Patricia A; Newschaffer, Craig; Robins, Diana; Wetherby, Amy; Stone, Wendy L; Yirmiya, Nurit; Estes, Annette; Hansen, Robin L; McPartland, James C; Natowicz, Marvin R

    2015-10-01

    This article reviews current evidence for autism spectrum disorder (ASD) interventions for children aged <3 years, based on peer-reviewed articles published up to December 2013. Several groups have adapted treatments initially designed for older, preschool-aged children with ASD, integrating best practice in behavioral teaching methods into a developmental framework based on current scientific understanding of how infants and toddlers learn. The central role of parents has been emphasized, and interventions are designed to incorporate learning opportunities into everyday activities, capitalize on "teachable moments," and facilitate the generalization of skills beyond the familiar home setting. Our review identified several comprehensive and targeted treatment models with evidence of clear benefits. Although some trials were limited to 8- to 12-week outcome data, enhanced outcomes associated with some interventions were evaluated over periods as long as 2 years. Based on this review, recommendations are proposed for clinical practice and future research.

  18. Paternal Psychosocial Characteristics and Corporal Punishment of Their 3-Year-Old Children

    ERIC Educational Resources Information Center

    Lee, Shawna J.; Perron, Brian E.; Taylor, Catherine A.; Guterman, Neil B.

    2011-01-01

    This study uses data from 2,309 biological fathers who participated in the Fragile Families and Child Well-Being Study (FFCWS) to examine associations between psychosocial characteristics and levels of corporal punishment (CP) toward their 3-year-old children over the past month. Results indicate that 61% of the fathers reported no CP over the…

  19. Enhancing the Executive Functions of 3-Year-Olds in the Dimensional Change Card Sort Task

    ERIC Educational Resources Information Center

    Perone, Sammy; Molitor, Stephen J.; Buss, Aaron T.; Spencer, John P.; Samuelson, Larissa K.

    2015-01-01

    Executive functions enable flexible thinking, something young children are notoriously bad at. For instance, in the dimensional change card sort (DCCS) task, 3-year-olds can sort cards by one dimension (shape), but continue to sort by this dimension when asked to switch (to color). This study tests a prediction of a dynamic neural field model that…

  20. Abstract Sentence Representations in 3-Year-Olds: Evidence from Language Production and Comprehension

    ERIC Educational Resources Information Center

    Bencini, Giulia M. L.; Valiana, Virginia V.

    2008-01-01

    We use syntactic priming to test the abstractness of the sentence representations of young 3-year-olds (35-42 months). In describing pictures with inanimate participants, 18 children primed with passives produced more passives (11 with a strict scoring scheme, 16 with lax scoring) than did 18 children primed with actives (2 on either scheme) or 12…

  1. Directly Observed Physical Activity among 3-Year-Olds in Finnish Childcare

    ERIC Educational Resources Information Center

    Soini, Anne; Villberg, Jari; Sääkslahti, Arja; Gubbels, Jessica; Mehtälä, Anette; Kettunen, Tarja; Poskiparta, Marita

    2014-01-01

    The main purpose of the study was to determine 3-year-olds' physical activity levels and how these vary across season, gender, time of day, location, and the physical and social environment in childcare settings in Finland. A modified version of the Observational System for Recording Physical Activity in Children-Preschool (OSRAC-P) was used to…

  2. Learning To Learn: Children's Progress through the First 3 Years of School. Junior School Study.

    ERIC Educational Resources Information Center

    Wylie, Cathy; Smith, Lesley

    This study organized in 2 sections examined the progress of 32 New Zealand children during their first 3 years at school. Their achievement levels in reading, mathematics, and writing were examined based on interviews with the children, their teachers, and their parents; school records; notes; and video recordings. Section 1 deals with perceptions…

  3. Earth Science. Developing an Early Interest in Science: A Preschool Science Curriculum. (3-Year-Olds).

    ERIC Educational Resources Information Center

    Summer, Gail L.; Giovannini, Kathleen

    This teaching guide on earth sciences for 3-year-old children is based on a modification of the "Plan, Do, Review" approach to education devised by High Scope in Ypsilanti, Michigan. First implemented as an outreach early childhood program in North Carolina, the science activities described in this guide can be adapted to various early childhood…

  4. Turning Believers into Skeptics: 3-Year-Olds' Sensitivity to Cues to Speaker Credibility

    ERIC Educational Resources Information Center

    Jaswal, Vikram K.; Malone, Lauren S.

    2007-01-01

    Under most circumstances, children (and adults) can safely assume that the testimony they hear is true. In two studies, we investigated whether 3-year-olds (N = 100) would continue to hold this assumption even if the person who provided the testimony behaved in an uncertain, ignorant, and/or distracted manner. In Study 1, children were less likely…

  5. The Baltimore City Drug Treatment Court: 3-Year Self-Report Outcome Study

    ERIC Educational Resources Information Center

    Gottfredson, Denise C.; Kearley, Brook W.; Najaka, Stacy S.; Rocha, Carlos M.

    2005-01-01

    This study reports results from interviews with 157 research participants who were interviewed 3 years after randomization into treatment and control conditions in the evaluation of the Baltimore City Drug Treatment Court. The interviews asked about crime, substance use, welfare, employment, education, mental and physical health, and family and…

  6. Examining Communicative Behaviors in a 3-Year-Old Boy Who Is Blind.

    ERIC Educational Resources Information Center

    Perfect, Michelle M.

    2001-01-01

    The communication patterns of a 3-year-old boy who is blind were observed during 35 videotaped classroom sessions to determine if his echolalic responses varied according to school activity and message category. Analysis revealed that, although the child was expressive with adults, he had difficulty communicating with his peers and in producing…

  7. Words, Shape, Visual Search and Visual Working Memory in 3-Year-Old Children

    ERIC Educational Resources Information Center

    Vales, Catarina; Smith, Linda B.

    2015-01-01

    Do words cue children's visual attention, and if so, what are the relevant mechanisms? Across four experiments, 3-year-old children (N = 163) were tested in visual search tasks in which targets were cued with only a visual preview versus a visual preview and a spoken name. The experiments were designed to determine whether labels facilitated…

  8. Dimensions of Oppositional Defiant Disorder in 3-Year-Old Preschoolers

    ERIC Educational Resources Information Center

    Ezpeleta, Lourdes; Granero, Roser; de la Osa, Nuria; Penelo, Eva; Domenech, Josep M.

    2012-01-01

    Background: To test the factor structure of oppositional defiant disorder (ODD) symptoms and to study the relationships between the proposed dimensions and external variables in a community sample of preschool children. Method: A sample of 1,341 3-year-old preschoolers was randomly selected and screened for a double-phase design. In total, 622…

  9. The Development of Core Cognitive Skills in Autism: A 3-Year Prospective Study

    ERIC Educational Resources Information Center

    Pellicano, Elizabeth

    2010-01-01

    This longitudinal study tested the veracity of one candidate multiple-deficits account of autism by assessing 37 children with autism (M age = 67.9 months) and 31 typical children (M age = 65.2 months) on tasks tapping components of theory of mind (ToM), executive function (EF), and central coherence (CC) at intake and again 3 years later. As a…

  10. Basic Facts about Low-Income Children: Children under 3 Years, 2013. Fact Sheet

    ERIC Educational Resources Information Center

    Jiang, Yang; Ekono, Mercedes; Skinner, Curtis

    2015-01-01

    Children under 18 years represent 23 percent of the population, but they comprise 33 percent of all people in poverty. Among all children, 44 percent live in low-income families and approximately one in every five (22 percent) live in poor families. Our very youngest children--infants and toddlers under age 3 years--appear to be particularly…

  11. A Field Training Model for Creative Arts Therapies: Report from a 3-Year Program Evaluation

    ERIC Educational Resources Information Center

    Orkibi, Hod

    2012-01-01

    Clinical field training is an essential component of educating future therapists. This article discusses a creative arts therapies field training model in Israel as designed and modified from 3 years of program evaluation in a changing regulatory context. A clinical seminar structure puts beginning students in the role of participant-observer in…

  12. Emotional and Personality-Related Career Decision-Making Difficulties: A 3-Year Follow-Up

    ERIC Educational Resources Information Center

    Gati, Itamar; Asulin-Peretz, Lisa; Fisher, Ahinoam

    2012-01-01

    This study tests the temporal stability and the concurrent and predictive validity of the Emotional and Personality-related Career decision-making Difficulties (EPCD) model and questionnaire. Five hundred forty-three participants filled out the EPCD twice, 3 years apart. The Anxiety cluster was the most stable of the three, followed by the…

  13. Behavioral and Emotional Problems among Turkish Children at Ages 2 to 3 Years.

    ERIC Educational Resources Information Center

    Erol, Nese; Simsek, Zeynep; Oner, Ozgur; Munir, Kerim

    2005-01-01

    Objective: Within the framework of the Mental Health Surveys of Turkey, the authors investigated the distribution and prevalence of parent-reported behavioral and emotional problems in a nationally representative sample of 2- to 3-year-old children. Method: A cross-sectional population-based survey from October 1996 through March 1997 using a…

  14. Does Attention Constrain Developmental Trajectories in Fragile X Syndrome? A 3-Year Prospective Longitudinal Study

    ERIC Educational Resources Information Center

    Cornish, Kim; Cole, Victoria; Longhi, Elena; Karmiloff-Smith, Annette; Scerif, Gaia

    2012-01-01

    Basic attentional processes and their impact on developmental trajectories in fragile X syndrome were assessed in a 3-year prospective study. Although fragile X syndrome is a monogenic X-linked disorder, there is striking variability in outcomes even in young boys with the condition. Attention is a key factor constraining interactions with the…

  15. Enhancing Students' Engagement: Report of a 3-Year Intervention with Middle School Teachers

    ERIC Educational Resources Information Center

    Turner, Julianne C.; Christensen, Andrea; Kackar-Cam, Hayal Z.; Trucano, Meg; Fulmer, Sara M.

    2014-01-01

    All teachers (N = 32) at one middle school participated in a university-led intervention to improve student engagement. Teachers discussed four principles of motivation and related instructional strategies. Teachers enacted instructional strategies in their classrooms. We observed six randomly selected teachers and their students over 3 years.…

  16. The Semiotic Landscape and 3-Year-Olds' Emerging Understanding of Multimodal Communication Practices

    ERIC Educational Resources Information Center

    Yamada-Rice, Dylan

    2014-01-01

    This article considers the impact of the increasing use of the visual mode in texts found in urban landscapes on two 3-year-olds' understanding of communication practices. The data discussed are taken from a study into a group of 3- to 6-year-olds' interaction with and emerging comprehension of the visual mode and its connection to writing in…

  17. Trajectories of Maternal Harsh Parenting in the First 3 Years of Life

    ERIC Educational Resources Information Center

    Kim, Hyoun K.; Pears, Katherine C.; Fisher, Philip A.; Connelly, Cynthia D.; Landsverk, John A.

    2010-01-01

    Objective: Despite the high prevalence rates of harsh parenting, the nature of developmental change in this domain early in life and the factors that contribute to changes in harsh parenting over time are not well understood. The present study examined developmental patterns in maternal harsh parenting behavior from birth to age 3 years and their…

  18. How Selective Are 3-Year-Olds in Imitating Novel Linguistic Material?

    ERIC Educational Resources Information Center

    Bannard, Colin; Klinger, Jörn; Tomasello, Michael

    2013-01-01

    In 3 studies we explored when 3-year-olds would imitate novel words in utterances produced by adult speakers. Child and experimenter took turns in requesting objects from a game master. The experimenter always went first and always preceded the object's familiar name with a novel adjective (e.g., "the dilsige duck"). In the first 2…

  19. The Development of Inhibitory Control in Early Childhood: A Twin Study from 2-3 Years

    ERIC Educational Resources Information Center

    Gagne, Jeffrey R.; Saudino, Kimberly J.

    2016-01-01

    Parent- and lab-based observer ratings were employed to examine genetic and environmental influences on continuity and change in inhibitory control (IC) in over 300 twin-pairs assessed longitudinally at 2 and 3 years of age. Genetic influences accounted for approximately 60% of the variance in parent-rated IC at both ages. Although many of the…

  20. 3-Year-Old Children Make Relevance Inferences in Indirect Verbal Communication

    ERIC Educational Resources Information Center

    Schulze, Cornelia; Grassmann, Susanne; Tomasello, Michael

    2013-01-01

    Three studies investigated 3-year-old children's ability to determine a speaker's communicative intent when the speaker's overt utterance related to that intent only indirectly. Studies 1 and 2 examined children's comprehension of indirectly stated requests (e.g., "I find Xs good" can imply, in context, a request for…

  1. Prevalence of malocclusion traits and sucking habits among 3-year-old children.

    PubMed

    Dimberg, Lillemor; Bondemark, Lars; Söderfeldt, Björn; Lennartsson, Bertil

    2010-01-01

    The aim of the present study was to evaluate the prevalence of malocclusion traits and sucking habits among 3-year-old children. A sample of 457 3-year-old children (234 girls and 223 boys) was obtained from three Public Dental Health clinics in Orebro County Council, Sweden. Data from clinical examination and a questionnaire were used to determine malocclusion traits, sucking habits, snoring and breathing pattern including nocturnal breathing disturbances. The results showed that 70% had one or more malocclusion traits at 3 years of age. The most common malocclusion traits were anterior open bite (50%), Class II occlusion (26%), increased overjet (23%) and posterior crossbite (19%). The prevalence of sucking habit was 66% and dummy sucking was dominating and in connection with more malocclusion traits than finger/thumb sucking. A significant association was found between the sucking habits and the most prevalent malocclusions, anterior open bite, Class II occlusion, increased overjet and posterior crossbite. In conclusion, the prevalence of malocclusion traits in 3-year-old children was high. Sucking habits was highly prevalent and dummy sucking resulted in more malocclusion traits than finger/thumb sucking did.

  2. Risk of Mother-Reported Child Abuse in the First 3 Years of Life

    ERIC Educational Resources Information Center

    Windham, Amy M.; Rosenberg, Leon; Fuddy, Loretta; McFarlane, Elizabeth; Sia, Calvin; Duggan, Anne K

    2004-01-01

    Objective: The purpose of this research was to investigate, within an at-risk population, parent and child characteristics associated with a mother's self-reports of severe physical assault and assault on the self-esteem of the child in the first 3 years of life. Design: The study population consisted of a community-based sample of mothers of…

  3. Two-and 3-Year-Olds Know What Others Have and Have Not Heard

    ERIC Educational Resources Information Center

    Moll, Henrike; Carpenter, Malinda; Tomasello, Michael

    2014-01-01

    Recent studies have established that even infants can determine what others know based on previous visual experience. In the current study, we investigated whether 2-and 3-year-olds know what others know based on previous auditory experience. A child and an adult heard the sound of one object together, but only the child heard the sound of another…

  4. Lesson of the month 2: a case of coma in a Parkinson's patient: a combination of fatigue, dehydration and high protein diet over the New Year period?

    PubMed

    Arulanantham, Nirmalan; Lee, Ralph Wing Fung; Hayton, Tom

    2014-08-01

    Although motor fluctuation can often be severe in Parkinson's disease (PD), it is rare for an 'off period' to result in coma. The case presented here is of a patient with longstanding PD who was admitted to our hospital with a Glasgow Coma Scale of three after missing just one or two doses of her medication. Investigation for infective, neurovascular and metabolic causes of coma were negative and the patient recovered very rapidly following reinstitution of dopaminergic therapy via nasogastric tube. This case highlights how florid the presentation of motor fluctuations in PD can be and the importance of restarting treatment as quickly as possible. Guidance is provided on how to administer dopaminergic medications in patients who are unable to swallow.

  5. Repetitive transcranial magnetic stimulation causes a short-term increase in the duration of the cortical silent period in patients with Parkinson's disease.

    PubMed

    Siebner, H R; Mentschel, C; Auer, C; Lehner, C; Conrad, B

    2000-04-28

    In ten patients with Parkinson's disease (PD) and ten age-matched healthy controls, we applied 15 30-s trains of subthreshold 5-Hz repetitive transcranial magnetic stimulation (rTMS) over the primary motor hand area. Ten minutes after rTMS, PD patients showed a significant prolongation of the transcranially evoked silent period (SP) in the contralateral first dorsal interosseus muscle, whereas the SP remained unchanged in healthy subjects. Since the duration of the transcranially evoked SP is a well-established measure of intracortical inhibition, this finding demonstrates that rTMS is capable of inducing a short-term increase in intracortical inhibition in PD. The lack of a prolongation of the SP in healthy controls suggests that PD patients may be particularly susceptible to modulatory effects of rTMS on motocortical inhibition.

  6. A 3-years full-scale mechanical ice deformation test from the artificial drainages of the Tête Rousse cavity

    NASA Astrophysics Data System (ADS)

    Gagliardini, Olivier; Krug, Jean; Gillet-Chaulet, Fabien; Durand, Gaël; Gilbert, Adrien; Thibert, Emmanuel; Vincent, Christian; Weiss, Jérôme

    2013-04-01

    History of the city of Saint Gervais Mont Blanc, in the french Alps, is deeply marked by the 1892 disaster which killed 175 persons, after the unexpected release of 100000 m3 of water contained in a hidden cavity inside the Tête-Rousse glacier. During summer 2010, a pressurised water-filled cavity of at least 50000 m3 was again discovered within the glacier. To avoid a repetition of the 1892 disaster, an unprecedented initiative has been risen up to drain the water cavity under this high altitude glacier. This procedure was further repeated in Autumns 2011 and 2012 since the cavity was permanently refiled in-between two drainages. However, as the cavity was decreasing in size due to the creep of ice when the water level was low, the total water volume drained out of the cavity was decreased each Autumn. At the same time, a dense network of stakes was deployed to survey the glacier surface displacements above the cavity during the pumping. Record of the water level evolution within the cavity together with the surface displacement measurements along an almost 3-years period constitute a very well documented full-scale experiment to characterise ice deformation. When the water level is low, the cavity is shrinking, whereas when the cavity is full of pressurised water, the cavity is growing. Because of the density ratio between ice and water, closing is approximately 9 time faster than opening. This dataset is completed by recently acquired surface and bedrock DEMs, as well as an image of the cavity geometry from sonar and radar measurements. This unique dataset was then used to constraint the finite-element ice flow model Elmer/Ice and perform transient simulations over the 3-years period. Both the evolution of the surface displacements and of the cavity volume are compared to measurements. We show the importance of accounting for ice damage to reproduce the observed surface displacements.

  7. Irregular Periods

    MedlinePlus

    ... number of days after the last one. The Menstrual Cycle Most girls get their first period between the ... to skip periods or to have an irregular menstrual cycle. Illness, rapid weight change, or stress can also ...

  8. Problems and challenges in the early period of rehabilitating patients with severe hypothermia treated using ecmo support.

    PubMed

    Batycka-Stachnik, Dominika; Piwoda, Agnieszka; Darocha, Tomasz; Spiewak, Malgorzata; Kosinski, Sylweriusz; Jarosz, Anna; Hymczak, Hubert; Sanak, Tomasz; Galazkowski, Robert; Piatek, Jacek; Konstanty-Kalandyk, Janusz; Drwila, Rafal

    The objectives: To show and discuss the most frequent functional problems encountered in patients who underwent extracorporeal membrane oxygenation (ECMO) treatment after severe hypothermia and point out appropriate physiotherapy procedures used in order to diminish the effects of hypothermia on the human organism. It is necessary to look for effective physiotherapeutic solutions, especially that the number of scientific publications on the subject is very limited.

  9. Conversion from cyclosporine to everolimus at 4.5 months posttransplant: 3-year results from the randomized ZEUS study.

    PubMed

    Budde, K; Lehner, F; Sommerer, C; Arns, W; Reinke, P; Eisenberger, U; Wüthrich, R P; Scheidl, S; May, C; Paulus, E-M; Mühlfeld, A; Wolters, H H; Pressmar, K; Stahl, R; Witzke, O

    2012-06-01

    The long-term effect of conversion from calcineurin inhibitor (CNI) therapy to an mTOR inhibitor requires clarification. Following completion of the 12-month, open-label, multicenter ZEUS study, in which 300 kidney transplant recipients were randomized to continue cyclosporine (CsA) or convert to everolimus at 4.5 months posttransplant, outcomes were assessed at month 36 (n = 284; 94.7%). CNI therapy was reintroduced in 28.4% of everolimus patients by month 36. The primary efficacy endpoint, estimated glomerular filtration rate (Nankivell, ANCOVA) was significantly higher with everolimus versus the CsA group at month 24 (7.6 mL/min/1.73 m(2) , 95%CI 4.3, 11.0 mL/min/1.73 m(2) ; p < 0.001) and month 36 (7.5 mL/min/1.73 m(2) , 95%CI 3.6, 11.4 mL/min/1.73 m(2) ; p < 0.001). The incidence of biopsy-proven acute rejection from randomization to month 36 was 13.0% in the everolimus arm and 4.8% in the CsA arm (p = 0.015). Patient and graft survival, as well as incidences of malignancy, severe infections and hospitalization, were similar between groups. Kidney transplant patients who are converted from CsA to everolimus at month 4.5 and who remain on everolimus thereafter may achieve a significant improvement in renal function that is maintained to 3 years. There was a significantly higher rate of rejection in the everolimus arm but this did not exert a deleterious effect by 3 years posttransplant.

  10. Hemoglobin level trajectories in the early treatment period are related with survival outcomes in patients with breast cancer

    PubMed Central

    Lee, Chia-Lin; Tsai, Chun-Hao; Yeh, Dah-Cherng; Lin, Chi-Shy; Li, Yu-Fen; Tzeng, Huey-En

    2017-01-01

    Hemoglobin (Hb) levels are reportedly related with treatment outcomes and survival in patients of breast cancer. However, the long-term change in Hb levels after treatment and the effects of Hb on survival remain unknown. This retrospective cohort study enrolled 1931 breast cancer patients with pathological stage I-IV between 1/1/2003 and 12/31/2013. Latent class modeling was used to identify trajectories in monthly Hb levels over time. The primary endpoint was 10-year cancer-related death. We identified 5 distinct Hb trajectories: persistent anemia (5.6 %; n = 109), improved anemia (4.8 %, n = 93), mild anemia (21.0%; n = 406), low normal Hb (46.6 %; n = 899), and normal Hb (21.9%; n = 424). Compared with the normal-Hb group, trajectories with low Hb levels had worst 10-year survival. The adjusted hazard ratios were 1.79(95% CI, 0.91-3.53) for the improved anemia group, 1.09(95% CI, 0.68-1.74) for the mild anemia group, 1.06 (95% CI, 0.71-1.60) for the low normal Hb group, and 2.19(95% CI 1.28-3.75) for the persistent anemia group. Our findings show there are five Hb level trajectories during breast cancer treatment. The anemia Hb level trajectory during the first 12 months after treatment reflect the worst cancer-related 10-year survival in breast cancer patients. PMID:27906669

  11. Mixed hepatoblastoma and teratoma of the liver in a 3-year-old child: a unique combination and clinical challenge

    PubMed Central

    2009-01-01

    Primary liver tumors in children are rare with malignant hepatoblastoma being the most common neoplasm. In this report, we describe the diagnosis and clinical management of a large liver tumor in a 3-year-old child that displayed the features of both, conventional hepatoblastoma and malignant teratoma. Pathological assessment on a pre-operative bioptical specimen showed an immature teratoid tumor with no area of hepatoblastic differentiation present. Histological and immunhistological examination of the resected tumor specimen additionally showed tumor areas of very different differentiation pattern intermixed with each other, namely areas of hepatoblastoma-typical and neuroblastoma-like morphology as well as areas of rhadomyosarcomatous differentiation. After chemotherapy the tumor size increased and an extended right hemihepatectomy was performed. Post-operatively, the general condition of the child improved and adjuvant chemotherapy was started two weeks later. 36 months after initial diagnosis the patient is healthy, in good general condition, and without any sign of residual tumor disease. Overall, we describe the diagnosis and clinical management of a large liver tumor in a 3-year-old child that displayed the features of both, conventional hepatoblastoma and malignant teratoma and was designated as mixed hepatoblastoma and teratoma. Though mesenchymal tumor portions can occur within hepatoblastomas, most commonly osteoid or chondroid, our case is different as it presents a large spectrum of mesenchymal and epithelial differentiation pattern in most of the lesion. PMID:19909520

  12. Incidence and Etiology of Surgical Site Infections in Appendectomies: A 3-Year Prospective Study

    PubMed Central

    Garcell, Humberto Guanche; Arias, Ariadna Villanueva; Sandoval, Cristobal A. Pancorbo; García, Elias Guilarte; Gamboa, Moraima E. Valle; Sado, Adam Bode; Serrano, Ramón N. Alfonso

    2017-01-01

    Objectives Surgical site infections (SSIs) constitute a threat, especially in complicated appendicitis, and are commonly due to gram-negative organisms. We sought to describe the incidence of SSIs in appendectomies performed during a three-year period (January 2013 to December 2015) in a community hospital in Qatar, and compare this with external benchmarks. Methods We conducted a longitudinal study at The Cuban Hospital, Qatar. We used the standardized surveillance criteria to define SSI developed by the Centers for Disease Control. Information about age, sex, smoking habits, diabetes mellitus status, body mass index, and the result of bacteriologic studies were collected. Results Of a total 603 patients, 22 (3.6%) cases of SSI were reported, with an infection rate of 13.6%, 4.5%, and 1.0% in 2013, 2014, and 2015, respectively. SSIs were observed more frequently in patients with contaminated/dirty wounds (6.6%). About 65% of isolates from the surgical site were multidrug-resistant organisms (Escherichia coli and Klebsiella spp.). Conclusions This study describes the incidence of SSI in appendectomy, which could be used as a benchmark for the facility improvement program. The high frequency of multidrug-resistant organisms in SSIs requires additional studies focused on evaluating the effectiveness of the current preventive practices with a particular reference to antimicrobial prophylaxis. PMID:28042400

  13. Hypoxic pulmonary hypertension: haemodynamic changes after oxygen and various vasodilators in the same patient at different time periods.

    PubMed

    Král, H; Hamet, A; Cernohorský, D; Stásek, J; Tilser, P

    1993-01-01

    The haemodynamic response to oxygen breathing and various vasodilatory drugs (Nifedipine, Ketanserin, Dihydralazine, Nitroglycerin, Iso-Mack, Nit-Ret) was repeatedly measured at different time intervals (4-24 months) in 10 males with hypoxic pulmonary hypertension due to chronic obstructive lung disease. It was found that the pulmonary artery mean pressure and pulmonary vascular resistance changes are stable in most of the patients, discordant reactions being exceptional and of small degree. The authors consider these findings important in the therapeutical decision making for longterm oxygen therapy and or vasodilatory drug administration.

  14. A 3-year-old boy with Guillain-Barré syndrome and encephalitis associated with Mycoplasma pneumoniae infection.

    PubMed

    Hanzawa, Fumie; Fuchigami, Tatsuo; Ishii, Wakako; Nakajima, Sonoko; Kawamura, Yuki; Endo, Ayumi; Arakawa, Chikako; Kohira, Ryutaro; Fujita, Yukihiko; Takahashi, Shori

    2014-02-01

    Mycoplasma pneumoniae is a common cause of respiratory tract illness in children. Among the most common extrapulmonary manifestations are disorders of the central nervous system, including meningitis, meningoencephalitis, cerebellitis, polyneuropathy, acute disseminated encephalomyelitis, and Guillain-Barré syndrome. Guillain-Barré syndrome, also known as acute inflammatory demyelinating polyradiculoneuropathy, is an acute-onset, immune-mediated disorder of the peripheral nervous system. The central nervous system is usually intact in patients with Guillain-Barré syndrome. However, there have been some reports of an association of Guillain-Barré syndrome with central nervous system involvement in children. We report a 3-year-old boy with M. pneumoniae infection associated with Guillain-Barré syndrome and encephalitis. Both serum anti-GM1 ganglioside (IgG and IgM) and anti-galactocerebroside IgG antibodies were detected in our patient: the former in the earlier stage of the disease, and the latter in the later stage. We speculate that anti-GM1 ganglioside was associated more with encephalitis, and anti-galactocerebroside antibody was associated more with GBS in our case. Our patient is the youngest report of Guillain-Barré syndrome with central nervous system involvement, and the first report of a pediatric patient with associated M. pneumoniae infection. Such cases are rarely reported, but highlight the need for awareness of the association of the infection with Guillain-Barré syndrome with central nervous system involvement.

  15. Opening snap and isovolumic relaxation period in relation to mitral valve flow in patients with mitral stenosis. Significance of A2--OS interval.

    PubMed Central

    Kalmanson, D; Veyrat, C; Bernier, A; Witchitz, S; Chiche, P

    1976-01-01

    In 15 patients with pure or predominant mitral stenosis and in a control group of 11 patients without mitral stenosis the blood flow velocity through the mitral valve orifice was recorded by means of a directional Doppler ultrasound velocity catheter introduced transeptally and positioned in the orifice of the mitral valve. A simultaneous surface phonocardiogram was obtained. The timing of the mitral opening snap in relation to the blood velocity record of the flow through the valve supported the hypothesis that the opening snap is due to a sudden tensing of the valve leaflets by the chordae tendineae. Determination of the exact time of mitral valve opening, made possible by the blood velocity record, led to the division of the classical A2-0S interval (aortic valve closure to opening snap) into two components representing respectively the diastolic isovolumic relaxation period and the time of excursion of the mitral valve cusps. The durations of the isovolumic relaxation period were compared with those in the control patients and were found to correlate with the severity of the mitral stenosis, whereas those of the excursion time of the mitral cusps were influenced by the presence or absence of mitral valve calcification. PMID:1259828

  16. Evidence of a dominant lineage of Vibrio cholerae-specific lytic bacteriophages shed by cholera patients over a 10-year period in Dhaka, Bangladesh.

    PubMed

    Seed, Kimberley D; Bodi, Kip L; Kropinski, Andrew M; Ackermann, Hans-Wolfgang; Calderwood, Stephen B; Qadri, Firdausi; Camilli, Andrew

    2011-01-01

    Lytic bacteriophages are hypothesized to contribute to the seasonality and duration of cholera epidemics in Bangladesh. However, the bacteriophages contributing to this phenomenon have yet to be characterized at a molecular genetic level. In this study, we isolated and sequenced the genomes of 15 bacteriophages from stool samples from cholera patients spanning a 10-year surveillance period in Dhaka, Bangladesh. Our results indicate that a single novel bacteriophage type, designated ICP1 (for the International Centre for Diarrhoeal Disease Research, Bangladesh cholera phage 1) is present in all stool samples from cholera patients, while two other bacteriophage types, one novel (ICP2) and one T7-like (ICP3), are transient. ICP1 is a member of the Myoviridae family and has a 126-kilobase genome comprising 230 open reading frames. Comparative sequence analysis of ICP1 and related isolates from this time period indicates a high level of genetic conservation. The ubiquitous presence of ICP1 in cholera patients and the finding that the O1 antigen of lipopolysaccharide (LPS) serves as the ICP1 receptor suggest that ICP1 is extremely well adapted to predation of human-pathogenic V. cholerae O1.

  17. Ability of patients to retain and recall new information in the post-anaesthetic recovery period: a prospective clinical study in day surgery.

    PubMed

    Blandford, C M; Gupta, B C; Montgomery, J; Stocker, M E

    2011-12-01

    Patients are frequently told new information in the early postoperative period and may retain little of it. Two hundred patients undergoing general anaesthesia for day surgery procedures were randomly allocated into two equal groups, 'Early' and 'Late'. Both groups were asked to undertake a simple memory test either in the early or late postoperative phase of their recovery. A list of five objects was verbally presented and recall of these five objects was tested after 30 min. A control group of 100 patients performed the same test. Patients in the control group received no sedative medications. Statistically significant differences (p < 0.001) in recall ability were demonstrable between each of the three groups. Twenty-three percent of patients in the 'Early' group had total amnesia of any test information given. Only 1% of the 'Late' group were unable to remember any information; a mean interval of 40 min separated the two groups. We recommend that verbal information given postoperatively be delayed until a recovery interval of at least 40 in, and should be supported with written material.

  18. GLYCEMIC BEHAVIOR IN 48 HOURS POSTOPERATIVE PERIOD OF PATIENTS WITH TYPE 2 DIABETES MELLITUS AND NON DIABETIC SUBMITTED TO BARIATRIC SURGERY

    PubMed Central

    de OLIVEIRA, Lucas Freitas; TISOTT, Caroline Gewehr; SILVANO, Diego Machado; CAMPOS, Camila Mafalda Mouta; do NASCIMENTO, Ricardo Reis

    2015-01-01

    Although there is no indication for surgery taking only into account the glycemic condition, results have shown that benefits can be obtained in glycemic control with bariatric surgery. Aim : To compare the glycemic behavior among type 2 diabetic and non-diabetic patients within 48 h after bariatric surgery, and clarify whether there is a reduction in blood glucose level in obese patients with diabetes before the loss of weight excess. Methods : Descriptive epidemiological study with prospective cohort design with 31 obese patients undergoing Roux-en-Y gastric bypass and sleeve gastrectomy. The patients were controlled with hemoglucotests in different periods of time: preoperative, postoperative and each 6 h after surgery for 48 h. Results : Average ambulatory blood glucose in diabetics was 120.7±2.9 mg/dl vs 91.8±13.9 mg/dl in the nondiabetic. After 48 h there was decrease in diabetics to 100.0±17.0 mg/dl (p=0.003), while the non-diabetic group did not change significantly (102.7±25.4 mg/dl; p=0.097). There were no differences between the surgical techniques. There were no death. Conclusions : Diabetic patients significantly reduced blood glucose after surgery regardless of the use of exogenous insulin or oral hypoglycemic agents. PMID:26537269

  19. The role of body image integrity and posttraumatic growth in kidney transplantation: A 3-year longitudinal study

    PubMed Central

    Devecsery, Ágnes; Lázár, György; Horváth, Zoltán; Szederkényi, Edit; Szenohradszky, Pál; Csabai, Márta

    2015-01-01

    The aim of this study was to explore the role of body image, posttraumatic growth, and emotional state in recovery after transplantation. A total of 53 kidney transplant patients were assessed using our Self-Test and Organ Drawing Test, the Spielberger Anxiety Inventory, the Beck Depression Inventory, and the Posttraumatic Growth Inventory in a 3-year follow-up. Logistic regression analysis showed that lower levels of integrity of the body image and posttraumatic growth, and higher pre-discharge serum creatinine levels were significant predictors of graft rejection. Our results suggest that the integrity of the body image and posttraumatic growth might contribute to better health outcomes in organ transplantation. PMID:28070354

  20. Longer than 3-year survival following hepato-ligamento-pancreatoduodenectomy for hilar cholangiocarcinoma with vascular involvement: report of a case.

    PubMed

    Kaneoka, Yuji; Yamaguchi, Akihiro; Isogai, Masatoshi; Suzuki, Masahiko

    2003-01-01

    A 70-year-old man presented with a mass-forming perihilar cholangiocarcinoma in his left liver, and both the portal trunk and proper hepatic artery were involved by the tumor. We performed a hepato-ligamento-pancreatoduodenectomy (HLPD), including an extended left lobectomy with a caudate lobectomy, and the external iliac vein graft was harvested for portal vein reconstruction while the right middle colic artery was anastomosed to the right posterior hepatic artery. Vascular involvement (portal vein and hepatic artery) and peripancreatic lymph node metastases were proven histologically. Although the liver abscess and pancreatic fistula both occurred postoperatively, the patient is now healthy and still alive 3 years 9 months after surgery without recurrence. We consider that the absence of para-aortic lymph node metastases and hepatic invasion which is not involved beyond the second order of the hepatic ducts in the future remnant liver might therefore have contributed to the satisfactory outcome after performing HLPD in this case.

  1. Management of symphysis fracture in a 3-year-old child with prefabricated acrylic splint and circum-mandibular wiring.

    PubMed

    Srinivasan, Ila; Kumar, M Naveen; Kumaran, P Satish; Bhandari, Arihant; Udhya, J

    2013-01-01

    Pediatric mandibular fractures are often the sequelae of facial skeletal injuries in patients with trauma and frequently require hospitalization. Due to the retrusive mid-face position relative to the calvarial prominence, facial fractures are rare in children younger than 5 years of age. Although rare, they most often occur as a result of motor vehicle accidents. The purpose of this report is to describe the management of a mandibular symphysis fracture in a 3-year-old boy with displacement between the primary mandibular left central and lateral incisors. The fracture was reduced and the fractured segment was stabilized under general anesthesia with a prefabricated acrylic splint with circum-mandibular wiring. Children have greater osteogenic potential and faster healing rates than adults; therefore, anatomic reduction in children is best accomplished earlier.

  2. Odontogenic myxoma involving the orbit in a 3-year-old boy: removal, reconstruction and review of the literature.

    PubMed

    Hansen, Teis Schjals; Danielsson, Lina Isabella; Fast, Søren; Thygesen, Torben H

    2016-02-17

    We present a rare case of a 3-year-old boy with an odontogenic myxoma (OM) involving the orbita. Including our case, only nine cases of OM have been reported to involve the eye in children.There is no gold standard for treatment of OM in children with orbital involvement. The recurrence rate of OM in children seems low, which advocates for less invasive surgery. A gentle resection of the OM was carried out. The floor and medial wall of the orbit was reconstructed immediately using a non-resorbable Medpor implant with passive adaptation. Reconstruction with a Medpor implant in children has rarely been reported in the literature. No clinical or radiological recurrence was observed 24 months after surgical removal, and the patient presented with symmetric appearance and normal vision.

  3. Nonsurgical approach to Class I open-bite malocclusion with extrusion mechanics: a 3-year retention case report.

    PubMed

    Atsawasuwan, Phimon; Hohlt, William; Evans, Carla A

    2015-04-01

    Anterior open bite is one of the most challenging malocclusions for orthodontic treatment. The high incidence of relapse is a major concern. Therefore, accurate initial examination, diagnosis, treatment plan, and consideration of habitual risk factors are crucial for a successful outcome without unwanted sequelae. Excellent patient compliance for retainer wear is also a critical factor. This case report shows the 3-year stability of a nonsurgical and nonextraction orthodontic treatment of a 5-mm anterior open-bite malocclusion in a 12-year-old girl with extrusion mechanics and habit modification. After 2 years of orthodontic treatment, excellent outcomes were achieved. With an appropriate retention protocol, the long-term stability of the treatment was favorable.

  4. Inflammatory pseudotumor of the liver in association with spilled gallstones 3 years after laparoscopic cholecystectomy: report of a case.

    PubMed

    Kayashima, H; Ikegami, T; Ueo, H; Tsubokawa, N; Matsuura, H; Okamoto, D; Nakashima, A; Okadome, K

    2011-11-01

    We report on a case of a female patient diagnosed with inflammatory pseudotumor of the liver in association with spilled gallstones 3 years after laparoscopic cholecystectomy for calculous acute cholecystitis. She was asymptomatic, but CT revealed an intrahepatic mass and two other extrahepatic masses between the liver and the diaphragm. Furthermore, diffusion-weighted MRI and PET suggested all three lesions could be malignant tumors. As the preoperative diagnosis was intrahepatic cholangiocellular carcinoma with peritoneal disseminations, we performed a posterior segmentectomy of the liver combined with partial resection of the diaphragm. Histological examination showed the intrahepatic tumor was an inflammatory granuloma with abscess formations. There were bilirubin stones between the liver and the diaphragm. Therefore, the tumor was diagnosed as inflammatory pseudotumor of the liver in association with spilled gallstones. In conclusion, the liver tumor emerged after laparoscopic cholecystectomy and may involve inflammatory pseudotumor of the liver in association with spilled gallstones.

  5. Rational action selection in 1½- to 3-year-olds following an extended training experience.

    PubMed

    Klossek, Ulrike M H; Dickinson, Anthony

    2012-02-01

    Previous studies failed to find evidence for rational action selection in children under 2 years of age. The current study investigated whether younger children required more training to encode the relevant causal relationships. Children between 1½ and 3 years of age were trained over two sessions to perform actions on a touch-sensitive screen to obtain video clips as outcomes. Subsequently, a visual habituation procedure was employed to devalue one of the training outcomes. As in previous studies, 2- and 3-year-olds chose actions associated with an expected valued outcome significantly more often during a subsequent choice test. Moreover, analysis of children's first responses in the post-devaluation test revealed evidence of rational action selection even in the youngest age group (18-23 months). Consistent with dual-process accounts of action control, the findings support the view that the ability to make rational action choices develops gradually.

  6. Probabilistic assessment of exposure to cosmetic products by French children aged 0-3 years.

    PubMed

    Ficheux, A S; Dornic, N; Bernard, A; Chevillotte, G; Roudot, A C

    2016-08-01

    Very few exposure data are available for children in Europe and worldwide. The aim of this study was to assess the exposure to cosmetic products used on children aged 0-3 years using recent consumption data generated for the French population. Exposure was assessed using a probabilistic method for 24 products including cleanser, skin care, fragrance, solar and bottom products. The exposure data obtained in this study for children aged 0-3 years were higher than the values fixed by the SCCS for all common products: liquid shampoo, face moisturizer cream, toothpaste, shower gel and body moisturizer cream. Exposure was assessed for the first time for many products such as sunscreens, Eau de toilette and massage products. These new French exposure values will be useful for safety assessors and for safety agencies.

  7. Concurrent and Predictive Validity of Parent Reports of Child Language at Ages 2 and 3 Years

    PubMed Central

    Campbell, Thomas F.; Kurs-Lasky, Marcia; Rockette, Howard E.; Dale, Philip S.; Colborn, D. Kathleen; Paradise, Jack L.

    2005-01-01

    The MacArthur–Bates Communicative Development Inventories (CDI; Dale, 1996; Fenson et al., 1994), parent reports about language skills, are being used increasingly in studies of theoretical and public health importance. This study (N = 113) correlated scores on the CDI at ages 2 and 3 years with scores at age 3 years on tests of cognition and receptive language and measures from parent–child conversation. Associations indicated reasonable concurrent and predictive validity. The findings suggest that satisfactory vocabulary scores at age 2 are likely to predict normal language skills at age 3, although some children with limited skills at age 3 will have had satisfactory scores at age 2. Many children with poor vocabulary scores at 2 will have normal skills at 3. PMID:16026501

  8. IQ trajectory, cognitive reserve, and clinical outcome following a first episode of psychosis: a 3-year longitudinal study.

    PubMed

    Leeson, Verity C; Sharma, Pranev; Harrison, Masuma; Ron, Maria A; Barnes, Thomas R E; Joyce, Eileen M

    2011-07-01

    Comparison of current and estimated premorbid IQ in schizophrenia suggests that there are subgroups with low IQ, deteriorated IQ (DIQ), or preserved IQ and that this is established by psychosis onset. There are no controlled studies examining the trajectory of these IQ subgroups longitudinally or their relationship with clinical and social outcomes. Of 129 individuals with first-episode schizophrenia or schizoaffective disorder, 25% showed stable low IQ, 31% showed stable IQ in the average/high range, and 44% demonstrated intellectual deterioration by 10 points or more. Patients in the low and deteriorated groups were equally impaired on tests of memory and executive function compared with the preserved average/high-IQ group and controls and showed more negative and disorganization symptoms than the preserved average/high-IQ group. Sixty patients and 27 controls were assessed again 1 and 3 years later. There was no evidence that those with IQ deterioration at baseline continued on a declining cognitive trajectory or that those with preserved average/high IQ experienced subsequent IQ decline. The low IQ group showed no change in IQ, whereas both the DIQ and the preserved IQ groups improved. However, the rate of improvement of these 2 subgroups was no greater than that of the healthy controls, suggesting that this reflected practice effects. Both the low and the deteriorated groups had longer index admissions, more core negative symptoms, and worse occupational outcomes at 3 years. These data suggest that following psychosis onset, IQ is stable and that it is IQ at psychosis onset rather than premorbid IQ predicts a more severe illness.

  9. Suspected disseminated histiocytic sarcoma in a 3-year-old Perro de Presa Canario dog.

    PubMed

    Denstedt, Emily

    2014-02-01

    A 3-year-old intact male Perro de Presa Canario dog was presented with acutely inflamed and edematous right hind limb, scrotum, prepuce, and an enlarged left carpus. Two weeks later the dog returned with weight loss, draining tracts in the right hind limb, dermal nodules, a palpable abdominal mass, and uveitis in the left eye. The dog succumbed to his illness 2 days later and a widely disseminated round cell tumor compatible with histiocytic sarcoma was diagnosed following postmortem examination.

  10. Maternal intake of methyl-donor nutrients and child cognition at 3 years of age.

    PubMed

    Villamor, Eduardo; Rifas-Shiman, Sheryl L; Gillman, Matthew W; Oken, Emily

    2012-07-01

    Methyl-donor nutrients are substrates for methylation reactions involved in neurodevelopment processes. The role of maternal intake of these nutrients on cognitive performance of the offspring is poorly understood. We examined the associations of maternal intake of folate, vitamin B12, choline, betaine and methionine during the first and second trimesters of pregnancy, with tests of cognitive performance in the offspring at 3 years of age using data from 1210 participants in Project Viva, a prospective pre-birth cohort study in Massachusetts. We assessed nutrient intake with the use of food frequency questionnaires. Children's cognition at age 3 years was evaluated with the Peabody Picture Vocabulary Test III (PPVT-III) and visual-motor skills with the Wide Range Assessment of Visual Motor Abilities test. In multivariable models adjusting for potential sociobehavioural and nutritional confounders, for each 600 µg/day increment in total folate intake during the first trimester, PPVT-III score at age 3 years was 1.6 points [95% confidence interval (CI) 0.1, 3.1; P = 0.04] higher. There was a weak inverse association between vitamin B12 intake during the second trimester and PPVT-III scores [-0.4 points per 2.6 µg/day; 95% CI -0.8, -0.1; P = 0.01]. We did not find associations between choline, betaine or methionine and cognitive outcomes at this age. Results of this study suggest that higher intake of folate in early pregnancy is associated with higher scores on the PPVT-III, a test of receptive language that predicts overall intelligence, at age 3 years.

  11. Maternal experiences of racial discrimination and child weight status in the first 3 years of life.

    PubMed

    Dixon, B; Rifas-Shiman, S L; James-Todd, T; Ertel, K; Krieger, N; Kleinman, K P; Rich-Edwards, J W; Gillman, M W; Taveras, E M

    2012-12-01

    Among US racial/ethnic minority women, we examined associations between maternal experiences of racial discrimination and child growth in the first 3 years of life. We analyzed data from Project Viva, a pre-birth cohort study. We restricted analyses to 539 mother-infant pairs; 294 were Black, 127 Hispanic, 110 Asian and 8 from additional racial/ethnic groups. During pregnancy, mothers completed the Experiences of Discrimination survey that measured lifetime experiences of racial discrimination in diverse domains. We categorized responses as 0, 1-2 or ≥3 domains. Main outcomes were birth weight for gestational age z-score; weight for age (WFA) z-score at 6 months of age; and at 3 years of age, body mass index (BMI) z-score. In multivariable analyses, we adjusted for maternal race/ethnicity, nativity, education, age, pre-pregnancy BMI, household income and child sex and age. Among this cohort of mostly (58.2%) US-born and economically non-impoverished mothers, 33% reported 0 domains of discrimination, 33% reported discrimination in 1-2 domains and 35% reported discrimination in ≥3 domains. Compared with children whose mothers reported no discrimination, those whose mothers reported ≥3 domains had lower birth weight for gestational age z-score (β -0.25; 95% CI: -0.45, -0.04), lower 6 month WFA z-score (β -0.34; 95% CI: -0.65, -0.03) and lower 3-year BMI z-score (β -0.33; 95% CI: -0.66, 0.00). In conclusion, we found that among this cohort of US racial/ethnic minority women, mothers' report of experiencing lifetime discrimination in ⩾ 3 domains was associated with lower fetal growth, weight at 6 months and 3-year BMI among their offspring.

  12. Acute myeloid leukemia with basophilic differentiation in a 3-year-old Standardbred gelding

    PubMed Central

    Furness, Mary Catherine; Setlakwe, Emile; Sallaway, John; Wood, Darren; Fromstein, Jordan; Arroyo, Luis G.

    2016-01-01

    A 3-year-old Standardbred gelding with a history of pyrexia, persistent hemorrhage from the oral cavity, and a large, soft swelling at the junction of the caudal aspect of the mandibular rami and proximal neck was evaluated. The horse had neutropenia and anemia, with atypical granulated cells in a blood smear. Additional tests confirmed acute myeloid leukemia with basophilic differentiation, which has been reported in humans, cats, dogs, and cattle but not horses. PMID:27708445

  13. Housing and mothering: their effects upon the developmental levels of 3-year-old children.

    PubMed Central

    Pollak, M

    1979-01-01

    The development of 200 3-year-old children was measured, using Gesell parameters of development. The levels of development were matched against the adequacy, or inadequacy, of maternal care and housing, the scales for which were derived from a questionnaire completed by the children's mothers. Housing was not found to affect the children's developmental levels, while the adequacy of maternal care was highly significantly related to satisfactory child development. PMID:420522

  14. The Rapid Development of Explicit Gaze Judgment Ability at 3 years

    ERIC Educational Resources Information Center

    Doherty, Martin J.; Anderson, James R.; Howieson, Lynne

    2009-01-01

    Two studies examined development of the ability to judge what another person is looking at. In Study 1, 54 2- to 4-year-olds judged where someone was looking in real-life, photograph, and drawing formats. A minority of 2-year-olds, but a majority of older children, passed all tasks, suggesting that the ability arises at around 3 years of age.…

  15. The Neural Correlates of Processing Newborn and Adult Faces in 3-Year-Old Children

    ERIC Educational Resources Information Center

    Peykarjou, Stefanie; Westerlund, Alissa; Cassia, Viola Macchi; Kuefner, Dana; Nelson, Charles A.

    2013-01-01

    The current study examines the processing of upright and inverted faces in 3-year-old children (n = 35). Event-related potentials (ERPs) were recorded during a passive looking paradigm including adult and newborn face stimuli. We observed three face-sensitive components, the P1, the N170 and the P400. Inverted faces elicited shorter P1 latency and…

  16. Acute myeloid leukemia with basophilic differentiation in a 3-year-old Standardbred gelding.

    PubMed

    Furness, Mary Catherine; Setlakwe, Emile; Sallaway, John; Wood, Darren; Fromstein, Jordan; Arroyo, Luis G

    2016-10-01

    A 3-year-old Standardbred gelding with a history of pyrexia, persistent hemorrhage from the oral cavity, and a large, soft swelling at the junction of the caudal aspect of the mandibular rami and proximal neck was evaluated. The horse had neutropenia and anemia, with atypical granulated cells in a blood smear. Additional tests confirmed acute myeloid leukemia with basophilic differentiation, which has been reported in humans, cats, dogs, and cattle but not horses.

  17. Racial and Ethnic Differentials in Overweight and Obesity Among 3-Year-Old Children

    PubMed Central

    Kimbro, Rachel Tolbert; Brooks-Gunn, Jeanne; McLanahan, Sara

    2007-01-01

    Objectives. We estimated racial/ethnic differences in overweight and obesity in a national sample of 3-year-olds from urban, low-income families and assessed possible determinants of differences. Methods. Survey, in-home observation, and interview data were collected at birth, 1 year, and 3 years. We used logistic regression analyses and adjusted for a range of covariates in examining overweight and obesity differentials according to race/ethnicity. Results. Thirty-five percent of the study children were overweight or obese. Hispanic children were twice as likely as either Black or White children to be overweight or obese. Although we controlled for a wide variety of characteristics, we were unable to explain either White–Hispanic or Black–Hispanic differences in overweight and obesity. However, birthweight, taking a bottle to bed, and mother’s weight status were important predictors of children’s overweight or obesity at age 3 years. Conclusions. Children’s problems with overweight and obesity begin as early as age 3, and Hispanic children and those with obese mothers are especially at risk. PMID:17194857

  18. Laparoscopic Sleeve Gastrectomy Versus Roux-Y-Gastric Bypass for Morbid Obesity—3-Year Outcomes of the Prospective Randomized Swiss Multicenter Bypass Or Sleeve Study (SM-BOSS)

    PubMed Central

    Peterli, Ralph; Wölnerhanssen, Bettina Karin; Vetter, Diana; Nett, Philipp; Gass, Markus; Borbély, Yves; Peters, Thomas; Schiesser, Marc; Schultes, Bernd; Beglinger, Christoph; Drewe, Juergen; Bueter, Marco

    2017-01-01

    Objective: Laparoscopic sleeve gastrectomy (LSG) is performed almost as often in Europe as laparoscopic Roux-Y-Gastric Bypass (LRYGB). We present the 3-year interim results of the 5-year prospective, randomized trial comparing the 2 procedures (Swiss Multicentre Bypass Or Sleeve Study; SM-BOSS). Methods: Initially, 217 patients (LSG, n = 107; LRYGB, n = 110) were randomized to receive either LSG or LRYGB at 4 bariatric centers in Switzerland. Mean body mass index of all patients was 44 ± 11 kg/m2, mean age was 43 ± 5.3 years, and 72% of patients were female. Minimal follow-up was 3 years with a rate of 97%. Both groups were compared for weight loss, comorbidities, quality of life, and complications. Results: Excessive body mass index loss was similar between LSG and LRYGB at each time point (1 year: 72.3 ± 21.9% vs. 76.6 ± 20.9%, P = 0.139; 2 years: 74.7 ± 29.8% vs. 77.7 ± 30%, P = 0.513; 3 years: 70.9 ± 23.8% vs. 73.8 ± 23.3%, P = 0.316). At this interim 3-year time point, comorbidities were significantly reduced and comparable after both procedures except for gastro-esophageal reflux disease and dyslipidemia, which were more successfully treated by LRYGB. Quality of life increased significantly in both groups after 1, 2, and 3 years postsurgery. There was no statistically significant difference in number of complications treated by reoperation (LSG, n = 9; LRYGB, n = 16, P = 0.15) or number of complications treated conservatively. Conclusions: In this trial, LSG and LRYGB are equally efficient regarding weight loss, quality of life, and complications up to 3 years postsurgery. Improvement of comorbidities is similar except for gastro-esophageal reflux disease and dyslipidemia that appear to be more successfully treated by LRYGB. PMID:28170356

  19. Maternal HIV infection, drug use, and growth of uninfected children in their first 3 years.

    PubMed Central

    Ross, A; Raab, G M; Mok, J; Gilkison, S; Hamilton, B; Johnstone, F D

    1995-01-01

    OBJECTIVE--To determine the separate effects of maternal HIV infection and drug use during pregnancy on growth of uninfected children in their first 3 years. DESIGN--Retrospective analysis of measurements from health visitor records made during routine child health surveillance at 6 weeks, 10 months, and 3 years of age. Multilevel analysis allowed for between-infant variation in fitted growth lines, and adjustment for other factors. Growth was described in terms of an intercept (z score at term) and growth slopes (change in z score per year) up to, and from, 4 months. SUBJECTS--290 case babies delivered in Edinburgh hospitals to women who reported injection drug use by either themselves or their HIV infected partner, and 186 community controls. A total of 131 (45%) of the case babies were born to women who used drugs, predominantly opiates, during pregnancy and 93 (32%) to HIV infected women. The eight infected children were excluded from analysis. MAIN OUTCOME MEASURES--Age and sex standardised z scores for height, weight, and body mass index. RESULTS--459 (96%) of the 476 records for cases and controls were traced, yielding 1432 weight and 939 height measurements. Maternal HIV infection was not found to affect growth; at 3 years the estimated effect on weight z score was 0.16 with 95% confidence interval (-0.25 to 0.57) and for height 0.18 (-0.19 to 0.55). Drug use during pregnancy was associated with lighter babies at 40 weeks followed by depressed growth in the first four months, these infants remaining just slightly smaller at 3 years with an estimated effect on z scores of -0.5 for weight with 95% confidence interval (-0.89 to -0.11) and -0.37 (-0.72 to -0.02) for height. CONCLUSIONS--Maternal HIV infection does not adversely affect growth in uninfected infants, and the effect of drug use during pregnancy is limited to small decrease in size at 3 years. PMID:8546501

  20. Dairy and plant based food intakes are associated with altered faecal microbiota in 2 to 3 year old Australian children

    PubMed Central

    Smith-Brown, P.; Morrison, M.; Krause, L.; Davies, P. S. W.

    2016-01-01

    The first 1000 days (conception to 24 months) is when gut microbiota composition and eating patterns are established, and a critical period influencing lifelong health. The aim of this study is to examine the associations between food intakes and microbiota composition at the end of this period. Diet was quantified for 37 well-nourished Australian children aged between 2 to 3 years by using a food frequency questionnaire and 24 hr recalls. Both dairy and plant-based (fruit, vegetables, soy, pulses and nuts) food intakes were associated with distinct microbiota profiles. Dairy intake was positively associated with the Firmicutes:Bacteroidetes ratio, and in particular Erysipelatoclostridium spp., but negatively associated with species richness and diversity. Vegetable intake was positively associated with the relative abundance of the Lachnospira genus, while soy, pulse and nut intake was positively associated with the relative abundance of bacteria related to Bacteroides xylanisolvens. Fruit intake, especially apples and pears, were negatively associated with the relative abundance of bacteria related to Ruminococcus gnavus. In this cohort of young children dairy and plant based food intakes were found to be associated with altered microbiota composition. Further exploration is needed to elucidate the effect of these dietary and microbial differences on host phenotype. PMID:27694811

  1. High-dose Chemotherapy With Autologous Stem Cell Rescue in Saudi Children Less Than 3 Years of Age With Embryonal Brain Tumors.

    PubMed

    Alsultan, Abdulrahman; Alharbi, Musa; Al-Dandan, Sadeq; Bayoumi, Yasser; Alharbi, Talal; Alsudairy, Reem; Alomari, Ali; Aljamaan, Khalid; Musleh, Othman; Alharbi, Qasim; Jarrar, Mohammed

    2015-04-01

    High-dose chemotherapy with autologous stem cell rescue (HDC/ASCR) has been used in children under the age of 3 years with embryonal brain tumors to avoid or delay the use of radiation. We reviewed the medical records of 10 Saudi children less than 3 years of age with embryonal brain tumors who underwent HDC/ASCR. All 10 patients underwent surgical resection followed by 3 to 5 cycles of induction chemotherapy and 1 to 3 cycles of HDC/ASCR using carboplatin and thiotepa. Isotretinoin was used as a maintenance therapy in 4 patients. Five patients had medulloblastoma, 3 had atypical teratoid/rhabdoid tumors, 1 had an embryonal tumor with abundant neuropil and true rosettes, and 1 had pineoblastoma. The median age of the patients was 1.9 years. A total of 19 HDC/ASCR procedures were performed. Radiotherapy (RT) was administered to 5 patients after HDC/ASCR and as a salvage therapy in 1 patient. The progression-free survival rate was 50% at 1 year and at 2 years, with a median follow-up of 24 months. All 5 patients with medulloblastoma are still alive without evidence of disease, but the other patients died secondary to tumor progression. This experience suggests that strategies combining myeloablative chemotherapy and autologous stem cell rescue appear to be feasible for children with embryonal brain tumors in the Middle East.

  2. Recovery from severe frontotemporal dysfunction at 3years after N-methyl-d-aspartic acid (NMDA) receptor antibody encephalitis.

    PubMed

    Leypoldt, Frank; Gelderblom, Mathias; Schöttle, Daniel; Hoffmann, Sascha; Wandinger, Klaus-Peter

    2013-04-01

    Encephalitis associated with antibodies against N-methyl-d-aspartic acid (NMDA) receptor is characterized by severe memory deficits, decreased consciousness, epileptic seizures and movement disorders and occurs most commonly in young women. Recovery is mostly good but little is known about the disease course in patients whose treatment has been delayed severely. We present a 16-year-old girl with a 36-month follow-up. A single course of methylprednisolone attenuated some symptoms but severe and incapacitating frontotemporal syndrome remained. Second-line treatment with rituximab was initiated 12months after the onset of symptoms. A surprising recovery occurred 18months after treatment and 30months after onset. Recovery in NMDA receptor antibody-associated encephalitis can be severely delayed and does not have to be linear. Whether delayed therapy contributed to recovery in this patient cannot be answered with certainty. Spontaneous recovery independent of therapy is possible, as it has been observed previously as late as 3years after onset. Although serum antibodies disappeared with recovery in this patient, previous cases have shown serum antibodies to be unreliable markers of disease activity. Second-line treatment, especially with substances as well tolerated as rituximab, should at least be considered in NMDA receptor encephalitis with persistent neuropsychiatric syndromes after first-line therapy.

  3. Trace Element Status (Iron, Zinc, Copper, Chromium, Cobalt, and Nickel) in Iron-Deficiency Anaemia of Children under 3 Years

    PubMed Central

    Angelova, Maria Georgieva; Petkova-Marinova, Tsvetelina Valentinova; Pogorielov, Maksym Vladimirovich; Loboda, Andrii Nikolaevich; Nedkova-Kolarova, Vania Nedkova; Bozhinova, Atanaska Naumova

    2014-01-01

    Aim. To determine trace element status and aetiologic factors for development of trace elements deficiencies in children with iron-deficiency anaemia (IDA) aged 0 to 3 years. Contingent and Methods. 30 patients of the University Hospital, Pleven, Bulgaria—I group; 48 patients of the Sumy Regional Child's Clinical Hospital, Sumy, Ukraine—II group; 25 healthy controls were investigated. Serum concentrations of iron, zinc, copper, chromium, cobalt, and nickel were determined spectrophotometrically and by atomic absorption spectrophotometry. Results. Because the obtained serum levels of zinc, copper, and chromium were near the lower reference limits, I group was divided into IA and IB. In IA group, serum concentrations were lower than the reference values for 47%, 57%, and 73% of patients, respectively. In IB group, these were within the reference values. In II group, results for zinc, cobalt, and nickel were significantly lower (P < 0.05), and results for copper were significantly higher in comparison to controls. Conclusion. Low serum concentrations of zinc, copper, cobalt, and nickel were mainly due to inadequate dietary intake, malabsorption, and micronutrient interactions in both studied groups. Increased serum copper in II group was probably due to metabolic changes resulting from adaptations in IDA. Data can be used for developing a diagnostic algorithm for IDA. PMID:24839556

  4. Comparison of the efficacy and safety of two preseasonal regimens of glutaraldehyde modified, tyrosine-adsorbed parietaria pollen extract over a period of three years in monosensitive patients.

    PubMed

    Negro, J M; Wheeler, A W; Hernández, J; Youlten, L J; Pascual, A; García-Sellés, F J; Pagán, J A; López-Sánchez, J D; Miralles, J C; Sarrió, F; Milán, J M; Contreras, L G; Vidal, D

    1999-01-01

    The purpose of this study was to evaluate the clinical efficacy over a period of three years (1988-90) of two preseasonal dosage regimens of a Parietaria allergoid (Bencard Tyrosine Parietaria) in patients who were only sensitive to this pollen. Fifty patients were included (14 men and 36 women, age: mean, 28 years; range, 14-47 years). Twenty five patients (group A) were treated each january with the basic course of Bencard Tyrosine Parietaria. This consisted of injecting subcutaneously 0.5 ml from each of three vials, with one week between each injection. A further injection using the vial with the highest dose was given one week later. Each january and february, twenty five patients (group B) were treated with the basic course of Bencard Tyrosine Parietaria, repeating the last dose five times, with one week between each injection. Immunotherapy with a tyrosine-adsorbed Parietaria judaica allergoid is an effective method for mitigating nasal (p < 0.0001), bronchial (p < 0.005), conjunctival (p < 0.001) and palatal itching symptoms (p < 0.0001) in patients who are sensitive to this pollen. Sensitivity to Parietaria pollen, as verified by skin test and nasal challenge, decreased during immunotherapy (p < 0.001). Histamine release by peripheral blood basophils decreased during the course of the study, falling from 43.5 ng/ml to 12.3 ng/ml in group A and from 42.9 ng/ml to 10.0 ng/ml in group B; during the second and third years, IgG levels were increased one and four months after starting treatment with the extract, while this was not the case after ten months; IgE levels were also increased. Finally, overall tolerance to this immunotherapy product was good in almost all patients.

  5. Effects of short-period exercise training and orlistat therapy on body composition and maximal power production capacity in obese patients.

    PubMed

    Colak, R; Ozcelik, O

    2004-01-01

    We examined the effects of weight loss induced by diet-orlistat (DO) and diet-orlistat combined with exercise (DOE) on maximal work rate production (Wmax) capacity in obese patients. Total of 24 obese patients were involved in this study. Twelve of them were subjected to DO therapy only and the remaining 12 patients participated in a regular aerobic exercise-training program in addition to DO therapy (DOE). Each patient performed two incremental ramp exercise tests up to exhaustion using an electromagnetically-braked cycle ergometer: one at the onset and one at the end of the 4th week. DOE therapy caused a significant decrease in total body weight: 101.5+/-17.4 kg (basal) vs 96.3+/-17.3 kg (4 wk) associated with a significant decrease in body fat mass: 45.0+/-10.5 kg (basal) vs 40.9+/-9.8 kg (4 wk). DO therapy also resulted in a significant decrease of total body weight 94.9+/-14.9 kg (basal) vs 91.6+/-13.5 kg (4 wk) associated with small but significant decreases in body fat mass: 37.7+/-5.6 kg (basal) to 36.0+/-6.2 kg (4 wk). Weight reduction achieved during DO therapy was not associated with increased Wmax capacity: 106+/-32 W (basal) vs 106+/-33 W (4 wk), while DOE therapy resulted in a markedly increased Wmax capacity: 109+/-39 W (basal) vs 138+/-30 W (4 wk). DO therapy combined with aerobic exercise training resulted in a significant reduction of fat mass tissue and markedly improved the aerobic fitness and Wmax capacities of obese patients. Considering this improvement within such a short period, physicians should consider applying an aerobic exercise-training program to sedentary obese patients for improving their physical fitness and thereby reduce the negative outcomes of obesity.

  6. Canakinumab treatment for patients with active recurrent or chronic TNF receptor-associated periodic syndrome (TRAPS): an open-label, phase II study

    PubMed Central

    Gattorno, Marco; Obici, Laura; Cattalini, Marco; Tormey, Vincent; Abrams, Ken; Davis, Nicole; Speziale, Antonio; Bhansali, Suraj G; Martini, Alberto; Lachmann, Helen J

    2017-01-01

    Objective To evaluate the efficacy of canakinumab, a high-affinity human monoclonal anti-interleukin-1β antibody, in inducing complete or almost complete responses in patients with active tumour necrosis factor receptor-associated periodic syndrome (TRAPS). Methods Twenty patients (aged 7–78 years) with active recurrent or chronic TRAPS were treated with canakinumab 150 mg every 4 weeks for 4 months (2 mg/kg for those ≤40 kg) in this open-label, proof-of-concept, phase II study. Canakinumab was then withdrawn for up to 5 months, with reintroduction on relapse, and 4 weekly administration (subsequently increased to every 8 weeks) for 24 months. The primary efficacy variable was the proportion of patients achieving complete or almost complete response at day 15, defined as clinical remission (Physician's Global Assessment score ≤1) and full or partial serological remission. Results Nineteen patients (19/20, 95%; 95% CI 75.1% to 99.9%) achieved the primary efficacy variable. Responses to canakinumab occurred rapidly; median time to clinical remission 4 days (95% CI 3 to 8 days). All patients relapsed after canakinumab was withdrawn; median time to relapse 91.5 days (95% CI 65 to 117 days). On reintroduction of canakinumab, clinical and serological responses were similar to those seen during the first phase, and were sustained throughout treatment. Canakinumab was well tolerated and clinical responses were accompanied by rapid and sustained improvement in health-related quality of life. Weight normalised pharmacokinetics of canakinumab, although limited, appeared to be consistent with historical canakinumab data. Conclusions Canakinumab induces rapid disease control in patients with active TRAPS, and clinical benefits are sustained during long-term treatment. Trial registration number NCT01242813; Results. PMID:27269295

  7. A 3-year randomized clinical trial evaluating two different bonded posterior restorations: Amalgam versus resin composite

    PubMed Central

    Kemaloglu, Hande; Pamir, Tijen; Tezel, Huseyin

    2016-01-01

    Objective: To compare the performance and postoperative sensitivity of a posterior resin composite with that of bonded amalgam in 40 (n = 20) large sized cavities and to evaluate whether resin composite could be an alternative for bonded amalgam. Materials and Methods: This was a randomized clinical trial. Twenty patients in need of at least two posterior restorations were recruited. Authors randomly assigned one half of the restorations to receive bonded amalgam and the other half to composite restorations. Forty bonded amalgams (n = 20) and composites (n = 20) were evaluated for their performance on modified-US Public Health Service criteria and postoperative sensitivity using visual analogue scale (VAS) for 36-months. Results: Success rate of this study was 100%. First clinical alterations were rated as Bravo after 1 year in marginal discoloration, marginal adaptation, anatomical form, and surface roughness for both amalgam and composite. At the 3rd year, overall “Bravo” rated restorations were 12 for bonded amalgam and 13 for resin composites. There were no significant differences among the VAS scores of composites and bonded amalgams for all periods (P > 0.05) except for the comparisons at the 3rd year evaluation (P < 0.05). Conclusions: Within the limitation of this study, both resin composite and bonded amalgam were clinically acceptable. Postoperative sensitivity results tend to decrease more in composite restorations rather than amalgams. Therefore, it was concluded that posterior resin composite can be used even in large sized cavities. PMID:27011734

  8. Prognostic Significance of Preoperative and Postoperative Plasma Levels of Ghrelin in Gastric Cancer: 3-Year Survival Study

    PubMed Central

    Soleyman-Jahi, Saeed; Abdirad, Afshin; Fallah, Amir Afraz; Ghasemi, Sevil; Sadeghi, Fatemeh; Heidari, Reza; Mahmoodzadeh, Habibollah; Zendehdel, Kazem

    2017-01-01

    OBJECTIVES: We aimed to investigate prognostic effects of plasma levels of ghrelin before and after gastrectomy in gastric cancer (GC). METHODS: We followed 81 GC patients up to 3 years in this study. They were candidates for curative gastrectomy with or without neoadjuvant chemotherapy. Plasma levels of total and active ghrelins before and after the operation were assessed. Association of plasma levels of ghrelin with survival were assessed and adjusted for other potential prognostic factors using Cox regression analyses. RESULTS: Both total and active ghrelins dropped after gastrectomy (P<0.001 for both). Multiple Cox models revealed worse survival for patients with postoperative total ghrelins below median (hazards ratio (HR)=2.33, 95% confidence interval (CI): 1.01–5.41) or 25th percentile (HR=4.29, 95% CI: 1.48–12.44) compared with patients with higher ghrelin levels. In case of preoperative total ghrelin, patients with either second or third quartiles of plasma ghrelin showed worse survival compared with patients with the lowest quartile (HR=2.67, 95% CI: 1.11–6.38 for second quartile, and HR=2.32, 95% CI: 1.01–5.35 for third quartile vs. the lowest quartile). However, there was no difference between patients with the highest and lowest quartiles (HR=0.78, 95% CI: 0.22–2.73). Similar pattern was observed for preoperative active ghrelin (HR=4.92, 95% CI: 1.80–13.54 for second quartile, and HR=2.87, 95% CI: 1.11–7.38 for third quartile vs. the lowest quartile). Advanced TNM stage (HR=4.88, 95% CI: 1.10–21.77), cachexia (HR=2.99, 95% CI: 1.35–6.63), and receiving no neoadjuvant chemotherapy (HR=2.02, 95% CI: 1.04–3.92) were other poor prognostic factors. CONCLUSIONS: Preoperative and postoperative plasma levels of ghrelin could predict survival of GC patients with different patterns. This prognostic effect was independent of stage and cachexia. Measurement of plasma ghrelin in GC patients could complement conventional staging for more precise

  9. Increased Serum CD14 Level Is Associated with Depletion of TNF-α in Monocytes in Migraine Patients during Interictal Period

    PubMed Central

    Michalak, Slawomir; Kalinowska-Lyszczarz, Alicja; Wegrzyn, Danuta; Niezgoda, Adam; Losy, Jacek; Osztynowicz, Krystyna; Kozubski, Wojciech

    2017-01-01

    The aim of the present study was to investigate the levels of circulating CD14 in relation to the expression of tumor necrosis factor alpha (TNF-α) in monocytes, and serum levels of TNF-α and macrophage inflammatory protein-1 (MIP-1) in migraine patients. Numerous studies revealed controversial changes in the components of the immune system during attacks and the interictal period in migraine patients. Our study included 40 migraineurs and 39 controls. The levels of TNF-α, MIP-1 and CD14 were measured in peripheral monocytes and in sera with the Enzyme-Linked Immunosorbent Assay (ELISA) method, and the monocyte expression of TNF-α was also analysed by immunostaining. Serum CD14 concentrations were higher and the expression of TNF-α in monocytes was decreased in migraineurs. The serum MIP-1 level correlated with Verbal Rating Scale (VRS); the MIP-1:CD14 ratio in monocytes correlated with Visual Analogue Scale (VAS); the MIP-1:CD14 ratio correlated with Migraine Severity (MIGSEV)-Pain scores; and serum CD14 concentration correlated with migraine duration in years. Increased serum CD14 and depletion of TNF-α in monocytes can orchestrate other components of the immune system during the interictal period. PMID:28208835

  10. Lidocaine-prilocaine cream reduces catheter-related bladder discomfort in male patients during the general anesthesia recovery period: A prospective, randomized, case-control STROBE study.

    PubMed

    Mu, Li; Geng, Li-Cheng; Xu, Hui; Luo, Man; Geng, Jing-Miao; Li, Li

    2017-04-01

    Urethral catheterization is a predictor of agitation during the general anesthesia recovery period. The aim of this study was to determine the effect of intraurethral 5% lidocaine and 25 mg/g prilocaine cream in reducing catheter-related bladder discomfort (CRBD) in male patients during the general anesthesia recovery period. Adult male patients undergoing elective operations that required urinary catheterization under general anesthesia were enrolled and assigned randomly to 2 groups. In the lidocaine-prilocaine cream group (n = 72), approximately 5 g of topical cream was spread in the preputial sac, the glans, the meatus, and on the urinary catheter surface before urinary catheterization. In the control group (n = 74), the urinary catheter was lubricated with lidocaine gel. The incidence and severity of CRBD were assessed 15, 30, 45, and 60 minutes postoperatively. We found that the incidence of CRBD in the lidocaine-prilocaine cream group was significantly lower than in the control group. Multivariate logistic regression analysis showed that lidocaine-prilocaine cream applications reduced moderate or severe CRBD. Thirty minutes postoperation was the most frequent time point for the incidence of CRBD. Application of lidocaine-prilocaine cream on the surface of the urinary catheter is an efficient and safe method to reduce the incidence and severity of CRBD.

  11. A retrospective study of 572 patients with hand burns treated at the Department of Plastic Surgery Kosovo during the period 2000-2010.

    PubMed

    Arifi, Hysni M; Duci, Shkelzen B; Zatriqi, Violeta K; Ahmeti, Hasan R; Haxhiu, Isa I; Mekaj, Agon Y; Gashi, Musli M; Buja, Zejn A; Derguti, Shkelqim H

    2014-01-01

    Hands participate in everyday human activities and they are the most vulnerable parts of a human body. The objective of this study is to understand the common causes of hand burns, the methods of surgical interventions, duration of hospitalization and distribution of hand burns in 11 year period regarding the age. This is a retrospective study that included 572 patients with hand burns treated at the Department of Plastic Surgery Kosovo during the period 2000-2010. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Data processing was done with the statistical package InStat 3. From statistical parameters were calculated structural index, arithmetic median and standard deviation. Data testing is done with X (2) test and the difference is significant if P<0.05. The Ministry of Health of our country should make efforts to organize training for health workers about treatment for minor burns in order to reduce the number of referral patients from other primary (Familiar Medicine) and secondary centers (regional Hospitals).

  12. In vivo degradation of resin-dentin bonds in humans over 1 to 3 years.

    PubMed

    Hashimoto, M; Ohno, H; Kaga, M; Endo, K; Sano, H; Oguchi, H

    2000-06-01

    The longevity of resin restorations is currently an area of great interest in adhesive dentistry. However, no work has been conducted to investigate the durability of resin-dentin bond structures using human substrate in vivo. The purpose of this study was to investigate the degradation of the resin-dentin bond structures aged in an oral environment for 1, 2, or 3 years. Cavities were prepared in primary molars, and an adhesive resin system (Scotchbond Multi-Purpose) was applied to the cavity. After 1 to 3 years, following the eruption of the succedaneous permanent teeth, the resin-restored teeth were extracted. Immediately after extraction, those teeth were sectioned perpendicular to the adhesive interface and trimmed to produce an hourglass-shaped specimen. Then, a micro-tensile test was performed at a crosshead speed of 1.0 mm/min. The mean bond strengths were statistically compared with one-way ANOVA and Fisher's PLSD test (p < 0.05). Further, all fractured surfaces were observed by SEM, and the area fraction of failure mode was calculated by means of a digital analyzer on SEM photomicrographs. There were significant differences in tensile-bond strength among all 3 groups (p < 0.05), with mean values ranging from 28.3 +/- 11.3 MPa (control), to 15.2 +/- 4.4 MPa (1 to 2 years), to 9.1 +/- 5.1 MPa (2 to 3 years). Moreover, under fractographic analysis, the proportion of demineralized dentin at the fractured surface in specimens aged in an oral environment was greater than that in control specimens. Furthermore, degradation of resin composite and the depletion of collagen fibrils was observed among the specimens aged in an oral environment. Analysis of the results of this study indicated that the degradation of resin-dentin bond structures occurs after aging in the oral cavity.

  13. Early response with dasatinib or imatinib in chronic myeloid leukemia: 3-year follow-up from a randomized phase 3 trial (DASISION)

    PubMed Central

    Jabbour, Elias; Saglio, Giuseppe; Steegmann, Juan Luis; Shah, Neil P.; Boqué, Concepción; Chuah, Charles; Pavlovsky, Carolina; Mayer, Jiří; Cortes, Jorge; Baccarani, Michele; Kim, Dong-Wook; Bradley-Garelik, M. Brigid; Mohamed, Hesham; Wildgust, Mark; Hochhaus, Andreas

    2014-01-01

    This analysis explores the impact of early cytogenetic and molecular responses on the outcomes of patients with chronic myeloid leukemia in chronic phase (CML-CP) in the phase 3 DASatinib versus Imatinib Study In treatment-Naive CML patients trial with a minimum follow-up of 3 years. Patients with newly diagnosed CML-CP were randomized to receive 100 mg dasatinib (n = 259) or 400 mg imatinib (n = 260) once daily. The retrospective landmark analysis included patients evaluable at the relevant time point (3, 6, or 12 months). Median time to complete cytogenetic response was 3 vs 6 months with dasatinib vs imatinib. At 3 and 6 months, the proportion of patients with BCR-ABL transcript levels ≤10% was higher in the dasatinib arm. Deeper responses at 3, 6, and 12 months were observed in a higher proportion of patients on dasatinib therapy and were associated with better 3-year progression-free survival and overall survival in both arms. First-line dasatinib resulted in faster and deeper responses compared with imatinib. The achievement of an early molecular response was predictive of improved progression-free survival and overall survival, supporting new milestones for optimal response in patients with early CML-CP treated with tyrosine kinase inhibitors. This study was registered at www.clinicaltrials.gov as NCT00481247. PMID:24311723

  14. Prevalence of Mental Disorders and Suicidal Thoughts Among Community-Dwelling Elderly Adults 3 Years After the Niigata-Chuetsu Earthquake

    PubMed Central

    Suzuki, Yuriko; Tsutsumi, Atsuro; Fukasawa, Maiko; Honma, Hiroko; Someya, Toshiyuki; Kim, Yoshiharu

    2011-01-01

    Background Japan is located in an area prone to natural disasters, and major earthquakes have occurred recently in rural areas where the proportion of elderly adults is high. Although elderly persons are vulnerable members of communities at a time of disaster, the prevalence of mental disorders among this population has yet to be reported in Japan. This study aimed to determine the prevalence of mental disorders and suicidal thoughts among community-dwelling elderly persons 3 years after an earthquake and to identify risk factors associated with their quality of life (QOL). Methods Face-to-face interviews were conducted with 496 community-dwelling persons aged 65 years or older in areas of Japan where 2 major earthquakes had occurred during a 3-year period. The main outcome was diagnosis of a mental disorder or suicidality. Results During the 3-year period after the earthquake, 1.6% of men and 5.5% of women had received a diagnosis of major depression. There were no cases of posttraumatic stress disorder. Women were more likely than men to report suicidality (7.8% vs 3.8%, P = 0.075). Conclusions The prevalence of mental disorders was lower than that reported in previous studies. Despite the low prevalence of mental disorders, the percentage of community-dwelling elderly persons with subclinical mental health symptoms was high. The results indicate that appropriate public health and medical interventions are warranted after a natural disaster. PMID:21325733

  15. Period Pain

    MedlinePlus

    ... You may also have other symptoms, such as lower back pain, nausea, diarrhea, and headaches. Period pain is not ... Taking a hot bath Doing relaxation techniques, including yoga and meditation You might also try taking over- ...

  16. Suspected disseminated histiocytic sarcoma in a 3-year-old Perro de Presa Canario dog

    PubMed Central

    Denstedt, Emily

    2014-01-01

    A 3-year-old intact male Perro de Presa Canario dog was presented with acutely inflamed and edematous right hind limb, scrotum, prepuce, and an enlarged left carpus. Two weeks later the dog returned with weight loss, draining tracts in the right hind limb, dermal nodules, a palpable abdominal mass, and uveitis in the left eye. The dog succumbed to his illness 2 days later and a widely disseminated round cell tumor compatible with histiocytic sarcoma was diagnosed following postmortem examination. PMID:24489399

  17. [Atypical presentation of hepatosplenic cat scratch disease in a 3-year-old child].

    PubMed

    Boiron, E; Soto, B; Zimmermann, B; Jullien, M

    2012-06-01

    Cat scratch disease is caused by a facultative intracellular Gram-negative bacteria, Bartonella henselae. This disease is transmitted by cat scratches or bites. The typical form is a large and rough adenopathy, with no general signs. In a few cases, the symptoms are aspecific and various, which makes the diagnosis difficult. A 3-year-old child presented a prolonged fever with an aspecific skin eruption and hepatosplenic lesions seen 1 month after the beginning of the disease, which led to the diagnosis of hepatosplenic cat scratch disease. An adapted antibiotic therapy completely cured the disease.

  18. Acute dapsone poisoning in a 3-year-old child: Case report with review of literature

    PubMed Central

    Sunilkumar, Menon Narayanankutty; Ajith, Thekkuttuparambil Ananthanarayanan; Parvathy, Vadakut Krishnan

    2015-01-01

    Dapsone (DDS-diamino diphenyl sulphone) is a sulfone antibiotic being used for a variety of clinical conditions. Poisoning in children by DDS is rarely reported. Poisoning in acute cases will be frequently unrecognized due to relative lack of severe signs and symptoms. Methemoglobinemia is the major life-threatening situation associated with poisoning of DDS. Hence, any delay for medical attention can lead to increased rate of mortality. In this case, we describe acute DDS poisoning in a 3-year-old child and the successful management using intravenous methylene blue. PMID:26488029

  19. Axial Length/Corneal Radius of Curvature Ratio and Myopia in 3-Year-Old Children

    PubMed Central

    Foo, Valencia Hui Xian; Verkicharla, Pavan Kumar; Ikram, Mohammad Kamran; Chua, Sharon Yu Lin; Cai, Shirong; Tan, Chuen Seng; Chong, Yap-Seng; Kwek, Kenneth; Gluckman, Peter; Wong, Tien-Yin; Ngo, Cheryl; Saw, Seang-Mei; on behalf of the GUSTO study group

    2016-01-01

    Purpose This study investigated the association of axial length (AL) to corneal radius of curvature (CRC) ratio with spherical equivalent (SE) in a 3-year old Asian cohort. Methods Three-hundred forty-nine 3-year old Asian children from The Growing Up in Singapore towards Healthy Outcomes (GUSTO) birth cohort study underwent AL and CRC measurements with a noncontact ocular biometer and cycloplegic refraction using an autorefractor. The ratio of AL to CRC (AL/CRC) was calculated for all the participants, and subsequently AL, CRC, and AL/CRC were analyzed in relationship to SE. Results The SE showed better correlation with AL/CRC (Spearman's correlation coefficient, ρ = −0.53; 95% confidence interval [CI]: −0.66; −0.49; P < 0.001) compared to either AL or CRC alone ([ρ = −0.36; 95% CI: −0.51 to 0.51; P = 0.01] and [ρ = 0.05; 95% CI: −0.04 to 0.17; P = 0.34], respectively). Mean AL/CRC was 2.91 ± 0.06 among myopes and decreased to 2.79 ± 0.06 among hyperopes. Axial length to corneal radius of curvature was strongly correlated with SE in myopes (ρ = −0.78; 95% CI: −3.76; −0.79; P = < 0.001), but not in emmetropes and hyperopes ([ρ = −0.39; 95% CI: −10.73; −0.57; P = 0.01] and [ρ = −0.18; 95% CI: −17.28; 12.42; P = 0.38], respectively). Linear regression adjusted for gender and ethnicity showed a 0.74-diopter shift in SE towards myopia with every 0.1 increase in AL/CRC ratio (P < 0.001, r2 = 0.33). Conclusion The correlation between SE and AL/CRC is stronger than that between AL or CRC alone. This suggests that in a research setting, when cycloplegic refraction is difficult to perform on 3-year-old children, AL/CRC may be the next best reference for refractive error. Translational Relevance In the research setting, AL/CRC may be the next best reference for refractive error over AL alone when cycloplegic refraction is unavailable in 3-year old children. PMID:26929885

  20. Bilateral cochlear nerve absence in a 3 year old child with VACTERL association.

    PubMed

    Rudić, Milan; Wong, Winson; Viner, Stuart; Strachan, David; Raine, Christopher

    2017-02-01

    We report a case of a 3 year old boy with bilateral profound sensorineural hearing loss diagnosed from New Born Hearing Screening, with severe form of VACTERL association. He was referred to our Cochlear Implant Unit for assessment with regard to the possibility of cochlear implantation. MRI findings have showed bilateral vestibulocochlear cystic abnormalities. Only single nerve noted within the IAM on the right and likely single nerve within the IAM on the left. Hence, decision was made not to offer cochlear implantation. This is the first report of severe bilateral cochleovestibular nerve abnormalities to be associated with VACTERL.

  1. Mycoplasma pneumoniae associated stroke in a 3-year-old girl

    PubMed Central

    Kim, Gun-Ha; Seo, Won Hee; Je, Bo-Kyung

    2013-01-01

    Infectious diseases precede a significant proportion of acute ischemic strokes in children. Here, we report a case of acute ischemic stroke in a 3-year-old girl with a Mycoplasma pneumonia-associated respiratory tract infection. She developed an acquired prothrombotic state of protein S deficiency and had increased fibrinogen and fibrinogen degradation product levels and increased titer of antinuclear antibodies. However, these conditions were completely alleviated at the 1-month follow-up examination. Infection with M. pneumoniae may cause a transient prothrombotic state that can potentially cause a thrombus. PMID:24223604

  2. Fever and rash in a 3-year-old girl: Rocky Mountain spotted fever.

    PubMed

    Kaufmann, Julie M; Zaenglein, Andrea L; Kaul, Aditya; Chang, Mary Wu

    2002-09-01

    Initial symptoms of Rocky Mountain spotted fever (RMSF), a tick-borne illness caused by Rickettsia rickettsii, are nonspecific and include headache, gastrointestinal disturbances, malaise, and myalgias, followed by fever and rash. The classic triad of fever, rash, and history of tick exposure is uncommon at presentation. Clinical manifestations of RMSF range from virtually asymptomatic to severe. Because of the potentially fatal outcome of RMSF, presumptive clinical diagnosis and empiric antimicrobial therapy can be critical. We present the case of a 3-year-old girl from New York State who presented with fever and rash.

  3. A special case of lower back pain in a 3-year-old girl

    PubMed Central

    Tassinari, Davide; Forti, Sara; Torella, Michele; Tani, Giovanni

    2013-01-01

    We describe the case of a 3-year-old girl with a 15-day clinical history of lower back pain. We diagnosed a spondylodiscitis of vertebral bodies L5–S1 caused by Salmonella species group B that totally recovered with appropriate antibiotic therapy. Spondylodiscitis in children is a rare condition and Salmonella infection is one of the rarest aetiology. A high index of suspicion is needed for prompt diagnosis to ensure better long-term outcome. Microbiological diagnosis is essential for the appropriate choice of antibiotic treatment. PMID:23475989

  4. Baldrige-based quality awards: Veterans Health Administration's 3-year experience.

    PubMed

    Shirks, Allan; Weeks, William B; Stein, Annie

    2002-01-01

    This article describes the Veterans Health Administration's (VHA's) 3-year experience with an internal, Baldrige-based quality award. The authors examined scores for Veterans Integrated Service Networks (VISNs), which received site visits, variation in year-to-year survey outcomes for repeat applicants, and variation in survey team reports for a VISN with multiple surveys. Individual VISNs that applied in multiple years had mixed results. Variation in feedback reports was not significant. Although some VISNs increased their scores over time, there was not measurable, systemwide improvement. Three years may be too short a time to significantly affect Baldrige scores in an organization as large as VHA.

  5. Periodized wavelets

    SciTech Connect

    Schlossnagle, G.; Restrepo, J.M.; Leaf, G.K.

    1993-12-01

    The properties of periodized Daubechies wavelets on [0,1] are detailed and contrasted against their counterparts which form a basis for L{sup 2}(R). Numerical examples illustrate the analytical estimates for convergence and demonstrate by comparison with Fourier spectral methods the superiority of wavelet projection methods for approximations. The analytical solution to inner products of periodized wavelets and their derivatives, which are known as connection coefficients, is presented, and several tabulated values are included.

  6. A Comparision of the Effect of Sugammadex on the Recovery Period and Postoperative Residual Block in Young Elderly and Middle-Aged Elderly Patients

    PubMed Central

    Yazar, Emine; Yılmaz, Canan; Bilgin, Hülya; Karasu, Derya; Bayraktar, Selcan; Apaydın, Yılmaz; Sayan, Halil Erkan

    2016-01-01

    Background: The importance of the characteristics of anesthesia and postoperative residual curarization (PORC) in the elderly population should be a growing concern in this century. Aims: To investigate the effect of sugammadex on the duration of the recovery from neuromuscular blocking agents and postoperative residual curarization in the young elderly and middle-aged elderly patients who underwent elective laparoscopic cholecystectomy, followed by a train of four (TOF) watch monitorization. Study Design: Prospective clinical trial study. Methods: Sixty patients over the age of 65 with American Society of Anesthesiologists I–III were divided into two groups according to their age (65–74 years old and ≥75 years old). Patients received sugammadex (2.0 mg/kg iv) at the reappearance of the second twitch of the TOF as an agent for reversal of neuromuscular blockage at the end of surgery. Patients were extubated at the time of TOF ≥0.9. The patients’ TOF responses were evaluated with regards to PORC in at the 5th minute and were followed up for one hour in the recovery room. Reintubation was applied for those patients who developed PORC and had peripheric oxygen saturation <90% despite being given 6 L oxygen per min with a face mask. Results: The onset time of neuromuscular blocking agent and time from T2 to achieve TOF ratio 90% (the duration of sugammadex effect) or over were found to be longer in the middle-aged elderly group than in the young elderly group. A statistically significant relationship was found between age and the duration of TOF ratio to reach 0.9 in the same direction. The PORC incidence and rate of reintubation were found to be 1.7% in all patients. Conclusion: In our opinion, it is necessary to remember that the duration of sugammadex effect on the recovery period is prolonged for patients who are aged ≥75 years compared to patients aged between 65–74 years. (ClinicalTrials.gov Identifier: ACTRN12615000758505) PMID:27403387

  7. Recent data on rapid eye movement sleep behavior disorder in patients with Parkinson disease: analysis of behaviors, movements, and periodic limb movements.

    PubMed

    Cochen De Cock, Valérie

    2013-08-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is a fascinating parasomnia in which patients are able to enact their dreams because of a lack of muscle atonia during REM sleep. RBD represents a unique window into the dream world. Frequently associated with Parkinson's disease (PD), RBD raises various issues about dream modifications in this pathology and about aggressiveness during RBD episodes in placid patients during wakefulness. Studies on these behaviors have underlined their non-stereotyped, action-filled and violent characteristics but also their isomorphism with dream content. Complex, learnt behaviors may reflect the cortical involvement in this parasomnia but the more frequent elementary movements and the associated periodic limb movements during sleep also implicate the brainstem. Surprisingly, patients with PD have an improvement of their movements during their RBD as if they were disease-free. Also not yet understood, this improvement of movement during REM sleep raises issues about the pathways involved in RBD and about the possibility of using this pathway to improve movement in PD during the day.

  8. Intra-host evolution of multiple genotypes of hepatitis C virus in a chronically infected patient with HIV along a 13-year follow-up period.

    PubMed

    Culasso, A C A; Baré, P; Aloisi, N; Monzani, M C; Corti, M; Campos, R H

    2014-01-20

    The intra-host evolutionary process of hepatitis C virus (HCV) was analyzed by phylogenetic and coalescent methodologies in a patient co-infected with HCV-1a, HCV-2a, HCV-3a and human immunodeficiency virus (HIV) along a 13-year period. Direct sequence analysis of the E2 and NS5A regions showed diverse evolutionary dynamics, in agreement with different relationships between these regions and the host factors. The Bayesian Skyline Plot analyses of the E2 sequences (cloned) yielded different intra-host evolutionary patterns for each genotype: a steady state of a "consensus" sequence for HCV-1a; a pattern of lineage splitting and extinction for HCV-2a; and a two-phase (drift/diversification) process for HCV-3a. Each genotype evolving in the same patient and at the same time presents a different pattern apparently modulated by the immune pressure of the host. This study provides useful information for the management of co-infected patients and provides insights into the mechanisms behind the intra-host evolution of HCV.

  9. The incidence of lymphocytic thyroid infiltration and Hashimoto's thyroiditis increased in patients operated for benign goiter over a 31-year period.

    PubMed

    Ott, Johannes; Meusel, Moritz; Schultheis, Andrea; Promberger, Regina; Pallikunnel, Shannon Joan; Neuhold, Nikolaus; Hermann, Michael

    2011-09-01

    The incidence of Hashimoto's thyroiditis (HT) seems to have increased over the last several decades. Since there is a lack of recent studies in the literature that evaluate this phenomenon on a histological basis, we aimed to assess the incidence of lymphocytic thyroid infiltration (LTI) in our large surgical patient collective over a 31-year period. In our study, a total of 1,050 patients who had undergone uni- or bilateral thyroid surgery for benign goiter were included (150 patients in each group, during 1979 to 2009). The stored histological sections of the removed thyroid specimens were re-analyzed, including routine grading of LTI severity on a scale of 0-4, according to Williams and Doniach. Positive correlations were seen for the incidences of LTI grading (0-4) (r = 0.077, p = 0.013) and HT (r = 0.044, p = 0.078) over the years. Furthermore, when comparing the years 1979-1989 and 1994-2009, i.e., before and after the second iodine prophylaxis had been introduced in Austria, a higher incidence of HT was found for the later years (2 out of 450, 0.4%, vs. 6 out of 600, 1.0%, respectively; p < 0.0001). In conclusion, the data demonstrate that the incidence of LTI and HT has increased substantially over the last 31 years.

  10. [Clinico-neurological and stabilometric analysis of betahistine (betaserc) efficacy in the patients with vertigo in the rehabilitation period of ischemic stroke].

    PubMed

    Gekht, A B; Vialkova, A B; Galanov, D V

    2005-01-01

    A study of betahistine (betaserc) in 65 patients aged 59,48 +/- 8,63 years with vertigo in early rehabilitation period of ischemic stroke has been carried out. Thirty-five patients got atiplatelet and antihypertensive therapy and were also treated by betaserc--8-16 mg 3 times per day for 14 days per os, after meals. The control group of 30 patients received only atiplatelet and antihypertensive therapy. Both groups were similar in demographic and clinical characteristics. The treatment with betahistine reduced the intensity and duration of vertigo, led to improvement of coordination and equilibrium, increase stability of a vertical posture that was accompanied by significant (p<0,05) improvement of the values on the Hoffenberth and Bohannon scales. Betahistine treatment also resulted in marked authentic (p<0,05) improvement of stabilometric parameters in biological feedback task that might be explained by activation of the mechanisms maintaining vertical balance. An improvement of clinical and neurophysiologic traits was more pronounced in the group treated with betaserc as compared to the control group.

  11. Neurodevelopment of children under 3 years of age with Smith-Magenis syndrome.

    PubMed

    Wolters, Pamela L; Gropman, Andrea L; Martin, Staci C; Smith, Michaele R; Hildenbrand, Hanna L; Brewer, Carmen C; Smith, Ann C M

    2009-10-01

    Systematic data regarding early neurodevelopmental functioning in Smith-Magenis syndrome are limited. Eleven children with Smith-Magenis syndrome less than 3 years of age (mean, 19 months; range, 5-34 months) received prospective multidisciplinary assessments using standardized measures. The total sample scored in the moderately to severely delayed range in cognitive functioning, expressive language, and motor skills and exhibited generalized hypotonia, oral-motor abnormalities, and middle ear dysfunction. Socialization skills were average, and significantly higher than daily living, communication, and motor abilities, which were below average. Mean behavior ratings were in the nonautistic range. According to exploratory analyses, the toddler subgroup scored significantly lower than the infant subgroup in cognition, expressive language, and adaptive behavior, suggesting that the toddlers were more delayed than the infants relative to their respective peers. Infants aged approximately 1 year or younger exhibited cognitive, language, and motor skills that ranged from average to delayed, but with age-appropriate social skills and minimal maladaptive behaviors. At ages 2 to 3 years, the toddlers consistently exhibited cognitive, expressive language, adaptive behavior, and motor delays and mildly to moderately autistic behaviors. Combining age groups in studies may mask developmental and behavioral differences. Increased knowledge of these early neurodevelopmental characteristics should facilitate diagnosis and appropriate intervention.

  12. Preventing Pregnancy in High School Students: Observations From a 3-Year Longitudinal, Quasi-Experimental Study

    PubMed Central

    Dierschke, Nicole; Lowe, Diana; Plastino, Kristen

    2016-01-01

    Objectives. To assess whether a sexual health education intervention reduces pregnancy rates in high school students. Methods. We performed a secondary analysis of a 3-year quasi-experimental study performed in South Texas from 2011 to 2015 in which 1437 students without a history of pregnancy at baseline were surveyed each fall and spring. Potentially confounding risk factors considered included sexual behaviors, intentions, and demographics. The outcome measure was self-reported pregnancy status for male and female students. We performed analyses for male and female students using separate discrete time-to-event models. Results. We found no difference in pregnancy rates between intervention and comparison students within the first 3 years of high school. Female and male students in the intervention groups had pregnancy hazard ratios of, respectively, 1.62 (95% CI = 0.9, 2.61; P = .1) and 0.78 (95% CI = 0.44, 1.48; P = .4) relative to the comparison groups. Conclusions. The educational intervention had no impact on the pregnancy rate. Social media tools in pregnancy prevention programs should be adaptive to new technologies and rapidly changing adolescent preferences for these services. PMID:27689503

  13. Growth, behavior, development and intelligence in rural children between 1-3 years of life.

    PubMed

    Agarwal, D K; Awasthy, A; Upadhyay, S K; Singh, P; Kumar, J; Agarwal, K N

    1992-04-01

    In a rural cohort of 625 children registered from 1981 to 1983 in 10 villages of K.V. Block, Varanasi, 196 children were assessed for physical growth, development, intelligence and concept development between 1 and 3 years of age. Home environment was also assessed using Caldwell Home inventory. These rural children remained below 3rd centile of NCHS standard for weight, height, skull and mid-arm circumferences throughout the study. Malnourished children scored poorly in all the areas of development, i.e., motor, adaptive, language and personal social, 9% in Grade I and 16.6% children in Grade II + III had IQ less than 79 (inferior). Concept for color shape and size was poorly developed in malnourished children. Maternal involvement and stimulation was strongly associated with better behavior development and intelligence. Multiple regression analysis showed that the effect of home environment on development and intelligence was of a higher magnitude as compared to status and family variables and nutritional status during 1-3 years of age.

  14. 3-Year-olds' comprehension, production, and generalization of Sesotho passives.

    PubMed

    Demuth, Katherine; Moloi, Francina; Machobane, Malillo

    2010-05-01

    Researchers have long been puzzled by the challenge English passive constructions present for language learners, with adult-like comprehension and production emerging only around the age of 5. It has therefore been of significant interest that researchers of other languages, including the Bantu language Sesotho, have reported acquisition of the passive by the age of 3 (Demuth, 1989). Such reports have typically been based on spontaneous production data, calling for further investigation. This study carried out a series of experiments with Sesotho-speaking 3-year-olds, testing their ability to comprehend the passive, produce the passive, and generalize novel verbs to passive frames. The results showed that passive comprehension was good, with no effect of actional/non-actional verb type. Elicited production of the passive was also good, with no difference between adversive and non-adversive verbs. Finally, all participants made both active and passive generalizations to novel verbs. These findings provide strong evidence that Sesotho-speaking 3-year-olds have robust, abstract knowledge of passive syntax. The paper concludes with a discussion of the factors that contribute to the early learning of the Sesotho passive, why acquisition of the passive may be delayed in English, and the implications for understanding grammatical development more generally.

  15. Joint action modulates motor system involvement during action observation in 3-year-olds.

    PubMed

    Meyer, Marlene; Hunnius, Sabine; van Elk, Michiel; van Ede, Freek; Bekkering, Harold

    2011-06-01

    When we are engaged in a joint action, we need to integrate our partner's actions with our own actions. Previous research has shown that in adults the involvement of one's own motor system is enhanced during observation of an action partner as compared to during observation of an individual actor. The aim of this study was to investigate whether similar motor system involvement is present at early stages of joint action development and whether it is related to joint action performance. In an EEG experiment with 3-year-old children, we assessed the children's brain activity and performance during a joint game with an adult experimenter. We used a simple button-pressing game in which the two players acted in turns. Power in the mu- and beta-frequency bands was compared when children were not actively moving but observing the experimenter's actions when (1) they were engaged in the joint action game and (2) when they were not engaged. Enhanced motor involvement during action observation as indicated by attenuated sensorimotor mu- and beta-power was found when the 3-year-olds were engaged in the joint action. This enhanced motor activation during action observation was associated with better joint action performance. The findings suggest that already in early childhood the motor system is differentially activated during action observation depending on the involvement in a joint action. This motor system involvement might play an important role for children's joint action performance.

  16. The relation between student motivation and student grades in physical education: A 3-year investigation.

    PubMed

    Barkoukis, V; Taylor, I; Chanal, J; Ntoumanis, N

    2014-10-01

    Enhancing students' academic engagement is the key element of the educational process; hence, research in this area has focused on understanding the mechanisms that can lead to increased academic engagement. The present study investigated the relation between motivation and grades in physical education (PE) employing a 3-year longitudinal design. Three hundred fifty-four Greek high school students participated in the study. Students completed measures of motivation to participate in PE on six occasions; namely, at the start and the end of the school year in the first, second, and third year of junior high school. Students' PE grades were also recorded at these time points. The results of the multilevel growth models indicated that students' PE grades increased over the 3 years and students had better PE grades at the end of each year than at the beginning of the subsequent year. In general, students and classes with higher levels of controlling motivation achieved lower PE grades, whereas higher levels of autonomous motivation were associated with higher PE grades. These findings provide new insight on the associations between class- and individual-level motivation with objectively assessed achievement in PE.

  17. Spatial but not verbal cognitive deficits at age 3 years in persistently antisocial individuals.

    PubMed

    Raine, Adrian; Yaralian, Pauline S; Reynolds, Chandra; Venables, Peter H; Mednick, Sarnoff A

    2002-01-01

    Previous studies have repeatedly shown verbal intelligence deficits in adolescent antisocial individuals, but it is not known whether these deficits are in place prior to kindergarten or, alternatively, whether they are acquired throughout childhood. This study assesses whether cognitive deficits occur as early as age 3 years and whether they are specific to persistently antisocial individuals. Verbal and spatial abilities were assessed at ages 3 and 11 years in 330 male and female children, while antisocial behavior was assessed at ages 8 and 17 years. Persistently antisocial individuals (N = 47) had spatial deficits in the absence of verbal deficits at age 3 years compared to comparisons (N = 133), and also spatial and verbal deficits at age 11 years. Age 3 spatial deficits were independent of social adversity, early hyperactivity, poor test motivation, poor test comprehension, and social discomfort during testing, and they were found in females as well as males. Findings suggest that early spatial deficits contribute to persistent antisocial behavior whereas verbal deficits are developmentally acquired. An early-starter model is proposed whereby early spatial impairments interfere with early bonding and attachment, reflect disrupted right hemisphere affect regulation and expression, and predispose to later persistent antisocial behavior.

  18. Psychotherapy with a 3-Year-Old Child: The Role of Play in the Unfolding Process

    PubMed Central

    Salcuni, Silvia; Di Riso, Daniela; Mabilia, Diana; Lis, Adriana

    2017-01-01

    Few studies have investigated the outcomes and process of psychodynamic psychotherapies with children. Among the limited number of studies, some only paid attention to play and verbal production, as they are fundamental aspects in assessing the psychotherapy process. This paper focuses on an empirical investigation of a 3-year, once-a-week psychodynamic psychotherapy carried out with a 3-year-old girl. A process-outcome design was implemented to evaluate play and verbal discourse in in the initial, middle, and final parts of 30 psychotherapy sessions. Repeated measurements of standardized play categories (the Play Category System and the Affect in Play Scale—Preschool version) and verbal discourse (Verbal Production) were analyzed. To increase the clinical validity of the study, data from the assessment phase and vignettes from the sessions were reported to deepen the patient’s picture during the unfolding therapy process. Parent reports before and after the therapy were also included. Empirically measured changes in play and verbal production were fundamental in evaluating the young patient’s psychotherapy process. Verbal production and discourse ability progressively increased and took the place of play, which instead became more symbolic. Developmental issues as well as psychotherapy’s influence on the patient’s change, were discussed in relation to the role of play in enhancing the development of verbal dialog and the expression of the child’s emotions, needs, and desires. PMID:28101070

  19. Mental Health Diagnoses 3 Years After Receiving or Being Denied an Abortion in the United States

    PubMed Central

    Neuhaus, John M.; Foster, Diana G.

    2015-01-01

    Objectives. We set out to assess the occurrence of new depression and anxiety diagnoses in women 3 years after they sought an abortion. Methods. We conducted semiannual telephone interviews of 956 women who sought abortions from 30 US facilities. Adjusted multivariable discrete-time logistic survival models examined whether the study group (women who obtained abortions just under a facility’s gestational age limit, who were denied abortions and carried to term, who were denied abortions and did not carry to term, and who received first-trimester abortions) predicted depression or anxiety onset during seven 6-month time intervals. Results. The 3-year cumulative probability of professionally diagnosed depression was 9% to 14%; for anxiety it was 10% to 15%, with no study group differences. Women in the first-trimester group and women denied abortions who did not give birth had greater odds of new self-diagnosed anxiety than did women who obtained abortions just under facility gestational limits. Conclusions. Among women seeking abortions near facility gestational limits, those who obtained abortions were at no greater mental health risk than were women who carried an unwanted pregnancy to term. PMID:26469674

  20. Longitudinal analysis of immune function in the first 3 years of life in thymectomized neonates during cardiac surgery

    PubMed Central

    Mancebo, E; Clemente, J; Sanchez, J; Ruiz-Contreras, J; De Pablos, P; Cortezon, S; Romo, E; Paz-Artal, E; Allende, L M

    2008-01-01

    The purpose of this study is to evaluate the effects of neonatal thymectomy in the functional capacity of the immune system. We selected a group of 23 subjects, who had undergone thymectomy in their first 30 days of life, during an intervention for congenital heart disease. Several parameters of the immune system were evaluated during their first 3 years of life. Lymphocyte populations and subpopulations (including naive, memory and effector subpopulations), T cell receptor (TCR) Vβ repertoire, response of T cells following in vitro stimulation by mitogen, quantification of immunoglobulins, TCR excision circles (TRECS) and interleukin (IL)-7 were measured. We found that neonatal thymectomy produces long-term diminution in total lymphocyte counts, especially in naive CD4+ and CD8+ T cells. Additionally, TRECS were decreased, and plasma IL-7 levels increased. A statistically significant negative correlation was found between absolute CD4+ T cells and IL-7 (r = −0·470, P = 0·02). The patients did not suffer more infectious events than healthy control children, but thymectomy in neonates resulted in a significant decrease in T lymphocyte levels and TRECS, consistent with cessation of thymopoiesis. This could produce a compromise in immune function later in life, especially if the patients suffer T cell depletion and need a reconstitution of immune function. PMID:18811694

  1. Prescription pain reliever misuse and levels of pain impairment: 3-year course in a nationally representative outpatient sample of US adults

    PubMed Central

    Novak, Scott P; Glasheen, Cristie; Roland, Carl L

    2016-01-01

    Background The primary aim of this work was to present the prevalence data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a representative 3-year longitudinal survey (ages 18+ years) that captured information on patterns of self-reported pain interference and prescription pain reliever misuse. A second aim was to assess the degree to which the risk of various types of opioid misuse (onset, desistance, and incidence of dependence) was related to the longitudinal course of self-reported pain interference over the 3-year period. Methods We used a two-wave, nationally representative sample of adults (aged 18+ years) in which the baseline data were collected during 2001–2002 and a single follow-up was obtained ~3 years later (2004–2005 with 34,332 respondents with complete data on study variables for both waves). Results Our findings indicated that ~10% reported high pain interference in the past month at each wave. There was tremendous stability in levels of pain, with ~5% reporting consistent levels of high impairment over the 3-year study, a proxy for chronic pain. Levels of pain were more strongly associated with prescription pain reliever misuse concurrently rather than prospectively, and the association was largely linear, with the likelihood of misuse increasing with levels of pain. Finally, health service factors were also prominent predictors of onset, but not the outcomes, of desistance or transitions to problem use. Conclusion This study is the first to use a nationally representative sample with measures of pain and drug use history collected over an extended period. These results may help provide clinicians with an understanding that the risk of misuse is greatest when pain is active and may help guide the selection of appropriate intervention materials and monitor strategies for those at greatest risk. PMID:27418863

  2. Periodontal health status and implication of periodic acid–Schiff diastase - a key in exfoliative cytology among diabetics mellitus patients: A case–control study

    PubMed Central

    Imran, Aesha; Parakh, Mayank Kumar; Kumar, Satish Muthu; Nachiammai, N.; Sriram, K.

    2016-01-01

    Objectives: The objectives of the study are: (i) To determine if periodic acid–Schiff (PAS)-Diastase is an effective tool to diagnose DM noninvasively, (ii) to use three different types of staining procedures to identify the staining pattern over the exfoliated cells of normal and diabetic patients, (iii) to study the periodontal health status of DM and normal subjects. Materials and Methods: Basic questions regarding the demographic data were asked, following which community periodontal index (CPI) was recorded. Oral smears were collected from clinically normal buccal mucosa of 150 patients using wooden tongue spatulas. The subjects were asked to gargle their mouth with water and the wooden spatula was scraped at the site from buccal mucosa. The smears were spread evenly on a dry clean glass slide and fixed immediately with absolute ethyl alcohol. Three slides were prepared for each of the patients. PAS, PAS with diastase digestion, and Papanicolaou staining were performed and examined under a microscope. Results: Average CPI for study subjects was 3.2 and control subjects was 2.1. The average loss of attachment was 1.1 in the study group and 0.2 in the control group (P - 0.00) and the result are statistically highly significant. All the 150 cases (100%) were positive for PAS staining, while PAS-diastase (PAS-D) staining showed positivity only for normal subjects and was negative (100%) in the diabetic group (P - 0.00) and the result are statistically highly significant. Conclusions: Results of our study showed that exfoliative cytology of the oral cavity, when stained with PAS and PAS-D, can be used as an effective screening and diagnostic tool for DM patients. PMID:28042261

  3. Detection of walking periods and number of steps in older adults and patients with Parkinson's disease: accuracy of a pedometer and an accelerometry-based method.

    PubMed

    Dijkstra, Baukje; Zijlstra, Wiebren; Scherder, Erik; Kamsma, Yvo

    2008-07-01

    The aim of this study was to examine if walking periods and number of steps can accurately be detected by a single small body-fixed device in older adults and patients with Parkinson's disease (PD). Results of an accelerometry-based method (DynaPort MicroMod) and a pedometer (Yamax Digi-Walker SW-200) worn on each hip were evaluated against video observation. Twenty older adults and 32 PD patients walked straight-line trajectories at different speeds, of different lengths and while doing secondary tasks in an indoor hallway. Accuracy of the instruments was expressed as absolute percentage error (older adults versus PD patients). Based on the video observation, a total of 236.8 min of gait duration and 24,713 steps were assessed. The DynaPort method predominantly overestimated gait duration (10.7 versus 11.1%) and underestimated the number of steps (7.4 versus 6.9%). Accuracy decreased significantly as walking distance decreased. Number of steps were also mainly underestimated by the pedometers, the left Yamax (6.8 versus 11.1%) being more accurate than the right Yamax (11.1 versus 16.3%). Step counting of both pedometers was significantly less accurate for short trajectories (3 or 5 m) and as walking pace decreased. It is concluded that the Yamax pedometer can be reliably used for this study population when walking at sufficiently high gait speeds (>1.0 m/s). The accelerometry-based method is less speed-dependent and proved to be more appropriate in the PD patients for walking trajectories of 5 m or more.

  4. A Case of Nonfatal Ventricular Arrhythmia Due to Thyrotoxic Periodic Paralysis in a Saudi Patient as an Initial Presentation of Graves’ Disease

    PubMed Central

    Hakami, Osamah; Ahmad, Maswood M.; Al Johani, Naji

    2016-01-01

    Thyrotoxic periodic paralysis (TPP) is a potentially lethal complication of hyperthyroidism characterized by recurrent muscle weakness and hypokalemia. It has been commonly reported in non-Asian populations. Four cases were reported in Saudis so far, and one had a life-threatening arrhythmia. We describe an additional case of a 28-year-old apparently healthy Saudi male patient, who presented with acute paraparesis associated with hypokalemia (K: 2.0 mmol/L), complicated by ventricular tachycardia and cardiac arrest. He was successfully resuscitated and his hypokalemia was corrected. A diagnosis of Graves’ disease associated with TPP was made. He was initially treated with carbimazole and β-blockers and then given a definitive therapy with radioactive iodine, which showed a good response. This case highlights the importance of early recognition and prompt treatment of TPP as a differential diagnosis for muscle weakness. A brief review of TPP and associated arrhythmia is included. PMID:26843815

  5. Preliminary Evaluation of a New Semi-Closed-Loop Insulin Therapy System Over the Prandial Period in Adult Patients With Type 1 Diabetes

    PubMed Central

    Quemerais, Marie Aude; Doron, Maeva; Dutrech, Florent; Melki, Vincent; Franc, Sylvia; Antonakios, Michel; Charpentier, Guillaume; Hanaire, Helene; Charpentier, Guillaume

    2014-01-01

    There is room for improvement in the algorithms used in closed-loop insulin therapy during the prandial period. This pilot study evaluated the efficacy and safety of the Diabeloop algorithm (model predictive control type) during the postprandial period. This 2-center clinical trial compared interstitial glucose levels over two 5-hour periods (with/without the algorithm) following a calibrated lunch. On the control day, the amount of insulin delivered by the pump was determined according to the patient’s usual parameters. On the test day, 50% or 75% of the theoretical bolus required was delivered, while the algorithm, informed of carbohydrate intake, proposed changes to insulin delivery every 15 minutes using modeling to forecast glucose levels. The primary endpoint was percentage of time spent at near normoglycemia (70-180 mg/dl). Twelve patients with type 1 diabetes (9 men, age 35.6 ± 12.7 years, HbA1c 7.3 ± 0.8%) were included. The percentage of time spent in the target range was 84.5 ± 20.8 (test day) versus 69.2 ± 33.9% (control day, P = .11). The percentage of time spent in hypoglycemia < 70 mg/dl was 0.2 ± 0.8 (test) versus 4.4 ± 8.2% (control, P = .18). Interstitial glucose at the end of the test (5 hours) was 127.5 ± 40.1 (test) versus 146 ± 53.5 mg/dl (control, P = .25). The insulin doses did not differ, and no differences were observed between the 50% and 75% boluses. In a semi-closed-loop configuration with manual priming boluses (25% or 50% reduction), the Diabeloop v1 algorithm was as successful as the manual method in determining the prandial bolus, without any exposure to excessive hypoglycemic risk. PMID:25097057

  6. The impact of remedial intervention on 3-year recidivism among first-time DUI offenders in Mississippi.

    PubMed

    Robertson, Angela A; Gardner, Sheena; Xu, Xiaohe; Costello, Humphrey

    2009-09-01

    This study examines the impact of the Mississippi Alcohol Safety Education Program (MASEP), a court-mandated intervention program, on 3-year recidivism rates among first-time DUI offenders (i.e. those convicted of a first offense for driving under the influence of alcohol or another drug). It also examines whether a new version of the curriculum that incorporates activities to enhance motivation for change further ameliorates recidivism. Cox proportional hazard regression models are used to compare recidivism rates among DUI offenders who completed MASEP with those who did not complete or who failed to enroll in the program. Recidivism rates were also compared for MASEP participants across time periods during which curriculum revisions were introduced. The hazard of recidivism was lower for individuals who completed the program than for individuals who did not complete or did not enroll in the program. Recidivism rates were further reduced following the introduction of curriculum revisions. Attendance of court-mandated remedial intervention programs lower subsequent DUI arrests and program content is associated with lower rates.

  7. Geophysical monitoring of simulated clandestine graves using electrical and ground-penetrating radar methods: 0-3 years after burial.

    PubMed

    Pringle, Jamie K; Jervis, John R; Hansen, James D; Jones, Glenda M; Cassidy, Nigel J; Cassella, John P

    2012-11-01

    This study provides forensic search teams with systematic geophysical monitoring data over simulated clandestine graves for comparison to active cases. Simulated "wrapped" and "naked" burials were created. Multigeophysical surveys were collected over a 3-year monitoring period. Bulk ground resistivity, electrical resistivity imaging, multifrequency ground-penetrating radar (GPR), and grave and background "soil-water" conductivity data were collected. Resistivity surveys revealed the naked burial had consistently low-resistivity anomalies, whereas the wrapped burial had small, varying high-resistivity anomalies. GPR 110- to 900-MHz frequency surveys showed the wrapped burial could be detected throughout, with the "naked" burial mostly resolved. Two hundred and twenty-five megahertz frequency GPR data were optimal. "Soil-water" analyses showed rapidly increasing (year 1), slowly increasing (year 2), and decreasing (year 3) conductivity values. Results suggest resistivity and GPR surveys should be collected if target "wrapping" is unknown, with winter to spring surveys optimal. Resistivity surveys should be collected in clay-rich soils.

  8. Severe periodontal disease manifested in chronic disseminated type of langerhans cell histiocytosis in a 3-year old child.

    PubMed

    Bansal, Monika; Srivastava, Vinay Kumar; Bansal, Rajesh; Gupta, Vineeta; Bansal, Manish; Patne, Shashikant

    2014-01-01

    Langerhans cell histiocytosis (LCH), previously known as histio-cytosis X, is a rare idiopathic disorder of reticulo-endothelial system with abnormal proliferation of bone marrow derived Langerhans cells along with a variable number of leukocytes, such as eosinophils, neutrophils, lymphocytes and plasma cells. Three years old male child presented with multifocal osteolytic lesions and papulosquamous skin lesions. Clinical and radio-graphic features, such as severe alveolar bone loss, mobility of teeth, precocious eruption of teeth, foating appearance of teeth in orthopantomogram (OPG), osteolytic lesion in skull and cutaneous lesions were highly suggestive of LCH disease. Skin biopsy confirmed a diagnosis of LCH. Induction chemotherapy with oral prednisolone and intravenous vinblastine was started. Child responded well to chemotherapy. The clinical significance of the presented case is to diagnose the case of LCH on the basis of the manifestation of severe periodontal disease as this can be first or only manifestation of LCH. A dentist plays a major role in the multidisciplinary treatment of LCH through routine examination and periodic follow-up. How to cite this article: Bansal M, Srivastava VK, Bansal R, Gupta V, Bansal M, Patne S. Severe Periodontal Disease Manifested in Chronic Disseminated Type of Langerhans Cell Histiocytosis in a 3-Year Old Child. Int J Clin Pediatr Dent 2014;7(3):217-219.

  9. Severe Periodontal Disease Manifested in Chronic Disseminated Type of Langerhans Cell Histiocytosis in a 3-Year Old Child

    PubMed Central

    Srivastava, Vinay Kumar; Bansal, Rajesh; Gupta, Vineeta; Bansal, Manish; Patne, Shashikant

    2014-01-01

    ABSTRACT% Langerhans cell histiocytosis (LCH), previously known as histio-cytosis X, is a rare idiopathic disorder of reticulo-endothelial system with abnormal proliferation of bone marrow derived Langerhans cells along with a variable number of leukocytes, such as eosinophils, neutrophils, lymphocytes and plasma cells. Three years old male child presented with multifocal osteolytic lesions and papulosquamous skin lesions. Clinical and radio-graphic features, such as severe alveolar bone loss, mobility of teeth, precocious eruption of teeth, foating appearance of teeth in orthopantomogram (OPG), osteolytic lesion in skull and cutaneous lesions were highly suggestive of LCH disease. Skin biopsy confirmed a diagnosis of LCH. Induction chemotherapy with oral prednisolone and intravenous vinblastine was started. Child responded well to chemotherapy. The clinical significance of the presented case is to diagnose the case of LCH on the basis of the manifestation of severe periodontal disease as this can be first or only manifestation of LCH. A dentist plays a major role in the multidisciplinary treatment of LCH through routine examination and periodic follow-up. How to cite this article: Bansal M, Srivastava VK, Bansal R, Gupta V, Bansal M, Patne S. Severe Periodontal Disease Manifested in Chronic Disseminated Type of Langerhans Cell Histiocytosis in a 3-Year Old Child. Int J Clin Pediatr Dent 2014;7(3):217-219. PMID:25709306

  10. Epidermoid Cyst in the Floor of the Mouth of a 3-Year-Old

    PubMed Central

    Pascual Dabán, Rossana; García Díez, Eloy; González Navarro, Beatriz; López-López, José

    2015-01-01

    Epidermoid cysts are a rare entity in the oral cavity and are even less frequent in the floor of the mouth, representing less than 0.01% of all the cases. We present the case of a 3-year-old girl with a growth in the floor of the mouth with 2 months of evolution and without changes since it was discovered by her parents. The lesion was asymptomatic; it did not cause dysphagia, dyspnea, or any other alteration. A CT scan with contrast was done which revealed the location and exact size of the lesion, allowing an intraoral approach for its excision. The histological examination confirmed the clinical speculation of an epidermoid cyst. PMID:25694831

  11. Workplace safety in Bangladesh ready-made garment sector: 3 years after the Rana Plaza collapse.

    PubMed

    Barua, Uttama; Ansary, Mehedi Ahmed

    2016-11-18

    Workplace safety is one of the most important issues in industries worldwide, and is endangered by industrial accidents. Different industrial disasters have resulted in several initiatives worldwide to protect human life and reduce material damage, both nationally and internationally. In Bangladesh, the ready-made garment (RMG) industry is one of the most important export-oriented business sectors, which is facing challenges to ensure workplace safety. The Rana Plaza collapse in Bangladesh is the consequence of such non-compliance. The accident resulted in different local and global initiatives to address the challenges. This article reviews progress and achievement of the initiatives to reduce vulnerability in the Bangladesh RMG industry within 3 years after the deadly accident. In the long run, the challenge is to maintain momentum already created for achieving sustainability in the RMG sector in Bangladesh and maintaining compliance even after the end of support from external partners.

  12. Hemiconvulsion-hemiplegia-epilepsy syndrome. Magnetic resonance findings in a 3-year-old boy.

    PubMed

    Salafia, Stefania; Praticò, Andrea D; Pizzo, Enza; Greco, Filippo; Di Bella, Domenico

    2013-01-01

    The term 'hemiconvulsion-hemiplegia-epilepsy syndrome' (HHE) was first used by Gastaut et al. to describe the se-quential combination of unilateral or predominantly unilateral clonic seizures (hemiconvulsion), occurring during the first 2 years of life, immediately followed by an ipsilateral flaccid hemiplegia lasting 7 or more days. In the following phase partial epileptic seizures occur. We report a case of HHE syndrome in a 3-year-old boy with partial seizures (hemiconvulsion lasting 15-30 minutes) followed by left hemiplegia and hyporeflexia. Magnetic resonance imaging showed diffuse and high signal hyperintensity of the whole right cerebral hemisphere. Diffusion-weighted images showed a reduction of the apparent diffusion coefficient in the subcortical region. Magnetic resonance arterio-graphy showed a narrow flow signal in the distal territory of the right middle cerebral artery. The authors emphasize the importance of neuroradiological findings in early diagnosis and in the follow-up of HHE syndrome.

  13. The neural correlates of processing newborn and adult faces in 3-year-old children

    PubMed Central

    Peykarjou, Stefanie; Westerlund, Alissa; Macchi Cassia, Viola; Kuefner, Dana; Nelson, Charles A.

    2013-01-01

    The current study examines the processing of upright and inverted faces in 3-year-old children (n = 35). Event-related potentials (ERPs) were recorded during a passive-looking paradigm including adult and newborn face stimuli. We observed three face-sensitive components, the P1, the N170 and the P400. Inverted faces elicited shorter P1 latency and larger P400 amplitude. P1 and N170 amplitudes were larger for adult faces. To examine the role of experience in the development of face processing, the processing of adult and newborn faces was compared for children with a younger sibling (n = 23) and children without a younger sibling (n = 12). Age of sibling at test correlated negatively with P1 amplitude for adult and newborn faces. This may indicate more efficient processing of different face ages in children with a younger sibling and potentially reflects a more flexible face representation. PMID:24118716

  14. Does attention constrain developmental trajectories in fragile x syndrome? A 3-year prospective longitudinal study.

    PubMed

    Cornish, Kim; Cole, Victoria; Longhi, Elena; Karmiloff-Smith, Annette; Scerif, Gaia

    2012-03-01

    Basic attentional processes and their impact on developmental trajectories in fragile X syndrome were assessed in a 3-year prospective study. Although fragile X syndrome is a monogenic X-linked disorder, there is striking variability in outcomes even in young boys with the condition. Attention is a key factor constraining interactions with the environment, so it is a perfect candidate to predict trajectories in cognitive and behavioral outcomes. In this study, 48 boys with fragile X syndrome were assessed 3 times over 24 months. Although nonverbal IQ declined, there were significant improvements in nonverbal growth scores and in cognitive attention. In contrast, behavioral difficulties (i.e., autistic symptomatology, hyperactivity-inattention) remained stable over this time frame. Attentional markers in the visual and auditory modalities predicted intellectual abilities and classroom behavior, whereas auditory markers alone predicted autistic symptomatology.

  15. Oral Hemorrhage in a 3-year-old Boy Caused by Self-Mutilating Behavior

    PubMed Central

    Uy, Jenny Lyn Y.; Lapeña, José Florencio F.

    2016-01-01

    A 3-year-old boy referred for persistent tongue bleeding was diagnosed with a rare self-mutilating disease that had also affected his lip and fingers. He underwent multiple odontectomy and partial glossectomy and continues to undergo behavior therapy and on-demand splints and restraints. He has stopped self-biting and has gained appetite and weight. Lesch-Nyhan Syndrome can cause significant morbidity including self-inflicted oral hemorrhage and emergent measures are not easily decided. The long-term management of its neurobehavioral symptoms is problematic and multidisciplinary, and health providers remain challenged to find the best treatment, prolong lifespan and improve quality of life within their respective contexts. PMID:28083069

  16. Development, Validation and Parametric study of a 3-Year-Old Child Head Finite Element Model

    NASA Astrophysics Data System (ADS)

    Cui, Shihai; Chen, Yue; Li, Haiyan; Ruan, ShiJie

    2015-12-01

    Traumatic brain injury caused by drop and traffic accidents is an important reason for children's death and disability. Recently, the computer finite element (FE) head model has been developed to investigate brain injury mechanism and biomechanical responses. Based on CT data of a healthy 3-year-old child head, the FE head model with detailed anatomical structure was developed. The deep brain structures such as white matter, gray matter, cerebral ventricle, hippocampus, were firstly created in this FE model. The FE model was validated by comparing the simulation results with that of cadaver experiments based on reconstructing the child and adult cadaver experiments. In addition, the effects of skull stiffness on the child head dynamic responses were further investigated. All the simulation results confirmed the good biofidelity of the FE model.

  17. Paternal psychosocial characteristics and corporal punishment of their 3-year-old children.

    PubMed

    Lee, Shawna J; Perron, Brian E; Taylor, Catherine A; Guterman, Neil B

    2011-01-01

    This study uses data from 2,309 biological fathers who participated in the Fragile Families and Child Well-Being Study (FFCWS) to examine associations between psychosocial characteristics and levels of corporal punishment (CP) toward their 3-year-old children over the past month. Results indicate that 61% of the fathers reported no CP over the past month, 23% reported using CP once or twice, and 16% reported using CP a few times in the past month or more. In multivariate models controlling for important sociodemographic factors as well as characteristics of the child, fathers' parenting stress, major depression, heavy alcohol use, and drug use were significantly associated with greater use of CP, whereas involvement with the child and generalized anxiety disorder were not. Girls were less likely to be the recipient of CP than were boys, and child externalizing behavior problems but not internalizing behavior problems were associated with more CP.

  18. Drug-induced systemic lupus erythematosus in a child after 3 years of treatment with carbamazepine.

    PubMed

    Molina-Ruiz, Ana María; Lasanta, Begoña; Barcia, Ana; Pérez-Vega, Elisa; Requena, Luis

    2017-02-01

    Drug-induced lupus erythematosus (DILE) is a less severe variant of systemic lupus erythematosus (SLE) that generally resolves within weeks or months after the withdrawal of the implicated drug. DILE is unusual during childhood, with the most frequent age of presentation being at 50-70 years of age. Among different drugs, most commonly procainamide and hydralazine have been implicated as a cause of DILE. However carbamazepine (CBZ) is considered a low-risk drug and very few cases have been reported in children. We describe the case of CBZ-induced SLE in a 9-year-old girl following 3 years of CBZ therapy. This case report shows that drug-induced SLE is an important side-effect to be considered, even after long-term treatment with CBZ, and also during childhood.

  19. The development of inhibitory control in early childhood: A twin study from 2-3 years

    PubMed Central

    Gagne, Jeffrey R.; Saudino, Kimberly J.

    2015-01-01

    Parent and lab-based observer ratings were employed to examine genetic and environmental influences on continuity and change in inhibitory control (IC) in over 300 twin-pairs assessed longitudinally at 2 and 3 years of age. Genetic influences accounted for approximately 60% of the variance in parent-rated IC at both ages. Although many of the same genetic effects on parent-rated IC were stable across age, there were also novel genetic effects that emerged at age 3 (i.e., genetic factors contributed to both continuity and change in parent ratings of IC). Observed IC displayed a different developmental pattern. Genetic influences were moderate at age 2 (38%) and nonsignificant at age 3 (6%). Change in observed IC across early childhood was due to shared and nonshared environmental factors. Findings indicate that it is important to consider the measurement of IC when interpreting developmental and etiological findings. PMID:26784384

  20. A 3-Year Climatology of Cloud and Radiative Properties Derived from GOES-8 Data Over the Southern Great Plains

    NASA Technical Reports Server (NTRS)

    Khaiyer, M. M.; Rapp, A. D.; Doelling, D. R.; Nordeen, M. L.; Minnis, P.; Smith, W. L., Jr.; Nguyen, L.

    2001-01-01

    While the various instruments maintained at the Atmospheric Radiation Measurement (ARM) Program Southern Great Plains (SGP) Central Facility (CF) provide detailed cloud and radiation measurements for a small area, satellite cloud property retrievals provide a means of examining the large-scale properties of the surrounding region over an extended period of time. Seasonal and inter-annual climatological trends can be analyzed with such a dataset. For this purpose, monthly datasets of cloud and radiative properties from December 1996 through November 1999 over the SGP region have been derived using the layered bispectral threshold method (LBTM). The properties derived include cloud optical depths (ODs), temperatures and albedos, and are produced on two grids of lower (0.5 deg) and higher resolution (0.3 deg) centered on the ARM SGP CF. The extensive time period and high-resolution of the inner grid of this dataset allows for comparison with the suite of instruments located at the ARM CF. In particular, Whole-Sky Imager (WSI) and the Active Remote Sensing of Clouds (ARSCL) cloud products can be compared to the cloud amounts and heights of the LBTM 0.3 deg grid box encompassing the CF site. The WSI provides cloud fraction and the ARSCL computes cloud fraction, base, and top heights using the algorithms by Clothiaux et al. (2001) with a combination of Belfort Laser Ceilometer (BLC), Millimeter Wave Cloud Radar (MMCR), and Micropulse Lidar (MPL) data. This paper summarizes the results of the LBTM analysis for 3 years of GOES-8 data over the SGP and examines the differences between surface and satellite-based estimates of cloud fraction.

  1. Environmental controls on fungal community composition and abundance over 3 years in native and degraded shrublands.

    PubMed

    Glinka, Clare; Hawkes, Christine V

    2014-11-01

    Soil fungal communities have high local diversity and turnover, but the relative contribution of environmental and regional drivers to those patterns remains poorly understood. Local factors that contribute to fungal diversity include soil properties and the plant community, but there is also evidence for regional dispersal limitation in some fungal communities. We used different plant communities with different soil conditions and experimental manipulations of both vegetation and dispersal to distinguish among these factors. Specifically, we compared native shrublands with former native shrublands that had been disturbed or converted to pasture, resulting in soils progressively more enriched in carbon and nutrients. We tested the role of vegetation via active removal, and we manipulated dispersal by adding living soil inoculum from undisturbed native sites. Soil fungi were tracked for 3 years, with samples taken at ten time points from June 2006 to June 2009. We found that soil fungal abundance, richness, and community composition responded primarily to soil properties, which in this case were a legacy of plant community degradation. In contrast, dispersal had no effect on soil fungi. Temporal variation in soil fungi was partly related to drought status, yet it was much broader in native sites compared to pastures, suggesting some buffering due to the increased soil resources in the pasture sites. The persistence of soil fungal communities over 3 years in this study suggests that soil properties can act as a strong local environmental filter. Largely persistent soil fungal communities also indicate the potential for strong biotic resistance and soil legacies, which presents a challenge for both the prediction of how fungi respond to environmental change and our ability to manipulate fungi in efforts such as ecosystem restoration.

  2. Surgical Treatment of 55 Patients with Pressure Ulcers at the Department of Plastic and Reconstructive Surgery Kosovo during the Period 2000-2010: A Retrospective Study.

    PubMed

    Duci, Shkelzen B; Arifi, Hysni M; Selmani, Mimoza E; Mekaj, Agon Y; Gashi, Musli M; Buja, Zejn A; Ismajli, Vildane H; Kllokoqi, Adem N; Hoxha, Enver T

    2013-01-01

    Objective. The objective of this study is to determine the incidence of PUs, the distribution of PUs, common injuries contributing to the occurrence of PUs in patients admitted to the Department of Plastic and Reconstructive Surgery Kosovo for surgical interventions of PUs, localization of PUs in body, the topical treatment of pressure ulcers before surgical intervention, the methods of surgical interventions, number of surgical interventions, duration of treatment, complications, and mortality. Materials and Methods. This study includes 55 patients with PUs treated surgically in 2000-2010 period in the Department of Plastic and Reconstructive Surgery Kosovo. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Data processing was done with the statistical package In Stat 3. From statistical parameters arithmetic median and standard deviation were calculated. Data testing is done with χ (2)-test and the difference is significant if P < 0.05. Conclusion. Despite preventive measures against PUs, the incidence of Pus remains high.

  3. BMP-2/ACS/allograft for combined maxillary alveolar split/sinus floor grafting with and without simultaneous dental implant placement: report of 21 implants placed into 7 alveolar split sites followed for up to 3 years.

    PubMed

    Jensen, Ole T; Kuhlke, K Lee; Leopardi, Aldo; Adams, Mark W; Ringeman, Jason L

    2014-01-01

    This report presents seven patients who were treated with combined alveolar split/sinus grafting technique and dental implants and followed for 1 to 3 years. The grafting material included bone morphogenetic protein-2 in an absorbable collagen sponge plus allograft. The procedure was successful in all patients, who received implants either simultaneously with grafting or 4 to 6 months after grafting.

  4. Periodic Polymers

    NASA Astrophysics Data System (ADS)

    Thomas, Edwin

    2013-03-01

    Periodic polymers can be made by self assembly, directed self assembly and by photolithography. Such materials provide a versatile platform for 1, 2 and 3D periodic nano-micro scale composites with either dielectric or impedance contrast or both, and these can serve for example, as photonic and or phononic crystals for electromagnetic and elastic waves as well as mechanical frames/trusses. Compared to electromagnetic waves, elastic waves are both less complex (longitudinal modes in fluids) and more complex (longitudinal, transverse in-plane and transverse out-of-plane modes in solids). Engineering of the dispersion relation between wave frequency w and wave vector, k enables the opening of band gaps in the density of modes and detailed shaping of w(k). Band gaps can be opened by Bragg scattering, anti-crossing of bands and discrete shape resonances. Current interest is in our group focuses using design - modeling, fabrication and measurement of polymer-based periodic materials for applications as tunable optics and control of phonon flow. Several examples will be described including the design of structures for multispectral band gaps for elastic waves to alter the phonon density of states, the creation of block polymer and bicontinuous metal-carbon nanoframes for structures that are robust against ballistic projectiles and quasi-crystalline solid/fluid structures that can steer shock waves.

  5. Revascularization of an Immature Tooth with Apical Periodontitis Using Calcium Hydroxide: A 3-year Follow-up.

    PubMed

    Silva, Mauro Henrique Chagas; Campos, Celso Neiva; Coelho, Marcelo Santos

    2015-01-01

    Root canal treatment of teeth presenting immature development is a great challenge for both the patient and the professional. The thinness of the root canal walls of immature teeth may lead to root fracture and thus the outcomes of such treatments are uncertain. Revascularization is based on root canal decontamination followed by the induction of blood migration from the periapical tissues and the development of new vascular tissue in the canal space. The principle of disinfection in regenerative endodontics is that it should be achieved with minimum root canal instrumentation; an intracanal medication is used to inhibit bacterial growth and appropriate sealing of the coronal portion is performed. The American Association of Endodontists (AAE) considerations for regenerative endodontics include calcium hydroxide as an alternative intracanal dressing. This material has also been claimed to diminish the possibility of dental staining during revascularization procedures. The relatively new treatment protocol has been widely reported in the last few years; however it should be performed only when other alternatives are not reasonable. This case report presents a 3-year follow-up of a case of revascularization of a maxillary central incisor using calcium hydroxide as a root canal disinfection dressing.

  6. Intestinal Obstruction in a 3-Year-Old Girl by Ascaris lumbricoides Infestation: Case Report and Review of the Literature.

    PubMed

    Andrade, Angel Medina; Perez, Yeudiel; Lopez, Cecilia; Collazos, Stephanie Serrano; Andrade, Alejandro Medina; Ramirez, Grecia Ortiz; Andrade, Laura Medina

    2015-04-01

    Ascaris lumbricoides infection affects approximately 1.5 billion people globally. Children with environmental and socio-economic risk factors are more susceptible to infestation, with serious complications such as intestinal obstruction (IO), volvulus, intussusception, and intestinal necrosis.We present the case of a 3-year-old girl who arrived at emergency department with abdominal pain and diarrhea for the last 3 days. The previous day she took an unspecified anthelmintic. Symptoms worsened with vomiting and diarrhea, with expulsion of roundworms through mouth and anus. Physical examination revealed bloating, absence of bowel sounds, abdominal tenderness, and a palpable mass in right hemi-abdomen. Abdominal radiographs showed air-fluid levels with mild bowel distention and shadows of roundworms. The diagnosis of IO by A lumbricoides. infestation was established and surgical approach scheduled. During exploratory laparotomy an intraluminal bolus of roundworms from jejunum to ascendant colon was evident. An ileum enterotomy was performed and worms were removed. Fluid therapy and antibiotics for 72  hours were administered, with posterior albendazol treatment for 3 days. Patient was uneventfully discharged on the tenth day.Reduction in parasitic load by means of improvements in sanitation, health education, and anthelmintic treatment must be implemented in endemic zones to prevent serious life-threatening complications by A lumbricoides. infestation, because some of them require urgent surgical treatment.

  7. Revascularization of an Immature Tooth with Apical Periodontitis Using Calcium Hydroxide: A 3-year Follow-up

    PubMed Central

    Silva, Mauro Henrique Chagas; Campos, Celso Neiva; Coelho, Marcelo Santos

    2015-01-01

    Root canal treatment of teeth presenting immature development is a great challenge for both the patient and the professional. The thinness of the root canal walls of immature teeth may lead to root fracture and thus the outcomes of such treatments are uncertain. Revascularization is based on root canal decontamination followed by the induction of blood migration from the periapical tissues and the development of new vascular tissue in the canal space. The principle of disinfection in regenerative endodontics is that it should be achieved with minimum root canal instrumentation; an intracanal medication is used to inhibit bacterial growth and appropriate sealing of the coronal portion is performed. The American Association of Endodontists (AAE) considerations for regenerative endodontics include calcium hydroxide as an alternative intracanal dressing. This material has also been claimed to diminish the possibility of dental staining during revascularization procedures. The relatively new treatment protocol has been widely reported in the last few years; however it should be performed only when other alternatives are not reasonable. This case report presents a 3-year follow-up of a case of revascularization of a maxillary central incisor using calcium hydroxide as a root canal disinfection dressing. PMID:26962377

  8. [VIABILITY OF MYOCAROIUM AS RISK FACTOR FOR MORTALITY IN EARLY AND LATE PERIOD AFTER BYPASS SURGERY OF CORONARY ARTERIES IN PATIENTS WITH CORONARY HEART DISEASE AND SEVERE LEFT VENTRICULAR DYSFUNCTION].

    PubMed

    Todurov, B M; Zelenchuk, V; Kuzmich, I M; Ivanyuk, N B; Nikolaichuk, M V

    2015-06-01

    In coronary heart disease and low ejection fraction of the left ventricle (LV) in patients after coronary artery bypass surgery tend mortality and complication rate higher than preserved LV systolic function. Significant preoperative predictors of early mortality and remote in these patients, and the incidence of complications in the early postoperative period were reveald.

  9. Molecular Evidence of Interhuman Transmission of Pneumocystis Pneumonia among Renal Transplant Recipients Hospitalized with HIV-Infected Patients

    PubMed Central

    Rabodonirina, Meja; Vanhems, Philippe; Couray-Targe, Sandrine; Gillibert, René-Pierre; Ganne, Christell; Nizard, Nathalie; Colin, Cyrille; Fabry, Jacques; Touraine, Jean-Louis; van Melle, Guy; Nahimana, Aimable; Francioli, Patrick

    2004-01-01

    Ten Pneumocystis jirovecii pneumonia (PCP) cases were diagnosed in renal transplant recipients (RTRs) during a 3-year period. Nosocomial transmission from HIV-positive patients with PCP was suspected because these patients shared the same hospital building, were not isolated, and were receiving suboptimal anti-PCP prophylaxis or none. P. jirovecii organisms were typed with the multitarget polymerase chain reaction–single-strand conformation polymorphism method. Among the 45 patients with PCP hospitalized during the 3-year period, 8 RTRs and 6 HIV-infected patients may have encountered at least 1 patient with active PCP within the 3 months before the diagnosis of their own PCP episode. In six instances (five RTRs, one HIV-infected patient), the patients harbored the same P. jirovecii molecular type as that found in the encountered PCP patients. The data suggest that part of the PCP cases observed in this building, particularly those observed in RTRs, were related to nosocomial interhuman transmission. PMID:15504262

  10. Reliability of cortical lesion detection on double inversion recovery MRI applying the MAGNIMS-Criteria in multiple sclerosis patients within a 16-months period

    PubMed Central

    Thaler, Christian; Ceyrowski, Tim; Broocks, Gabriel; Treffler, Natascha; Sedlacik, Jan; Stürner, Klarissa; Stellmann, Jan-Patrick; Heesen, Christoph; Fiehler, Jens; Siemonsen, Susanne

    2017-01-01

    Purpose In patients with multiple sclerosis (MS), Double Inversion Recovery (DIR) magnetic resonance imaging (MRI) can be used to identify cortical lesions (CL). We sought to evaluate the reliability of CL detection on DIR longitudinally at multiple subsequent time-points applying the MAGNIMs scoring criteria for CLs. Methods 26 MS patients received a 3T-MRI (Siemens, Skyra) with DIR at 12 time-points (TP) within a 16 months period. Scans were assessed in random order by two different raters. Both raters separately marked all CLs on each scan and total lesion numbers were obtained for each scan-TP and patient. After a retrospective re-evaluation, the number of consensus CLs (conL) was defined as the total number of CLs, which both raters finally agreed on. CLs volumes, relative signal intensities and CLs localizations were determined. Both ratings (conL vs. non-consensus scoring) were compared for further analysis. Results A total number of n = 334 CLs were identified by both raters in 26 MS patients with a first agreement of both raters on 160 out of 334 of the CLs found (κ = 0.48). After the retrospective re-evaluation, consensus agreement increased to 233 out of 334 CL (κ = 0.69). 93.8% of conL were visible in at least 2 consecutive TP. 74.7% of the conL were visible in all 12 consecutive TP. ConL had greater mean lesion volumes and higher mean signal intensities compared to lesions that were only detected by one of the raters (p<0.05). A higher number of CLs in the frontal, parietal, temporal and occipital lobe were identified by both raters than the number of those only identified by one of the raters (p<0.05). Conclusions After a first assessment, slightly less than a half of the CL were considered as reliably detectable on longitudinal DIR images. A retrospective re-evaluation notably increased the consensus agreement. However, this finding is narrowed, considering the fact that retrospective evaluation steps might not be practicable in clinical routine

  11. Long-term post-marketing surveillance of mizoribine for the treatment of lupus nephritis: Safety and efficacy during a 3-year follow-up

    PubMed Central

    Okada, Kenya; Sudo, Yohei; Itoh, Hiromichi; Yoshida, Hisao; Kuroda, Tatsuhiko

    2014-01-01

    Objective: To determine the safety and efficacy of long-term use of mizoribine by undertaking a 3-year post-marketing surveillance study. Methods: Subjects were all lupus nephritis patients newly treated with mizoribine between 1 October 2003 and 30 September 2005 at contracted study sites. Results: Mizoribine was administered to 881 lupus nephritis patients in the safety analysis set consisting of 946 patients recruited from 281 contracted study sites after satisfying the eligibility criteria. There were 301 events of adverse drug reactions that were observed in 196 (20.7%) of the 946 subjects. There were 34 events of serious adverse drug reactions in 31 patients (3.2%). No deterioration in hematological and biochemical test values was observed, but immunological testing showed significant improvements in C3, CH50, and anti-DNA antibody titers. The negative rate of proteinuria also increased over time. The median steroid dosage was 15 mg/day at the commencement of treatment, but was reduced to 10 mg/day at 12 months and 8 mg/day at 36 months. Conclusion: The findings of the 3-year long-term drug use surveillance study indicated that mizoribine can be used over the long term with relatively few adverse drug reactions, suggesting its suitability for use in maintenance drug therapy. PMID:26770729

  12. Research on 2041 Cases of High Inpatient Expenditure and Influence Factors during 3 Years in a Single Center

    PubMed Central

    Wu, Suo-Wei; Pan, Qi; Wei, Liang-Yu; Li, Chao; Wang, Qin; Song, Jing-Chen; Chen, Tong

    2016-01-01

    Background: The study was to explore the causes of high inpatient expenditure through analyzing the distribution characteristics as well as the influence factors of high inpatient expenditure cases during 3 years within a Grade-A tertiary hospital through various aspects and multiple angles, thus identifying the major influence factors for high medical expenditure to develop further research. Methods: We retrospectively studied 2041 inpatient cases which cost more than RMB 100,000 Yuan per case in a Grade-A tertiary hospital from 2013 to 2015. We analyzed the compositions of the medical cost to evaluate the major factors that cause the high inpatient expenditure. All the data and materials were collected from medical record system, and the statistical methods included t-test, variance of analysis, and multivariate linear regression. Results: The average cost of the 2,041 cases was RMB 152,173 Yuan for medicines and materials of medical costs, which respectively accounted for 33.03% and 32.32% of the total cost; and the average length of hospital stay was 28.39 days/person. Diseases of skeletal and muscular system, circulatory system, and tumor were the top three disease categories of high inpatient expenditure, which accounted for 39.00%, 33.46%, and 18.03%, respectively. Complications, criticality of the disease, gender of the patients, the occurrence of death, and the excessive length of hospital stay all had great impacts on average medical expenditure, while age, hospital infection, and surgery showed no significant impact on average medical cost. Conclusions: The main factors for high inpatient expenditure included the inadequate use of high-value medicines and materials, lacking cost control measures within the hospital, the excessive length of hospital stay for inpatients, and the unnecessary treatment for the patients. PMID:27647192

  13. Gender Abuse, Depressive Symptoms, and Substance Use Among Transgender Women: A 3-Year Prospective Study

    PubMed Central

    Bockting, Walter; Rosenblum, Andrew; Hwahng, Sel; Mason, Mona; Macri, Monica; Becker, Jeffrey

    2014-01-01

    Objectives. We examined the effects of gender abuse (enacted stigma), depressive symptoms, and demographic, economic, and lifestyle factors on substance use among transgender women. Methods. We conducted a 3-year prospective study (December 2004 to September 2007) of 230 transgender women aged 19 to 59 years from the New York Metropolitan Area. Statistical techniques included generalized estimating equations with logistic and linear regression links. Results. Six-month prevalence of any substance use at baseline was 76.2%. Across assessment points, gender abuse was associated with alcohol, cannabis, cocaine, or any substance use during the previous 6 months, the number of days these substances were used during the previous month, and the number of substances used. Additional modeling associated changes in gender abuse with changes in substance use across time. Associations of gender abuse and substance use were mediated 55% by depressive symptoms. Positive associations of employment income, sex work, transgender identity, and hormone therapy with substance use were mediated 19% to 42% by gender abuse. Conclusions. Gender abuse, in conjunction with depressive symptoms, is a pervasive and moderately strong risk factor for substance use among transgender women. Improved substance abuse treatment is sorely needed for this population. PMID:25211716

  14. Urinary 1-Hydroxypyrene as a Biomarker of PAH Exposure in 3-Year-Old Ukrainian Children

    PubMed Central

    Mucha, Amy Pelka; Hryhorczuk, Daniel; Serdyuk, Andrij; Nakonechny, Joseph; Zvinchuk, Alexander; Erdal, Serap; Caudill, Motria; Scheff, Peter; Lukyanova, Elena; Shkiryak-Nyzhnyk, Zoreslava; Chislovska, Natalia

    2006-01-01

    Urinary 1-hydroxypyrene (1-OHP) is a biomarker of polycyclic aromatic hydrocarbon (PAH) exposure. We measured urinary 1-OHP in 48 children 3 years of age in Mariupol, Ukraine, who lived near a steel mill and coking facility and compared these with 1-OHP concentrations measured in 42 children of the same age living in the capital city of Kiev, Ukraine. Children living in Mariupol had significantly higher urinary 1-OHP and creatinine-adjusted urinary 1-OHP than did children living in Kiev (adjusted: 0.69 vs. 0.34 μmol/mol creatinine, p < 0.001; unadjusted: 0.42 vs. 0.30 ng/mL, p = 0.002). Combined, children in both cities exposed to environmental tobacco smoke in their homes had higher 1-OHP than did children not exposed (0.61 vs. 0.42 μmol/mol creatinine; p = 0.04; p = 0.07 after adjusting for city). In addition, no significant differences were seen with sex of the children. Our sample of children in Mariupol has the highest reported mean urinary 1-OHP concentrations in children studied to date, most likely due to their proximity to a large industrial point source of PAHs. PMID:16581553

  15. Periosteal desmoplastic fibroma of the tibia in a 3-year-old child.

    PubMed

    Sferopoulos, N K

    2015-12-01

    Desmoplastic fibroma is a rare benign fibrogenic, locally aggressive, primary bone tumor. It is the intraosseous counterpart of soft tissue aggressive fibromatosis. The lesion may very rarely appear as a superficial bone lesion arising from the periosteum; in such cases, a soft tissue mass with changes in the adjacent bone is evident. Periosteal lesions are very rare in the literature; diagnosis is usually based on the radiographic findings, and histological proof of the tumor origin is missing. A periosteal desmoplastic fibroma of the distal tibial metaphysis in a 3-year-old boy is presented. Radiographic investigation included plain radiographs and computed tomography imaging. Both demonstrated a soft tissue lesion involving the superficial bone tissues with non-aggressive looking borders and a pressure effect with a sclerotic rim in the bone. The lesion was excised, and the surgical as well as the histological findings indicated the diagnosis of a desmoplastic fibroma of bone arising from the periosteum. No recurrence was detected 5 years after surgery.

  16. The cultural and linguistic diversity of 3-year-old children with hearing loss.

    PubMed

    Crowe, Kathryn; McLeod, Sharynne; Ching, Teresa Y C

    2012-01-01

    Understanding the cultural and linguistic diversity of young children with hearing loss informs the provision of assessment, habilitation, and education services to both children and their families. Data describing communication mode, oral language use, and demographic characteristics were collected for 406 children with hearing loss and their caregivers when children were 3 years old. The data were from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study, a prospective, population-based study of children with hearing loss in Australia. The majority of the 406 children used spoken English at home; however, 28 other languages also were spoken. Compared with their caregivers, the children in this study used fewer spoken languages and had higher rates of oral monolingualism. Few children used a spoken language other than English in their early education environment. One quarter of the children used sign to communicate at home and/or in their early education environment. No associations between caregiver hearing status and children's communication mode were identified. This exploratory investigation of the communication modes and languages used by young children with hearing loss and their caregivers provides an initial examination of the cultural and linguistic diversity and heritage language attrition of this population. The findings of this study have implications for the development of resources and the provision of early education services to the families of children with hearing loss, especially where the caregivers use a language that is not the lingua franca of their country of residence.

  17. Idiopathic midaortic syndrome with malignant hypertension in 3-year-old boy

    PubMed Central

    Ahn, Kyung Jin; Yoon, Ja Kyoung; Kwon, Bo Sang; Bae, Eun Jung; Noh, Chung Il

    2016-01-01

    Midaortic syndrome (MAS) is a rare vascular disease that commonly causes renovascular hypertension. The lumen of the abdominal aorta narrows and the ostia of the branches show stenosis. MAS is associated with diminished pulses in the lower extremities compared with the upper extremities, severe hypertension with higher blood pressure in the upper rather than lower extremities, and an abdominal bruit. The clinical symptoms are variable, and recognition in children with hypertension can aid early diagnosis and optimal treatment. Hypertension with MAS is malignant and often refractory to several antihypertensive drugs. Recently, radiologic modalities have been developed and have led to numerous interventional procedures. We describe the case of a 3-year-old boy presenting with left ventricular hypertrophy whose severely elevated blood pressure led to the diagnosis of idiopathic MAS. This case highlights the importance of measuring blood pressure and conducting a detailed physical examination to diagnose MAS. This is the first reported case of idiopathic MAS diagnosed in childhood in Korea. PMID:28018454

  18. Negative cognitive styles synergistically predict suicidal ideation in bipolar spectrum disorders: a 3-year prospective study.

    PubMed

    Stange, Jonathan P; Hamilton, Jessica L; Burke, Taylor A; Kleiman, Evan M; O'Garro-Moore, Jared K; Seligman, Nicole D; Abramson, Lyn Y; Alloy, Lauren B

    2015-03-30

    Rates of suicidal ideation and behavior are extremely high in bipolar spectrum disorders (BSDs). However, relatively little work has evaluated potentially synergistic relationships between cognitive and emotion-regulatory processes proposed by theoretical models of suicidality in BSDs. The present study evaluated whether negative cognitive style and subtypes of rumination would exacerbate the impact of self-criticism on suicidal ideation in a prospective study of individuals with BSDs. Seventy-two young adults with BSDs (bipolar II, bipolar NOS, or cyclothymia) completed diagnostic interviews and trait measures of self-criticism, negative cognitive style, and brooding and reflective rumination at a baseline assessment. The occurrence of suicidal ideation was assessed as part of diagnostic interviews completed every 4 months for an average of 3 years of follow-up. Negative cognitive style and reflective rumination strengthened the association between self-criticism and the prospective occurrence of suicidal ideation across follow-up. Individuals with high levels of self-criticism in conjunction with negative cognitive style or reflective rumination were most likely to experience the onset of suicidal ideation. Self-criticism may work synergistically with negative cognitive style and rumination to confer risk for suicidal ideation in bipolar spectrum disorders. These results support theoretical models of suicidality in BSDs and indicate that evaluating and understanding negative cognitive styles may help to identify individuals who are at risk of suicide.

  19. The impact of early literacy guidance on language skills of 3-year-olds.

    PubMed

    Theriot, Judy A; Franco, Sofia M; Sisson, Barbara A; Metcalf, Sharon C; Kennedy, Mary A; Bada, Henrietta S

    2003-03-01

    The objective of this prospective study was to determine the impact of early literacy anticipatory guidance (AG) with provision of books on language development in 3-year-olds in an early literacy program at a University-affiliated inner-city pediatric clinic. The Peabody Picture Vocabulary Test (PPVT-III) and the Expressive One Word Picture Vocabulary Test (EOWPVT-R) were administered to 33-39-month-old children exposed to an early literacy program, which included AG and provision of an age-appropriate book at each well-child visit starting at 2 months old. Children with developmental delays were excluded. Parental surveys on literacy and demographic data were obtained. Univariate and multivariate analyses were performed. Sixty-four children were evaluated; 88% African American, 89% Medicaid recipients. Fifty-eight percent of families reported family-centered literacy orientation. The PPVT-III scores directly correlated with the number of AG visits with book given x number of books purchased (r2 = 0.025, p = 0.0006). Higher scores in EOWPVT-R were predicted by race and the number of visits with books given x number of books purchased (r2 = 0.182, p = 0.0009). All families reported reading together, half reporting positive family-centered literacy. Given the same number of books purchased for each child, the outcome scores were higher the greater the number of clinic visits wherein AG included early literacy and provision of books.

  20. Growth of children with Down's syndrome: birth to age 3 years.

    PubMed

    Cronk, C E

    1978-04-01

    A sample of 90 children with Down's syndrome were measured for recumbent length and weight from birth to age 36 months at the Children's Hospital Medical Center in Boston. At birth, means for both length and weight were reduced by about 0.5 SDs from the control group means. By 36 months, mean recumbent length was greater than 2 SDs below that for the control group, while the mean for weight was reduced by about 1.5 SDs from the control group mean. Growth velocity for both length and weight was most deficient within the first two years of life. About 30% of the sample demonstrated excess weight for length relations by 36 months. Children with moderate or severe heart disease were significantly smaller than those without or with mild cardiac problems at all times after birth. Measurements of a subsample of children at 4, 5, and 6 years of age suggested that growth velocity after 3 years of age may be within the range of normal. Assessment of growth of the child with Down's syndrome may be carried out with reference to charts plotting tenth to 90th percentiles based on these data.

  1. The Megha-Tropiques Mission: Review and Status after 3 Years in Orbit

    NASA Astrophysics Data System (ADS)

    Roca, R.

    2014-12-01

    The Megha-Tropiques satellite is the indo-french contribution to the Global Precipitation Mission constellation.The operation of the MT mission has recently been formally extended for 2015 and 2016 after reaching in october this year its original 3 years duration. While the MADRAS instrument stopped data acquisition in January 2013, the SAPHIR multichannel 183 GHz sounder is up and running nominally. Real time distribution of SAPHIR is performed by EUMETSAT via the EUMETcast system since mid-2014.In this presentation, I will review the performances of the microwave radiometers on-board MT and illustrate thescientific outcome of the mission as well as the results of the extensive validation exercices which have been finalized. I will put the emphasis on the impact of the low inclinaison orbit on assimilation, convective systems monitoring and estimation of precipitation. In particular, I will show how the SAPHIR radiometer data are used in our GPM multiple platforms merged 1°-1day accumulated rainfall product to mitigate the loss of MADRAS.

  2. Sustained Effectiveness of the Maternal Pertussis Immunization Program in England 3 Years Following Introduction

    PubMed Central

    Amirthalingam, Gayatri; Campbell, Helen; Ribeiro, Sonia; Fry, Norman K.; Ramsay, Mary; Miller, Elizabeth; Andrews, Nick

    2016-01-01

    The effectiveness of maternal immunization in preventing infant pertussis was first demonstrated in England, 1 year after the program using diphtheria–tetanus–5-component acellular pertussis–inactivated polio vaccine (dT5aP-IPV) was introduced in 2012. Vaccine effectiveness against laboratory-confirmed pertussis has been sustained >90% in the 3 years following its introduction, despite changing to another acellular vaccine with different antigen composition. Consistent with this, disease incidence in infants <3 months of age has remained low despite high activity persisting in those aged 1 year and older. Vaccine effectiveness against infant deaths was estimated at 95% (95% confidence interval, 79%–100%). Additional protection from maternal immunization is retained in infants who received their first dose of the primary series. There is no longer evidence of additional protection from maternal vaccination after the third infant dose. Although numbers are small and ongoing assessment is required, there is no evidence of increased risk of disease after primary immunization in infants whose mothers received maternal vaccination. PMID:27838678

  3. Words, shape, visual search and visual working memory in 3-year-old children

    PubMed Central

    Vales, Catarina; Smith, Linda B.

    2014-01-01

    Do words cue children’s visual attention, and if so, what are the relevant mechanisms? Across four experiments, 3-year-old children (N = 163) were tested in visual search tasks in which targets were cued with only a visual preview versus a visual preview and a spoken name. The experiments were designed to determine whether labels facilitated search times and to examine one route through which labels could have their effect: By influencing the visual working memory representation of the target. The targets and distractors were pictures of instances of basic-level known categories and the labels were the common name for the target category. We predicted that the label would enhance the visual working memory representation of the target object, guiding attention to objects that better matched the target representation. Experiments 1 and 2 used conjunctive search tasks, and Experiment 3 varied shape discriminability between targets and distractors. Experiment 4 compared the effects of labels to repeated presentations of the visual target, which should also influence the working memory representation of the target. The overall pattern fits contemporary theories of how the contents of visual working memory interact with visual search and attention, and shows that even in very young children heard words affect the processing of visual information. PMID:24720802

  4. A statistical skull geometry model for children 0-3 years old.

    PubMed

    Li, Zhigang; Park, Byoung-Keon; Liu, Weiguo; Zhang, Jinhuan; Reed, Matthew P; Rupp, Jonathan D; Hoff, Carrie N; Hu, Jingwen

    2015-01-01

    Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO). To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0-3 YO population. In this study, head CT scans from fifty-six 0-3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models.

  5. The Cultural and Linguistic Diversity of 3-Year-Old Children with Hearing Loss

    PubMed Central

    Crowe, Kathryn

    2012-01-01

    Understanding the cultural and linguistic diversity of young children with hearing loss informs the provision of assessment, habilitation, and education services to both children and their families. Data describing communication mode, oral language use, and demographic characteristics were collected for 406 children with hearing loss and their caregivers when children were 3 years old. The data were from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study, a prospective, population-based study of children with hearing loss in Australia. The majority of the 406 children used spoken English at home; however, 28 other languages also were spoken. Compared with their caregivers, the children in this study used fewer spoken languages and had higher rates of oral monolingualism. Few children used a spoken language other than English in their early education environment. One quarter of the children used sign to communicate at home and/or in their early education environment. No associations between caregiver hearing status and children’s communication mode were identified. This exploratory investigation of the communication modes and languages used by young children with hearing loss and their caregivers provides an initial examination of the cultural and linguistic diversity and heritage language attrition of this population. The findings of this study have implications for the development of resources and the provision of early education services to the families of children with hearing loss, especially where the caregivers use a language that is not the lingua franca of their country of residence. PMID:22942315

  6. Restrictions on cosmogenic neutrinos and UHECR from Fermi 3 years data

    NASA Astrophysics Data System (ADS)

    Gelmini, Graciela B.; Kalashev, Oleg; Semikoz, Dmitri V.

    2012-07-01

    Ultra-high energy cosmic ray protons accelerated in astrophysical objects produce secondary electromagnetic cascades during propagation in the cosmic microwave and infrared backgrounds. Those cascades contribute to the GeV-TeV diffuse photon flux, measured by Fermi LAT experiment. Recent studies of 3 years of Fermi LAT data have shown that diffuse gamma-ray background at E > 10GeV is about factor of 2 smaller then original one year data. This affects both models of UHECR and secondary cosmogenic neutrino fluxes. We show the allowed range of cosmogenic neutrino fluxes scanning over unknown UHECR parameters such as injected proton maximum energy and power law index, evolution of sources, systematic shift of UHECR energy scale. We consider three evolution models in which the UHECR sources are assumed to have the same evolution of either the star formation rate (SFR), or the gamma-ray burst (GRB) rate, or the active galactic nuclei (AGN) rate in the Universe and found that the last two are disfavored (and in the dip model rejected) by the new VHE gamma-ray background. We show that the largest fluxes predicted in the dip model would be detectable by IceCube in about 10 years of observation and are within the reach of a few years of observation with the ARA project. In the incomplete UHECR model in which protons are assumed to dominate only above 1019 eV, the cosmogenic neutrino fluxes could be a factor of 2 or 3 larger.

  7. Words, shape, visual search and visual working memory in 3-year-old children.

    PubMed

    Vales, Catarina; Smith, Linda B

    2015-01-01

    Do words cue children's visual attention, and if so, what are the relevant mechanisms? Across four experiments, 3-year-old children (N = 163) were tested in visual search tasks in which targets were cued with only a visual preview versus a visual preview and a spoken name. The experiments were designed to determine whether labels facilitated search times and to examine one route through which labels could have their effect: By influencing the visual working memory representation of the target. The targets and distractors were pictures of instances of basic-level known categories and the labels were the common name for the target category. We predicted that the label would enhance the visual working memory representation of the target object, guiding attention to objects that better matched the target representation. Experiments 1 and 2 used conjunctive search tasks, and Experiment 3 varied shape discriminability between targets and distractors. Experiment 4 compared the effects of labels to repeated presentations of the visual target, which should also influence the working memory representation of the target. The overall pattern fits contemporary theories of how the contents of visual working memory interact with visual search and attention, and shows that even in very young children heard words affect the processing of visual information.

  8. Diffuse Spinal Leptomeningeal Spread of a Pilocytic Astrocytoma in a 3-year-old Child.

    PubMed

    Alyeldien, Ameer; Teuber-Hanselmann, Sarah; Cheko, Azad; Höll, Tanja; Scholz, Martin; Petridis, Athanasios K

    2016-03-25

    Pilocytic astrocytomas correspond to low-grade gliomas and therefore metastasize exceedingly rare. However, pilocytic astrocytomas are able to and leptomeningeal dissemination may be seen. What are the treatment options of these cases? We present a case report of a 3-year-old child with a pilocytic astrocytoma of the optic chiasm with leptomeningeal dissemination of the spinal meninges. Partial resection of the cerebral tumor has been performed. Since the leptomeningeal dissemination was seen all over the spinal meninges, the child did not undergo further surgical treatment. A wait and watch strategy were followed. Chemotherapy was initiated, if a 25% tumor growth was seen. Leptomeningeal dissemination of a pilocytic astrocytoma is seen so infrequently that no standard therapy is established. Since these metastases may occur even up to 2 decades after primary tumor resection, long-term follow-up is indicated. In case of spinal metastases, surgical treatment should be performed if feasible. Otherwise observation should be possessed and/or chemotherapy should be initiated.

  9. Diffuse Spinal Leptomeningeal Spread of a Pilocytic Astrocytoma in a 3-year-old Child

    PubMed Central

    Alyeldien, Ameer; Teuber-Hanselmann, Sarah; Cheko, Azad; Höll, Tanja; Scholz, Martin; Petridis, Athanasios K.

    2016-01-01

    Pilocytic astrocytomas correspond to low-grade gliomas and therefore metastasize exceedingly rare. However, pilocytic astrocytomas are able to and leptomeningeal dissemination may be seen. What are the treatment options of these cases? We present a case report of a 3-year-old child with a pilocytic astrocytoma of the optic chiasm with leptomeningeal dissemination of the spinal meninges. Partial resection of the cerebral tumor has been performed. Since the leptomeningeal dissemination was seen all over the spinal meninges, the child did not undergo further surgical treatment. A wait and watch strategy were followed. Chemotherapy was initiated, if a 25% tumor growth was seen. Leptomeningeal dissemination of a pilocytic astrocytoma is seen so infrequently that no standard therapy is established. Since these metastases may occur even up to 2 decades after primary tumor resection, long-term follow-up is indicated. In case of spinal metastases, surgical treatment should be performed if feasible. Otherwise observation should be possessed and/or chemotherapy should be initiated. PMID:27162602

  10. Chronic kidney disease progression: a retrospective analysis of 3-year adherence to a low protein diet.

    PubMed

    Rizzetto, Felipe; Leal, Viviane de Oliveira; Bastos, Leonardo Soares; Fouque, Denis; Mafra, Denise

    2017-11-01

    The potential benefits and dangers of dietary protein restriction in chronic kidney disease (CKD) are still controversial. Thus, the aim of this study is to evaluate the effect of low protein diet (LPD) on the renal function in nondialysis CKD patients. A retrospective study was conducted from 321 nondialysis CKD patient's medical files (65.1 ± 12.7 yrs, 58.2% men). These patients received individualized dietary protein prescription (0.6-0.8 g protein/kg/day). Protein intake was evaluated by food diary and 24 h-food recall. Adherence to the LPD was considered when patients intake from 90 to 110% of the prescribed amount of protein. The patients were divided into 4 groups: (G1) adherent diabetes mellitus (DM) patients (n = 83); (G2) non-adherent DM patients (n = 106); (G3) adherent non-DM patients (n = 75); (G4) non-adherent non-DM patients (n = 57). Renal function was assessed by estimated glomerular filtration rate (eGFR). Both groups of patients (DM and non-DM) that adhered to the LPD showed significant improvement in eGFR (G1: 38.7 ± 13.2 mL/min to 51.1 ± 17.0 mL/min (p < 0.001); G3: 35.1 ± 16.8 mL/min to 46.8 ± 21.4 mL/min (p < 0.001)). In adherent patients, no differences in albumin and BMI were observed at the end of follow up. In non-adherent patients, eGFR significantly decreased in DM group (G2: 44.2 ± 18.5 mL/min to 38.2 ± 15.8 mL/min (p = 0.003)). According to multivariate analysis, annual changes in eGFR were not independent associated with age, gender, BMI, lipid profile, bicarbonate or smoking status. In summary, adherence to low protein diet could be able to improve serum creatinine and eGFR, well-known markers of renal function. However, prospective studies are needed to control confounders which affect renal function and CKD progression.

  11. Serum Calcium and the Risk of Incident Metabolic Syndrome: A 4.3-Year Retrospective Longitudinal Study

    PubMed Central

    Baek, Jong Ha; Jin, Sang-Man; Bae, Ji Cheol; Jee, Jae Hwan; Yu, Tae Yang; Kim, Soo Kyoung; Hur, Kyu Yeon; Lee, Moon-Kyu

    2017-01-01

    Background An association between serum calcium level and risk of metabolic syndrome (MetS) has been suggested in cross-sectional studies. This study aimed to evaluate the association between baseline serum calcium level and risk of incident MetS in a longitudinal study. Methods We conducted a retrospective longitudinal study of 12,706 participants without MetS who participated in a health screening program, had normal range serum calcium level at baseline (mean age, 51 years), and were followed up for 4.3 years (18,925 person-years). The risk of developing MetS was analyzed according to the baseline serum calcium levels. Results A total of 3,448 incident cases (27.1%) of MetS developed during the follow-up period. The hazard ratio (HR) for incident MetS did not increase with increasing tertile of serum calcium level in an age- and sex-matched model (P for trend=0.915). The HRs (95% confidence interval [CI]) for incident MetS comparing the second and the third tertiles to the first tertile of baseline serum calcium level were 0.91 (95% CI, 0.84 to 0.99) and 0.85 (95% CI, 0.78 to 0.92) in a fully adjusted model, respectively (P for trend=0.001). A decreased risk of incident MetS in higher tertiles of serum calcium level was observed in subjects with central obesity and/or a metabolically unhealthy state at baseline. Conclusion There was no positive correlation between baseline serum calcium levels and incident risk of MetS in this longitudinal study. There was an association between higher serum calcium levels and decreased incident MetS in individuals with central obesity or two components of MetS at baseline. PMID:28029017

  12. Estimating Body Composition in Adolescent Sprint Athletes: Comparison of Different Methods in a 3 Years Longitudinal Design

    PubMed Central

    Aerenhouts, Dirk

    2015-01-01

    A recommended field method to assess body composition in adolescent sprint athletes is currently lacking. Existing methods developed for non-athletic adolescents were not longitudinally validated and do not take maturation status into account. This longitudinal study compared two field methods, i.e., a Bio Impedance Analysis (BIA) and a skinfold based equation, with underwater densitometry to track body fat percentage relative to years from age at peak height velocity in adolescent sprint athletes. In this study, adolescent sprint athletes (34 girls, 35 boys) were measured every 6 months during 3 years (age at start = 14.8 ± 1.5yrs in girls and 14.7 ± 1.9yrs in boys). Body fat percentage was estimated in 3 different ways: 1) using BIA with the TANITA TBF 410; 2) using a skinfold based equation; 3) using underwater densitometry which was considered as the reference method. Height for age since birth was used to estimate age at peak height velocity. Cross-sectional analyses were performed using repeated measures ANOVA and Pearson correlations between measurement methods at each occasion. Data were analyzed longitudinally using a multilevel cross-classified model with the PROC Mixed procedure. In boys, compared to underwater densitometry, the skinfold based formula revealed comparable values for body fatness during the study period whereas BIA showed a different pattern leading to an overestimation of body fatness starting from 4 years after age at peak height velocity. In girls, both the skinfold based formula and BIA overestimated body fatness across the whole range of years from peak height velocity. The skinfold based method appears to give an acceptable estimation of body composition during growth as compared to underwater densitometry in male adolescent sprinters. In girls, caution is warranted when interpreting estimations of body fatness by both BIA and a skinfold based formula since both methods tend to give an overestimation. PMID:26317426

  13. [Psychiatric disability and work: assessment of a group of patients examined at the Occupational Medicine Outpatient Department of the Turin University in the period 2000-2012].

    PubMed

    Gullino, A; Coggiola, M; Accomazzo, V; Baracco, A; De Marzi, G P; Occhipinti, R; Perrelli, F; Romano, C

    2012-01-01

    Problems at workplace with psychiatric subjects are increasing and the role of occupational physicians is basic to achieve a suitable job role. The purpose of this study is to assess the main occupational factors and to evaluate the judgement of fitness to work in 1109 patients with psychiatric diseases examined in our outpatients department during the period 2000-2012. These subjects were sent to our service by family doctors or, more frequently, by the companies seeking for judgement of the working residual capacities. The psychiatric diseases were classified according to the DSM IV; for each group considered, we evaluated the production sector, the specific job role, the pharmacological therapy as compared to the final judgement. The most frequent diagnoses were depressive and anxious disorders. The pharmacological therapy does not seem to be related to the final judgement but the small number of subjects defined as unfit to work does not allow a final evaluation. The study suggests the relevance of team work among the different actors of prevention to achieve a successful management of these workers in a specific job role.

  14. Effects of Otitis Media with Effusion on Hearing in the First 3 Years of Life.

    ERIC Educational Resources Information Center

    Gravel, Judith S.; Wallace, Ina F.

    2000-01-01

    Hearing sensitivity was examined prospectively in 114 young children as a function of otitis media with effusion (OEM)status in years 1, 2, and 3. Results indicated that children classified as bilaterally OME positive in years 1, 2, and 3 had significantly poorer hearing than children classified as bilaterally OME free at these periods. (Contains…

  15. Schistosoma mansoni in infants (aged < 3 years) along the Ugandan shoreline of Lake Victoria.

    PubMed

    Odogwu, S E; Ramamurthy, N K; Kabatereine, N B; Kazibwe, F; Tukahebwa, E; Webster, J P; Fenwick, A; Stothard, J R

    2006-06-01

    In two complementary epidemiological surveys of villages on the Ugandan shoreline of Lake Victoria, the putative occurrence of intestinal schistosomiasis in the local infants (children aged < 3 years) was investigated. When, during the first survey, 136 mother-and-infant pairs from a total of 12 villages were studied, only 7% of the infants but 45% of the mothers were found to be egg-patent for Schistosoma mansoni infection. The use of dipstick tests for urine-circulating cathodic antigen indicated, however, a much higher prevalence, of approximately 40%, among the infants. In the second survey, urine samples and multiple, not single, stool samples were collected from another 19 mother-and-infant pairs in two of the 12 study villages (Bugoto and Bwondha), and a standardized questionnaire was implemented. The prevalence of egg-patent infection was then found to be markedly higher in the study infants from Bugoto (86%) than in those from Bwondha (25%). A greater level of mother-and-infant water contact, a higher abundance of (infected) Biomphalaria choanomphala, and an unusual lakeshore topology may explain why S. mansoni infection was so much more common in the Bugoto subjects than in the Bwondha. All but one of the infants studied in the second survey were found to be anaemic (with <110 g haemoglobin/litre). Taken together, these children were less likely to be found infected with hookworm (16%), Hymenolepis nana (11%) or Trichuris trichiura (5%) than with S. mansoni (47%). Infection with the parasites causing intestinal schistosomiasis can be common among the infants living in these lakeshore villages. Although the immediate and later-life clinical impacts of such infection have yet to be elucidated, such infants would probably benefit from regular de-worming. Mothers should be strongly encouraged to visit the nearest health-services clinic, with their infants, for any necessary anthelmintic treatment.

  16. Predictors of child-to-parent aggression: A 3-year longitudinal study.

    PubMed

    Calvete, Esther; Orue, Izaskun; Gamez-Guadix, Manuel; Bushman, Brad J

    2015-05-01

    Although we rarely hear about it, children sometimes aggress against their parents. This is a difficult topic to study because abused parents and abusive children are both reluctant to admit the occurrence of child-to-parent aggression. There are very few research studies on this topic, and even fewer theoretical explanations of why it occurs. We predicted that exposure to violence in the home (e.g., parents aggressing against each other) and ineffective parenting (i.e., parenting that is overly permissive or lacks warmth) influences cognitive schemas of how children perceive themselves and the world around them (i.e., whether aggression is normal, whether they develop grandiose self-views, and whether they feel disconnected and rejected), which, in turn, predicts child-to-parent aggression. In a 3-year longitudinal study of 591 adolescents and their parents, we found that exposure to violence in Year 1 predicted child-to-parent aggression in Year 3. In addition, parenting characterized by lack of warmth in Year 1 was related to narcissistic and entitled self-views and disconnection and rejection schemas in Year 2, which, in turn, predicted child-to-mother and child-to-father aggression in Year 3. Gender comparisons indicated that narcissism predicted child-to-parent aggression only in boys and that exposure to violence was a stronger predictor of child-to-father violence in boys. This longitudinal study increases our understanding of the understudied but important topic of child-to-parent aggression, and will hopefully stimulate future research.

  17. Blood Lead Concentrations in 1–3 Year Old Lebanese Children: A Cross-sectional study

    PubMed Central

    Nuwayhid, Iman; Nabulsi, Mona; Muwakkit, Samar; Kouzi, Sarah; Salem, George; Mikati, Mohamed; Ariss, Majd

    2003-01-01

    Background Childhood lead poisoning has not made the list of national public health priorities in Lebanon. This study aims at identifying the prevalence and risk factors for elevated blood lead concentrations (B-Pb ≥ 100 μg/L) among 1–3 year old children. It also examines the need for universal blood lead screening. Methods This is a cross-sectional study of 281 well children, presenting to the pediatric ambulatory services at the American University of Beirut Medical Center in 1997–98. Blood was drawn on participating children for lead analysis and a structured questionnaire was introduced to mothers asking about social, demographic, and residence characteristics, as well as potential risk factors for lead exposure. Children with B-Pb ≥ 100 μg/L were compared to those with B-Pb < 100 μg/L. Results Mean B-Pb was 66.0 μg/L (median 60.0; range 10–160; standard deviation 26.3) with 39 (14%) children with B-Pb ≥ 100 μg/L. Logistic regression analysis showed that elevated B-Pb was associated with paternal manual jobs (odds ratio [OR]: 4.74), residence being located in high traffic areas (OR: 4.59), summer season (OR: 4.39), using hot tap water for cooking (OR: 3.96), exposure to kohl (OR: 2.40), and living in older buildings (OR: 2.01). Conclusion Lead screening should be offered to high-risk children. With the recent ban of leaded gasoline in Lebanon, emphasis should shift to other sources of exposure in children. PMID:12780938

  18. A 3 year update on the influence of noise on performance and behavior.

    PubMed

    Clark, Charlotte; Sörqvist, Patrik

    2012-01-01

    The effect of noise exposure on human performance and behavior continues to be a focus for research activities. This paper reviews developments in the field over the past 3 years, highlighting current areas of research, recent findings, and ongoing research in two main research areas: Field studies of noise effects on children's cognition and experimental studies of auditory distraction. Overall, the evidence for the effects of external environmental noise on children's cognition has strengthened in recent years, with the use of larger community samples and better noise characterization. Studies have begun to establish exposure-effect thresholds for noise effects on cognition. However, the evidence remains predominantly cross-sectional and future research needs to examine whether sound insulation might lessen the effects of external noise on children's learning. Research has also begun to explore the link between internal classroom acoustics and children's learning, aiming to further inform the design of the internal acoustic environment. Experimental studies of the effects of noise on cognitive performance are also reviewed, including functional differences in varieties of auditory distraction, semantic auditory distraction, individual differences in susceptibility to auditory distraction, and the role of cognitive control on the effects of noise on understanding and memory of target speech materials. In general, the results indicate that there are at least two functionally different types of auditory distraction: One due to the interruption of processes (as a result of attention being captured by the sound), another due to interference between processes. The magnitude of the former type is related to individual differences in cognitive control capacities (e.g., working memory capacity); the magnitude of the latter is not. Few studies address noise effects on behavioral outcomes, emphasizing the need for researchers to explore noise effects on behavior in more

  19. Summary of Medipix Technology's 3-Years in Space and Plans for Future Developments

    NASA Astrophysics Data System (ADS)

    Pinsky, Lawrence

    2016-07-01

    NASA has evaluated 7 Timepix-based radiation imaging detectors from the CERN-based Medipix2 collaboration on the International Space Station (ISS), collecting more than 3-years of data, as well on the December, 2014 EFT-1 mission testing the new Orion Multi-Purpose Crew Vehicle. These data along with data collected at ground-based accelerator facilities including the NASA Space Radiation Lab (NSRL) at Brookhaven in the US, as well as at the HIMAC facility at the National Institute for Radiological Sciences in Japan, have allowed the development of software analysis techniques sufficient to provide a stand-alone accurate assessment of the space radiation environment for dosimetric purposes. Recent comparisons of the performance of the Timepix with both n-on-p and p-on-n Si sensors will be presented. The further evolution of the Timepix technology by the Medipix3 collaboration in the form of the Timepix3 chip, which employs a continuous data-driven readout scheme, is being evaluated for possible use in future space research applications. Initial performance evaluations at accelerators will be reported. The Medipix2 Collaboration is also in the process of designing an updated version of the Timepix chip, called the Timepix2, which will continue the frame-based readout scheme of the current Timepix chip, but add simultaneous charge encoding using the Time-Over-Threshold (TOT) and first-hit Time-of-Arrival (TOA) encoding. Current plans are to replace the Timepix by the Timepix2 with minimal reconfiguration of the supporting electronics. Longer-term plans include participation in the currently forming Medipix4 collaboration. A summary of these prospects will also be included.

  20. Perfectionism, neuroticism, and daily stress reactivity and coping effectiveness 6 months and 3 years later.

    PubMed

    Dunkley, David M; Mandel, Tobey; Ma, Denise

    2014-10-01

    The present study addressed a fundamental gap between research and clinical work by advancing longitudinal explanatory conceptualizations of stress and coping processes that trigger daily affect in the short- and long-term for individuals with higher levels of personality vulnerability. Community adults completed measures of 2 higher order dimensions of perfectionism (personal standards [PS], self-criticism [SC]), neuroticism, and conscientiousness. Then, 6 months later and again 3 years later, participants completed daily questionnaires of stress, coping, and affect for 14 consecutive days. PS was associated with aggregated daily problem-focused coping and positive reinterpretation, whereas SC was uniquely associated with daily negative social interactions, avoidant coping, negative affect, and sadness at Month 6 and Year 3. Multilevel modeling results demonstrated that both individuals with higher PS and those with higher SC were emotionally reactive to event stress, negative social interactions, and avoidant coping at Month 6 and Year 3 and to less perceived control at Year 3. Positive reinterpretation was especially effective for individuals with higher SC at Month 6 and Year 3. The effects of PS on daily stress reactivity and coping (in)effectiveness were clearly distinguished from the effects of neuroticism and conscientiousness, whereas the SC effects were due to shared overlap with PS and neuroticism. The present findings demonstrate the promise of using repeated daily diary methodologies to help therapists and clients reliably predict future client reactions to daily stressors, which, in turn, could help guide interventions to break apart dysfunctional patterns connected to distress and build resilience for vulnerable individuals.

  1. Use of Corporal Punishment for 3-year Old Children and Associated Intimate Partner Aggression or Violence

    PubMed Central

    Taylor, Catherine A.; Lee, Shawna J.; Guterman, Neil B.; Rice, Janet C.

    2016-01-01

    Objective To examine associations between maternal and paternal use of corporal punishment (CP) for 3-year old children and intimate partner aggression or violence (IPAV) in a population-based sample. Methods The study sample (n = 1997) was derived from wave 3 of the Fragile Families and Child Well-being Study. Mother and father reports regarding their use of CP and their IPAV victimization were analyzed. IPAV included coercion, non-physical and physical aggression. Results About 65% of the children were spanked at least once in the prior month by one or both parents. Of those couples that reported any family aggression (87%), 54% reported that both CP and IPAV occurred. The most prevalent patterns of co-occurrence involved both parents as aggressors either toward each other (i.e., bilateral IPAV) or toward the child. The presence of bilateral IPAV essentially doubled the odds that one or both parents would use CP, even after controlling for potential confounders such as parenting stress, depression, and alcohol or other drug use. Of the five patterns of co-occurring family aggression assessed, the “single aggressor” model, in which only one parent aggressed in the family, received the least amount of empirical support. Conclusions Despite American Academy of Pediatrics’ recommendations against the use of CP, CP use remains common in the U.S. CP prevention and intervention efforts should carefully consider assumptions made about patterns of co-occurring aggression in families, given that adult victims of IPAV, including even minor, non-physical aggression between parents, have increased odds of using CP with their children. PMID:20732943

  2. Breastfeeding and dietary variety among preterm children aged 1-3 years.

    PubMed

    Husk, Jesse S; Keim, Sarah A

    2016-04-01

    Among infants born at term, breastfeeding is associated with increased dietary variety in childhood. Preterm birth can limit early feeding options while simultaneously increasing risk for negative health outcomes that could benefit from dietary-based preventative measures. We assessed whether breastfeeding is associated with increased dietary variety at 1-3 years amongst children born preterm. We analyzed baseline data from two clinical trials investigating cognitive development after fatty-acid supplementation for 10-39 month-old children born before 35 weeks gestation (n = 189). At baseline, mothers reported breastfeeding history and completed a 161-item food-frequency questionnaire for their child. Dietary variety was assessed via 3 measures: (1) proportion items consumed at least once per month, (2) servings of a given item consumed relative to total monthly food servings, (3) daily probability of consuming a given item. Overall, 88% of children were ever breastfed (median duration = 89 days, range = 0-539), and 48% of children were ever exclusively breastfed (median duration = 59 days, range = 3-240). Exclusive breastfeeding duration was associated with dietary variety increases of 0.9% (95% CI = 0.1-1.7) for vegetables, 1.6% (95% CI = 0.2-3.0) for meat/fish, and 1.3% (95% CI = 0.2-2.4) for grain/starch, for each additional month of exclusive breastfeeding after adjustment for key confounders. Correspondingly, the variety of sweets consumed decreased by 1.2% (CI: -2.1, -0.3) per month of any breastfeeding after adjustment. These results are consistent with those in children born at term, and if causal, could provide additional support for exclusive breastfeeding to improve diet and health in children born preterm.

  3. Pragmatic inference, not semantic competence, guides 3-year-olds' interpretation of unknown number words.

    PubMed

    Brooks, Neon; Audet, Jennifer; Barner, David

    2013-06-01

    Before children learn the specific meanings of numerals like six, do they know that they represent precise quantities? Previous studies have reported conflicting evidence and have found that children expect numerals to label precise quantities in some tasks but not in others (Condry & Spelke, 2008; Sarnecka & Gelman, 2004). In this article, we present evidence that some of children's apparent successes are best explained not by domain-specific semantic understanding of number but instead by language-general pragmatic abilities. In Experiment 1, we replicated the findings of the previous studies in a within-subject design. When 3-year-olds saw a set labeled with a number (e.g., five) and an item was added, they preferred a new label (six) over the old one, as though they believed that number words have precise meanings. However, when 1 of 2 sets was labeled (e.g., as five) and children were asked to find the same quantity (five) or a new quantity (six), they performed identically whether the original set was changed in quantity or merely rearranged. Thus, when 2 numerals were offered as alternative labels for 1 set, children behaved as though they had precise meanings, whereas when they were asked to determine which of 2 sets a single numeral referred to, they did not. In Experiment 2, children were tested using similar methods but with novel nouns and objects that were transformed, instead of sets. Children showed the identical pattern of results despite lacking meanings for these words, suggesting that their judgments for numerals may not have relied on semantic knowledge that numerals have precise meanings. We propose that children's behavior can be explained by the use of domain-general pragmatic inference and does not require positing domain-specific numerical knowledge.

  4. Categorization and abstraction abilities in 3-year-old children: a comparison with monkey data.

    PubMed

    Bovet, Dalila; Vauclair, Jacques; Blaye, Agnès

    2005-01-01

    Three-year-old children were tested on three categorization tasks of increasing levels of abstraction (used with adult baboons in an earlier study): the first was a conceptual categorization task (food vs toys), the second a perceptual matching task (same vs different objects), and the third a relational matching task in which the children had to sort pairs according to whether or not the two items belonged to the same or different categories. The children were tested using two different procedures, the first a replication of the procedure used with the baboons (pulling one rope for a category or a relationship between two objects, and another rope for the other category or relationship), the second a task based upon children's prior experiences with sorting objects (putting in the same box objects belonging to the same category or a pair of objects exemplifying the same relation). The children were able to solve the first task (conceptual categorization) when tested with the sorting into boxes procedure, and the second task (perceptual matching) when tested with both procedures. The children were able to master the third task (relational matching) only when the rules were clearly explained to them, but not when they could only watch sorting examples. In fact, the relational matching task without explanation requires analogy abilities that do not seem to be fully developed at 3 years of age. The discrepancies in performances between children tested with the two procedures, with the task explained or not, and the discrepancies observed between children and baboons are discussed in relation to differences between species and/or problem-solving strategies.

  5. Complete recovery from acute encephalopathy of late-onset ornithine transcarbamylase deficiency in a 3-year-old boy.

    PubMed

    Mak, C M; Siu, T-S; Lam, C-W; Chan, G C-F; Poon, G W-K; Wong, K-Y; Low, L C-K; Tang, N L; Li, S K; Lau, K-Y; Kwong, N-S; Tam, S

    2007-11-01

    Ornithine transcarbamylase deficiency is the commonest urea cycle disorder which is transmitted in X-linked inheritance. It is mainly characterized in males by acute encephalopathy and hyperammonaemia with fatal outcomes in both classical neonatal and late-onset types. We report a 3-year-old healthy Hong Kong Chinese boy who presented with acute encephalopathy and coma after three days of gastroenteritis. He had no focal neurological deficit and brain CT imaging was normal. His plasma ammonia (54 micromol/L) and glutamine (747 micromol/L) concentrations were normal. The only biochemical abnormalities detected were marked orotic aciduria (700 micromol/mmol creatinine) and elevated urinary uracil. He regained consciousness spontaneously after three days under intensive care with parenteral fluid therapy. He recovered completely without any neurological deficits. Five months after discharge, urinary uracil concentration remained elevated despite normalized orotic acid concentration. Finally, ornithine transcarbamylase deficiency was diagnosed by DNA analysis. A missense mutation of arginine-to-glutamine substitution on amino acid 277 (p.R277Q) was revealed to be a late-onset mutant. Our case strengthens the argument that in any child with coma or acute encephalopathy of undetermined cause, genetic analysis of the OTC gene and the measurement of urinary uracil concentration remain the most reliable indicators of late-onset OTCD during acute and even quiescent phases. Existing neonatal screening programmes for inheritable metabolic disorders fail to detect late-onset variants. Therefore, a high clinical suspicion is a key to correct and timely diagnosis, especially in those patients with atypical presentations.

  6. Water Quality Conditions Monitored at the Corps’ Big Bend Project in South Dakota during the 3-Year Period 2008 through 2010

    DTIC Science & Technology

    2011-11-01

    formulation of plant and animal protein. Nitrogen, similar to carbon, also has a gaseous form. Many species of cyanobacteria can use or fix elemental...algae, cyanobacteria , or cryptomonad algae. Chlorophyll a represents a common variable used to estimate phytoplankton biomass. Seasonal succession...the diatoms. Decreases in nitrogen or a decreased competitive advantage for carbon at higher pH may result in cyanobacteria succeeding the green algae

  7. Water Quality Conditions Monitored at the Corps’ Gavins Point Project in Nebraska/South Dakota during the 3-Year Period 2008 through 2010

    DTIC Science & Technology

    2011-11-01

    Recreation Beneficial Use using cyanobacteria toxins data. ................................................................... 26 Table 4-5. State of...Many species of cyanobacteria can use or fix elemental or gaseous N2 as a nitrogen source. The most common forms of nitrogen in aquatic systems are...Phytoplankton can be generally grouped as diatoms, green algae, cyanobacteria , or cryptomonad algae. Chlorophyll a represents a common variable used to

  8. A study of blood and urine alcohol concentrations in cases of alleged drug-facilitated sexual assault in the United Kingdom over a 3-year period.

    PubMed

    Scott-Ham, Michael; Burton, Fiona C

    2006-04-01

    This paper details the alcohol concentrations found in a selection of 1,014 cases of claimed drug-facilitated sexual assault analysed at The Forensic Science Service, London Laboratory between January 2000 and December 2002. Where appropriate, either a whole blood sample and/or a urine sample was analysed for alcohol, common drugs of abuse and potentially stupefying drugs. The samples were collected from a complainant within 12 h of an alleged incident in 391 of the 1014 cases analysed. Of these, the majority (81%) contained alcohol. The presence of alcohol itself was not surprising as most of the alleged incidents were associated with social situations such as at a public house, bar, night-club or party, where it is expected that alcohol would have been consumed. However, 233 (60%) of the 391 cases had a high back-calculated figure, where high is defined as greater than 150 milligrams per 100 millilitres (150 mg%). Some of these samples were also found to contain illicit drugs. This is the first paper to our knowledge which discusses in detail the significance of the alcohol concentrations found in cases of this type.

  9. Water Quality Conditions Monitored at the Corps’ Oahe Project in South Dakota during the 3-Year Period 2005 through 2007

    DTIC Science & Technology

    2008-02-01

    represented by taxa collected in the phytoplankton samples: Bacillariophyta (Diatoms), Chlorophyta (Green Algae), Chrysophyta (Golden Algae...prevalence of these taxonomic divisions in the reservoir, based on taxa occurrence, were Bacillariophyta > Chlorophyta > Cyanobacteria > Cryptophyta...occasion), Cyclotella sp. (1 occasion), Navicula sp. (1 occasion), Synedra sp. (1 occasion), and Tabellaria sp.; Chlorophyta Cosmarium sp. (3 occasions

  10. Water Quality Conditions Monitored at the Corps’ Fort Peck Project in Montana during the 3-Year Period 2004 through 2006

    DTIC Science & Technology

    2007-03-01

    Chlorophyta (Green Algae), Chrysophyta (Golden Algae), Cryptophyta (Cryptomonad Algae), Cyanobacteria (Blue-Green Algae), Euglenophyta (Euglenoid...were Bacillariophyta > Chlorophyta /Cryptophyta/Cyanobacteria > Pyrrophyta > Chrysophyta >> Euglenophyta. The diatoms were generally the most prevalent...through 2006. Site Date Biovolume (um3) Bacillariophyta Chlorophyta Chrysophyta Cryptophyta Cyanobacteria Euglenophyta Pyrrophyta L1 May 2004

  11. Mycobacterial interspersed repetitive unit typing and mutational profile for multidrug-resistant and extensively drug-resistant tuberculosis surveillance in Portugal: a 3-year period overview.

    PubMed

    Silva, Carla; Perdigão, João; Jordão, Luísa; Portugal, Isabel

    2014-12-01

    Multidrug tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) cases constitute a serious health problem in Portugal, of which the majority of isolates belong to the Lisboa family and the Q1 cluster, highly related to the Lisboa family. Here we sought to investigate the molecular basis of resistant TB as well as to determine the prevalence of specific drug resistance mutations and their association with MDR-TB and/or XDR-TB. In total, 74 Mycobacterium tuberculosis clinical isolates collected in Lisbon Health Region were genotyped by 24-loci mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR), and the mutational profile associated with first- and second-line drug resistance was studied. Seven new mutations were found, whilst the remaining 28 mutations had been previously associated with drug resistance. None of the mutations was specifically associated with MDR-TB. The mutational patterns observed among isolates belonging to Lisboa3 and Q1 clusters were also observed in isolates with unique MIRU-VNTR patterns but closely related to these strains. Such data suggest that the genotyping technique employed discriminates isolates with the same mutational profile. To establish the most adequate genotyping technique, the discriminatory power of three different MIRU-VNTR sets was analysed. The 15-loci MIRU-VNTR set showed adequate discriminatory power, comparable with the 24-loci set, allowing clustering of 60% and 86% of the MDR-TB and XDR-TB isolates, respectively, the majority of which belonged to the Lisboa3 and Q1 clusters. From an epidemiological standpoint, this study suggests combined mutational and genotyping analysis as a valuable tool for drug resistance surveillance.

  12. Crystalline-amorphous interfaces and their relation to grain boundary films. A report for the 3-year period, 15 November 1988--14 November 1991

    SciTech Connect

    Carter, C.B.

    1992-02-03

    In presence of glass in grain boundaries greatly enhances sintering, in part, because transport of matter along and across the intergranular regions is faster. The glass does not simply act as a catalyst but also changes the character of the interfacial regions. In particular, it tends to encourage faceting of the grains; the scale of this faceting may vary from nanometers to microns. After processing, the glass may remain as a thin layer in the interface during preparation of the polycrystalline compact as was initially demonstrated for Si{sub 3}N{sub 4} and proposed for other ceramics. The glass may also crystallize to form an intergranular crystalline layer or it may withdraw from the planar interfaces into three-grain and four-grain junctions (the dewetting process). The present program has begun to examine how glass affects and interacts with crystalline ceramics. The main aim of the program is to examine how glass moves into and out of grain boundaries and why this movement takes. By understanding this process we will be better able to control this important aspect of many ceramic materials. Since TEM is the main tool used in this investigation, we will continue to develop methods for analyzing interfaces as part of this program.

  13. Water Quality Conditions Monitored at the Corps’ Fort Randall Project in South Dakota during the 3-Year Period 2006 through 2008

    DTIC Science & Technology

    2009-02-01

    the onset of snowmelt. The annual melting of mountain and plains snowpacks along with spring and 1 2 summer rainfall produces the annual runoff...into the Mainstem System. In a typical year, mountain snowpack , plains snowpack , and rainfall events, respectively, contribute 50, 25, and 25

  14. Individuals with Autism Spectrum Disorders Have Equal Success Rate But Require Longer Periods of Systematic Desensitization than Control Patients to Complete Ambulatory Polysomnography

    PubMed Central

    Primeau, Michelle; Gershon, Anda; Talbot, Lisa; Cotto, Isabelle; Lotspeich, Linda; Hardan, Antonio; Hallmayer, Joachim; O'Hara, Ruth

    2016-01-01

    Study Objectives: Polysomnography (PSG) is the gold standard for the assessment of sleep, yet the extensive apparatus required for monitoring with PSG can be difficult to tolerate, particularly in children. Clinical populations, such as those with anxiety or tactile sensitivity, may have even greater difficulty tolerating the PSG equipment. This study evaluated an innovative protocol for obtaining full PSG in individuals diagnosed autism spectrum disorders (ASD) or developmental delay (DD), as well as typically developing controls (TD). The primary aim was to assess whether this protocol was equally successful for obtaining PSG between these groups. Methods: One hundred sixty-one individuals were recruited for participation; 93 with a diagnosis of ASD, 23 with a diagnosis of DD, and 45 TD. The participants and families were instructed on a procedure of systematic desensitization to the ambulatory PSG equipment; PSG was performed in the home of the participant. Results: PSG was successfully attained in 144 (89.4%) participants. There was no difference in completion rate by diagnosis (p = 0.1), though younger age (p = 0.018) and duration of desensitization (p = 0.024) did predict PSG failure. Further, it was found that individuals with ASD took longer to desensitize to the equipment (16.08 d), than those with DD (8.04 d) or TD (0.98 d). Conclusions: Systematic desensitization to PSG equipment, in combination with PSG completed in the home, allows for individuals with ASD to be equally successful in completing PSG, though they do take longer to acclimate to the equipment. Citation: Primeau M, Gershon A, Talbot L, Cotto I, Lotspeich L, Hardan A, Hallmayer J, O'Hara R. Individuals with autism spectrum disorders have equal success rate but require longer periods of systematic desensitization than control patients to complete ambulatory polysomnography. J Clin Sleep Med 2016;12(3):357–362. PMID:26564388

  15. Three-year outcome analysis of alpha 1-blocker naftopidil for patients with benign prostatic hyperplasia in a prospective multicenter study in Japan

    PubMed Central

    Masumori, Naoya; Tsukamoto, Taiji; Shibuya, Akihiko; Miyao, Noriomi; Kunishima, Yasuharu; Iwasawa, Akihiko

    2016-01-01

    Purpose Our aim was to prospectively analyze the 3-year outcomes of naftopidil treatment for patients with benign prostatic hyperplasia (BPH), including those who dropped out during follow-up and had retreatment for BPH after termination of the drug within 3 years. Patients and methods Naftopidil, 50 mg/d or 75 mg/d, was given to 117 patients having BPH aged 50 years and older who had international prostate symptom scores (IPSS) ≥8. They were prospectively followed for 3 years with periodic evaluation. If naftopidil was terminated, the reason was determined. For patients with termination, an outcome survey was done to evaluate the status of retreatment for BPH at 3 years. Results Twenty-five patients (21.4%) continued the same medication for 3 years. The total IPSS, quality of life index, BPH problem index, and maximum flow rate were significantly improved during 3 years. Treatment failure defined as symptomatic progression (an increase in the IPSS of ≥4 points compared to the baseline value), development of acute urinary retention, conversion to other α1-blockers, add-on of a 5α-reductase inhibitor, or conversion to surgery was observed in 41 patients (35.0%). In the univariate analysis, age, prostate volume, and serum prostate-specific antigen were predictors of treatment failure. Of the 50 patients who discontinued naftopidil during the follow-up, only 13 (26%) patients reported that they needed retreatment with α1-blockers and/or surgery within 3 years. Conclusion Long-term efficacy of naftopidil was observed, although older age, increased prostate volume, and elevated prostate-specific antigen at baseline were highly likely to result in treatment failure. Even after termination for various reasons, only a small portion of the patients needed retreatment for BPH within 3 years. PMID:27524886

  16. Changes in Childhood Diarrhea Incidence in Nicaragua Following 3 Years of Universal Infant Rotavirus Immunization

    PubMed Central

    Becker-Dreps, Sylvia; Paniagua, Margarita; Dominik, Rosalie; Cao, Hongyuan; Shah, Naman K.; Morgan, Douglas R.; Moreno, Gilberto; Espinoza, Félix

    2011-01-01

    Background While the pentavalent rotavirus vaccine was highly efficacious against rotavirus diarrhea in clinical trials, the vaccine’s effectiveness under field conditions in the developing world is unclear. In October, 2006, Nicaragua became the first developing nation to implement universal infant immunization with the pentavalent rotavirus vaccine. To assess the impact of the immunization program, we examined the incidence of diarrhea