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Sample records for 3-year period patients

  1. Successful stenting of four spontaneous oesophageal perforations in a single patient during a 3-year period

    PubMed Central

    Sundbom, Magnus; Hedberg, Jakob

    2016-01-01

    Spontaneous oesophageal perforation, a rare condition associated with high mortality due to mediastinitis and multi-organ failure, can be treated surgically or with endoscopic stents. We present a case of four right-sided oesophageal perforations during a 3-year period in a single patient, all successfully stented. The 51-year-old Caucasian male had his first oesophageal perforation in 2012, which was successfully treated with a fully covered endoscopic stent. No residual pathology was seen at stent removal. Two years later, the patient was successfully treated with stents twice for recurrent perforations. The fourth spontaneous perforation at the same site occurred this fall, and again endoscopic treatment was successful. The patient does not report any squeals. In spite of the successful outcome, we would like to emphasize the need for close surveillance and readiness for definitive surgical treatment. PMID:27154748

  2. Pyogenic liver abscess: a retrospective analysis of 107 patients during a 3-year period.

    PubMed

    Chan, Khee-Siang; Chen, Chin-Ming; Cheng, Kuo-Chen; Hou, Ching-Cheng; Lin, Hung-Jung; Yu, Wen-Liang

    2005-12-01

    Pyogenic liver abscess (PLA) is a potentially life-threatening disease, and early diagnosis may be difficult. In order to provide diagnostic clues and to enhance the prompt management of such cases, we retrospectively investigated the clinical characteristics of PLA during a 3-year period in a tertiary-care hospital. The crude incidence rate of PLA in our study was 446.1 per 100,000 hospital admissions. Male predominance and a mean age of 57.6 +/- 14.4 years were observed. Diabetes mellitus was the most common concomitant disease, and biliary pathologies were the most common predisposing cause of this type of abscess. The most common clinical features were fever, chills, and abdominal pain. Leukocytosis was found in 67.3% of the patients, and the observed C-reactive protein (CRP) values were high. The most common pathogen was Klebsiella pneumoniae. The mortality rate was 6.5%. A complete history, physical examination, evaluation of the white blood cell count and CRP, and the prompt arrangement of imaging studies may lead to an earlier diagnosis. The aggressive performance of image-guided catheter drainage and the appropriate administration of antibiotics may reduce the mortality rate of PLA. PMID:16377869

  3. 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

  4. 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.

  5. 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

  6. Susceptibility to tulathromycin in Mannheimia haemolytica isolated from feedlot cattle over a 3-year period

    PubMed Central

    Alexander, Trevor W.; Cook, Shaun; Klima, Cassidy L.; Topp, Ed; McAllister, Tim A.

    2013-01-01

    Mannheimia haemolytica isolated from feedlot cattle were tested for tulathromycin resistance. Cattle were sampled over a 3-year period, starting 12 months after approval of tulathromycin for prevention and treatment of bovine respiratory disease. Nasopharyngeal samples from approximately 5,814 cattle were collected when cattle entered feedlots (N = 4) and again from the same cattle after ≥60 days on feed. The antimicrobial use history for each animal was recorded. Mannheimia haemolytica was isolated from 796 (13.7%) entry samples and 1,038 (20.6%) ≥ 60 days samples. Of the cattle positive for M. haemolytica, 18.5, 2.9, and 2.4% were administered therapeutic concentrations of tulathromycin, tilmicosin, or tylosin tartrate, respectively. In addition, 13.2% were administered subtherapeutic concentrations of tylosin phosphate in feed. In years one and two, no tulathromycin-resistant M. haemolytica were detected, whereas five isolates (0.4%) were resistant in year three. These resistant isolates were collected from three cattle originating from a single pen, were all serotype 1, and were genetically related (≥89% similarity) according to pulsed-field gel electrophoreses patterns. The five tulathromycin-resistant isolates were multi-drug resistant also exhibiting resistance to oxytetracycline, tilmicosin, ampicillin, or penicillin. The macrolide resistance genes erm(42), erm(A), erm(B), erm(F), erm(X) and msr(E)-mph(E), were not detected in the tulathromycin-resistant M. haemolytica. This study showed that tulathromycin resistance in M. haemolytica from a general population of feedlot cattle in western Canada was low and did not change over a 3-year period after tulathromycin was approved for use in cattle. PMID:24130555

  7. Equal 3-Year Outcomes for Kidney Transplantation Alone in HCV-Positive Patients With Cirrhosis

    PubMed Central

    Parsikia, Afshin; Campos, Stalin; Khanmoradi, Kamran; Pang, John; Balasubramanian, Manjula; Zaki, Radi; Ortiz, Jorge

    2015-01-01

    Kidney transplantation alone in clinically compensated patients with cirrhosis is not well documented. Current guidelines list cirrhosis as a contraindication for kidney transplantation alone. This is an Institutional Review Board–approved retrospective study. We report our experience with a retrospective comparison between transplants in hepatitis C virus–positive (HCV+) patients without cirrhosis and HCV+ patients with cirrhosis. All of the patients were followed for at least a full 3-year period. All of the deaths and graft losses were recorded and analyzed using Kaplan-Meier methodology. One- and three-year cumulative patient survival rates for noncirrhotic patients were 91% and 82%, respectively. For cirrhotic patients, one- and three-year cumulative patient survival rates were 100% and 83%, respectively (P = NS). One- and three-year cumulative graft survival rates censored for death were 94% and 81%, and 95% and 82% for the noncirrhosis and cirrhosis groups, respectively (P = NS). Comparable patient and allograft survival rates were observed when standard kidney allograft recipients were analyzed separately. This study is the longest follow-up document in the literature showing that HCV+ clinically ompensated patients with cirrhosis may undergo kidney transplantation alone as a safe and viable practice. PMID:25594655

  8. 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. PMID:25762774

  9. 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

  10. Molecular epidemiology of Mycobacterium tuberculosis strains isolated during a 3-year period (1993 to 1995) in Seville, Spain.

    PubMed Central

    Safi, H; Aznar, J; Palomares, J C

    1997-01-01

    The genetic polymorphism of Mycobacterium tuberculosis strains isolated in Seville, Spain, was studied by using computer-assisted analysis of the IS6110 fingerprint in order to determine the current situation and to evaluate the human-to-human transmission of this pathogen. One hundred seventy-six isolates from 175 patients among the 205 patients diagnosed with tuberculosis (TB) during a 3-year period (1993 to 1995) were cultured and analyzed. One hundred nine patients (62%) were infected with genetically different isolates, and 67 isolates (38%) were grouped into 19 clusters. These results demonstrate that the level of clustering of strains in Seville is intermediate between those in developed and developing countries. Epidemiological relatedness was shown for isolates from only 10 of these clusters. Active and high transmission rates exist in children and in human immunodeficiency virus (HIV)-infected adults, while in non-HIV-infected adults this transmission rate is moderate. Although transmission from children to adults is uncommon, the probability of transmission from HIV-infected patients to young adults not infected with HIV may be higher. On the basis of these observations, we predict a constant rise in the rate of TB transmission among HIV-infected patients and probably in young adult patients not infected with HIV if measures for the effective prevention of TB among the HIV-infected population are not implemented. PMID:9316891

  11. Pediatric encephaloceles: A series of 20 cases over a period of 3 years

    PubMed Central

    Ramdurg, Shashank Ravindra; Sukanya, M.; Maitra, Jayabrata

    2015-01-01

    Background: Encephalocele is the protrusion of the cranial contents beyond the normal confines of the skull through a defect in the calvarium and is far less common than spinal dysraphism. The exact worldwide frequency is not known. Aims and Objectives: To determine the epidemiological features, patterns of encephalocele, and its postsurgical results. Materials and Methods: The study was carried from year July 2012 to June 2015. Patients with encephalocele were evaluated for epidemiological characteristics, clinical features, imaging characteristics, and surgical results. Results: 20 encephaloceles patients were treated during the study period. Out of these 12 (60%) were male and 8 (40%) female. Age range was 1 day to 6 years. The most common type of encephalocele was occipital 12 (60%), occipito-cervical 4 (20%), parietal 2 (10%), fronto-nasal 1 (5%), and fronto-naso-ethmoidal 1 (5%). One patient had a double encephalocele (one atretic and other was occipital) with dermal sinus tract and limited dermal myeloschisis. Other associations: Chiari 3 malformation (2), meningomyeloceles (4), and syrinx (4). Three patients presented with rupture two of whom succumbed to meningitis and shock. Seventeen patients treated surgically did well with no immediate surgical mortality (except a case of Chiari 3 malformation who succumbed 6 months postsurgery to unrelated causes). Shunt was performed in 4 cases. Conclusion: The most common type of encephalocele is occipital in our set up. Early surgical management of encephalocele is not only for cosmetic reasons but also to prevent tethering, rupture, and future neurological deficits. PMID:26962334

  12. The Natural Course of Intermittent Exotropia over a 3-year Period and the Factors Predicting the Control Deterioration

    PubMed Central

    Kwok, Jeremy J. S. W.; Chong, Gabriela S. L.; Ko, Simon T. C.; Yam, Jason C.S.

    2016-01-01

    The natural course of intermittent exotropia and the factors affecting its control has been unclear. We aim to report the natural course of our cohort of 117 Chinese children with intermittent exotropia and to identify baseline parameters that may have predictive value in the control deterioration of the disease. The visual acuity, spherical equivalent, compliance to orthoptic exercise, angle of deviation fusional convergence parameters and Newcastle Control Score were recorded for all children at baseline and at 3 years apart. Patients were divided into two groups according to the change in control over the 3 years: group 1 included patients who had no deterioration or had improvement in disease control; and group 2 were those who had deteriorated control or had undergone surgery. There were 77 patients (66%) in group 1 and 40 (34%) patients in group 2. Comparing the baseline parameters of the two groups, group 1 had statistically significantly smaller angle of deviation, larger fusional reserve, larger fusional recovery, and higher fusional reserve ratio (p < 0.05). Other baseline parameters were similar between the two groups. The baseline fusional parameters may have predictive value in determining the control of intermittent exotropia. PMID:27257120

  13. How schizophrenic patients change during 3 years' treatment with depot neuroleptics.

    PubMed

    Dencker, S J; Frankenberg, K; Lepp, M; Lindberg, D; Malm, U

    1978-02-01

    A group of patients, initially 67 individuals, with chronic schizophrenia were studied on repeated occasions during 1 year and followed up after 3 years. The patients were given depot neuroleptics, either fluphenazine decanoate or pipotiazine palmitate, at intervals of 1 month. The symptom scores from three rating scales were subjected to factor analysis. Four factors were found to explain the variance satisfactorily: one comprising psychopathological symptoms specific for schizophrenia, one relating to contact disturbances, one psychomotor activity and one representing neurotic symptoms. Analysis of these factors revealed certain differences between the treatment groups over time and demonstrated the effect of combination of psychotherapy and neuroleptic drugs in a subgroup of patients. This type of analysis of treatment results might contribute to improving our knowledge of rehabilitation of schizophrenic patients and help us to draw up giudelines for selection of suitable measures. PMID:24982

  14. MyoRing Implantation in Keratoconic Patients: 3 years Follow-up Data

    PubMed Central

    Janani, Leila; Jadidi, Khosrow; Mosavi, Seyed Aliasghar; Nejat, Farhad; Naderi, Mostafa; Nourijelyani, Keramat

    2016-01-01

    Purpose: To evaluate long-term follow-up data on implantation of a full-ring intra-corneal implant (MyoRing) for management of keratoconus. Methods: A total of 40 keratoconic eyes of 37 consecutive patients who had undergone MyoRing implantation using the Pocket Maker microkeratome (Dioptex, GmbH, Linz, Austria) and completed 3 years of follow-up appointments were included in this retrospective study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction and keratometry (K) readings were measured and evaluated preoperatively, and 3 years, postoperatively. Results: No intraoperative complications were observed in this case series. Three years postoperatively, there was a significant improvement in UDVA, CDVA, K readings, spherical equivalent (SE), and manifest sphere and cylinder (P < 0.05 for all comparisons). UDVA was significantly improved from 1.14 ± 0.27 to 0.30 ± 0.21 LogMAR (P = 0.001), CDVA was also improved from 0.52 ± 0.23 to 0.18 ± 0.12 LogMAR (P = 0.001), SE was decreased by 4.35 diopters (D) and average keratometric values were reduced by 2.34 D (P = 0.001). Overall, 81% of subjects were moderately to highly satisfied 3 years after surgery and 64.90% agreed to have the fellow eye implanted with MyoRing. Conclusion: MyoRing implantation using the Pocket Maker microkeratome was found to be a minimally invasive procedure for improving visual acuity and refraction in the majority of the patients with keratoconus. PMID:27195081

  15. Impacts of anemia on 3-year ischemic events in patients undergoing percutaneous coronary intervention: a propensity-matched study

    PubMed Central

    Wang, Xiaoyan; Qiu, Miaohan; Li, Jing; Wang, Heyang; Qi, Jing; Wang, Geng; Xu, Kai; Liu, Haiwei; Zhao, Xin; Jing, Quanmin; Han, Yaling

    2015-01-01

    Background Anemia correlates with worse outcomes in patients undergoing percutaneous coronary intervention (PCI), improved anemia can improve the outcomes in patients who underwent PCI. But the influence of anemia on long-term ischemic events after PCI remains unknown. Methods We analyzed 8,825 consecutive patients who underwent PCI at General Hospital of Shenyang Military Region and identified 581 patients with anemia. Patients (anemia vs. no anemia) were compared using a propensity score analysis to best match between groups. The main outcome of this study is 3-year ischemic events after PCI, the secondary outcome of this study is 3-year mortality and major adverse cardiac events (MACE) after PCI. Results Compared with nonanemic patients, anemic patients were often female (38.90% vs. 14.51%) and elder patients (66.44% vs. 34.95%). Anemic patients have lower left ventricular ejection fraction (LVEF) and creatinine clearance (Ccr) and were more likely to have history of cardiovascular and cerebrovascular diseases, hypertension, peripheral vascular diseases (PVD) (P<0.05). However, the prevalences of diabetes and hyperlipidemia were lower in anemic patients (P<0.01). Anemia was an independent predictor for 3-year ischemic events [hazard ratio (HR): 2.20, 95% confidence intervals (CI): 1.61-3.00, P<0.01], 3-year mortality (HR: 3.58, 95% CI: 1.75-7.32, P<0.01) and 3-year MACE (HR: 2.14, 95% CI: 1.64-2.79, P<0.01) after PCI in post-match samples. The incidence of 3-year ischemic events was 41.0% and 19.3% in anemic and nonanemic patients, respectively. Conclusions Anemia is an independent predictor for 3-year ischemic events, 3-year mortality and 3-year MACE in patients who underwent PCI. Further studies need to explore the impact of the pathogenesis and progress, prevention and therapy of anemia on the outcome of patients undergoing PCI. PMID:26716033

  16. [Anemia management in French hemodialysis patients: DiaNE study results at 3 years (DiaNE2)].

    PubMed

    Kessler, Michèle; Landais, Paul; Bataille, Pierre; Yver, Laurent; Koné, Sébastien; Kraemer, Sandrine; Brillet, Georges; Canivet, Eric

    2011-06-01

    The observational study DiaNE provides a current state of anemia management with Epoetine bêta in hemodialysis patients regarding European recommendations over a 3-year period in France. Patients still treated with Epoetine bêta twelve months after their inclusion in DiaNE were eligible for a 24-month extension phase entitled DiaNE 2. Data regarding 439 patients followed during three years, from M0 to M36, were analyzed. Hemoglobin (Hb) level of the cohort remained over the target value of 11g/dL during the study (M0: 11.3±1.2g/dL; M36: 11.8±1.3g/dL). The anemia management had evolved with European recommendations updates and was in accordance with the last recommended target range (11-12g/dL) in a third of patients. During the follow-up, the majority of patients (97%) had at least one modification of treatment with Epoetine bêta (change in frequency of injections, adjustment of doses) mainly justified by excursion of Hb level out of the target range. However, the median dose of Epoetine bêta was relatively stable. The number of patients with iron treatment remained stable (60%). In spite of undertaken efforts, anemia management of hemodialysed patients in France still needs optimization for maintaining Hb level in the recommended target range. PMID:21227765

  17. 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

  18. Thyrotoxicosis after a massive levothyroxine ingestion in a 3-year-old patient.

    PubMed

    Hays, Hannah L; Jolliff, Heath A; Casavant, Marcel J

    2013-11-01

    Most children with exploratory levothyroxine ingestions remain asymptomatic or suffer only minor effects, and most patients can be managed in the home or with supportive care in the hospital. We present a case of a 3-year-old girl who was found after a witnessed massive ingestion of levothyroxine. The patient was initially seen in an emergency department and discharged in stable condition, only to return 4 days after ingestion with thyrotoxicosis, hypertension, tachycardia, 24 hours of persistent vomiting, and clinical and laboratory evidence of dehydration. On the day of hospital admission, her thyroid-stimulating hormone was 0.018 µIU/mL (reference range, 0.6-4.5 µIU/mL); free T4 (tetraiodothyronine) was greater than 6.0 ng/dL (reference range, 0.7-2.1 ng/dL); and T3 (triiodothyronine) total was 494 ng/dL (reference range, 100-200 ng/dL). During a 3-day hospital admission, she was managed with supportive care, including intravenous fluid rehydration and antiemetics, and was ultimately discharged in good condition. The patient was followed up until 2 months after ingestion and remained asymptomatic. Although most exploratory levothyroxine ingestions suffer little to no clinical effects, serious symptoms can occur. Because serious symptoms can occur in a delayed fashion, it is important for clinicians to give proper anticipatory guidance regarding home symptom monitoring, follow-up, and reasons to return to the emergency department when patients present for medical evaluation. PMID:24196094

  19. 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

  20. Influence of Shared Medical Appointments on Patient Satisfaction: A Retrospective 3-Year Study

    PubMed Central

    Heyworth, Leonie; Rozenblum, Ronen; Burgess, James F.; Baker, Errol; Meterko, Mark; Prescott, Debra; Neuwirth, Zeev; Simon, Steven R.

    2014-01-01

    PURPOSE Shared medical appointments (SMAs) are becoming popular, but little is known about their association with patient experience in primary care. We performed an exploratory analysis examining overall satisfaction and patient-centered care experiences across key domains of the patient-centered medical home among patients attending SMAs vs usual care appointments. METHODS We undertook a cross-sectional study using a mailed questionnaire measuring levels of patient satisfaction and other indicators of patient-centered care among 921 SMA and 921 usual care patients between 2008 and 2010. Propensity scores adjusted for potential case mix differences between the groups. Multivariate logistic regression assessed propensity-matched patients’ ratings of care. Generalized estimating equations accounted for physician-level clustering. RESULTS A total of 40% of SMA patients and 31% of usual care patients responded. In adjusted analyses, SMA patients were more likely to rate their overall satisfaction with care as “very good” when compared with usual care counterparts (odds ratio = 1.26; 95% CI, 1.05–1.52). In the analysis of patient-centered medical home elements, SMA patients rated their care as more accessible and more sensitive to their needs, whereas usual care patients reported greater satisfaction with physician communication and time spent during their appointment. CONCLUSIONS Overall, SMA patients appear more satisfied with their care relative to patients receiving usual care. SMAs may also improve access to care and deliver care that patients find to be sensitive to their needs. Further research should focus on enhancing patient-clinician communication within an SMA as this model of care becomes more widely adopted. PMID:25024240

  1. Unicystic ameloblastoma in 3 year old paediatric patient – A rare entity

    PubMed Central

    Kumar, Priya; Urs, Aadithya B.; Augustine, Jeyaseelan

    2013-01-01

    Unicystic ameloblastoma (UA) is a benign epithelial odontogenic tumor of the jaws that commonly occurs in 2nd and 3rd decade of life. In fact, this entity is rare in children under 12 years of age. It is characterised as a distinct variant of ameloblastoma, exhibiting a less aggressive behaviour and a lower rate of recurrence than solid conventional ameloblastoma. There are very few reported cases of UA occurring in children below five years of age. The purpose of this case report is to describe a case of UA involving the crown of an unerupted maxillary second premolar in a 3 year old girl. The pathogenesis, clinical appearance, radiographic presentation, histological findings and management of the tumour have also been discussed. PMID:24455052

  2. Coronary revascularization in diabetic patients. A focus on the 3-year SYNTAX trial outcomes.

    PubMed

    Groot, M W; Head, S J; Bogers, Ad J J C; Kappetein, A P

    2012-05-01

    The prevalence of diabetes is growing worldwide. Diabetics are predisposed to coronary artery disease due to an increased rate of atherosclerosis. The optimal treatment for these patients remains uncertain. Randomized trials compared percutaneous coronary intervention (PCI) to coronary artery bypass surgery (CABG) to determine the most suitable revascularization strategy. Meta-analyses suggest a survival advantage in favor of surgery over angioplasty or stenting with bare-metal stents (BMS). New evidence was needed since advances in medical therapy, PCI technology, and surgical techniques have emerged. The Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial was the first to compare a drug-eluting stent to CABG and showed an increased rate of major adverse cardiac or cerebrovascular events after PCI. Results are mainly driven by the increased rates in patients with high lesion complexity; therefore, the current evidence suggests that diabetic patients with complex coronary disease have better outcomes with CABG. PMID:22430286

  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. PMID:15374173

  4. Gallstone Obstructive Ileus 3 Years Post-cholecystectomy to a Patient with an Old Ileoileal Anastomosis

    PubMed Central

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

    2009-01-01

    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. PMID:19949687

  5. Gastrointestinal stromal tumor of the stomach in a child with a 3-year follow-up period-Case report.

    PubMed

    Miranda, Marcelo Eller; Alberti, Luiz Ronaldo; Tatsuo, Edson Samesima; Piçarro, Clécio; Rausch, Marcelo

    2011-01-01

    We report a case of a nine-year-old boy with a 4-week history of general fatigue, loss of appetite, vomits and hematemesis. Laboratory evaluation revealed a hemoglobin level of 4.4 g/dl. After a transfusion of packed red blood cells the patient underwent an esophagogastroduodenoscopy, which showed a smooth, rounded 6-8 cm submucosal lesion with a central depression with ulceration and active bleeding in the cardia extending to the fundus.Computed tomography (CT) of the chest, abdomen and pelvis showed a large mass originating from the gastric wall but not infiltrating surrounding organs, approximately 8.0 cm × 7.0 cm × 5 cm. Despite the tumor size, no metastases were diagnosed. The patient underwent a total gastrectomy in an en-bloc resection including the distal part of the esophagus (3 cm) and omentum with oncologic margins. Reconstruction was performed with a mediastinal end-to-side esophago-jejunal anastomosis. Immunehistochemic confirmed GIST. He remains well without evidence of disease after 36 months of follow-up with a multiprofessional team. PMID:22096700

  6. 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. PMID:22749243

  7. 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

    2016-04-01

    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. PMID:27089364

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

    PubMed Central

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

    2016-01-01

    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. PMID:27089364

  9. Operative management of traumatic cervical spine distraction and complete cord transection in a 3-year-old patient.

    PubMed

    Davern, Monica Salazar; Garg, Sumeet; Hankinson, Todd C

    2015-02-01

    This report describes the presentation and operative treatment of a 3-year-old boy who survived a motor vehicle accident that resulted in a C6-7 distraction injury, complete avulsion of the spinal cord, and gross spinal instability. Only 5%-10% of all spinal cord and vertebral column injuries occur in children. Survival after such an injury is exceptionally rare in very young patients and is associated with severe neurological deficits. The authors discuss the substantial ethical challenges involved in the care of a patient with this injury. To their knowledge, only two other cases of survival have been reported in pediatric patients following motor vehicle trauma resulting in complete injury to the lower cervical spinal cord. PMID:25415253

  10. 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

  11. Stress Hyperglycaemia in Hospitalised Patients and Their 3-Year Risk of Diabetes: A Scottish Retrospective Cohort Study

    PubMed Central

    McAllister, David A.; Hughes, Katherine A.; Lone, Nazir; Mills, Nicholas L.; Sattar, Naveed; McKnight, John; Wild, Sarah H.

    2014-01-01

    Background Hyperglycaemia during hospital admission is common in patients who are not known to have diabetes and is associated with adverse outcomes. The risk of subsequently developing type 2 diabetes, however, is not known. We linked a national database of hospital admissions with a national register of diabetes to describe the association between admission glucose and the risk of subsequently developing type 2 diabetes. Methods and Findings In a retrospective cohort study, patients aged 30 years or older with an emergency admission to hospital between 2004 and 2008 were included. Prevalent and incident diabetes were identified through the Scottish Care Information (SCI)-Diabetes Collaboration national registry. Patients diagnosed prior to or up to 30 days after hospitalisation were defined as prevalent diabetes and were excluded. The predicted risk of developing incident type 2 diabetes during the 3 years following hospital discharge by admission glucose, age, and sex was obtained from logistic regression models. We performed separate analyses for patients aged 40 and older, and patients aged 30 to 39 years. Glucose was measured in 86,634 (71.0%) patients aged 40 and older on admission to hospital. The 3-year risk of developing type 2 diabetes was 2.3% (1,952/86,512) overall, was <1% for a glucose ≤5 mmol/l, and increased to approximately 15% at 15 mmol/l. The risks at 7 mmol/l and 11.1 mmol/l were 2.6% (95% CI 2.5–2.7) and 9.9% (95% CI 9.2–10.6), respectively, with one in four (21,828/86,512) and one in 40 (1,798/86,512) patients having glucose levels above each of these cut-points. For patients aged 30–39, the risks at 7 mmol/l and 11.1 mmol/l were 1.0% (95% CI 0.8–1.3) and 7.8% (95% CI 5.7–10.7), respectively, with one in eight (1,588/11,875) and one in 100 (120/11,875) having glucose levels above each of these cut-points. The risk of diabetes was also associated with age, sex, and socio-economic deprivation, but not with specialty (medical versus

  12. Younger adults with acute myeloid leukemia in remission for ≥3 years have a high likelihood of cure: the ECOG experience in over 1200 patients

    PubMed Central

    Watts, Justin M.; Wang, Xin Victoria; Litzow, Mark R.; Luger, Selina M.; Lazarus, Hillard M.; Cassileth, Peter A.; Fernandez, Hugo F.; Douer, Dan; Zickl, Lynette; Paietta, Elisabeth; Rowe, Jacob M.; Tallman, Martin S.

    2015-01-01

    We examined 1229 younger patients with acute myeloid leukemia who achieved CR1 on Eastern Cooperative Oncology Group trials. We defined late relapse as occurring after ≥3 years of CR1. With median follow-up of 11.3 years, there were 14 late relapses (1.1% of CR1 patients; 3.3% of 3-year CR1 patients). Eight achieved second CR and median overall survival after late relapse was 3.2 years. Most patients tested (9/11) had a normal karyotype at diagnosis; none had new cytogenetic abnormalities at relapse. Late relapse is rare and nearly all 3-year CR1 patients are cured. If late relapse occurs, outcomes are relatively favorable. PMID:24986381

  13. 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

  14. Population Pharmacokinetics Analysis To Inform Efavirenz Dosing Recommendations in Pediatric HIV Patients Aged 3 Months to 3 Years

    PubMed Central

    Luo, Man; Chapel, Sunny; Sevinsky, Heather; Savant, Ishani; Cirincione, Brenda; Bertz, Richard

    2016-01-01

    Efavirenz (EFV) is a nonnucleoside reverse transcriptase inhibitor approved worldwide for the treatment of HIV in adults and children over 3 years of age or weighing over 10 kg. Only recently EFV was approved in children over 3 months and weighing at least 3.5 kg in the United States and the European Union. The objective of this analysis was to support the selection of an appropriate dose for this younger pediatric population and to explore the impact of CYP2B6 genetic polymorphisms on EFV systemic exposures. A population pharmacokinetic (PPK) model was developed using data from three studies in HIV-1-infected pediatric subjects (n = 168) and one study in healthy adults (n = 24). The EFV concentration-time profile was best described by a two-compartment model with first-order absorption and elimination. Body weight was identified as a significant predictor of efavirenz apparent clearance (CL), oral central volume of distribution (VC), and absorption rate constant (Ka). The typical values of efavirenz apparent CL, VC, oral peripheral volume of distribution (VP), and Ka for a reference pediatric patient were 4.8 liters/h (4.5 to 5.1 liters/h), 84.9 liters (76.8 to 93.0 liters), 287 liters (252.6 to 321.4 liters), and 0.414 h−1 (0.375 to 0.453 h−1), respectively. The final model was used to simulate steady-state efavirenz concentrations in pediatric patients weighing <10 kg to identify EFV doses that produce comparable exposure to adult and pediatric patients weighing ≥10 kg. Results suggest that administration of EFV doses of 100 mg once daily (QD) to children weighing ≥3.5 to <5 kg, 150 mg QD to children weighing ≥5 to <7.5 kg, and 200 mg QD to children weighing ≥7.5 to <10 kg produce exposures within the target range. Further evaluation of the impact of CYP2B6 polymorphisms on EFV PK showed that the identification of CYP2B6 genetic status is not predictive of EFV exposure and thus not informative to guide pediatric dosing regimens. PMID:27067333

  15. Population Pharmacokinetics Analysis To Inform Efavirenz Dosing Recommendations in Pediatric HIV Patients Aged 3 Months to 3 Years.

    PubMed

    Luo, Man; Chapel, Sunny; Sevinsky, Heather; Savant, Ishani; Cirincione, Brenda; Bertz, Richard; Roy, Amit

    2016-06-01

    Efavirenz (EFV) is a nonnucleoside reverse transcriptase inhibitor approved worldwide for the treatment of HIV in adults and children over 3 years of age or weighing over 10 kg. Only recently EFV was approved in children over 3 months and weighing at least 3.5 kg in the United States and the European Union. The objective of this analysis was to support the selection of an appropriate dose for this younger pediatric population and to explore the impact of CYP2B6 genetic polymorphisms on EFV systemic exposures. A population pharmacokinetic (PPK) model was developed using data from three studies in HIV-1-infected pediatric subjects (n = 168) and one study in healthy adults (n = 24). The EFV concentration-time profile was best described by a two-compartment model with first-order absorption and elimination. Body weight was identified as a significant predictor of efavirenz apparent clearance (CL), oral central volume of distribution (VC), and absorption rate constant (Ka). The typical values of efavirenz apparent CL, VC, oral peripheral volume of distribution (VP), and Ka for a reference pediatric patient were 4.8 liters/h (4.5 to 5.1 liters/h), 84.9 liters (76.8 to 93.0 liters), 287 liters (252.6 to 321.4 liters), and 0.414 h(-1) (0.375 to 0.453 h(-1)), respectively. The final model was used to simulate steady-state efavirenz concentrations in pediatric patients weighing <10 kg to identify EFV doses that produce comparable exposure to adult and pediatric patients weighing ≥10 kg. Results suggest that administration of EFV doses of 100 mg once daily (QD) to children weighing ≥3.5 to <5 kg, 150 mg QD to children weighing ≥5 to <7.5 kg, and 200 mg QD to children weighing ≥7.5 to <10 kg produce exposures within the target range. Further evaluation of the impact of CYP2B6 polymorphisms on EFV PK showed that the identification of CYP2B6 genetic status is not predictive of EFV exposure and thus not informative to guide pediatric dosing regimens. PMID:27067333

  16. 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.

  17. 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

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

    2016-01-01

    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

  18. Toxicology findings in cases of hanging in the City and County of San Francisco over the 3-year period from 2011 to 2013.

    PubMed

    San Nicolas, A C; Lemos, N P

    2015-10-01

    In postmortem cases where the cause of death is hanging, toxicological analyses may be considered unnecessary by some medical examiners, toxicologists, and other persons involved in medico-legal investigations because the cause of death seems "obvious." To ascertain if toxicological analyses are necessary when the cause of death is hanging, all 102 hanging cases (25 females; 77 males) from 2011 to 2013 that came under the jurisdiction of the San Francisco Office of the Chief Medical Examiner were examined from a total of 3912 sudden, unexpected, or violent death cases in the same period. Suicide was the manner of death in 99 of these cases, with two accidental and one undetermined death. The average age of decedents was 43.9 years (median 41), the youngest was an 11-year old male and the oldest was an 86-year old female. Of the 102 cases, 33 had negative toxicology while 69 cases had at least one positive toxicology result. Females were equally likely to have negative or positive results (12 and 13 cases respectively), but males were 37.5% more likely to have positive toxicology (n=56) rather than negative toxicology (n=21). For females, alcohol, mirtazapine, venlafaxine, and trazodone were the top psychoactive substances in peripheral blood while THC, cocaine, hydrocodone, bupropion, olanzapine, doxylamine, quetiapine and dextromethorphan were also reported. For males, alcohol, THC, cocaine, amphetamine, methamphetamine, bupropion, and diphenhydramine were the top psychoactive substances in blood, but several other drugs were also found in individual cases. Our study of hanging cases over a 3-year period support the idea that complete postmortem toxicology investigation of hangings should be performed, even when the "obvious" cause of death is asphyxia due to hanging. Many of these cases involved psychoactive substances (most often alcohol and cannabis), and having such knowledge provides a better understanding of the circumstances surrounding the decedent's death

  19. 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

  20. 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…

  1. 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...

  2. 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

  3. 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. PMID:26337619

  4. 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

  5. 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

  6. Increased Immunoendocrine Cells in Intestinal Mucosa of Postinfectious Irritable Bowel Syndrome Patients 3 Years after Acute Shigella Infection - An Observation in a Small Case Control Study

    PubMed Central

    Kim, Hee Sun; Lim, Jung Hyun; Lee, Sang In

    2010-01-01

    Purpose Postinfectiously irritable bowel syndrome (PI-IBS) develops in 3-30% of individuals with bacterial gastroenteritis. Recent studies demonstrated increases in inflammatory components in gut mucosa of PI-IBS patients even after complete resolution of infection. We aimed to investigate histological changes in colon and rectum of PI-IBS subjects after long term period of infection. Materials and Methods We recruited PI-IBS subjects who had been diagnosed IBS after complete resolution of enteritis caused by shigellosis outbreak 3 years earlier. We compared unmatched four groups, PI-IBS (n = 4), non PI-IBS (n = 7), D-IBS (n = 7, diarrhea predominant type) and healthy controls (n = 10). All of them underwent colonoscopic biopsy at three areas, including descending colon (DC), sigmoid colon (SC) and rectum, which were assessed for 5-hydroxytryptamine (5-HT)/peptide YY (PYY)-containing enterochromaffin (EC) cell, intraepithelial (IEL) and lamina propria T lymphocyte (CD3), CD8 lymphocytes, mast cells and CD68/calprotectin+ macrophages. Results All subjects had no structural or gross abnormalities at colonoscopy. In PI-IBS, 5-HT containing EC cells, PYY containing EC cells, IELs, CD3 lymphocytes, CD8 lymphocytes, mast cells, and CD68 + macrophages were increased compared to control (p < 0.05). In D-IBS, PYY containing EC cells, IELs, and CD3 lymphocytes were increased compared to control (p < 0.05). In PI-IBS, 5-HT containing EC cells tended to increase and PYY containing EC cells, CD8 lymphocytes, mast cells, and CD68+ macrophages were increased compared to non PI-IBS (p < 0.05). Calprotectin + marcrophages were decreased in PI-IBS, non PI-IBS and IBS compared to control. Conclusion The immunoendocrine cells were sporadically increased in PI-IBS, non PI-IBS and D-IBS compared with control. Our findings in a very small number of patients suggest that mucosal inflammation may play a role in long-term PI-IBS, and that other sub-groups of IBS and larger scale studies are

  7. 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

  8. 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. PMID:24600653

  9. 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. PMID:25993254

  10. Thyrotoxic periodic paralysis in a pediatric patient.

    PubMed

    Jones, Peter; Papadimitropoulos, Laura; Tessaro, Mark O

    2014-01-01

    Thyrotoxic periodic paralysis is a reversible metabolic disorder that is characterized by acute muscle weakness and hypokalemia. It predominantly affects males of Asian descent. We describe the youngest such patient yet reported, a 13-year-old Asian male with a history of transient attacks of weakness who presented to our emergency department with weakness in his extremities and mild tachycardia. Laboratory test results initially revealed marked hypokalemia and later confirmed associated hyperthyroidism. Correction of the hypokalemia reversed the patient's weakness in the emergency department. PMID:24378858

  11. A 3-year follow-up study of β-cell function in patients with early-onset type 2 diabetes

    PubMed Central

    Zhou, Shaoling; Meng, Xiaomei; Wang, Shuyan; Ren, Ruizhen; Hou, Weikai; Huang, Kuixiang; Shi, Hongli

    2016-01-01

    Insulin resistance and reduced β-cell glucose sensitivity are present in patients with type 2 diabetes. In the present study, we investigated the changes in β-cell function in patients with type 2 diabetes during a 3-year follow-up study. A total of 48 patients with early-onset type 2 diabetes (EOD) and 55 patients with late-onset type 2 diabetes (LOD) were enrolled. Weight, height, waist circumference, hip circumference, blood pressure and plasma levels of lipids, glucose, fasting serum C-peptide (CPR0) and serum C-peptide 6 min after glucagon stimulation (CPR6) were measured. In addition, islet β-cell secretory activity was detected. Subjects with EOD had lower Systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), fasting CPR0, CPR6 and greater glycated hemoglobin A1c (HbA1c), triglyceride (TG) compared with subjects with LOD. CPR0, CPR6 and TG were decreased in both EOD and LOD groups 3 years later. The ratio of β-cell function failure was 29.17 and 10.91% in the EOD and LOD groups, respectively, and there was significant difference between the two groups. A positive correlation was identified between the CPR0 and waist-hip ratio, HbA1c in the EOD group. A similar positive correlation was observed between CPR0 and BMI in the LOD group. Collectively, islet β-cell function has declined in patients with EOD, and this change may be more evident when compared with those with LOD. PMID:27446326

  12. Thyrotoxic periodic paralysis in Caucasian patients: a diagnostic challenge.

    PubMed

    Pichon, Bertrand; Lidove, Olivier; Delbot, Thierry; Aslangul, Elisabeth; Hausfater, Pierre; Papo, Thomas

    2005-09-01

    Secondary hypokalemic periodic paralysis is rare. However, when it occurs, it is usually associated with Graves' disease and it is mostly diagnosed in Asiatic male patients. In this report, we analyze the diagnostic procedure in three cases of hypokalemic periodic paralysis associated with Graves' disease, diagnosed in three different emergency care units over the last 3 years. Three Caucasian men (26, 30, and 39 years of age) came to the emergency care unit for acute tetraparesia. One of them had suffered 15 stereotypical episodes of tetraparesia during the last 2 years. Goiter was present in each case. Kalemia was 1.8, 2.1, and 3 mmol/l, respectively. Triggering events such as considerable sugar intake and physical exercise were present in two cases. In all cases, low TSH levels, high FT4 levels, and anti-TSH receptor antibodies led to the diagnosis of Graves' disease. All patients were treated with potassium supplementation and neomercazole. Outcome was good with a follow-up of 6, 9, and 24 months, respectively. Emergency care practitioners should be aware of this diagnosis, which may affect Caucasian patients presenting with transient tetraparesia in a primary care unit. PMID:16137557

  13. Sexual behaviors over a 3-year period among individuals with advanced HIV/AIDS receiving antiretroviral therapy in an urban HIV clinic in Kampala, Uganda

    PubMed Central

    Wandera, Bonnie; Kamya, Moses R.; Castelnuovo, Barbara; Kiragga, Agnes; Kambugu, Andrew; Wanyama, Jane N; Easterbrook, Philippa; Sethi, Ajay K.

    2011-01-01

    Background Few studies have prospectively examined sexual behaviors of HIV-infected person on antiretroviral therapy (ART) in Sub-Saharan Africa. Methods From 2004 to 2005, 559 HIV-infected, ART-naïve individuals initiating ART at an HIV clinic in Kampala, Uganda were enrolled into a prospective study and followed to 2008. Clinical and sexual behavior information was assessed at enrollment and semi-annually for three years after ART initiation. Using log-binomial regression models, we estimated prevalence ratios (PRs) to determine factors associated with being sexually active and having unprotected sex over three-years after initiating ART. Results 559 adults contributed 2,594 person-visits of follow-up. At the time of ART initiation, 323 (57.9%) were sexually active of which 176 (54.5%) had unprotected sex at last sexual intercourse. Majority (63.4%) of married individuals were unaware of their partner’s HIV status. Female gender (PR=2.97; 95% CI: 1.85, 4.79), being married (PR=1.48; 95% CI: 1.06, 2.06), and reporting unprotected sex prior to ART (PR=1.68; 95% CI: 1.16, 2.42) were among factors independently associated with unprotected sex while on ART. Overall, 7.3% of visit intervals of unprotected sex, 1.0% of intervals of sexual activity, occurred when plasma viral load >1,500 copies/ml, representing periods of greater HIV transmission risk. Conclusions Although unprotected sex reduced over time, women reported unprotected sex more often than men. Disclosure of HIV status was low. Integration of comprehensive prevention programs into HIV care is needed, particularly ones specific for women. PMID:21297481

  14. Developmental milestones record - 3 years

    MedlinePlus

    Normal childhood growth milestones - 3 years; Growth milestones for children - 3 years; Childhood growth milestones - 3 years ... provider. Physical and motor milestones for a typical 3-year-old include: Gains about 4 - 5 pounds ...

  15. A 3-year experience with Molecular Adsorbent Recirculating System (MARS): our results on 63 patients with hepatic failure and color Doppler US evaluation of cerebral perfusion.

    PubMed

    Novelli, Gilnardo; Rossi, Massimo; Pretagostini, Renzo; Novelli, Luigi; Poli, Luca; Ferretti, Giancarlo; Iappelli, Massimo; Berloco, Pasquale; Cortesini, Raffaello

    2003-01-01

    In our 3-year experience, we treated 63 patients with Molecular Adsorbent Recirculating System (MARS). The patients were divided as follows: 10 primary non-function (PNF) 16%, 10 delayed non-function (DNF) 16%, 16 Fulminant hepatitis (FH) 24%, 23 acute decompensation of chronic liver disease (ACLF) 38%, and 4 hepatic resection 6%. All patients who underwent MARS treatment had bilirubin >15 mg/dL, Glasgow Coma Score between 9 and 11, ammonium >160 microg/dL and non-coagulability. The determining factors taken into consideration for the continuation of MARS treatment were: an improvement in Glasgow Coma Score, and a decrease in ammonium and bilirubin. We also monitored hemodynamic parameters, acid-base equilibrium, and blood gas analysis before and after each treatment. In order to determine patients' neurological conditions, we not only took into account the Glasgow Coma Score, which does not give mathematically precise results but also took into account the fact that patients with hepatic coma had lower cerebral mean velocity in the cerebral arteries than patients without encephalopathy. For this reason, in the last 22 patients we monitored cerebral perfusion, determined by mean flow velocity (Vmean) in the middle cerebral artery. Our results were expressed as mean +/- SD and we analyzed the differences between mean values for each variable, before and after treatment by means of Student's t-test. At the end of treatment, we obtained significant P-values for bilirubin, ammonium, Glasgow Coma Score and creatinine. In 16/20 patients, we could demonstrate a clear correlation between the improvement in clinical conditions (especially neurological status) and improvement in cerebral perfusion, measured by color Doppler US. PMID:12950955

  16. The influence of immediate complete anterior guidance development technique on subjective symptoms in Myofascial pain patients: Verified using digital analysis of occlusion (Tek-scan) for analysing occlusion: A 3 years clinical observation

    PubMed Central

    Thumati, Prafulla

    2015-01-01

    Objectives: The purpose of this study is to evaluate the effect of occlusal equilibration using immediate complete anterior guidance development (ICAGD) technique by Kerstein and Farrell on the subjective symptoms of myofascial pain. This technique is the most advanced verifiable and measurable way of digitally analyzing the occlusion using T-scan technology. The primary objective is to reduce the anterior disclusion time to <0.4 s and the secondary objective is to reduce the signs and symptoms of myofascial pain. Materials and Methods: This study is to assess the reducing effects of subjective symptoms of 100 patients diagnosed as myofascial pain patients treated by ICAGD technique as described by Kerstein and Farrell. The common complaints of the patients were a pain in the masseter and temporal muscles, jaw tiredness in the mornings, night bruxing and difficulty in chewing. In this technique occlusal equilibration involves removal of posterior interferences and establish anterior guidance. The patients were treated over three visits 1-week apart and followed for 3 years with an interval of 3 months for the subsequent visits. A visual analog ordinal scale is used to rate the symptoms. The symptoms reduction occurred for all the patients after the first correction in about 5–10 days. In about a period of 3 years review, no recurrence was seen of the chronic myofascial symptoms. Results: In spite of the chronic nature of the patient's symptoms, symptom reduction occurred in a week's time. This was assessed by the results of the ordinal scale values. This agrees with the studies of Kerstein and Farrell. Conclusion: Equilibration of occlusion using digital analysis by T-scan in which force is quantified against time, should be done to establish free functional movements without any interference; otherwise the disturbances in the excursive movements may lead to muscle dysfunction at later years. PMID:26929516

  17. 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

  18. 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

    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

  19. 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

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

    PubMed

    Normann-Eide, Eivind; Johansen, Merete Selsbakk; Normann-Eide, Tone; Egeland, Jens; Wilberg, Theresa

    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

  1. Incidence and Prevalence of Major Central Nervous System Involvement in Systemic Lupus Erythematosus: A 3-Year Prospective Study of 370 Patients

    PubMed Central

    Kampylafka, Eleni I.; Alexopoulos, Haralampos; Kosmidis, Michalis L.; Panagiotakos, Demosthenes B.; Vlachoyiannopoulos, Panayiotis G.; Dalakas, Marinos C.; Moutsopoulos, Haralampos M.; Tzioufas, Athanasios G.

    2013-01-01

    Background The incidence and prevalence of CNS involvement in SLE remains unclear owing to conflicting results in the published studies. The aim of the study was to evaluate the incidence and prevalence of major definite CNS events in SLE patients. Methods 370 SLE patients with no previous history of CNS involvement were prospectively evaluated in a tertiary hospital referral center for 3 years. Major CNS manifestations were codified according to ACR definitions, including chorea, aseptic meningitis, psychosis, seizures, myelopathy, demyelinating syndrome, acute confusional state and strokes. Minor CNS events were excluded. ECLAM and SLEDAI-SELENA Modification scores were used to evaluate disease activity and SLICC/ACR Damage Index was used to assess accumulated damage. Results 16/370 (4.3%) patients presented with a total of 23 major CNS events. These included seizures (35%), strokes (26%), myelopathy (22%), optic neuritis (8.7%), aseptic meningitis (4.3%) and acute psychosis (4.3%). Incidence was 7.8/100 person years. Among hospitalizations for SLE, 13% were due to CNS manifestations. Epileptic seizures were associated with high disease activity, while myelopathy correlated with lower disease activity and NMO-IgG antibodies (P≤0.05). Stroke incidence correlated with APS coexistence (P = 0.06). Overall, CNS involvement correlated with high ECLAM and SLEDAI scores (P<0.001). Conclusions Clinically severe CNS involvement is rare in SLE patients, accounting for 7.8/100 person years. CNS involvement correlates with high disease activity and coexistence of specific features that define the respective CNS syndromes. PMID:23424638

  2. TRMM 3-Year Anniversary

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Ever wonder about the rain? Beyond the practicality of needing an umbrella, climate researchers have wondered about the science of rainfall for a long time. But it's only in the past few years that they've begun to roll back some of its secrets. One of their tools for doing so is a powerful satellite called the Tropical Rainfall Measuring Mission, or TRMM. Now, after three years of continual operation, project scientists have released dramatic new maps of rainfall patterns gathered across a wide band of the Earth. And with measurements from one of the satellite's advanced sensors, meteorologists are now able to calibrate ground-based rain monitoring systems with greater precision than ever before. A complete accounting of the world's total rainfall has long been a major goal of climate researchers. Rain acts as the atmosphere's fundamental engine for heat exchange; every time a raindrop falls, the atmosphere gets churned up and latent heat flows back into the total climate system. Considering that rainfall is the primary driving force of heat in the atmosphere, and that two thirds of all rain falls in the tropics, these measurements are significant for our understanding of overall climate. The above image shows a one month average of rainfall measurements taken by the TRMM's unique precipitation radar during January of 1998. Areas of low rainfall are colored light blue, while regions with heavy rainfal are colored orange and red. TRMM began collecting data in December of 1997, and continues today. For more information about TRMM's 3-year anniversary, read Maps of Falling Water To learn more about the TRMM mission or order TRMM data, see the TRMM Home Page. Image courtesy TRMM Science team and the NASA GSFC Scientific Visualization Studio.

  3. PSA Bounce and Biochemical Failure After Brachytherapy for Prostate Cancer: A Study of 820 Patients With a Minimum of 3 Years of Follow-Up

    SciTech Connect

    Caloglu, Murat; Ciezki, Jay P.; Reddy, Chandana A.; Angermeier, Kenneth; Ulchaker, James; Chehade, Nabil; Altman, Andrew; Magi-Galuzzi, Christina; Klein, Eric A.

    2011-07-01

    Purpose: To determine clinical or dosimetric factors associated with a prostate-specific antigen (PSA) bounce, as well as an association between a PSA bounce and biochemical relapse-free survival (bRFS), in patients treated with iodine-125 brachytherapy. Methods and Materials: A variety of clinical and treatment factors were examined in 820 patients who had a minimum of 3 years of PSA follow-up with T1-T2cN0M0 prostate cancer. Four different PSA threshold values were used for defining a PSA bounce: a PSA rise of {>=}0.2, {>=}0.4, {>=}0.6, and {>=}0.8 ng/mL. Results: A PSA bounce of {>=}0.2, {>=}0.4, {>=}0.6, and {>=}0.8 ng/mL was noted in 247 patients (30.1%), 161 (19.6%), 105 (12.8%), and 78 (9.5%), respectively. The median time to the first PSA rise was 17.4, 16.25, 16.23, and 15.71 months, respectively, vs. 34.35 months for a biochemical failure (p < 0.0001). A PSA rise of {>=}0.2 ng/mL was the only definition for which there was a significant difference in bRFS between bounce and non-bounce patients. The 5-year bRFS rate of patients having a PSA bounce of {>=}0.2 was 97.7% vs. 91% for those who did not have a PSA bounce (p = 0.0011). On univariate analysis for biochemical failure, age, risk group, and PSAs per year had a statistically significant correlation with PSA bounce of {>=}0.2 ng/mL. On multivariate analysis, age and PSAs per year remained statistically significant (p < 0.0001 and p = 0.0456, respectively). Conclusions: A bounce definition of a rise {>=}0.2 ng/mL is a reliable definition among several other definitions. The time to first PSA rise is the most valuable factor for distinguishing between a bounce and biochemical failure.

  4. 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

  5. [The mechanical properties of the lungs in patients with congenital heart defects in the immediate postoperative period].

    PubMed

    Zatevakhina, M V; Nikitin, E S; Tskhovrebov, S V; Makrushin, I M; Suvorova, G Iu; Safonova, E M

    1998-01-01

    Static compliance and inspiratory resistance were assessed in 218 patients aged over 3 years after open-heart surgery for correction of congenital heart disease during the immediate postoperative period without complications. Cst in the immediate postoperative period in patients with Fallot's tetralogy, intraventricular septum defect, intraatrial septum defect, and incomplete form of atrioventricular communication was higher than in patients operated on for Fallot's tetralogy with a previous systemic-pulmonary anastomosis and pulmonary artery atresia, whereas Rinsp was virtually the same in all groups. Age-specific differences were noted. The data are recommended for use as reference values in stress. PMID:9770809

  6. Efficacy, safety, and survival with ruxolitinib in patients with myelofibrosis: results of a median 3-year follow-up of COMFORT-I.

    PubMed

    Verstovsek, Srdan; Mesa, Ruben A; Gotlib, Jason; Levy, Richard S; Gupta, Vikas; DiPersio, John F; Catalano, John V; Deininger, Michael W N; Miller, Carole B; Silver, Richard T; Talpaz, Moshe; Winton, Elliott F; Harvey, Jimmie H; Arcasoy, Murat O; Hexner, Elizabeth O; Lyons, Roger M; Raza, Azra; Vaddi, Kris; Sun, William; Peng, Wei; Sandor, Victor; Kantarjian, Hagop

    2015-04-01

    In the phase III COMFORT-I study, the Janus kinase 1 (JAK1)/JAK2 inhibitor ruxolitinib provided significant improvements in splenomegaly, key symptoms, and quality-of-life measures and was associated with an overall survival benefit relative to placebo in patients with intermediate-2 or high-risk myelofibrosis. This planned analysis assessed the long-term efficacy and safety of ruxolitinib at a median follow-up of 149 weeks. At data cutoff, approximately 50% of patients originally randomized to ruxolitinib remained on treatment whereas all patients originally assigned to placebo had discontinued or crossed over to ruxolitinib. At week 144, mean spleen volume reduction was 34% with ruxolitinib. Previously observed improvements in quality-of-life measures were sustained with longer-term ruxolitinib therapy. Overall survival continued to favor ruxolitinib despite the majority of placebo patients crossing over to ruxolitinib [hazard ratio 0.69 (95% confidence interval: 0.46-1.03); P = 0.067]. Exploratory analyses suggest that crossover may have contributed to an underestimation of the true survival difference between the treatment groups. Ruxolitinib continued to be generally well tolerated; there was no pattern of worsening grade ≥ 3 anemia or thrombocytopenia with longer-term ruxolitinib exposure. These longer-term data continue to support the efficacy and safety of ruxolitinib in patients with myelofibrosis. The study is registered at clinicaltrials.gov: NCT00952289. PMID:25616577

  7. Efficacy, safety, and survival with ruxolitinib in patients with myelofibrosis: results of a median 3-year follow-up of COMFORT-I

    PubMed Central

    Verstovsek, Srdan; Mesa, Ruben A.; Gotlib, Jason; Levy, Richard S.; Gupta, Vikas; DiPersio, John F.; Catalano, John V.; Deininger, Michael W.N.; Miller, Carole B.; Silver, Richard T.; Talpaz, Moshe; Winton, Elliott F.; Harvey, Jimmie H.; Arcasoy, Murat O.; Hexner, Elizabeth O.; Lyons, Roger M.; Raza, Azra; Vaddi, Kris; Sun, William; Peng, Wei; Sandor, Victor; Kantarjian, Hagop

    2015-01-01

    In the phase III COMFORT-I study, the Janus kinase 1 (JAK1)/JAK2 inhibitor ruxolitinib provided significant improvements in splenomegaly, key symptoms, and quality-of-life measures and was associated with an overall survival benefit relative to placebo in patients with intermediate-2 or high-risk myelofibrosis. This planned analysis assessed the long-term efficacy and safety of ruxolitinib at a median follow-up of 149 weeks. At data cutoff, approximately 50% of patients originally randomized to ruxolitinib remained on treatment whereas all patients originally assigned to placebo had discontinued or crossed over to ruxolitinib. At week 144, mean spleen volume reduction was 34% with ruxolitinib. Previously observed improvements in quality-of-life measures were sustained with longer-term ruxolitinib therapy. Overall survival continued to favor ruxolitinib despite the majority of placebo patients crossing over to ruxolitinib [hazard ratio 0.69 (95% confidence interval: 0.46–1.03); P=0.067]. Exploratory analyses suggest that crossover may have contributed to an underestimation of the true survival difference between the treatment groups. Ruxolitinib continued to be generally well tolerated; there was no pattern of worsening grade ≥3 anemia or thrombocytopenia with longer-term ruxolitinib exposure. These longer-term data continue to support the efficacy and safety of ruxolitinib in patients with myelofibrosis. The study is registered at clinicaltrials.gov: NCT00952289. PMID:25616577

  8. Solitary brain metastasis of an occult and stable small-cell lung cancer in a schizophrenic patient: a 3-year control.

    PubMed

    Jesien-Lewandowicz, Emilia; Spych, Michal; Fijuth, Jacek; Kordek, Radzislaw

    2010-08-01

    Small-cell lung cancer is a highly aggressive carcinoma, with poorer prognosis in patients with brain metastases. We present the case of a 49-year-old woman diagnosed with a cerebellar tumour which, following surgery, was revealed to be a metastatic small-cell lung carcinoma. Subsequent CT and PET scanning showed a small, isolated 8 mm nodule in the upper lobe of the right lung. The patient was suffering from schizophrenia and has been treated with clozapine for 17 years. Because of the unusual presentation, there was no therapy given for the primary tumour at the time, and systemic therapy or surgery was discussed. However, 18 months later, the nodule was slightly larger (14 mm), and surgery was performed. On pathology examination, the tumour was presented as a typical small-cell carcinoma. Standard chest irradiation with systemic chemotherapy was given. At the time of writing, 39 months after diagnosis of metastatic small-cell carcinoma, the patient is disease free. However, this case is unusual in that a long-term observation of a small stable primary tumour in the lung took place without any therapy being given. This case strongly supports the thesis that small-cell lung cancer may comprise a heterogeneous group of tumours with different biological properties. The proapoptotic effect of clozapine may be also taken into account. PMID:20537425

  9. Outcome of isolated fetal choroid plexus cyst detected in prenatal sonography among infertile patients referred to Royan Institute: A 3-year study

    PubMed Central

    Irani, Shohreh; Ahmadi, Firoozeh; Javam, Maryam; Vosough Taghi dizaj, Ahmad; Niknejad, Fatemeh

    2015-01-01

    Background: Several studies have assessed the correlation of fetal choroid plexus cyst (CPC) and the risk of congenital anomalies, but few ones have discussed isolated CPC (with no other abnormal sonographic finding). Objective: The aim of this study was to determine the outcome of isolated fetal choroid plexus cyst and to specify its clinical significance. Materials and Methods: This cross sectional study was carried out at Royan Institute in Tehran, Iran, between April 2009 and December 2012. All prenatal sonographies in this period of time were assessed using a computerized database and fetuses who had isolated CPC were recruited in the study. Sonography reports, mother serum screening test results, fetal echocardiography and amniocentesis were evaluated until birth. A follow-up phone call was made to all individuals to learn about the neonatal outcomes. Results: Overall, 6240 prenatal sonographies were performed in this setting during this period. Isolated CPC was detected in 64 fetuses. The results of double test (N=30), triple test (N=5) and fetal echocardiography (N =24) were normal. Quadruple test result showed 3 abnormal out of 29 cases that all had normal karyotypes. Four samples were dropped out due to premature rupture of membranes (N=3) and intrauterine fetal death (N=1). It was found that the outcomes of all remaining fetuses (N=60) were normal and no anomaly ones were seen until birth. Conclusion: Isolated CPC is a benign regressive condition with no clinical significance. PMID:26568762

  10. A randomised, phase II study of nintedanib or sunitinib in previously untreated patients with advanced renal cell cancer: 3-year results

    PubMed Central

    Eisen, T; Loembé, A-B; Shparyk, Y; MacLeod, N; Jones, R J; Mazurkiewicz, M; Temple, G; Dressler, H; Bondarenko, I

    2015-01-01

    Background: This exploratory study evaluated the safety/efficacy of nintedanib or sunitinib as first-line therapy in patients with advanced renal cell carcinoma (RCC). Methods: Ninety-six patients were randomised (2:1) to either nintedanib (200 mg twice daily) or sunitinib (50 mg kg−1 once daily (4 weeks on treatment; 2 weeks off)). Primary endpoint was progression-free survival (PFS) at 9 months. P-values reported are descriptive only; the study was not powered for such comparisons. Results: Progression-free survival at 9 months was comparable between nintedanib and sunitinib (43.1% vs 45.2%, respectively; P=0.85). Median PFS was 8.4 months in each group (hazard ratio (HR), 1.12; 95% confidence interval (CI): 0.70–1.80; P=0.64). Median overall survival was 20.4 and 21.2 months for nintedanib and sunitinib, respectively (HR, 0.92; 95% CI: 0.54–1.56; P=0.76). Overall incidence of any grade adverse events (AEs) was comparable (90.6% vs 93.8%); AEs grade ⩾3 were lower with nintedanib than sunitinib (48.4% vs 59.4%). Nintedanib was associated with lower incidences of some AEs typical of antiangiogenic tyrosine kinase inhibitors (TKIs): hypertension, hypothyroidism, hand–foot syndrome, cardiac disorders and haematological abnormalities. Conclusions: In patients with advanced RCC, nintedanib has promising efficacy and similar tolerability to sunitinib, and a manageable safety profile with fewer TKI-associated AEs. PMID:26448178

  11. 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

  12. Long-lasting intestinal bleeding in an old patient with multiple mucosal vascular abnormalities and Glanzmann's thrombasthenia: 3-year pharmacological management.

    PubMed

    Coppola, A; De Stefano, V; Tufano, A; Nardone, G; Amoriello, A; Cerbone, A M; Di Minno, G

    2002-09-01

    A 75-year-old woman with Glanzmann's thrombasthenia was admitted because of persistent melaena. Endoscopic examination showed multiple angiodysplastic lesions, with active bleeding in small and large bowel. Electro-coagulation of some lesions, octreotide, conjugated oestrogens and selective embolization of jejunal vessels did not change transfusion requirements. After 8 month-transfusions, ethinylestradiol + norethisterone in association with octreotide was started, leading to no transfusion over the following 9 months. Bleeding recurred after withdrawing octreotide and substituting ethinylestradiol + norgestrel for the ethinylestradiol + norethisterone combination. Re-introduction of octreotide did not improve bleeding; however, a reduction of transfusion requirement was observed when the ethinylestradiol + norethisterone pill was re-administered. The association of octreotide and of an oestrogen-progesterone combination was helpful in the difficult management of recurrent bleeding in this patient with diffuse gastrointestinal vascular abnormalities and a severe condition predisposing to bleeding. PMID:12270009

  13. Anorectal Complications During Neutropenic Period in Patients with Hematologic Diseases

    PubMed Central

    Solmaz, Soner; Korur, Aslı; Gereklioğlu, Çiğdem; Asma, Süheyl; Büyükkurt, Nurhilal; Kasar, Mutlu; Yeral, Mahmut; Kozanoğlu, İlknur; Boğa, Can; Ozdoğu, Hakan

    2016-01-01

    Background Neutropenic patients are susceptible to any anorectal disease, and symptomatic anorectal disease afflicts 2–32% of oncology patients. Perianal infections are the most feared complication, considering the lack of natural defense against infectious microorganisms. When septic complications develop, the anorectal disease is potentially fatal, especially in neutropenic patients in whom mortality rates range between 11–57%. Although anorectal diseases are a frequent complication with potentially fatal outcomes among patients with hematologic diseases, sufficient data are not available in the literature. In this study, we aimed to investigate the anorectal complications developing during the neutropenic period in patients with hematologic diseases. Methods A total of 79 patients whose neutropenic period (absolute neutrophil count <500/mcL) continued for 7 days, or longer were included in the study. Results A total of 34 patients out of 79 (43%) were detected to develop anorectal complications, of them 6 (7.6%) developed an anorectal infection. The patients were characterized according to the hematological disease and its status (active or not), the type of treatment and the presence of a history of an anorectal pathology before the onset of the hematologic disease. Nineteen (24.1%) patients had the history of anorectal disturbances before diagnosis of the hematologic disease, and recurrence of an anorectal pathology was found in 14 out of 19 patients(73.7%). In addition, the overall mortality rate was higher among the patients who developed anorectal complications compared to another group (41.2% vs. 22.2%, p=0.059). Conclusion Anorectal pathology is a common complication with high recurrence rate in neutropenic patients. Perianal infections are important as they can cause life-threatening outcomes although they are relatively rare among all anorectal complications. Therefore perianal signs and symptoms should be meticulously evaluated concerning early

  14. [Thyrotoxic hypokalemic periodic paralysis in patients of African descent].

    PubMed

    Maia, Morgana Lima e; Trevisam, Paula Grasiele Carvalho; Minicucci, Marcos; Mazeto, Glaucia M F S; Azevedo, Paula S

    2014-10-01

    Thyrotoxic hypokalemic periodic paralysis (THPP) is an endocrine emergency marked by recurrent attacks of muscle weakness associated with hypokalemia and thyrotoxicosis. Asiatic male patients are most often affected. On the other hand, African descents rarely present this disease. The case described shows an afrodescendant patient with hypokalemia and tetraparesis, whose diagnosis of hyperthyroidism was considered during this crisis. The THPP, although rare, is potentially lethal. Therefore, in cases of flaccid paresis crisis this diagnosis should always be considered, especially if associated with hypokalemia. In this situation, if no previous diagnosis of hyperthyroidism, this should also be regarded. PMID:25372590

  15. Managing a chronic pain patient in the perioperative period.

    PubMed

    Kopf, Andreas

    2013-12-01

    The chronic pain patient with and without chronic opioid medication is at risk for under- and overtreatment perioperatively. Careful planning of the perioperative period by the anesthesiologist, the pain service and the surgeon is crucial. Epidural analgesia requires reduction of preoperative opioid doses to a maximum of 50% to avoid withdrawal as well as continuous postanesthesia care unit-monitoring for the first 24 hours. Brief cognitive behavioral interventions pre- and postoperatively contribute to successful pain management. The perioperative period may be used to re-evaluate the patient's opioid requirements. A follow-up by an experienced pain management service should be available after discharge of the chronic pain patient. Individualized assessment by a pain management team is necessary for this increasing group of patients. This report is adapted from paineurope 2013; Issue 2, ©Haymarket Medical Publications Ltd., and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International, LTD. and is distributed free of charge to healthcare professionals in Europe. Archival issues can be accessed via the website: http://www.paineurope.com at which European health professionals can register online to receive copies of the quarterly publication. PMID:24303836

  16. A 3-Year Retrospective Evaluation of the Clinical Performance of Fiber Posts.

    PubMed

    Amaral, Marina; Coppo, Priscilla Pessin; Rosalem, Cíntia Gonçalves Carvalho; Suaid, Fabricia Ferreira; Guerra, Selva Maria Gonçalves

    2015-12-01

    This retrospective study evaluated the clinical outcome of 139 teeth restored with carbon fiber posts after 3 years of placement, considering the amount of remaining dentin as the main variable. Eighty-one patients received the fiber posts within a period of 16 months and were recalled after 3 years. The tooth type, amount of remaining dentin, and prosthetic crown material were evaluated. No loss of post or core retention was detected after 3 years of follow up. During the observed time, root or post fracture and secondary caries were not recorded. Only one failure concerning endodontic treatment was detected. The amount of remaining dentin was not an important characteristic in the restorative failure of endodontically treated teeth restored with carbon fiber posts within 3 years. PMID:26963206

  17. 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…

  18. Lung cancer drug therapy in Hungary – 3-year experience

    PubMed Central

    Moldvay, Judit; Rokszin, György; Abonyi-Tóth, Zsolt; Katona, Lajos; Fábián, Katalin; Kovács, Gábor

    2015-01-01

    Hungary is a world leader in lung cancer deaths, so it is of crucial importance that patients have access to modern treatments. The aim of our analysis was to explore how drug treatments are used in Hungary and how they are compatible with international practice. The inpatient and prescription database of the National Health Insurance Fund Administration of Hungary was used to study the frequency of certain chemotherapy protocols and duration of therapies during a 3-year period (2008–2010). During the study period, 12,326 lung cancer patients received first-line chemotherapy, a third of those (n=3,791) received second-line treatment, and a third of the latter (n=1,174) received third-line treatment. The average treatment duration was between 3 and 4 months. The first-line treatment of non-small-cell lung carcinoma mainly consisted of platinum treatment in combination with third-generation cytotoxic agents. A downward trend of gemcitabine, still the most common combination compound, was observed, in parallel with a significantly increased use of paclitaxel, and as a consequence carboplatin replaced cisplatin. Among the new agents, the use of pemetrexed and bevacizumab increased. Pemetrexed appeared mainly in second-line treatment, while erlotinib appeared also in second-line but mostly in third-line treatments. The first-line treatment of small-cell lung carcinoma consisted of a platinum–etoposide combination, while in the second-line setting topotecan was the most commonly used drug. According to our results, the chemotherapeutic combinations and sequencing are in accordance with international and national recommendations. Further detailed analysis of the available data may help to obtain a more accurate picture of the efficacy of lung cancer treatments as well. PMID:25999737

  19. [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. PMID:12815792

  20. A 3-year randomized therapeutic trial of nitisinone in alkaptonuria.

    PubMed

    Introne, Wendy J; Perry, Monique B; Troendle, James; Tsilou, Ekaterini; Kayser, Michael A; Suwannarat, Pim; O'Brien, Kevin E; Bryant, Joy; Sachdev, Vandana; Reynolds, James C; Moylan, Elizabeth; Bernardini, Isa; Gahl, William A

    2011-08-01

    Alkaptonuria is a rare, autosomal recessive disorder of tyrosine degradation due to deficiency of the third enzyme in the catabolic pathway. As a result, homogentisic acid (HGA) accumulates and is excreted in gram quantities in the urine, which turns dark upon alkalization. The first symptoms, occurring in early adulthood, involve a painful, progressively debilitating arthritis of the spine and large joints. Cardiac valvular disease and renal and prostate stones occur later. Previously suggested therapies have failed to show benefit, and management remains symptomatic. Nitisinone, a potent inhibitor of the second enzyme in the tyrosine catabolic pathway, is considered a potential therapy; proof-of-principle studies showed 95% reduction in urinary HGA. Based on those findings, a prospective, randomized clinical trial was initiated in 2005 to evaluate 40 patients over a 36-month period. The primary outcome parameter was hip total range of motion with measures of musculoskeletal function serving as secondary parameters. Biochemically, this study consistently demonstrated 95% reduction of HGA in urine and plasma over the course of 3 years. Clinically, primary and secondary parameters did not prove benefit from the medication. Side effects were infrequent. This trial illustrates the remarkable tolerability of nitisinone, its biochemical efficacy, and the need to investigate its use in younger individuals prior to development of debilitating arthritis. PMID:21620748

  1. Myocardial Revascularization in Dyalitic Patients: In-Hospital Period Evaluation

    PubMed Central

    Miranda, Matheus; Hossne, Nelson Américo; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; da Fonseca, José Honório de Almeida Palma; Pestana, José Osmar Medina de Abreu; Juliano, Yara; Buffolo, Enio

    2014-01-01

    Background Coronary artery bypass grafting currently is the best treatment for dialytic patients with multivessel coronary disease, but hospital morbidity and mortality related to procedure is still high. Objective Evaluate results and in-hospital outcomes of coronary artery bypass grafting in dialytic patients. Methods Retrospective unicentric study including 50 consecutive and not selected dialytic patients, who underwent coronary artery bypass grafting in a tertiary university hospital from 2007 to 2012. Results High prevalence of cardiovascular risk factors was observed (100% hypertensive, 68% diabetic and 40% dyslipidemic). There was no intra-operative death and 60% of the procedures were performed off-pump. There were seven (14%) in-hospital deaths. Postoperative infection, previous heart failure, cardiopulmonary bypass, abnormal ventricular function and surgical re-exploration were associated with increased mortality. Conclusion Coronary artery bypass grafting is feasible to dialytic patients although high in-hospital morbidity and mortality. It is necessary better understanding about metabolic aspects to plan adequate interventions. PMID:24270865

  2. Chronic autoimmune thrombocytopenic purpura. A 3-year study.

    PubMed

    Fotos, P G; Graham, W L; Bowers, D C; Perfetto, S P

    1983-06-01

    Idiopathic (autoimmune) thrombocytopenic purpura (ATP) is accepted to be a disorder resulting from accelerated platelet destruction attributed to an autoimmune process. The patient whose case is presented in this article was first seen by a dentist. The oral findings have been documented as the case was followed for 3 years through acute exacerbations, pregnancy, and delivery of an infant with thrombocytopenia. The patient was managed with intermittent steroid therapy and splenectomy. PMID:6576288

  3. The self-tapping and ICE 3i implants: a prospective 3-year multicenter evaluation.

    PubMed

    Davarpanah, M; Martinez, H; Tecucianu, J F; Alcoforado, G; Etienne, D; Celletti, R

    2001-01-01

    This multicenter prospective clinical evaluation was undertaken to determine the therapeutic success and marginal bone level stability of 3i's self-tapping and ICE implants after 3 years of prosthetic loading. Between July 1995 and June 1996, 189 completely or partially edentulous patients were treated with 614 machined-surface screw-type commercially pure titanium implants (self-tapping or ICE). Two hundred seventy-seven self-tapping implants were placed in 85 patients (average age of 56 years), and 337 ICE implants were placed in 104 patients (average age of 61 years). A total of 360 implants (58.6%) were placed in posterior segments. Easier placement was reported with the ICE implant in normal or dense bone. For the self-tapping implants, survival rates of 92.9% and 91.6% were noted after 1 and 3 years of prosthetic loading, respectively. Survival rates of 95.4% and 93.8% were obtained with the ICE implant for the same periods. Late failures (after loading) were more common than early failures (before loading) for both types of implants. The marginal bone level of 238 self-tapping implants (85.9%) and of 307 ICE implants (91%) was radiographically evaluated at 3 years. Marginal bone level was at the first thread for 95.1% of implants. A loss of marginal bone level of 2 to 4 threads was noted for 4.9% of the evaluated implants. No implant showed bone loss greater than the fourth thread. Overall survival rates of 94.3% and 92.9% were obtained after 1 and 3 years of prosthetic loading, respectively, for 596 and 588 implants. PMID:11280362

  4. 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

  5. Distribution of Active and Resting Periods in the Motor Activity of Patients with Depression and Schizophrenia

    PubMed Central

    Hauge, Erik; Berle, Jan Øystein; Dilsaver, Steven; Oedegaard, Ketil J.

    2016-01-01

    Objective Alterations of activity are prominent features of the major functional psychiatric disorders. Motor activity patterns are characterized by bursts of activity separated by periods with inactivity. The purpose of the present study has been to analyze such active and inactive periods in patients with depression and schizophrenia. Methods Actigraph registrations for 12 days from 24 patients with schizophrenia, 23 with depression and 29 healthy controls. Results Patients with schizophrenia and depression have distinctly different profiles with regard to the characterization and distribution of active and inactive periods. The mean duration of active periods is lowest in the depressed patients, and the duration of inactive periods is highest in the patients with schizophrenia. For active periods the cumulative probability distribution, using lengths from 1 to 35 min, follows a straight line on a log-log plot, suggestive of a power law function, and a similar relationship is found for inactive periods, using lengths from 1 to 20 min. For both active and inactive periods the scaling exponent is higher in the depressed compared to the schizophrenic patients. Conclusion The present findings add to previously published results, with other mathematical methods, suggesting there are important differences in control systems regulating motor behavior in these two major groups of psychiatric disorders. PMID:26766953

  6. 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

  7. Effects of a 3-Year Nurse-Based Case Management in Aged Patients with Acute Myocardial Infarction on Rehospitalisation, Mortality, Risk Factors, Physical Functioning and Mental Health. A Secondary Analysis of the Randomized Controlled KORINNA Study

    PubMed Central

    Kirchberger, Inge; Hunger, Matthias; Stollenwerk, Björn; Seidl, Hildegard; Burkhardt, Katrin; Kuch, Bernhard; Meisinger, Christa; Holle, Rolf

    2015-01-01

    Background Home-based secondary prevention programs led by nurses have been proposed to facilitate patients’ adjustment to acute myocardial infarction (AMI). The objective of this study was to conduct secondary analyses of the three-year follow-up of a nurse-based case management for elderly patients discharged from hospital after an AMI. Methods In a single-centre randomized two-armed parallel group trial of hospitalized patients with AMI ≥65 years, patients hospitalized between September 2008 and May 2010 in the Hospital of Augsburg, Germany, were randomly assigned to case management or usual care. The case-management intervention consisted of a nurse-based follow-up for three years including home visits and telephone calls. Study endpoints were time to first unplanned readmission or death, clinical parameters, functional status, depressive symptoms and malnutrition risk. Persons who assessed three-year outcomes and validated readmission data were blinded. The intention-to-treat approach was applied to the statistical analyses which included Cox Proportional Hazards models. Results Three hundred forty patients were allocated to receive case-management (n = 168) or usual care (n = 172). During three years, in the intervention group there were 80 first unplanned readmissions and 6 deaths, while the control group had 111first unplanned readmissions and 3 deaths. The intervention did not significantly affect time to first unplanned readmission or death (Hazard Ratio 0.89, 95% confidence interval (CI) 0.67–1.19; p = 0.439), blood pressure, cholesterol level, instrumental activities of daily life (IADL) (only for men), and depressive symptoms. However, patients in the intervention group had a significantly better functional status, as assessed by the HAQ Disability Index, IADL (only for women), and hand grip strength, and better SCREEN-II malnutrition risk scores than patients in the control group. Conclusions A nurse-based management among elderly patients with

  8. 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. PMID:24831932

  9. Single-stage closing–opening wedge osteotomy of spine to correct severe post-tubercular kyphotic deformities of the spine: a 3-year follow-up of 17 patients

    PubMed Central

    Vijay, Kamath; Shetty, Ajoy Prasad

    2009-01-01

    The correction of severe post-tubercular kyphosis (PTK) is complex and has the disadvantage of being multiple staged with a high morbidity. Here, we describe the procedure and results of closing–opening osteotomy for correction of PTK which shortens the posterior column and opens the anterior column appropriately to correct the deformity without altering the length of the spinal cord. Seventeen patients with PTK (10 males; 7 females) with an average age of 18.3 ± 10.6 years (range 4–40 years) formed the study group. There were ten thoracolumbar, one lumbar and six thoracic deformities. The number of vertebrae involved ranged from 2 to 5 (average 2.8). Preoperative kyphosis averaged 69.2° ± 25.1° (range 42°–104°) which included ten patients with deformity greater than 60°. The average vertebral body loss was 2.01 ± 0.79 (range 1.1–4.1). The neurological status was normal in 13 patients, Frankel’s grade D in three patients and grade C in one. Posterior stabilization with pedicle screw instrumentation was followed by a preoperatively calculated wedge resection. Anterior column reconstruction was performed using rib grafts in four, tricortical iliac bone graft in five, cages in six, and bone chips alone and fibular graft in one patient each. Average operating time was 280 min (200–340 min) with an average blood loss of 820 ml (range 500–1,600 ml). The postoperative kyphosis averaged 32.4° ± 19.5° (range 8°–62°). The percentage correction of kyphosis achieved was 56.8 ± 14.6% (range 32–83%). No patient with normal preoperative neurological status showed deterioration in neurology after surgery. The last follow-up was at an average of 43 ± 4 months (range 32–64 months). The average loss of correction at the last follow-up was 5.4° (range 3°–9°). At the last follow-up, the mean preoperative pain visual analogue scale score decreased significantly from 9.2 (range 8–10 points) to 1.5 (range 1–2 points). There

  10. 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. PMID:25793039

  11. 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

  12. 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

  13. Articular cartilage of the knee 3 years after ACL reconstruction

    PubMed Central

    Bae, Ji-Hoon; Hosseini, Ali; Wang, Yang; Torriani, Martin; Gill, Thomas J; Grodzinsky, Alan J

    2015-01-01

    Background and purpose T1ρ or T2 relaxation imaging has been increasingly used to evaluate the cartilage of the knee. We investigated the cartilage of ACL-reconstructed knees 3 years after surgery using T2 relaxation times. Patients and methods 10 patients with a clinically successful unilateral ACL reconstruction were examined 3 years after surgery. Multiple-TE fast-spin echo sagittal images of both knees were acquired using a 3T MRI scanner for T2 mapping of the tibiofemoral cartilage. T2 values of the superficial and deep zones of the tibiofemoral cartilage were analyzed in sub-compartmental areas and compared between the ACL-reconstructed and uninjured contralateral knees. Results Higher T2 values were observed in 1 or more sub-compartmental areas of each ACL-reconstructed knee compared to the uninjured contralateral side. Most of the T2 increases were observed at the superficial zones of the cartilage, especially at the medial compartment. At the medial compartment of the ACL-reconstructed knee, the T2 values of the femoral and tibial cartilage were increased by 3–81% compared to the uninjured contralateral side, at the superficial zones of the weight-bearing areas. T2 values in the superficial zone of the central medial femoral condyle differed between the 2 groups (p = 0.002). Interpretation The articular cartilage of ACL-reconstructed knees, although clinically satisfactory, had higher T2 values in the superficial zone of the central medial femoral condyle than in the uninjured contralateral side 3 years after surgery. Further studies are warranted to determine whether these patients would undergo cartilage degeneration over time. PMID:25854533

  14. Implants and sinus-inlay bone grafts in a 1-stage procedure on severely atrophied maxillae: surgical aspects of a 3-year follow-up study.

    PubMed

    Johansson, B; Wannfors, K; Ekenbäck, J; Smedberg, J I; Hirsch, J

    1999-01-01

    This 3-year follow-up study compares implant treatment in 39 1-stage sinus-inlay block-grafted patients (study group) with 37 patients treated without bone grafting (reference group), all of whom were edentulous in the maxilla and were treated over the same time period. The cumulative success rate (CSR) of implant stability after 3 years in the study group was 75.3% in grafted areas and 82.2% in non-grafted areas. The CSR after 3 years in the reference group was 93.1%. The mean marginal bone resorption after 3 years of loading was 1.4 mm in grafted areas and 1.6 mm in non-grafted areas in the study group and 1.1 mm in the reference group. Complications noted during the postoperative healing periods correlated significantly with implant failures later on (P < .05). Since prosthesis stability (CSR) after 3 years was 94.9% in the study group and 97.3% in the reference group, it can be concluded that 1-stage sinus-inlay block grafts can be regarded as a safe method with a predictable outcome for use on patients with severely atrophied edentulous maxillae, although increased failure rates are to be expected for implants placed in bone-grafted regions. PMID:10612917

  15. [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. PMID:22068935

  16. Blowout fracture in a 3-year-old.

    PubMed

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

    2013-06-01

    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

  17. 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

  18. 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

  19. Can Patients with Parkinson's Disease Use Dry Powder Inhalers during Off Periods?

    PubMed

    Luinstra, M; Rutgers, A W F; Dijkstra, H; Grasmeijer, F; Hagedoorn, P; Vogelzang, J M J; Frijlink, H W; de Boer, A H

    2015-01-01

    Because of its rapid onset of action, pulmonary administration of levodopa is an interesting alternative to oral administration for the rescue treatment of Parkinson's disease patients in an off period. We studied the ability of Parkinson's disease patients to operate a dry powder inhaler (DPI) correctly during an off period. We used an instrumented test inhaler with three different resistances to air flow to record flow curves and computed various inhalation parameters. We observed that all (13) patients were able to generate pressure drops > 2 kPa over the highest resistance and 10 out of 13 patients achieved at least 4 kPa. Inhaled volumes (all resistances) varied from 1.2 L to 3.5 L. Total inhalation time and the time to peak inspiratory flow rate both decreased with decreasing inhaler resistance. Twelve out of thirteen patients could hold their breath for at least five seconds after inhalation and nine could extend this time to ten seconds. The data from this study indicate that patients with Parkinson's disease will indeed be able to use a dry powder inhaler during an off period and they provide an adequate starting point for the development of a levodopa powder inhaler to treat this particular patient group. PMID:26173114

  20. Can Patients with Parkinson’s Disease Use Dry Powder Inhalers during Off Periods?

    PubMed Central

    Luinstra, M.; Rutgers, A. W. F.; Dijkstra, H.; Grasmeijer, F.; Hagedoorn, P.; Vogelzang, J. M. J.; Frijlink, H. W.; de Boer, A. H.

    2015-01-01

    Because of its rapid onset of action, pulmonary administration of levodopa is an interesting alternative to oral administration for the rescue treatment of Parkinson’s disease patients in an off period. We studied the ability of Parkinson’s disease patients to operate a dry powder inhaler (DPI) correctly during an off period. We used an instrumented test inhaler with three different resistances to air flow to record flow curves and computed various inhalation parameters. We observed that all (13) patients were able to generate pressure drops > 2 kPa over the highest resistance and 10 out of 13 patients achieved at least 4 kPa. Inhaled volumes (all resistances) varied from 1.2 L to 3.5 L. Total inhalation time and the time to peak inspiratory flow rate both decreased with decreasing inhaler resistance. Twelve out of thirteen patients could hold their breath for at least five seconds after inhalation and nine could extend this time to ten seconds. The data from this study indicate that patients with Parkinson’s disease will indeed be able to use a dry powder inhaler during an off period and they provide an adequate starting point for the development of a levodopa powder inhaler to treat this particular patient group. PMID:26173114

  1. Randomized trial of partial vs. stepwise caries removal: 3-year follow-up.

    PubMed

    Maltz, M; Garcia, R; Jardim, J J; de Paula, L M; Yamaguti, P M; Moura, M S; Garcia, F; Nascimento, C; Oliveira, A; Mestrinho, H D

    2012-11-01

    This randomized, multicenter clinical trial evaluated the effectiveness of 2 treatments for deep caries lesions - partial caries removal (PCR) and stepwise excavation (SW) - with respect to the primary outcome of pulp vitality for a 3-year follow-up period. Inclusion criteria were as follows: patients with permanent molars presenting deep caries lesions (lesion affecting ≥ 1/2 of the dentin on radiographic examination), positive response to a cold test, absence of spontaneous pain, negative sensitivity to percussion, and absence of periapical lesions (radiographic examination). Teeth randomly assigned to PCR (test) received incomplete caries removal and filling in a single session. Outcome success was evaluated by assessment of pulp vitality, determined by pulp sensitivity to a cold test and the absence of periapical lesions. Data were analyzed by a Weibull regression model with shared frailty term (survival analysis). At baseline, 299 treatments were executed: PCR, 152 and SW, 147. By the end of the 3-year follow-up period, 213 teeth had been evaluated. Adjusted survival rates were 91% for PCR and 69% for SW (p = 0.004). These results suggest that there is no need to re-open a cavity and perform a second excavation for pulp vitality to be preserved (Clinical trials registration NCT00887952). PMID:22983407

  2. [Influence of antidepressant therapy on psychovegetative disorders in patients with chronic calculous cholecystitis in perioperative period].

    PubMed

    Tsimmerman, Ia S; Shchekotov, V V; Tret'iakova, Iu I; Solov'eva, I V; Tsimmerman, I Ia

    2008-01-01

    The results of prospective study of the stage of vascular endothelium and neutrophil phagocytic activity (NPA) in patients with chronic calculous cholecystitis (CCC) in perioperative period, who had anxious depressive disturbances (ADD), were represented. 61 patients were examined 3 weeks before cholecystectomy (CE). Intensity of anxiety and depression, vegetative tonus, desquamated endotheliocytes (DE) in blood and phagocytosis degree were assessed. The patients were randomized into 2 groups. The patients of 1st group (n = 30) received antidepressant coaxil during perioperative period (6 weeks); 2nd group (the control) was composed of 31 patients and was treated without coaxil. In 1st group significant decrease in AAD and symptoms of vegetative dystonia (VD) in 3 weeks after CE was detected; number of DE in blood was considerable reduces, and NPA was significantly increased vs. control group. Correlation analysis made possible to show that the higher AAD and VD intensity, the more frequently epithelium desquamation was detected, and percentage of phagocytes was reduced at increase in DE in blood. Use of balanced antidepressant coaxil in perioperative period in CCC patients makes possible to reduce occurrence and intensity of AAD and VD after operation, improve vascular endothelium state, increase NPA and adaptive reserves of organism. PMID:18720713

  3. Giant left atrial myxoma in an elderly patient: natural history over a 7-year period.

    PubMed

    Bajraktari, Gani; Emini, Merita; Berisha, Venera; Gashi, Fitnete; Beqiri, Arton; Zahiti, Bedri; Selmani, Hamza; Shatri, Faik; Manaj, Rexhep

    2006-01-01

    We present the case of a 71-year-old woman with a 7-year history of a giant left atrial myxoma. The myxoma was attached to the atrial septum and occupied almost the entire left atrial cavity. The patient was hospitalized 4 times because of dyspnea on exertion, palpitations, fatigue, general asthenia, and weight loss. During prior hospitalizations, the patient had refused cardiac surgery. She developed several complications, including atrial fibrillation, mitral and tricuspid regurgitation, mesenteric embolism, pulmonary edema, and thrombotic stroke. We herein describe the natural history of left atrial myxoma in an elderly patient over a 7-year period. PMID:17024671

  4. Rare KCNJ18 variants do not explain hypokalaemic periodic paralysis in 263 unrelated patients

    PubMed Central

    Kuhn, Marius; Jurkat-Rott, Karin; Lehmann-Horn, Frank

    2016-01-01

    Objective To examine rare KCNJ18 variations recently reported to cause sporadic and thyrotoxic hypokalaemic periodic paralysis (TPP). Methods We sequenced KCNJ18 in 474 controls (400 Caucasians, 74 male Asians) and 263 unrelated patients with periodic paralysis (PP), including 30 patients with TPP without mutations in established PP genes. Results In 10 patients without TPP, we identified 9 heterozygous, novel variations (c.–3G>A, L15S, R81C, E273X, T309I, I340T, N365S, G394R, R401W) and a questionable heterozygous causative R399X stop variant. Studies on 40 relatives of these 10 patients showed that none of the variants were de novo in the patients and that R399X occurred in 3 non-affected relatives. Most affected amino acids lacked conservation and several clinically affected relatives did not carry the patient’s variant. T309I, however, could be pathogenic under the pre-requisite of strongly reduced penetrance in females. Of the controls, 17 revealed 12 novel rare variants including the heterozygous E273X stop variant in three individuals. Conclusions Our study shows many different, rare KCNJ18 alterations in patients as well as controls. Only perhaps one meets the requirements of a disease-causing mutation. Therefore, KCNJ18 alterations are seldom pathogenic. Additional studies are required before patients with PP can be genetically diagnosed on the basis of a KCNJ18 variant alone. PMID:25882930

  5. Topiramate-induced periodic limb movement disorder in a patient affected by focal epilepsy

    PubMed Central

    Romigi, Andrea; Vitrani, Giuseppe; D'Aniello, Alfredo; Di Gennaro, Giancarlo

    2014-01-01

    Periodic limb movement disorder (PLMD) is characterized by pathological periodic limb movements during sleep, insomnia and/or diurnal sleepiness, and the absence of another primary sleep disorder. We report a patient with complex partial seizures who developed PLMD while taking topiramate (TPM). He had no evidence of metabolic and/or other conditions inducing PLMD. He also had fragmented sleep and disruptive PLMS on polysomnography, and PLMS subsided with change of antiepileptic drug. Topiramate may modulate the dopaminergic pathway by inhibition of glutamate release, thereby inducing PLMD as observed in our patient. Although a single case does not allow any generalization, PLMD should be considered in patients complaining of insomnia and treated with TPM. PMID:25667887

  6. 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

  7. Life experiences of Taiwanese oral cancer patients during the postoperative period.

    PubMed

    Chen, Shu-Ching

    2012-03-01

    The incidence of oral cancer has rapidly increased in Taiwan. Oral cancer and its surgical treatment may also cause physical and psychological problems for patients. During the postoperative period, patients face adjustments in their disease, treatment and lives. However, research on these relevant issues is scant. A qualitative study was conducted with the purpose of exploring the life experiences of surgically treated Taiwanese oral cancer patients during the postoperative period. Thirteen patients with oral cancer were recruited from the otolaryngology head and neck surgery wards of a medical centre in northern Taiwan. Semi-structured interviews were conducted and tape recorded after informed consent had been obtained. Data were analysed using the content analysis method. Results show that the life experiences of the patients with oral cancer were related to the impact of threatening symptoms, concerns about survival, restriction of interpersonal relationships, self-restructuring and constructing a support network. The results of this study can provide healthcare professionals with a reference for implementing care plans to address the unique needs of patients with oral cancer. PMID:21883343

  8. A 3-year postoperative clinical evaluation of posts and cores beneath existing crowns.

    PubMed

    Hatzikyriakos, A H; Reisis, G I; Tsingos, N

    1992-04-01

    Fabrication of posts and cores for fixed partial denture (FPD) and removable partial denture (RPD) abutment restorations is common in dentistry. The biocompatibility of various post and core techniques with the restorations was clinically evaluated according to location and function. In this study, 154 post and core constructions for 150 patients were observed for a 3-year period to determine if the function of the original restorations remained unsatisfactory. The following techniques were included: (1) screw post and light-curing composite resins, (2) cemented post with parallel sides and light-curing composite resins, and (3) a cast and core technique. Seventeen of the 154 restorations failed; four failures were attributed to root fractures, three to radicular caries, and five to crown dislodgement, while five failures were from detachment of the post and core from the root. The statistical analysis revealed that only the factor "type of abutment" (RPDs and FPDs) had some effect on the failure of the restorations. PMID:1507125

  9. Final Results of a 3-Year Literacy-Informed Intervention to Promote Annual Fecal Occult Blood Test Screening.

    PubMed

    Arnold, Connie L; Rademaker, Alfred; Wolf, Michael S; Liu, Dachao; Lucas, Geoffrey; Hancock, Jill; Davis, Terry C

    2016-08-01

    This three arm study was designed to make CRC screening with FOBTs more accessible, understandable and actionable for patients cared for in predominantly rural Federally Qualified Health Centers. Patients in an enhanced version of usual care received an annual CRC recommendation and FOBT kit; those in the education arm additionally received brief literacy and culturally appropriate education and those in the nurse arm received the education by a nurse manager who followed up by telephone. Baseline FOBT rates in this population were 3 %. We evaluated if FOBT rates could be sustained over 3 years. A three-arm, quasi-experimental evaluation was conducted among eight clinics in Louisiana. Screening efforts included: (1) enhanced usual care, (2) literacy-informed education of patients, and (3) education plus nurse support. Overall, 961 average-risk patients, ages 50-85, eligible for routine CRC screenings were recruited. The primary outcome was completing three annual FOBT tests. Of 961 patients enrolled, 381 (39.6 %) participants did not complete a single FOBT, 60.4 % completed at least one FOBT of which 318 (33.1 %) completed only one, 162 (16.9 %) completed two and 100 (10.4 %) completed three FOBTs over the 3-year period (the primary study outcome). The primary outcome, return of three FOBT kits over the 3-year period, was achieved by 4.7 % in enhanced care, 11.4 % in education and 13.6 % in the nurse arm (p = 0.005). Overall 3-year FOBT screening rates were not sustained with any of the three interventions, despite reports of promising interim results at years 1 and 2. New strategies for sustaining FOBT screening over several years must be developed. PMID:26769026

  10. Timing of breast cancer surgery in relation to menstrual cycle phase: no effect on 3-year prognosis: The ITS Study

    PubMed Central

    Thorpe, H; Brown, S R; Sainsbury, J R; Perren, T J; Hiley, V; Dowsett, M; Nejim, A; Brown, J M

    2007-01-01

    The effect of breast cancer surgery timing during the menstrual cycle on prognosis remains controversial. We conducted a multicentre prospective study to establish whether timing of interventions influences prognosis. We report 3-year overall and disease-free survival (OS/DFS) results for ‘primary analysis' patients (regular cycles, no oral contraceptives within previous 6 months). Data were collected regarding timing of interventions in relation to patients' last menstrual period (LMP) and first menstrual period after surgery (FMP). Hormone profiles were also measured. Cox's proportional hazards model incorporated LMP in continuous form. Exploratory analyses used menstrual cycle categorisations of Senie, Badwe and Hrushesky. Hormone profiles with LMP and FMP data were also used to define menstrual cycle phase. Four hundred and twelve ‘primary analysis' patients were recruited. Three-year OS from first surgery was 90.7, 95% confidence interval (CI) [87.9, 93.6%]. Menstrual cycle according to LMP was not statistically significant (OS: hazard ratio (HR)=1.02, 95%CI [0.995,1.042], P=0.14; DFS: HR=1.00, 95%CI [0.980,1.022], P=0.92). Timing of surgery in relation to menstrual cycle phase had no significant impact on 3-year survival. This may be due to 97% of patients receiving some form of adjuvant therapy. Survival curves to 10 years indicate results may remain true for longer-term survival. PMID:18087287

  11. Periodic Lateralized Epileptiform Discharges (PLEDs) in Patients With Neurosyphilis and HIV Infection.

    PubMed

    Takagaki, Kentaroh; Morales, Megan K; Vitantonio, Daniel; Berkowitz, Frank; Bell, William L; Kumar, Princy N; Motamedi, Gholam K

    2016-07-01

    Periodic lateralized epileptiform discharges (PLEDs) are an electroencephalographic pattern recorded in the setting of a variety of brain abnormalities. It is best recognized for its association with acute viral encephalitis, stroke, tumor, or latestatus epilepticus. However, there are other conditions that have been recognized as the underlying pathology for PLEDs such as alcohol withdrawal, Creutzfeldt-Jacob disease, anoxic brain injury, and hemiplegic migraine. However, there are only rare case reports of PLEDs in patients with neurosyphilis. Here, we report 2 patients presenting with encephalopathy and seizures with PLEDs, ipsilateral or contralateral to their main brain magnetic resonance imaging abnormalities. Further workup revealed neurosyphilis in both patients, one in association with human immunodeficiency virus (HIV) infection. Given the increasing incidence of neurosyphilis with or without HIV infection, these cases suggest neurosyphilis as a consideration in the differential for patients presenting with PLEDs. PMID:25326288

  12. Thyrotoxic hypokalaemic periodic paralysis: a rare presentation of Graves' disease in a Hispanic patient.

    PubMed

    Matta, Abhishek; Koppala, Jahnavi; Gossman, William

    2014-01-01

    A 26-year-old Hispanic man with no significant medical history presented to our emergency room with gradual onset weakness of his lower extremities. He was haemodynamically stable and examination revealed loss of motor function in his lower limbs up to the level of hips. Laboratory data revealed hypokalaemia. The patient was started on potassium supplementation and he recovered his muscle strength. Differential diagnosis included familial hypokalaemic periodic paralysis and thyrotoxic periodic paralysis (TPP). Further investigations revealed a low thyroid-stimulating hormone and high free thyroxine levels. Radio iodine 123 scan revealed an enhanced homogeneous uptake in the thyroid suggesting Graves' disease. Thyroid stimulating antibodies were also found to be elevated. The patient was started on methimazole and propranolol and he never had another attack of TPP even at 1 year follow-up. PMID:24717588

  13. Predictive value of health-related quality of life in progression of disability and depression in persons with multiple sclerosis: a 3-year study.

    PubMed

    Kisic Tepavcevic, Darija; Pekmezovic, Tatjana; Stojsavljevic, Nebojsa; Kostic, Jelena; Dujmovic Basuroski, Irena; Mesaros, Sarlota; Drulovic, Jelena

    2013-12-01

    In our study, we examined whether health-related quality of life (HRQoL) could predict changes in disability, depression, and fatigue in patients with multiple sclerosis (MS) over a 3-year follow-up period. A group of 109 consecutive MS patients (McDonald's criteria) referring to the Institute of Neurology, Belgrade were enrolled in the study. At two time points during the study (baseline, and after a 3-year period) an HRQoL (measured by MSQoL-54), EDSS, Hamilton Rating Scale for Depression (HDRS) and Fatigue Severity Scale (FSS) were assessed. At the end of a 3-year follow-up, 12 out of 109 patients (11%) had dropped out. Multiple linear regression analysis showed that Physical Health scale of MSQoL-54 is significant independent predictor of change in EDSS after 3 years (p = 0.035). Mental health composite score of MSQoL-54 was predictor of change in HDRS score (p = 0.049). In separate regression analysis, only social function was independent predictor of the development of depression (p = 0.041). None of the HRQoL domains had predictive effect on the change of FSS. Our study suggests that baseline HRQoL scores, measured by MSQoL-54, could be applied as a prognostic marker for progression of both, disability, and severity of depressive symptoms in MS. PMID:23460394

  14. Severe hypercholesterolemia and liver disease in a 3-year old.

    PubMed

    Patel, Amol M; Brautbar, Ariel; Desai, Nirav K; Wilson, Don P

    2016-01-01

    Lipoprotein-X, which is composed of phospholipids and non-esterified cholesterol, is an abnormal lipoprotein with a density range similar to LDL-C. The two most common ways which lipoprotein-X accumulates is from reflux of bile salts into plasma or deficiency in lecithin cholesterol acyltransferase. This is a case of severe hypercholesterolemia and liver disease in a 3- year old male that presented with pruritus, pale stool, scleral ictus, and abdominal distention. He was diagnosed with primary sclerosing cholangitis which was confirmed by liver biopsy. Our patient was treated with steroids and immunomodulator therapy which was associated with significant reduction in cholestasis and LDL-C levels. Lipoprotein-X has several properties that make it anti-atherogenic, which raises the question if treatment for hypercholesterolemia should be initiated. PMID:27206954

  15. 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

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

    PubMed

    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

  17. Mutation analysis of CACNA1S and SCN4A in patients with hypokalemic periodic paralysis.

    PubMed

    Wang, Xiao-Ying; Ren, Bing-Wen; Yong, Zeng-Hua; Xu, Hong-Yan; Fu, Qiu-Xia; Yao, He-Bin

    2015-10-01

    Mutations in CACNA1S (calcium channel, voltage‑dependent, L type, alpha 1S subunit) and SCN4A (sodium channel, voltage‑gated, type IV, alpha subunit) are associated with hypokalemic periodic paralysis (HPP). The aim of the current study was to investigate CACNA1S and SCN4A mutations in patients with HPP. Mutations in CACNA1S and SCN4A were detected in three familial hypokalemic periodic paralysis (FHPP) pedigrees and in two thyrotoxic hypokalemic periodic paralysis (THPP) pedigrees using polymerase chain reaction, DNA sequencing and sequence alignment with GenBank data. A single base mutation from cytosine to guanine at site 1582 was identified in exon 11 of CACNA1S in one FHPP pedigree, resulting in an arginine to glycine (R528G) substitution. A single base mutation from thymine to cytosine at site 2012 was identified in exon 12 of SCN4A in one THPP pedigree, resulting in a phenylalanine to serine (F671S) substitution. No mutations in CACNA1S or SCN4A were identified in the remaining three pedigrees. The present study indicated that CACNA1S and SCN4A mutations are relatively rare in patients with HPP, and further studies are required to determine whether these mutation‑associated substitutions are representative of patients with HPP. PMID:26252573

  18. 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

  19. Should Patients Have Periodic Health Examinations?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

    PubMed

    Reynolds, Eileen E; Heffernan, James; Mehrotra, Ateev; Libman, Howard

    2016-02-01

    Physicians and patients have come to expect that periodic health examinations (PHEs) are a standard part of comprehensive ongoing medical care. However, considerable research has not demonstrated a substantial benefit of the PHE. Given this lack of benefit and the high total cost of PHE to the health care system, the American Board of Internal Medicine (ABIM) Foundation and the Society of General Internal Medicine (SGIM) have identified "routine health checks in asymptomatic patients" as something of low value that physicians and patients should question, as a part of the Choosing Wisely campaign. Two discussants review the debate about PHE and consider the value of PHE for a healthy 70-year-old woman who appreciates seeing her physician annually. PMID:26829911

  20. Management of inter-episodic periods in patients with bipolar disorder.

    PubMed

    Samalin, Ludovic; Murru, Andrea; Vieta, Eduard

    2016-06-01

    The management of inter-episodic periods of bipolar disorder (BD) appears complex as it combines several therapeutic approaches and takes into account individual characteristics of BD patients. Over recent decades, new evidence has been provided about pharmacological treatments, psychosocial interventions or models of care for the long-term management of BD patients. Considering this, guidelines for the maintenance treatment of BD should be regarded as an evidence-based ground for everyday clinical practice in real-life setting. This article critically reviews recently published clinical guidelines on the management of BD patients during the inter-episodic phases of illness, in order to highlight the consensual or controversial recommendations. PMID:27058008

  1. Orthostatic Reactivity in Patients with Ischemic Stroke in the Chronic Period

    PubMed Central

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

    2015-01-01

    AIM: This study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on orthostatic reactivity in patients with ischemic stroke in the chronic period (ISChP). MATERIAL AND METHODS: An active orthostatic test is used for the evaluation of the orthostatic reactions. The arterial blood pressure and heart rate were defined in the 10 minutes of supine position, before and after 1, 5 and 10 minutes of active upright position. The orthostatic autoregulation is evaluated four times - at the beginning of the study, on the 10th day, on the 1st month and three months after the start of the KT. The classification by Thulesius was used to separate the patients into two groups depending on the type of their orthostatic reactivity. RESULTS: At the beginning of the study of infringements symptomatic type orthostatic reactivity (SOR) was observed in 24 patients and hypertensive type orthostatic reactivity (HOR) was observed in the remaining 32 patients. Once applied SKTM establish improvement of orthostatic autoregulation for the groups SOR and HOR at the 10th day and the 1st month with a level of significance p <0.05. CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as an adapted exercise program at home, has significantly improved the orthostatic reactivity in patients with orthostatic dysregulation due to the ISChP.

  2. Long-term safety profile of anakinra in patients with severe cryopyrin-associated periodic syndromes

    PubMed Central

    Löfqvist, Malin; Leinonen, Mika; Goldbach-Mansky, Raphaela; Olivecrona, Hans

    2016-01-01

    Objective. Anakinra is approved for the treatment of RA and cryopyrin-associated periodic syndromes (CAPS). While the anakinra safety profile is well established in RA, the long-term safety profile in severe CAPS is less well documented and will therefore be discussed in this report. Methods. A prospective, open-label, single centre, clinical cohort study was conducted at the National Institutes of Health in the USA, from 2003 to 2010, investigating the efficacy and safety of anakinra treatment for up to 5 years in 43 patients with CAPS. Safety was evaluated using adverse event (AE) reports, laboratory assessments, vital signs and diary reports. Results. In total, 1233 AEs were reported during the study, with a yearly rate of 7.7 AEs per patient. The event rate decreased over time, and dose escalation during the study did not affect AE frequency. Anakinra had similar safety profiles in adults and children. The most frequently reported AEs were typical CAPS disease symptoms such as headache and arthralgia. Injection site reactions occurred mainly during the first month of anakinra treatment. In total, 14 patients experienced 24 serious AEs (SAEs), all of which resolved during the study period. The most common types of SAEs were infections such as pneumonia and gastroenteritis. There were no permanent discontinuations of treatment due to AEs. Conclusion. In this study anakinra treatment of patients with severe CAPS for up to 5 years was safe and well tolerated both in paediatric and adult patients, with most AEs emerging during the first months after treatment initiation. Trial registration: ClincialTrials.gov, clinicaltrials.gov, NCT00069329 PMID:27143789

  3. Impaired cytokine responses in patients with cryopyrin-associated periodic syndrome (CAPS)

    PubMed Central

    Haverkamp, M H; van de Vosse, E; Goldbach-Mansky, R; Holland, S M

    2014-01-01

    Cryopyrin-associated periodic syndrome (CAPS) is characterized by dysregulated inflammation with excessive interleukin (IL)-1β activation and secretion. Neonatal-onset multi-system inflammatory disease (NOMID) is the most severe form. We explored cytokine responses in 32 CAPS patients before and after IL-1β blocking therapy. We measured cytokines produced by activated peripheral blood monuclear cells (PBMCs) from treated and untreated CAPS patients after stimulation for 48 h with phytohaemagglutinin (PHA), PHA plus IL-12, lipopolysaccharide (LPS) or LPS plus interferon (IFN)-γ. We measured IL-1β, IL-6, IL-10, tumour necrosis factor (TNF), IL-12p70 and IFN-γ in the supernatants. PBMCs from three untreated CAPS patients were cultured in the presence of the IL-1β blocker Anakinra. Fifty healthy individuals served as controls. CAPS patients had high spontaneous production of IL-1β, IL-6, TNF and IFN-γ by unstimulated cells. However, stimulation indexes (SIs, ratio of stimulated to unstimulated production) of these cytokines to PHA and LPS were low in NOMID patients compared to controls. Unstimulated IL-10 and IL-12p70 production was normal, but up-regulation after PHA and LPS was also low. LPS plus IFN-γ inadequately up-regulated the production of IL-1β, IL-6, TNF and IL-10 in CAPS patients. In-vitro but not in-vivo treatment with Anakinra improved SIs by lowering spontaneous cytokine production. However, in-vitro treatment did not improve the low stimulated cytokine levels. Activating mutations in NLRP3 in CAPS are correlated with poor SIs to PHA, LPS and IFN-γ. The impairment in stimulated cytokine responses in spite of IL-1β blocking therapy suggests a broader intrinsic defect in CAPS patients, which is not corrected by targeting IL-1β. PMID:24773462

  4. Intrathecal opioid treatment for chronic non-malignant pain: a 3-year prospective study.

    PubMed

    Thimineur, Mark A; Kravitz, Edward; Vodapally, Mohan S

    2004-06-01

    Intrathecal (IT) opioid therapy is a treatment alternative for patients with severe chronic non-malignant pain. Several uncontrolled retrospective and prospective outcome studies have suggested a benefit in chronic non-malignant pain patients, but uncertainties about patient selection in these studies weaken the results. This study evaluated long-term outcome of IT opioid therapy in chronic non-malignant pain prospectively, and included two comparative groups to improve understanding of selection criteria and relative severity of intrathecal pump recipients (PRs). The study subjects included 38 PRs while the comparative groups included 31 intrathecal candidates who either had an unsuccessful trial, or declined the IT therapy, and another group of 41 newly referred patients. The following data were analyzed at study entry, and at 6 monthly intervals for a 3-year period: Symptom Check List 90 (SLC-90), SF-36 Health survey, Beck Depression Inventory, McGill Pain Questionnaire (short form), Oswestry Disability Index, Pain Drawings and Pain rating on visual analogue scale. Data analysis suggests the study group of PRs had improvements in pain, mood, and function from baseline to 36 months. These same parameters improved among new referrals (less severe patients receiving conservative pain management) while non-recipients significantly worsened. Although PRs improved, they were still worse off at 36 months than new referrals were at baseline. The study showed that when patients with extremely severe pain problems are selected as pump candidates, they will likely improve with the therapy, but their overall severity of pain and symptoms still remains high. PMID:15157684

  5. Use of transoesophageal echocardiography during the peri-operative period for trauma patients.

    PubMed

    Smyth, K; Hebballi, R; Peterson, M K

    2010-12-01

    The medical facility at Camp Bastion continues to evolve as a consequence of the increased throughput of battlefield trauma patients. There is a requirement for rapid and accurate diagnosis of haemodynamic instability and continued haemodynamic monitoring throughout the peri-operative period. Transoesophageal echocardiography (TOE) has been used for this purpose in the arena of cardiac anaesthesia since the mid 1980s. It is being introduced to other peri-operative settings where severe haemodynamic instability is expected. The old proverb: 'There are none so blind as those who cannot see' (Jeremiah 5:21) is applicable to this topic, in that TOE is proven to be a rapid, portable, safe and effective tool in the assessment of the haemodynamically unstable patient. This paper explores the application of TOE for the assessment of the major causes of haemodynamic instability in the trauma population. PMID:21302659

  6. 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

  7. Isolation and Characterization of Glycopeptide-Resistant Enterococci from Hospitalized Patients over a 30-Month Period

    PubMed Central

    Nelson, R. R. S.; McGregor, K. F.; Brown, A. R.; Amyes, S. G. B.; Young, H.-K.

    2000-01-01

    In February 1996, a Hospital Infection Control Practices Advisory Committee-style screening program was commenced to isolate and subsequently characterize glycopeptide-resistant enterococci (GRE) from patients at a hospital trust in Glasgow, Scotland. Over the next 30 months, GRE were isolated from 154 patients. GRE were isolated from patients in traditionally high-risk areas such as the renal unit and intensive care unit and also in areas considered to be lower risk, including medical wards and associated long-stay geriatric hospitals. The majority (90%) of isolates were Enterococcus faecium vanB. The remaining isolates consisted of seven E. faecalis (vanA), three E. gallinarum (vanC), and a further six E. faecium (five vanA, one both vanA and vanB) isolates. Analysis of SmaI-digested DNA by pulsed-field gel electrophoresis revealed that 34 of 40 (85%) VanB E. faecium isolates were identical or closely related, while 11 of 13 (85%) VanA GRE were distinct. High-level aminoglycoside resistance was seen in less than 8% of isolates. VanB E. faecium isolates were almost uniformly resistant to ampicillin and tetracycline. In this study, GRE have been isolated over a prolonged period from a broad range of patients. Glycopeptide resistance within the study hospital trust appeared to be mainly due to the clonal dissemination of a single strain of E. faecium VanB. PMID:10834962

  8. [Reverse myocardial remodeling in patients with aortic valve disease and mitral insufficiency in early postoperative period].

    PubMed

    Belov, Iu V; Katkov, A I; Seslavinskaia, T V; Vinokurov, I A; Salagaev, G I

    2015-01-01

    Surgical treatment of patients with aortic valve disease and concomitant mitral insufficiency remains debatable. We analyzed early postoperative results of surgical treatment of 80 patients depending on type of surgery. All patients were divided into three groups: the 1st - aortic valve replacement in patients without mitral valve dysfunction (control group) (n=44); the 2nd - isolated aortic valve replacement in patients with concomitant mitral regurgitation degree 2-3 (n=18), the 3rd - simultaneous aortic and mitral valve replacement (n=18). Combined valve replacement was associated with more intraoperative blood loss (852.78±442.08 ml) compared with aortic valve replacement (658.7±374.09 ml), p<0.05. In patients with mitral regurgitation greater hematocrit decrease was observed (22.13±3.6% in group 2 and 21.4±4.48 in group 3) in comparison with control group (24.17±3.72% in group 1), p<0.05. Incidence of postoperative complications did not differ in all groups. Mortality rate was 6.8% in group 1 and 11.1% in group 3, there were no deaths in group 2. Both valves correction provided faster myocardial remodeling. Left ventricular end-diastolic volume decreased on 50 ml in group 3, on 33.67 ml in group 2 and on 50.73 ml in group 1 (p<0.05). Pulmonary pressure decreased on 20 mm Hg in group 3, on 13 mm Hg - in group 2 and on 12.57 mm Hg - in group 1, p<0.05. In groups 1 and 3 pulmonary pressure became normal after operation, in group 2 signs of pulmonary hypertension were observed (pressure - 35.3 mm Hg). Analysis of the results showed that simultaneous mitral and aortic valves replacement initiates normalization of intracardiac hemodynamics in early postoperative period. PMID:26081181

  9. 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.

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

    PubMed

    Wang, Sui; Morré, Dorothy M; Morré, D James

    2003-02-20

    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. PMID:12565167

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

    MedlinePlus

    ... to Know About Zika & Pregnancy 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' ...

  12. 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

  13. 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. PMID:27313616

  14. Attenuated preejection period response to tyramine in patients with cardiac sympathetic denervation

    PubMed Central

    Imrich, Richard; Eldadah, Basil A.; Bentho, Oladi; Pechnik, Sandra; Sharabi, Yehonatan; Holmes, Courtney; Goldstein, David S.

    2016-01-01

    Background Stress is a well-known factor affecting cardiac contractility through the cardiac sympathetic nerves. A positive inotropic effect of the cardiac sympathetic nerves on the myocardium is reflected by preejection period (PEP) shortening. Patients with Parkinson disease (PD) and neurogenic orthostatic hypotension (NOH) (PD+NOH) or with pure autonomic failure (PAF) have markedly decreased myocardial 6-[18]F-fluorodopamine-derived radioactivity, reflecting cardiac sympathetic denervation. The functional effects of the cardiac sympathetic denervation have been unknown. Methods We measured PEP and heart rate-corrected PEP (PEPI) responses to i.v. tyramine (1 mg/min) in 13 patients (9 PD+OH and 4 PAF) with low 6-[18]F-fluorodopamine-derived radioactivity and in subjects with normal radioactivity (15 multiple system atrophy with NOS patients (MSA+NOS). Results Baseline PEP and PEPI did not differ between the groups. By 10 minutes after initiation of tyramine infusion, PEP and PEPI were significantly lower (p<0.01) in MSA+NOS, compared to baseline, whereas PEP and PEPI remained unchanged in the PD+NOH/PAF group. The PEP and PEPI decrease was larger in the MSA+NOS group than in the PD+NOH/PAF group (p<0.05). Conclusion One of the functional consequences of cardiac sympathetic denervation is failure to increase contractility in response to stimuli that depend on endogenous norepinephrine release. PMID:19120145

  15. 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

  16. 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…

  17. 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…

  18. Patient Management with Metallic Valve Prosthesis during Pregnancy and Postpartum Period.

    PubMed

    Garcez, Juliane Dantas Seabra; Rosa, Vitor Emer Egypto; Lopes, Antonio Sergio de Santis Andrade; Accorsi, Tarso Augusto Duenhas; Fernandes, João Ricardo Cordeiro; Pomerantzeff, Pablo Maria; Avila, Walkiria Samuel; Tarasoutchi, Flavio

    2015-10-01

    Prosthetic thrombosis is a rare complication, but it has high mortality and morbidity. Young women of childbearing age that have prosthetic heart valves are at increased risk of thrombosis during pregnancy due to changes in coagulation factors. Anticoagulation with adequate control and frequent follow-up if pregnancy occurs must be performed in order to prevent complications related to anticoagulant use. Surgery remains the treatment of choice for prosthetic heart valve thrombosis in most clinical conditions. Patients with metallic prosthetic valves have an estimated 5% risk of thrombosis during pregnancy and maternal mortality of 1.5% related to the event. Anticoagulation with vitamin K antagonists during pregnancy is related to varying degrees of complications at each stage of the pregnancy and postpartum periods. Warfarin sodium crosses the placental barrier and when used in the first trimester of pregnancy is a teratogenic agent, causing 1-3% of malformations characterized by fetal warfarin syndrome and also constitutes a major cause of miscarriage in 10-30% of cases. In the third trimester and at delivery, the use of warfarin is associated with maternal and neonatal bleeding in approximately 5 to 15% of cases, respectively. On the other hand, inadequate anticoagulation, including the suspension of the oral anticoagulants aiming at fetal protection, carries a maternal risk of about 25% of metallic prosthesis thrombosis, particularly in the mitral valve. This fact is also due to the state of maternal hypercoagulability with activation of coagulation factors V, VI, VII, IX, X, platelet activity and fibrinogen synthesis, and decrease in protein S levels. The Registry of Pregnancy and Cardiac Disease (ROPAC), assessing 212 pregnant women with metal prosthesis, showed that prosthesis thrombosis occurred in 10 (4.7%) patients and maternal hemorrhage in 23.1%, concluding that only 58% of patients with metallic prosthesis had a complication-free pregnancy. PMID

  19. Transoral robotic surgery for hypopharyngeal squamous cell carcinoma: 3-year oncologic and functional analysis.

    PubMed

    Park, Young Min; Kim, Won Shik; De Virgilio, Armando; Lee, So Yoon; Seol, Jeong Hun; Kim, Se-Heon

    2012-06-01

    The recent trend in treatment of hypopharyngeal cancer is organ preservation in order to maintain swallowing and speech function as well as improve quality of life. Transoral robotic surgery (TORS) can remove hypopharyngeal lesions successfully without an external incision, preserving physiologic functions of affected organs. However, studies have yet to assess the oncologic and functional results of TORS for the treatment of hypopharyngeal cancer. This prospective study evaluated the oncologic and functional results of TORS for the treatment of hypopharyngeal cancer obtained at our institution over a period of 3 years and confirmed the validity of TORS as a surgical organ-preserving strategy. Between April 2008 and September 2011, 23 patients who were diagnosed with hypopharyngeal cancer underwent TORS for removal of a primary lesion. The da Vinci Robotic system (Intuitive Surgical Inc., Sunnyvale, California) was used to remove the lesion. The Kaplan-Meier method was used to analyze overall survival and disease-free survival. Videopharyngogram study (VEF) was performed and functional outcome swallowing scale (FOSS) was utilized to measure and evaluate swallowing function. Acoustic wave form analysis was conducted to evaluate voice status. Overall survival at 3 years was 89% and disease-free survival was 84%. On the VEF study, serious aspiration or delay of swallowing was not observed during the pharyngeal stage of the swallowing process. Overall, 96% of the patients showed favorable swallowing abilities with an FOSS score ranging from 0 to 2. The fundamental frequency variation (vF0) and jitter were increased upon acoustic waveform analysis (vF0=2.71 ± 0.063, Jitter=2.01 ± 0.034), but the harmonic-to-noise ratio (HNR) and shimmer were maintained close to the normal range (HNR=1.28 ± 0.001, Shim=1.74 ± 0.036). The oncologic and functional results of TORS were quite acceptable for the treatment of hypopharyngeal cancer. TORS is a valid treatment option as a

  20. Loa loa microfilarial periodicity in ivermectin-treated patients: comparison between those developing and those free of serious adverse events.

    PubMed

    Kamgno, Joseph; Pion, Sébastien D; Mackenzie, Charles D; Thylefors, Björn; Boussinesq, Michel

    2009-12-01

    The main risk factor of post-ivermectin serious adverse events (SAEs) is the presence of a high Loa loa microfilaremia. However, the majority of patients with such high loads do not develop SAEs, suggesting that co-factors may be involved. An infection with simian Loa parasites, whose microfilariae show a nocturnal periodicity, might be such a co-factor. The periodicity of Loa microfilariae was compared, using cosinor methodology, in 4 patients who had developed a post-ivermectin neurologic SAE, 4 patients who had experienced a non-neurologic SAE, and 14 control individuals. The periodicity was similar in all three groups, with a peak of microfilaremia occurring between 12:30 and 2:00 PM. The results of this study, which for the first time characterizes the periodicity of Loa microfilariae mathematically, suggest that post-ivermectin SAEs are not related to an infection with a Loa simian strain. PMID:19996437

  1. Rehabilitation of resorbed mandibular ridges using mini implant retained overdentures: A case series with 3 year follow-up.

    PubMed

    Kumari, Pooja; Verma, Mahesh; Sainia, Vikrant; Gupta, Rekha; Gill, Shubhra

    2016-01-01

    With the increasing average life expectancy of human beings, the need to cater geriatric patients is ever increasing. Complete dentures are an indispensable tool in this regard. The loose and unstable lower complete denture owing to residual ridge resorption is one of the most common problems faced by edentulous patients. Dental implant retained overdentures have emerged as an efficient treatment modality for such patients. Though useful, not every patient is a suitable candidate to go for conventional implant-borne prosthesis, limitation being the available bone width. In such cases, mini implants may be used for augmenting the retention of the dentures and improving the quality of life of patients. In this case series, rehabilitation of three compromised cases with mini implant retained overdentures have been described wherein patients are experiencing instability of lower denture due to thin resorbed mandibular ridges. In one of the cases, three mini implants placed in A, C, and E position were splinted using a cemented bar to retain the mandibular denture. The other two cases were rehabilitated using unsplinted ball type one piece mini implants placed in A, C, and E position in one case and B and D position in another case. Though splinted bar design should be preferred but the lack of available vertical space precluded the utilization of bar in other two cases. The results were found to be satisfactory with no complications reported during a follow-up period of over 3 years in all the cases. PMID:27141177

  2. [Status of blood coagulation and various background endocrine indices in patients with basal meningiomas during pre- and postoperative periods].

    PubMed

    Burgman, G P; Snigireva, R Ia; Vial'tseva, I N; Shvorneva, V Z; Snigirev, V S

    1980-01-01

    The condition of blood coagulation activity and the indices of the endocrine background were studied in patients with tumors of prevalently basal localization which caused a direct effect on the central regulating centers. Thirty patients with basal and medially located meningiomas were examined in the pre- and postoperative periods. Before the operation most patients had clinical signs of endocrine-metabolic disorders, often in the presence of an increased content of ACTH and cortisol in the blood. Blood coagulation was disturbed in the majority of patients, mainly due to increased activity of the blood coagulation system. In the postoperative period, blood coagulation activity in 24 of 30 patients was increased or showed a tendency to increase in the presence of elevated blood ACTH content while processes of fibrinolysis were inhibited, which substantiates the necessity for anticoagulant therapy when large doses of glucocorticoids are used. PMID:6254292

  3. Sustained favorable long-term outcome in the treatment of schizophrenia: a 3-year prospective observational study

    PubMed Central

    2011-01-01

    Background This study of chronically ill patients with schizophrenia aimed to identify patients who achieve sustained favorable long-term outcome - when the outcome incorporates severity of symptoms, level of functioning, and use of acute care services - and to identify the best baseline predictors of achieving this sustained favorable long-term outcome. Methods Using data from the United States Schizophrenia Care and Assessment Program (US-SCAP) (N = 2327), a large 3-year prospective, multisite, observational study of individuals treated for schizophrenia in the US, a hierarchical cluster analysis was performed to group patients based upon baseline symptom severity. Symptom severity was assessed using the Positive and Negative Syndrome Scale (PANSS) scores, level of functioning, and use of acute care services. Level of functioning reflected patient-reported productivity and clinician-rated occupational role functioning. Use of acute care services reflected self-reported psychiatric hospitalization and emergency service use. Change of health state was determined over the 3-year period. A patient was classified as having a sustained favorable long-term outcome if their health state values had the closest distance to the defined "best baseline cluster" at each point over the length of the study. Stepwise logistic regression was used to determine baseline predictors of sustained favorable long-term outcome. Results At baseline, 5 distinct health state clusters were identified, ranging from "best" to "worst." Of 1635 patients with sufficient data, only 157 (10%) experienced sustained favorable long-term outcome during the 2-years postbaseline. The baseline predictors associated with sustained favorable long-term outcome included better quality of life, more daily activities, patient-reported clearer thinking from medication, better global functioning, being employed, not being a victim of a crime, not having received individual therapy, and not having received help

  4. 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

  5. [Epidemiologic aspects of gastroduodenal ulcer in Burundi. Apropos of 1,476 new cases seen in 3 years].

    PubMed

    Ndabaneze, E; Kadende, P; Laroche, R; Aubry, P

    1989-10-01

    The objective of this study is to evaluate the main epidemiological characteristics of gastroduodenal ulcer in Burundi, from 3,282 high gastrointestinal endoscopies, performed over a 3-year period, permitting the diagnosis of 1,476 ulcers (45%): the duodenal ulcer is predominant, almost 93 p. cent. The sex-ratio is 2.75/1. There is a peak of maximum frequency between the ages of 20 and 29 years for duodenal ulcer. The results of this study are consistent with the series published in Africa regarding the location of the ulcer, sex and age. The frequency is high in relation with the series coming from West Africa. Two provinces in the 15 which form Burundi, share between them 50% of ulcer patients. These are the highest regions of the country (average attitude = 1,800 meters), but where the socio-cultural and dietary customs are the same as in the other provinces. PMID:2817766

  6. A retrospective study of the changing trends of antimicrobial resistance of Klebsiella pneumoniae isolated from urine samples over last 3 years (2012-2014)

    PubMed Central

    Sharma, Neetu; Gupta, Anita K.; Walia, Geeta; Bakhshi, Rupinder

    2016-01-01

    Background: In our country, the problem of antibiotic resistance is compounding because of overuse and misuse of antibiotics. There is no systematic national surveillance of antibiotic resistance and insufficient data are available to quantify the problem. Objectives: To study the changing pattern of antimicrobial resistance of Klebsiella pneumoniae isolates from patients of urinary tract infections over last 3 years. Materials and Methods: A retrospective, record-based study carried out based on the records culture sensitivity reports of indoor patients, during past 3 years (2012-2014). The type of organisms most common in urine sample was noted, and the drugs still effective for the particular organism were noted. Results: Klebsiella was the second most frequent isolate throughout the 3 years (14%) of the total isolates). Analysis of the results year wise indicated that the lowest percentage of resistance was manifested against imipenem between 11.94% (2012) and 13.75% (2014). Over the successive years, resistance to ceftriaxone tends to increase from 74.95 % (2012) to 81% (2014). Klebsiella showed very high resistance 90.78% (2012) and 95.63% (2012) to co-trimoxazole and tetracycline, respectively with increasing trend to absolute resistance to both groups over the 3 years period. On an average over the 3 years Klebsiella showed a high amount of resistances to fluoroquinolones (72.71%) and aminoglycosides (76.22%). While multi-drug resistant Klebsiella range between 65% (2012) and 67% (2014). Conclusion: The antimicrobial resistance patterns are constantly evolving and vary from region to region it has become a necessity to do constant antimicrobial sensitivity surveillance. This will help clinicians to provide safe and effective empirical therapies. PMID:27003967

  7. 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. PMID:26541241

  8. 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…

  9. 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…

  10. The Structure of Executive Function in 3-Year-Olds

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

  11. [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. PMID:25558751

  12. Experience in the use of Actovegin in the treatment of patients with cognitive disorders in the acute period of stroke.

    PubMed

    Derev'yannykh, E A; Bel'skaya, G N; Knoll, E A; Krylova, L G; Popov, D V

    2008-10-01

    Forty-three patients with mild-moderate ischemic stroke were studied in the acute period and were divided into two groups. The experimental group consisted of 32 patients who were given Actovegin; the reference group consisted of 11 patients who were given piracetam. Patients were investigated before treatment and at 10 and 30 days; investigations included examination, points assessments of neurological disorders using the original Gusev-Skvortsova scale, neuropsychological tests using the MMSE scale, rheoencephalography, and electroencephalography. Analysis of changes in clinical features in patients treated with Actovegin during the acute period showed that Actovegin had clear positive effects both on general cerebral and on focal neurological symptoms. By the end of treatment, the extent of recovery of impaired functions, assessed in terms of total ischemic points and cognitive functions, was significantly greater in patients treated with Actovegin than in patients given piracetam. These data lead to the conclusion that Actovegin is effective in the treatment of patients with ischemic stroke. PMID:18802768

  13. Pituitary stalk hemangioblastoma in a von hippel-lindau patient : clinical course follow-up over a 20-year period.

    PubMed

    Lee, Kyung Mi; Kim, Eui Jong; Choi, Woo Suk; Kim, Tae Sung

    2013-05-01

    Supratentorial hemangioblastomas (HBs) are rare, and pituitary stalk HBs are extremely uncommon; therefore, pituitary stalk evaluation is often overlooked. Herein, we report the development of pituitary stalk HB over a 20-year period and the importance of regular long-term follow up for patients with HBs. PMID:23908704

  14. Risk factors for mortality in patients with bloodstream infections during the pre-engraftment period after hematopoietic stem cell transplantation

    PubMed Central

    Karpov, Igor; Milanovich, Natalia; Uss, Anatoly; Iskrov, Igor

    2016-01-01

    Background Bloodstream infections (BSI) remain a frequent complication during the pre-engraftment period after hematopoietic stem cell transplantation (HSCT), resulting in high mortality rates. This study evaluated risk factors for mortality in hematopoietic stem cell transplant recipients with BSI in the pre-engraftment period. Methods This prospective case control study was performed at the Center of Hematology and Bone Marrow Transplantation in Minsk, Republic of Belarus. Data relating to patient age and gender, date and type of transplantation, conditioning chemotherapy regimen, microorganisms isolated from blood, and antibacterial therapy were prospectively collected from all hematopoietic stem cell recipients with microbiologically proven cases of BSI in the pre-engraftment period. The primary outcome was all-cause 30-day mortality after onset of febrile neutropenia. Results A total of 135 adult patients with microbiologically proven BSI after HSCT were studied, with 65.2% of cases caused by gram-negative microorganisms and 21.5% by non-fermenting bacteria. Inadequate empiric antibacterial therapy and isolation of carbapenem-resistant non-fermenting gram-negative bacteria (Acinetobacter baumannii and Pseudomonas aeruginosa) were independently associated with increased all-cause 30-day mortality in these patients. Conclusion The risk factors for mortality in adult patients with BSI in the pre-engraftment period after HSCT were inadequacy of empirical antibacterial therapy and isolation of carbapenem-resistant A. baumannii or P. aeruginosa. PMID:27382554

  15. 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. PMID:16384839

  16. 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

  17. A prospective clinical evaluation of different single-tooth restoration designs on osseointegrated implants. A 3-year follow-up of Brånemark implants.

    PubMed

    Wannfors, K; Smedberg, J I

    1999-12-01

    Since single-tooth implant restorations were introduced 12 years ago (Jemt 1986), there has been continuous development both in the technical design and the aesthetic outcome of the treatment. In order to ensure high quality in single-tooth implant treatments a clinical follow-up study was carried out on patients treated with modifications to the original regimen. In this study 69 consecutive patients were provided with 80 single-tooth implant restorations. The patients were followed for 3 years. There was continuous development of the prosthetic design during the time of the study, allowing us to analyse possible prognostic differences for the different prosthetic treatments. This study confirms earlier reports which describe the single-tooth implant treatment as a safe method with few surgical complications and minimal marginal bone loss. Only 1 implant was lost during the follow-up period and the average marginal bone loss was 0.48 mm over the 3-year follow-up period. Crowns veneered with acrylic and with gold casted directly to the abutments, screwed onto the implants, led to recurring prosthetic complications and gave an appearance of rapid ageing. The first generation of crowns made following the Cera-One design, sometimes produced a gap between the crown and the abutment associated with significant marginal bone loss during the first year. Few surgical or prosthetic complications were noted with cemented all-ceramic constructions, although the number of these crowns in this study was limited. PMID:10740454

  18. Alveolar recruitment in patients in the immediate postoperative period of cardiac surgery.

    PubMed

    Padovani, Cauê; Cavenaghi, Odete Mauad

    2011-01-01

    Lung complications during postoperative period of cardiac surgery are frequently, highlighting atelectasis and hypoxemia. Alveolar recruitment maneuvers have an important role in the prevention and treatment of these complications. Thus, this study reviewed and updated the alveolar recruitment maneuvers performance in the immediate postoperative period of cardiac surgery. We noted the efficacy of alveolar recruitment through different specific techniques and the need for development of new studies. PMID:21881720

  19. Successful reuse of a transplanted kidney: 3-year follow-up.

    PubMed

    Celik, Ali; Saglam, Funda; Cavdar, Caner; Sifil, Aykut; Gungor, Ozkan; Bora, Seymen; Gulay, Huseyin; Camsari, Taner

    2007-07-01

    The number of new transplantations has not kept pace with the ever-growing number of patients waiting for a kidney transplant, and there has been a growing shortage of deceased donor kidneys. Previously transplanted organs have been used to increase the donor pool. There is very little data about the reuse of a transplanted kidney. We report a case of successful reuse of a kidney graft after the death of the first recipient with a 3-year follow-up. PMID:17591534

  20. [THE DIAGNOSTIC AND THERAPEUTIC BRONCHOSCOPY IN CARDIAC PATIENTS UNDERGOING MECHANICAL VENTILATION IN THE POSTOPERATIVE PERIOD].

    PubMed

    Titova, I V; Khrustaleva, M V; Eremenko, A A; Babaev, M A

    2016-01-01

    The review presents an analysis of domestic and foreign literature on the use of bronchoscopy in patients with obstructive respiratory failure in the ICU. Separately considered the issue of additional research when performing bronchoscopy and create an algorithmfor the application of diagnostic and therapeutic bronchoscopy in cardiac surgical patients undergoing mechanical ventilation. PMID:27192859

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ... lung cancer patient-focused drug development. In the Federal Register of June 5, 2013 (78 FR 33581... In the Federal Register of June 5, 2013 (78 FR 33581), FDA announced an opportunity for public... HUMAN SERVICES Food and Drug Administration Lung Cancer Patient-Focused Drug Development; Extension...

  2. 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

  3. Glycemic effects of vildagliptin in patients with type 2 diabetes before, during and after the period of fasting in Ramadan

    PubMed Central

    Malha, Line P.; Taan, Ghazi; Zantout, Mira S.

    2014-01-01

    Objective To study the incidence of hypoglycemia, glycemic control and body weight changes in patients with type 2 diabetes treated with vildagliptin and metformin versus another group treated with sulphonylureas and metformin during and after the period of fasting in Ramadan. Patients and methods This is a randomized open-label clinical trial that recruited 69 patients previously treated with a combination therapy of metformin and sulphonylurea. Patients in the control group were maintained on their usual metformin and sulphonylurea regimen with dose adjustment for the fasting period. Patients in the study group were given vildagliptin 50 mg twice daily (at Suhur and at Iftar). One group remained on the previous background therapy unchanged and the other group was switched from sulphonylurea to vildagliptin in combination with metformin. Four visits were scheduled, one before the beginning of Ramadan (baseline), a second visit at mid Ramadan, a third at the end of Ramadan and a final visit 1 month after the end of Ramadan. At every visit, patients were assessed for hypoglycemic events and patient education was given on lifestyle needs and hypoglycemia monitoring and management. Results The calculated change in hemoglobin A1c from baseline to last visit was similar for both groups. The incidence of hypoglycemia during Ramadan was higher in the control group (26 episodes versus 19 episodes in the study group); this result was not statistically significant (p = 0.334). However, the number of patients who dropped out from the study because of discomfort due to treatment and fear of hypoglycemia was higher in the control group. Conclusion For patients who insist on observing the fast, physicians can allow it only with close follow up and monitoring for hypoglycemic events, and vildagliptin may be a better agent than sulphonylurea. PMID:24696775

  4. A case of periodic hypokalemic paralysis in a patient with celiac disease.

    PubMed

    Ranjan, Amitabh; Debata, Pradeep K

    2014-06-01

    A 4-year-old male child presented with recurrent episodes of diarrhoea for 6-months, each episode associated with weakness of all four limbs and documented hypokalemia who on examination had some pallor, short stature, flaccid quadriparesis with absent DTR. The patient responded clinically and biochemically to potassium supplement. TTG and Intestinal biopsy confirmed celiac disease. Patient was put on gluten free diet and patient is doing well with no recurrence. We present a case of Recurrent hypokalemic paralysis with previously unsuspected celiac disease who was not in celiac crisis. PMID:25121038

  5. 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

  6. 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. PMID:23062741

  7. Supportive telephone outreach as an interventional strategy for elderly patients in a period of crisis.

    PubMed

    Berkman, P; Heinik, J; Rosenthal, M; Burke, M

    1999-01-01

    During the Gulf War in 1991 a telephone-based support system was established for elderly patients living at home in Israel. The study population involved 93 elderly patients (mean age 74), who had recently been discharged from hospital and were chosen for supervision by the Home-Care Unit of the Tel Aviv Sourasky Medical Center, Israel. Two different teams were involved with the telephone support calls: secretarial staff (nonprofessional team) and social workers (professional team). The research examined the characteristics of the study population and also included a comparison between the two groups of patients receiving the psycho-social support. The latter indicated that better results of outcome indices were achieved by the professional team. Further, this study demonstrated the feasibility of telephone-support outreach as an interventional strategy for psycho-social support for elderly patients at a time of crisis. PMID:10425672

  8. Hypokalaemic Periodic Paralysis in a Patient with Subclinical Hyperthyroidism: A Rare Case

    PubMed Central

    Shaikh, Mohammed Aslam; Gummadi, Thejaswi

    2016-01-01

    Thyrotoxic Periodic Paralysis (TPP) is an uncommon disorder. Though many cases of hypokalaemic periodic paralysis are reported in overt hyperthyroidism, hypokalaemic paralysis in subclinical hyperthyroidism is very rare. Subclinical hyperthyroidism is characterised by circulating TSH levels below reference range and normal thyroid hormone levels. We describe a case of 32-year-old Asian male who presented to the emergency department with acute onset weakness and hypokalaemia with no previous history of thyroid disorder or any signs and symptoms suggestive of hyperthyroidism. He was subsequently diagnosed with Graves’ disease with subclinical hyperthyroidism. PMID:26894115

  9. [Body temperature regulation as a prognostic criterion for the postoperative period in patients with femoral fractures].

    PubMed

    Samokhin, A V

    2002-01-01

    Frequency is studied of adequate, redundant, inert, and reduced types of thermoreactivity in healthy subjects and patients with fractures. Definition of type of thermoreactivity to cooling in patients with fractures of the thighbone permits prognosticating the course of the bone fracture healing process. The symptom of distal hyperthermia/hypothermia is unspecific but is regarded as a supplementary index of the type of thermoreactivity and character of the course of the fracture healing process. PMID:12073260

  10. 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

  11. Negative and positive childhood experiences across developmental periods in psychiatric patients with different diagnoses – an explorative study

    PubMed Central

    Saleptsi, Evangelia; Bichescu, Dana; Rockstroh, Brigitte; Neuner, Frank; Schauer, Margarete; Studer, Karl; Hoffmann, Klaus; Elbert, Thomas

    2004-01-01

    Background A high frequency of childhood abuse has often been reported in adult psychiatric patients. The present survey explores the relationship between psychiatric diagnoses and positive and negative life events during childhood and adulthood in psychiatric samples. Methods A total of 192 patients with diagnoses of alcohol-related disorders (n = 45), schizophrenic disorders (n = 52), affective disorders (n = 54), and personality disorders (n = 41) completed a 42-item self-rating scale (Traumatic Antecedents Questionnaire, TAQ). The TAQ assesses personal positive experiences (competence and safety) and negative experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas, and alcohol and drugs abuse) during four developmental periods, beginning from early childhood to adulthood. Patients were recruited from four Psychiatric hospitals in Germany, Switzerland, and Romania; 63 subjects without any history of mental illness served as controls. Results The amount of positive experiences did not differ significantly among groups, except for safety scores that were lower in patients with personality disorders as compared to the other groups. On the other side, negative experiences appeared more frequently in patients than in controls. Emotional neglect and abuse were reported in patients more frequently than physical and sexual abuse, with negative experiences encountered more often in late childhood and adolescence than in early childhood. The patients with alcohol-related and personality disorders reported more negative events than the ones with schizophrenic and affective disorders. Conclusions The present findings add evidence to the relationship between retrospectively reported childhood experiences and psychiatric diagnoses, and emphasize the fact that a) emotional neglect and abuse are the most prominent negative experiences, b) adolescence is a more 'sensitive' period for negative experiences as compared to

  12. Fluoxetine in adolescents with comorbid major depression and an alcohol use disorder: a 3-year follow-up study.

    PubMed

    Cornelius, Jack R; Clark, Duncan B; Bukstein, Oscar G; Kelly, Thomas M; Salloum, Ihsan M; Wood, D Scott

    2005-05-01

    The goal of this 3-year follow-up evaluation was to determine whether the decreases in drinking and in depressive symptoms that were noted during our acute phase study with fluoxetine in comorbid adolescents persisted at a 3-year follow-up evaluation. At the 3-year follow-up evaluation, the group continued to demonstrate significantly fewer DSM criteria for an AUD and fewer BDI depressive symptoms and also consumed fewer standard drinks than they had demonstrated at the baseline of the acute phase study. However, 7 of the 10 participants demonstrated MDD at the 3-year follow-up assessment, and 4 demonstrated an AUD. The presence of a MDD was significantly correlated with the presence of an AUD at both the 1-year and the 3-year follow-up assessments. Four of the participants restarted SSRI medications during the follow-up period. Half of the subjects graduated from college during the 3-year assessment period, despite their residual depressive symptoms and drinking. We conclude that the long-term therapeutic effects of an acute phase trial of fluoxetine plus psychotherapy slowly decrease but did not disappear when fluoxetine is discontinued shortly after the acute phase trial. The high rate of MDD at follow-up suggests that longer term antidepressant medication treatment may be needed for at least some comorbid adolescents. PMID:15833583

  13. Myocardial ischaemia and angina in the early post-infarction period: a comparison with patients with stable coronary artery disease.

    PubMed Central

    Marchant, B; Stevenson, R; Vaishnav, S; Ranjadayalan, K; Timmis, A D

    1993-01-01

    OBJECTIVE--To evaluate Holter and treadmill responses in patients with stable angina or recent myocardial infarction in order to compare the mechanisms of ischaemia and its symptomatic expression in these two groups. PATIENTS--75 patients with ischaemic ST segment depression on both a treadmill stress test and ambulatory Holter monitoring. Group A comprised 35 patients with stable angina, and group B comprised 40 patients in the early period after infarction. SETTING--The coronary care unit and cardiology department of a district general hospital. DESIGN--A prospective, between group, comparative study. RESULTS--Treadmill test showed demand driven ischaemia in both groups. Although ST depression occurred at comparable rate-pressure products and workloads, it was associated with angina in 80% of group A compared with only 40% of group B (p < 0.005). During Holter monitoring, ST depression was associated with an attenuated increase in rate in group A and almost no increase in rate in group B (18.2% v 3.7%; p < 0.005), suggesting that reductions in myocardial oxygen delivery were contributing to the ischaemic episodes, particularly in group B. Ischaemic episodes were more commonly silent during Holter monitoring, particularly patients in group B, only two of whom experienced angina in association with ST depression. Spectral and non-spectral measures of heart rate variability were significantly reduced in group B compared with group A. Patients with silent exertional ischaemia in group A had significantly less heart rate variability than patients who experienced angina but this difference was not seen in group B. CONCLUSION--In stable angina, myocardial ischaemia is usually painful and demand driven, whereas in the early period after infarction silent, supply driven ischaemia predominates. The failure of myocardial ischaemia to provoke symptoms in some patients with stable angina may be related to autonomic dysfunction affecting the sensory supply to the heart. In the

  14. Effects of dexmedetomidine on anesthesia recovery period and postoperative cognitive function of patients after robot-assisted laparoscopic radical cystectomy

    PubMed Central

    Ding, Lingling; Zhang, Hong; Mi, Weidong; Wang, Tao; He, Yan; Zhang, Xu; Ma, Xin; Li, Hongzhao

    2015-01-01

    Objective: The purpose of the study was to evaluate the neuroprotective effect of dexmedetomidine on anesthesia recovery period and postoperative cognitive function of patients after robot-assisted laparoscopic radical cystectomy and ileal conduit diversion. Methods: A total of 40 elective patients who would undergo robot-assisted laparoscopic radical cystectomy and ileal conduit diversion. They were randomly divided into two groups in a double-blind manner. After pneumoperitoneum established, all patients adopted 40° trendelenberg position. Mean arterial pressure (MAP), heart rate (HR), and bispectral index (BIS) of each patient were recorded at four moments respectively, namely the end of surgery (T0), palinesthesia (T1), extubation (T2), 10 min after extubation (T3). Results: In the dexmedetomidine group, the mean arterial pressure and heart rate decreased at T1 and T2 compared with controls (P<0.05); in addition, the delirium rating scale was lower than the latter (P<0.05) while Ramsay sedation score was significantly higher (P<0.05). POCD was observed on 28 patients, containing 17 controls and 11 dexmedetomidine individuals, one day after operation, and 21 patients (12 controls, 9 dexmedetomidine people) five days after operation. One- and five-day after operation, the levels of TNF-α, NSE and IL-6 in the dexmedetomidine group were significantly lower than those in the control group (P<0.05), and serum SOD significantly increased in the former (P<0.05). Conclusion: Dexmedetomidine had a neuroprotective effect on anesthesia recovery and postoperative period of the elderly patients undergone robot-assisted laparoscopic radical cystectomy, which might be related to the reduction of inflammatory reaction induced by dexmedetomidine. PMID:26379954

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

    PubMed

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

    2008-11-27

    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

  16. 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

  17. 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

  18. 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

  19. Medical care costs of patients with rheumatoid arthritis during the prebiologics period in Japan: a large prospective observational cohort study.

    PubMed

    Tanaka, Eiichi; Inoue, Eisuke; Mannalithara, Ajitha; Bennett, Mihoko; Kamitsuji, Shigeo; Taniguchi, Atsuo; Momohara, Shigeki; Hara, Masako; Singh, Gurkirpal; Yamanaka, Hisashi

    2010-02-01

    Our objective was to describe outpatient medical care costs of patients with rheumatoid arthritis (RA) in the prebiologics period in Japan. The outpatient costs of 6,771 RA patients (17,666 patient years) who were enrolled in an observational cohort study at the Institute of Rheumatology, Rheumatoid Arthritis (IORRA), in Tokyo, Japan, were calculated from the billing records dated from 2000 to 2004. Associations between outpatient costs and variables such as age, RA duration, RA disease activities, and disability levels were assessed. The average outpatient cost gradually increased (+7.7% in 4 years) from 271,498 JPY per year in 2000 to 292,417 JPY per year in 2004. Medications accounted for approximately 50% of total outpatient costs, which increased 29.6% during the 4 years. The outpatient costs increased in association with aging, longer RA duration, higher Disease Activity Score of 28 Joints (DAS28), and higher Japanese version of Health Assessment Questionnaire (J-HAQ) score. Generalized linear regression analysis revealed that both DAS28 and J-HAQ scores were the most significant factors associated with outpatient costs (p < 0.001). Outpatient costs for patients with RA increased year after year over the 4-year period under observation in Japan. Medical costs were higher with increasing RA disease activity and disability levels. PMID:19821162

  20. 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. PMID:27084549

  1. 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.

  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. PMID:17293318

  3. Adherence to Competing Strategies for Colorectal Cancer Screening Over 3 Years

    PubMed Central

    Liang, Peter S.; Wheat, Chelle L.; Abhat, Anshu; Brenner, Alison T.; Fagerlin, Angela; Hayward, Rodney A.; Thomas, Jennifer P.; Vijan, Sandeep; Inadomi, John M.

    2016-01-01

    Objectives We have shown that, in a randomized trial comparing adherence to different colorectal cancer (CRC) screening strategies, participants assigned to either fecal occult blood testing (FOBT) or given a choice between FOBT and colonoscopy had significantly higher adherence than those assigned to colonoscopy during the first year. However, how adherence to screening changes over time is unknown. Methods In this trial, 997 participants were cluster randomized to one of the three screening strategies: (i) FOBT, (ii) colonoscopy, or (iii) a choice between FOBT and colonoscopy. Research assistants helped participants to complete testing only in the first year. Adherence to screening was defined as completion of three FOBT cards in each of 3 years after enrollment or completion of colonoscopy within the first year of enrollment. The primary outcome was adherence to assigned strategy over 3 years. Additional outcomes included identification of sociodemographic factors associated with adherence. Results Participants assigned to annual FOBT completed screening at a significantly lower rate over 3 years (14%) than those assigned to colonoscopy (38%, P<0.001) or choice (42%, P<0.001); however, completion of any screening test fell precipitously, indicating the strong effect of patient navigation. In multivariable logistic regression analysis, being randomized to the choice or colonoscopy group, Chinese language, homosexuality, being married/partnered, and having a non-nurse practitioner primary care provider were independently associated with greater adherence to screening (P<0.01). Conclusions In a 3-year follow-up of a randomized trial comparing competing CRC screening strategies, participants offered a choice between FOBT and colonoscopy continued to have relatively high adherence, whereas adherence in the FOBT group fell significantly below that of the choice and colonoscopy groups. Patient navigation is crucial to achieving adherence to CRC screening, and FOBT is

  4. 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

  5. Clinical and functional results after the rehabilitation period in minimally-invasive unicondylar knee arthroplasty patients.

    PubMed

    Fuchs, Susanne; Rolauffs, Bernd; Plaumann, Thorsten; Tibesku, Carsten O; Rosenbaum, Dieter

    2005-04-01

    The objective of the present study was to analyze the clinical and functional outcome after minimally-invasive implantation of a Repicci-type unicompartmental sledge prosthesis . In 29 patients with primary unicompartmental knee osteoarthritis, 29 replacements of the medial compartment and four of the lateral compartment were performed using the minimally-invasive technique with the metal-backed and the all-polyethylene versions of the Repicci sledge prosthesis. Electromyography (EMG) of standardized locations was measured with the MyoSystem 2000 and analyzed with Myoresearch software. Gait analysis was performed with a six-camera motion analysis system and force platforms. Established clinical and quality of life (SF-36) scores were used to compare patients with 11 healthy age-matched individuals. The Repicci sledge prosthesis led postoperatively to functional results that were in the range of healthy joints, and superior to sledge prostheses of a different design. Gait and balance parameters were comparable to the control group, whilst electromyographically lower amplitudes were found in the patients than the controls and in the operated legs as compared to the non-operated legs. Many parameters of quality of life and activity were comparable to age-matched healthy individuals, and quality of life was superior to total knee replacement. When implanted using a minimally-invasive technique and with suitable patient selection, the Repicci sledge led to functional results comparable to those of healthy joints and gait parameters comparable to those of healthy individuals. The level of evidence is Level III, retrospective cohort study. PMID:15175850

  6. 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. PMID:27313111

  7. [Results of 3-year study of toothbrushing with a fluoride amine gel].

    PubMed

    Szöke, J; Kozma, M

    1989-12-01

    265 6-year-old children were investigated over a period of 3 years. In the test group, 6 toothbrushing exercises and 25-30 controlled applications of Elmex Gelèe were carried out yearly. The effect was analyzed by oral hygiene, caries frequency, caries intensity, and caries increase. The improvement of the oral hygiene index according to Silness-Löe was 30% and can be characterized as highly statistically significant (p less than 0.001). The inhibition of caries increase related to the surface (delta DMF-S) was 53% in the case of caries with substance loss and was also highly significant. PMID:2639721

  8. Intraoperative optical mapping of epileptogenic cortices during non-ictal periods in pediatric patients

    PubMed Central

    Song, Yinchen; Riera, Jorge J.; Bhatia, Sanjiv; Ragheb, John; Garcia, Claudia; Weil, Alexander G.; Jayakar, Prasanna; Lin, Wei-Chiang

    2016-01-01

    Complete removal of epileptogenic cortex while preserving eloquent areas is crucial in patients undergoing epilepsy surgery. In this manuscript, the feasibility was explored of developing a new methodology based on dynamic intrinsic optical signal imaging (DIOSI) to intraoperatively detect and differentiate epileptogenic from eloquent cortices in pediatric patients with focal epilepsy. From 11 pediatric patients undergoing epilepsy surgery, negatively-correlated hemodynamic low-frequency oscillations (LFOs, ~ 0.02–0.1 Hz) were observed from the exposed epileptogenic and eloquent cortical areas, as defined by electrocorticography (ECoG), using a DIOSI system. These LFOs were classified into multiple groups in accordance with their unique temporal profiles. Causal relationships within these groups were investigated using the Granger causality method, and 83% of the ECoG-defined epileptogenic cortical areas were found to have a directed influence on one or more cortical areas showing LFOs within the field of view of the imaging system. To understand the physiological origins of LFOs, blood vessel density was compared between epileptogenic and normal cortical areas and a statistically-significant difference (p < 0.05) was detected. The differences in blood-volume and blood-oxygenation dynamics between eloquent and epileptogenic cortices were also uncovered using a stochastic modeling approach. This, in turn, yielded a means by which to separate epileptogenic from eloquent cortex using hemodynamic LFOs. The proposed methodology detects epileptogenic cortices by exploiting the effective connectivity that exists within cortical regions displaying LFOs and the biophysical features contributed by the altered vessel networks within the epileptogenic cortex. It could be used in conjunction with existing technologies for epileptogenic/eloquent cortex localization and thereby facilitate clinical decision-making. PMID:27104137

  9. Intraoperative optical mapping of epileptogenic cortices during non-ictal periods in pediatric patients.

    PubMed

    Song, Yinchen; Riera, Jorge J; Bhatia, Sanjiv; Ragheb, John; Garcia, Claudia; Weil, Alexander G; Jayakar, Prasanna; Lin, Wei-Chiang

    2016-01-01

    Complete removal of epileptogenic cortex while preserving eloquent areas is crucial in patients undergoing epilepsy surgery. In this manuscript, the feasibility was explored of developing a new methodology based on dynamic intrinsic optical signal imaging (DIOSI) to intraoperatively detect and differentiate epileptogenic from eloquent cortices in pediatric patients with focal epilepsy. From 11 pediatric patients undergoing epilepsy surgery, negatively-correlated hemodynamic low-frequency oscillations (LFOs, ~ 0.02-0.1 Hz) were observed from the exposed epileptogenic and eloquent cortical areas, as defined by electrocorticography (ECoG), using a DIOSI system. These LFOs were classified into multiple groups in accordance with their unique temporal profiles. Causal relationships within these groups were investigated using the Granger causality method, and 83% of the ECoG-defined epileptogenic cortical areas were found to have a directed influence on one or more cortical areas showing LFOs within the field of view of the imaging system. To understand the physiological origins of LFOs, blood vessel density was compared between epileptogenic and normal cortical areas and a statistically-significant difference (p < 0.05) was detected. The differences in blood-volume and blood-oxygenation dynamics between eloquent and epileptogenic cortices were also uncovered using a stochastic modeling approach. This, in turn, yielded a means by which to separate epileptogenic from eloquent cortex using hemodynamic LFOs. The proposed methodology detects epileptogenic cortices by exploiting the effective connectivity that exists within cortical regions displaying LFOs and the biophysical features contributed by the altered vessel networks within the epileptogenic cortex. It could be used in conjunction with existing technologies for epileptogenic/eloquent cortex localization and thereby facilitate clinical decision-making. PMID:27104137

  10. 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.(2-11)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. PMID:26354738

  11. Natural inflation: Status after WMAP 3-year data

    SciTech Connect

    Savage, Christopher; Freese, Katherine; Kinney, William H.

    2006-12-15

    The model of natural inflation is examined in light of recent 3-year data from the Wilkinson Microwave Anisotropy Probe and shown to provide a good fit. The inflaton potential is naturally flat due to shift symmetries, and in the simplest version takes the form V({phi})={lambda}{sup 4}[1{+-}cos(N{phi}/f)]. The model agrees with WMAP3 measurements as long as f>0.7m{sub Pl} (where m{sub Pl}=1.22x10{sup 19} GeV) and {lambda}{approx}m{sub GUT}. The running of the scalar spectral index is shown to be small--an order of magnitude below the sensitivity of WMAP3. The location of the field in the potential when perturbations on observable scales are produced is examined; for f>5m{sub Pl}, the relevant part of the potential is indistinguishable from a quadratic, yet has the advantage that the required flatness is well-motivated. Depending on the value of f, the model falls into the large field (f{>=}1.5m{sub Pl}) or small field (f<1.5m{sub Pl}) classification scheme that has been applied to inflation models. Natural inflation provides a good fit to WMAP3 data.

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

    PubMed

    Kubonova, Eliska; Svoboda, Zdenek; Janura, Miroslav; Gallo, Jiri; 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

  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. 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)…

  15. 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…

  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. [Electrical burns in children. 3 years of case histories].

    PubMed

    Caneira, E; Serafim, Z; Duarte, R; Leal, M J

    1996-01-01

    The Burn Unit of Dona Estefânia Hospital admitted a total of 454 patients from January 1992 to January 1995, 24 of these patients suffered from electric shock. Of these 24 patients 3 suffered burns in the mouth, 15 in one or both hands and 6 multiple burns. In 19 patients the burns were up to 1%. A description is made of 5 cases, male children between the ages of 9 and 13 years, which were deemed severe. The incidents occurred outdoors with different voltages and in activities considered of ludic or experimental nature: two on the roof of a house, two with railway cables and one with an electrical cable in a port zone. The burnt areas vary between 4% and 70%, all of them 2nd and 3rd degree, with hospitalization lasting from 36 to 116 days. In addition to early and coordinated medical and rehabilitative treatment, according to individual needs, a description is also made of the cutaneous sequelae (deforming cicatrices, bridles), neurologic and psychologic sequelae, with emphasis on a patient who underwent amputation of the lower left leg and 4th and 5th ranges of the right foot. It was concluded that measures should be taken in education and legislation to prevent these accidents. Relevance is given to the need for a multidisciplinary team and specialized center for the treatment of these patients. PMID:9254529

  18. No causative DLL4 mutations in periodic catatonia patients from 15q15 linked families.

    PubMed

    McKeane, D P; Meyer, J; Dobrin, S E; Melmed, K M; Ekawardhani, S; Tracy, N A; Lesch, K P; Stephan, D A

    2005-06-01

    Two well-supported theories of schizophrenia pathogenesis are the neurotransmitter theory and the neurodevelopmental theory, suggesting, respectively, that dysregulation of neurotransmitter signaling and abnormal brain development are causative in this disease. The strongest evidence of neurotransmitter involvement are suggestions of abnormal dopamine signaling in the prefrontal cortex and one of the strongest indications of developmental abnormalities contributing to this disease is an inverse layering of the prefrontal cortex. These two theories of schizophrenia pathogenesis can be united by their involvement of the prefrontal cortex, where structural abnormalities could lead to neurochemical abnormalities. Accordingly, any gene expressed in the prefrontal cortex of developing brains is a functional candidate for schizophrenia. We have previously reported strong linkage to 15q15 (LOD = 3. 57; P = 2.6 x 10(-5)) in a collection of German multiplex families segregating the periodic catatonia subtype of schizophrenia in a nearly Mendelian fashion. A gene within our 15q15 linkage region, DLL4, is expressed in developing forebrain and produces a NOTCH4 ligand. Variants of NOTCH4 are associated with schizophrenia, thus DLL4 is both a functional as well as a positional candidate for schizophrenia. We screened this gene for mutations in three affected individuals and two unrelated controls and found two previously unreported SNPs, one non-synonymous polymorphism that changed an arganine to a histadine in Exon 7 and one synonymous polymorphism in exons. The non-synonymous SNP is a rare variant in that it was not found in 100 control chromosomes; however, it did not cosegregate with the disease in the extended family so it is not causative in this pedigree. It is unlikely that mutations in DLL4 are causative in this collection of families with linkage to 15q15. PMID:15820317

  19. Semen Analysis in Cancer Patients Referred for Sperm Cryopreservation before Chemotherapy over a 15-Year Period in Korea

    PubMed Central

    Ku, Ja Yoon; Park, Nam Cheol; Jeon, Tae Gyeong

    2015-01-01

    Purpose This study evaluated the demographics and semen parameters of males with cancer who banked their sperm prior to chemotherapy. Materials and Methods This is a retrospective study of 66 cases referred for sperm banking prior to initiation of chemotherapy over a 15-year period (1999~2014). Patients who had previously received cancer treatment including chemotherapy or radiotherapy were not included in this study. Results We studied a total of 66 cancer patients referred for cryopreservation of sperm prior to chemotherapy. The mean age of the patients at the time of banking was 32.0±7.9 years (range, 19~58 years). The types of cancer were testicular cancer (31 cases, 47.0%), non-Hodgkin's disease (10 cases, 15.1%), Hodgkin's disease (5 cases, 7.6%), leukemia (8 cases, 12.1%), gastrointestinal malignancy (5 cases, 7.6%), and musculoskeletal malignancy (5 cases, 7.6%). There were significant differences in sperm concentration and viability among the various types of cancer, but no significant difference in semen volume or sperm motility and morphology. Conclusions In this study we found that sperm quality could decrease even before chemotherapy. Because chemotherapy can also negatively affect spermatogenesis, sperm cryopreservation prior to treatment should be strongly recommended for cancer patients of reproductive age. PMID:25927057

  20. Bioequivalence of Generic and Brand Name Clozapine in Korean Schizophrenic Patients: A Randomized, Two-Period, Crossover Study

    PubMed Central

    Woo, Young Sup; Wang, Hee-Ryung; Yoon, Bo-Hyun; Lee, Sang-Yeol; Lee, Kwang Hun; Seo, Jeong Seok

    2015-01-01

    Objective Clozapine is the treatment of choice for refractory schizophrenia. The aim of this study was to compare the pharmacokinetics of the brand name (Clozaril) formulation and a generic formulation (Clzapine) of clozapine in Korean schizophrenic patients. Methods A prospective, randomized, crossover study was conducted to evaluate the steady-state pharmacokinetic profiles of Clozaril and Clzapine. Schizophrenic patients were randomized to receive either the brand name or generic formulation (100 mg twice daily) for 10 days, followed by the other formulation for 10 days. Plasma samples were collected on the last day of each treatment period. Results Twenty-two of 28 patients (78.6%) completed the study. The mean Cmax,ss values for Clzapine and Clozaril were 524.62 and 551.18 ng/mL, and the mean AUC0-12 values were 4479.90 hr·ng/mL and 4724.56 hr·ng/mL, respectively. The 90% CI values for the natural logarithmically transformed Cmax,ss and AUC0-12 ratios (Clzapine to Clozaril) after a single oral dose (100 mg) were 0.934 (0.849-1.028) and 0.936 (0.869-1.008), respectively. Five patients (20.8%) among 24 patients who took Clzapine reported 11 adverse events and six adverse events were reported by four patients (15.4%) among 26 who took Clozaril; there were no significant differences on physical examination or in vital signs, ECG, and laboratory tests between groups. Conclusion Generic clozapine (Clzapine) appears to be bioequivalent to brand name clozapine (Clozaril). PMID:26207129

  1. A 3-year community-based periodontal disease prevention programme for adults in a developing nation.

    PubMed

    Cutress, T W; Powell, R N; Kilisimasi, S; Tomiki, S; Holborow, D

    1991-12-01

    A field trail of a community programme for improving periodontal health of adults was carried out in a geographically remote, unsophisticated rural population in the South Pacific islands of Tonga. The 3-year project (1986-89) involved three village communities, each with a population of approximately 1200. Village N received supplies of toothbrushes and toothpaste without charge, health education (videos, talks, posters) and periodic dental scaling (ultrasonic). Village K received the same as N except that dental scaling was not provided. Village E received none of the services provided to the villages N and K. Baseline and final examinations of 20-44-year olds showed that unsupervised self-care promoted at the community level, when supplemented with periodic removal of subgingival calculus, significantly improved periodontal health. Improvement was age dependent. PMID:1800382

  2. [Transfer of cardiac catheterisation from a paediatric to an adult cardiological centre: results at 3 years].

    PubMed

    Agnoletti, G; Boudjemline, Y; Ladouceur, M; Iserin, L

    2007-05-01

    The advances of surgical and interventional treatment of congenital heart diseases have allowed a large number of patients with congenital heart disease to reach adult age. This population involves almost 0.3/1000 of total population in West Europe and North America and can be estimated around 200000 patients in France. Patients with operated Tetralogy of Fallot, benign forms of pulmonary atresia with ventricular septal defect, simple or complex transposition of the great arteries usually survive beyond childhood. These patients can need repeated interventions to treat lesions of native or reconstructed pulmonary arteries and/or aortic arch, to occlude residual shunts, to treat pulmonary incompetence. More complex heart diseases such as single ventricle, rarely allow survival until the adult age. The majority of these patients undergo heart transplant, often made difficult by multiple cardiac surgeries, anomalies of pulmonary arteries, chronic cyanosis, aorto-pulmonary shunts. Patients with relatively simple or complex congenital heart diseases need to be followed-up in specialized units, like those created more than twenty years ago in the United States, Canada, and United Kingdom. Interventional cardiac catheterisation play a major role in the management of this population. The results of 3 years of activity in a new centre treating GUCH patients are illustrated. PMID:17646764

  3. The association of human leukocyte antigen polymorphisms with disease severity and latency period in patients with silicosis

    PubMed Central

    2014-01-01

    Background Denim sandblasting may cause silicosis as a result of free crystalline silica inhalation. Its pathogenesis remains unclear, but autoimmunity may play a role in the development of silicosis. The present study aimed to investigate the relationships between human leukocyte antigen (HLA) and the severity and latency period of silicosis. Methods 48 silicotic patients in the Eastern part of Turkey were classified according to their latency period and disease severity. The distribution of HLAs according to disease severity and latency period was assessed. Results A23 (7.5%), B49 (7.5%), and B51 (25%) were more common in the mild group than in the severe group, and B55 (8.9%) and DR4 (17.9%) were more common in the severe group than in the mild one. Only B51 was significantly more common in the mild group than in the severe one (25%, n = 10 vs. 7.1%, n = 4; p = 0.016). Conclusions This study suggests that HLA antigens may play a particular role in the severity of silica-induced lung disease, but there was no association between HLA and progression time of the disease. PMID:24646632

  4. Derived Arterial Stiffness is Increased in Patients with Obstructive Sleep Apnea and Periodic Limb Movements during Sleep

    PubMed Central

    Drakatos, Panagis; Higgins, Sean; Pengo, Martino F.; Kent, Brian D.; Muza, Rex; Karkoulias, Kiriakos; Leschziner, Guy; Williams, Adrian

    2016-01-01

    Study Objectives: Both periodic limb movements during sleep (PLMS) and obstructive sleep apnea (OSA) have been associated with increased risk of cardiovascular disease (CVD). OSA has also been linked to increased large arterial stiffness, which is considered an independent risk factor for CVD. We utilized a previously validated index of large artery stiffness (SIDVP) derived from the digital volume pulse (DVP) to seek comparison in patients with PLMS and OSA. Methods: Forty-nine adult male subjects, without known comorbidities that could affect arterial stiffness or on vasoactive medication, were retrospectively identified and categorized into controls (n = 8), PLMS (n = 13), OSA (n = 17), and OSA/PLMS (n = 11). The cutoff for PLMS was a periodic limb movement index (PLMI) > 15 events/h, and for OSA an apnea-hypopnea index (AHI) > 10 events/h. SIDVP was derived from the raw data of photoplethysmography of the nocturnal polysomnography, averaged for 2 min prior to sleep study initiation (baseline), after completion in the morning, and every half hour after sleep onset. Results: The groups were age/body mass index-matched. Controls showed lower baseline, morning, and overall SIDVP compared to the other groups (p < 0.01). Patients with PLMS (PLMI: 50.69 ± 9.7 events/h) and the OSA group (AHI: 29.7 ± 2 events/h) demonstrated similar overall SIDVP (6.78 ± 0.08 versus 6.94 ± 0.04, respectively, p = 0.5), whereas the OSA/PLMS (AHI: 29.35 ± 8, PLMI: 50.63 ± 7.2) group demonstrated the highest (7.40 ± 0.06, p < 0.001). Conclusions: Based on an easily reproducible and applicable marker of large arterial stiffness, patients with significant PLMS had higher SIDVP when compared to controls and comparable to those with moderate/severe OSA. The OSA/PLMS group had the highest SIDVP, implying a possible additive effect of OSA and PLMS on arterial stiffness. Citation: Drakatos P, Higgins S, Pengo MF, Kent BD, Muza R, Karkoulias K, Leschziner G, Williams A. Derived arterial

  5. Early Childhood Autism and Structural Therapy: Outcome after 3 Years.

    ERIC Educational Resources Information Center

    Ward, Alan J.

    1978-01-01

    Examines the effect of three years of structural therapy on inpatient cases of early childhood autism (ECA). Treatment resulted in the discharge of 12 patients. Results indicate that high stimulation, physically intrusive, gamelike, novelty filled, and developmentally oriented treatment of structural therapy can produce significant improvement in…

  6. Experience with 300 laparoscopic inguinal hernia repairs with up to 3 years follow-up.

    PubMed Central

    Davies, N. M.; Dunn, D. C.; Appleton, B.; Bevington, E.

    1995-01-01

    The long-term results of 300 laparoscopic inguinal hernia repairs are reported with 11 cases followed up more than 3 years, 104 cases more than 2 years, and 225 cases more than 1 year. There were five early failures owing to the use of too small a piece of mesh. There have been no long-term recurrences. The results indicate that transabdominal preperitoneal laparoscopic mesh repair of hernias is a satisfactory technique with a low recurrence rate and a low major complication rate (4%). Patients have found the procedure to be remarkably pain free and 51% have taken no analgesics after discharge from hospital. Of the patients, 78% returned to work within 2 weeks of the operation. These results suggest that laparoscopic hernia repair can be performed safely with excellent long-term results. PMID:8540657

  7. 7 CFR 3015.21 - Retention period.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... for 3 years from the starting date specified in § 3015.22. (b) If any litigation, claim, negotiation, audit or other action involving the records has been started before the end of the 3-year period, the records shall be kept until all issues are resolved, or until the end of the regular 3-year...

  8. 7 CFR 3015.21 - Retention period.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... for 3 years from the starting date specified in § 3015.22. (b) If any litigation, claim, negotiation, audit or other action involving the records has been started before the end of the 3-year period, the records shall be kept until all issues are resolved, or until the end of the regular 3-year...

  9. Refined multiscale entropy analysis of heart period and QT interval variabilities in long QT syndrome type-1 patients.

    PubMed

    Bari, Vlasta; Valencia, Jose F; Vallverdu, Montserrat; Girardengo, Giulia; Bassani, Tito; Marchi, Andrea; Calvillo, Laura; Caminal, Pere; Cerutti, Sergio; Brink, Paul A; Crotti, Lia; Schwartz, Peter J; Porta, Alberto

    2013-01-01

    This study assesses complexity of cardiovascular control in patients affected by type-1 variant of long QT (LQT1) syndrome. Complexity was assessed by refined multiscale entropy of heart period (HP) and QT interval variabilities. HP was taken as the time distance between two consecutive R peaks (RR) and QT interval was approximated as the time distance between the R-peak and T-wave apex (RTa) and between R-peak and T-wave end (RTe). RR, RTa and RTe intervals were automatically extracted from 24h Holter recordings and the daytime period was analyzed (from 02:00 to 06:00 PM). Non mutation carrier (NMC) individuals (n=11), utilized as a control group, were taken from the same family line of the mutation carrier (MC) subjects (n=26). We found that, while NMC and MC groups were indistinguishable based on time domain and complexity analyses of RR dynamics, complexity analysis of RTa and RTe variabilities clearly separates the two populations and suggests an impairment in the cardiac control mechanisms acting on the ventricles. PMID:24110995

  10. 3-year real-world outcomes with the Swedish adjustable gastric band™ in France.

    PubMed

    Ribaric, G; Buchwald, J N; d'Orsay, G; Daoud, F

    2013-02-01

    The study objective was to ascertain outcomes with the Swedish adjustable gastric band (SAGB) on an intention-to-treat basis in multiple centers across the French social health insurance system. SAGB results at 3-year follow-up are reported. The noncomparative, observational, prospective, consecutive cohort study design sought a 500-patient minimum recruitment geographically representative of continental France. Safety (adverse events [AEs], device-related morbidity, and mortality) and effectiveness (change in body mass index [BMI, kilograms per square meter], percentage excess weight loss, comorbidities, quality of life [QoL]) were assessed. Adjustable gastric band survival was calculated. Thirty-one surgeons in 28 multidisciplinary teams/sites enrolled patients between September 2, 2007 and April 30, 2008. SAGB was successfully implanted in 517 patients: 88.0 % female; mean age, 37.5 years; obesity duration, 15.3 years (baseline: mean BMI, 41.0; comorbidities, 773 in 74.3 % of patients; Bariatric Analysis and Reporting Outcome System (BAROS), 1.4; EuroQoL 5-Dimensions (EQ-5D), 0.61; EuroQoL-visual analog scale (EQ-VAS), 52.3). At 3 years: BMI, 32.2 (mean change, -9.0; p < 0.0001); excess weight loss, 47.4 %; comorbidities, 161 in 27.2 %; BAROS, 3.6 (+2.2, p < 0.0001); EQ-5D, 0.84 (+0.22, p < 0.0001); EQ-VAS, 73.4 (+21.4, p < 0.0001). SAGB-induced weight loss was associated with substantially improved QoL. One death occurred and was unrelated to the treatment. No AE was reported in 68.3 % of patients, and no confirmed device-related AE in 77.0 %. Overall AE rate was 0.19 per patient year. Device retention was 87.0 %. Analysis of patients lost to follow-up showed a nonsignificant effect on overall study results. In a prospective, consecutive cohort, "real-world", nationwide study, the Swedish Adjustable Gastric Band was found safe and effective at 3-year follow-up. PMID:23054572

  11. Etiologic and clinical analysis of chronic complex anal and rectal inflammation in children less than 3 years old

    PubMed Central

    Huang, Yanlei; Zheng, Shan; Xiao, Xianmin

    2014-01-01

    Objective: To analyze the etiology and clinical diagnostic method for chronic complex anal and rectal inflammation in children less than 3 years old. Method: Seven children (5 males and 2 females; 1 year 8 months to 3 years of age at the time of physician evaluation) with chronic complex anal and rectal inflammation were enrolled between May 2008 and May 2013 at our hospital. Clinical history, results of auxiliary examinations, and empirical treatment of the children were analyzed retrospectively combined with the etiologic diagnosis. Results: Four patients were confirmed to have Crohn’s disease and one patient was confirmed to have intestinal tuberculosis; two patients were suspected to have Crohn’s disease. Anemia and low pre-albumin level were common (seven patients); serologic testing revealed four patients with elevated IgG levels and seven patients with elevated IgA levels; there were no patients with positive tuberculosis antibody titers and two patients were weakly positive for C-ANCA (one patient with Crohn’s disease and one patient intestinal tuberculosis). Colonoscopies revealed that the entire colon was affected in one patient, the left hemicolon was affected in four patients, and the sigmoid colon and rectum were affected in two patients. Two patients with Crohn’s disease and one patient with intestinal tuberculosis were diagnosed by colonoscopies in combination with histopathologic examinations. Two patients with Crohn’s disease were confirmed after empirical drug treatment, and two other patients were not definitely diagnosed. Conclusion: The possibility of Crohn’s disease or intestinal tuberculosis should be considered in the clinical diagnosis of complex chronic anal and rectal inflammation in younger children. Local surgery is sometimes unnecessary. Empirical drug treatment should be used if necessary. PMID:25550910

  12. Myxomatous stromal changes and necrosis of bone marrow--a retrospective study of 3 years.

    PubMed

    Gupta, Nalini; Kumar, Vijay; Varma, Neelam; Garewal, Gurjeevan; Das, Reena; Ahluwalia, Jasmina; Dash, Sumitra

    2004-07-01

    Myxomatous stromal changes and bone marrow necrosis (BMN) are uncommon histologic findings. These changes have been found in various conditions like disseminated carcinomatosis, postchemotherapy cases, chronic infections, infiltrative disorders of the marrow etc. The present study is a retrospective study of 3 years (Jan, 1999 to Dec. 2001) from Deptt. Of Hematology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh (India). During this period, 3740 bone marrow samples were examined. Myxomatous stromal changes and bone marrow necrosis were noted in 0.43% (16/3740) and 0.45% (17/3740) samples respectively. In addition to common causes of myxomatous stromal changes and bone marrow necrosis as described in the literature, this study highlights the association of these conditions with some of the rarer entities like hyperoxalosis, leishmaniasis, parvovirus induced marrow aplasia and cryptococcal infection. There is paucity of such associations in the literature. PMID:16295422

  13. Predictors of reading development in deaf children: a 3-year longitudinal study.

    PubMed

    Kyle, Fiona E; Harris, Margaret

    2010-11-01

    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 longitudinal growth in reading achievement. The relations between reading and the predictor variables showed developmental change. Earlier reading ability was related to later phonological awareness skills, suggesting that deaf children might develop their phonological awareness through reading. Deaf children who had the most age-appropriate reading skills tended to have less severe hearing losses and earlier diagnoses and also preferred to communicate through speech. The theoretical implications of the role for speechreading, vocabulary and phonological awareness in deaf children's literacy are discussed. PMID:20570282

  14. [Chemical characteristics of 3-year atmospheric precipitation in summer, Taiyuan].

    PubMed

    Guo, Xiao-fang; Cui, Yang; Wang, Kai-yang; He, Qiu-sheng; Wang, Xin-ming

    2015-02-01

    The chemical characteristics of the precipitation in Taiyuan in summer of 2011-2013 were investigated. The results showed that the pH of precipitation varied from 4.63 to 8.02 with a volume-weighted mean of 5.19. The frequency of acid rain was 37.0%, 31.2% and 17.4%, respectively, in 2011-2013. SO4(2-) and NO3(-) were dominant anions in the precipitation, which accounted for 67.2% and 22.0% of the total anions, respectively. While Ca2+ and NH4+ were dominant cations in the precipitation, which accounted for 55.1% and 29.0% of the total cations, respectively. There were evident declining trends in the concentration of SO4(2-), NO3-, Ca2+ and NH4+ in the precipitation over the study period. The mean ratio of SO4(2-) to NO3(-) in summer precipitation was 3.02, indicating that the acid rain was of sulfuric-nitrous mixed type, however, NO3- was very important for the acidity of rain water. Neutralization factors (NF) were calculated to show that Ca2+ and NH4+ were the predominant neutralizers in rainwater samples, but Mg2+ could also not be negligible. The correlation analysis revealed that coal combustion was the dominant source of chemical composition of rainwater in summer of Taiyuan. The back trajectory analysis demonstrated that the air pollutants of Taiyuan were from the local plants and the coal coking plants in the southern Taiyuan basin. However, to improve the air quality in this city, both industrial emissions from thermal power plants and coal coking plants in Taiyuan basin need to be controlled. PMID:26031061

  15. Aetiopathology of maxillary swelling--a 3-year prospective study.

    PubMed

    Biswas, Deb; Crank, Stephen

    2007-11-01

    A wide variety of lesions and not necessarily a malignant tumour can cause maxillary swelling. Non-specificity of clinical and radiological features of these maxillary lesions makes their diagnosis difficult. Review of literature adds a little regarding the aetiopathological distribution of the various lesions causing maxillary swelling. We present our finding regarding the relative distribution of various conditions causing maxillary swelling. The awareness of the spectrum of pathology related to maxillary swelling is essential for correct diagnosis and treatment. Forty-eight patients who presented with a swelling of the maxilla to our hospital between May 1998 and April 2001 were prospectively studied regarding the clinical presentations, radiological features and histological findings. Maxillary swelling was found to be caused by malignant tumours in 54.2%, benign neoplasms in 22.9% and non-neoplastic lesions in 22.9%. Overall squamous cell carcinoma (22.9%) was the commonest lesion, tumour of vascular origin was the commonest benign neoplasm and odontogenic cyst was the commonest among the non-neoplastic lesions. PMID:17611767

  16. Effects of prosthetic limb prescription on 3-year mortality among lower extremity veteran amputees

    PubMed Central

    Kurichi, Jibby E.; Kwong, Pui; Vogel, W. Bruce; Xie, Dawei; Ripley, Diane Cowper; Bates, Barbara E.

    2015-01-01

    Our objective was to determine the relationship between receipt of a prescription for a prosthetic limb and three-year mortality post-surgery among veterans with lower extremity amputation. We conducted a retrospective observational study that included 4,578 veterans hospitalized for lower extremity amputation and discharged in Fiscal Years 2003 and 2004. The outcome was time to all-cause mortality from the amputation surgical date up to the 3-year anniversary of the surgical date. There were 1,300 (28.4%) veterans with lower extremity amputations who received a prescription for a prosthetic limb within a year after the surgical amputation. About 46% (n=2086) died within three-years of the surgical anniversary. Among those who received a prescription for a prosthetic limb, only 25.2% died within 3 years of the surgical anniversary. After adjustment, veterans who received a prescription for a prosthetic limb were less likely to die after the surgery than veterans without a prescription with a hazard ratio of 0.68 (95% CI, 0.60-0.77). Findings demonstrated that veterans with lower extremity amputations who received a prescription for a prosthetic limb within a year after the surgical amputation were less likely to die within three years of the surgical amputation after controlling for patient-, treatment-, and facility-level characteristics. PMID:26348602

  17. Typing and Antibiogram of Vibrio cholerae Isolates from a Tertiary Care Hospital in Pune: A 3 Year Study

    PubMed Central

    Palewar, Meghna S; Choure, Archana C; Mudshingkar, Swati; Dohe, Vaishali; Kagal, Anju; Bhardwaj, Renu; Jaiswal, Abhishek; Sarkar, Banwarilal

    2015-01-01

    A retrospective analysis was done over a period of 3 years (January 2010- December 2012) in a tertiary care hospital, Pune, to note the changes in the prevalence and distribution of biotypes, serotypes, antibiotic susceptibility pattern and phage types of Vibrio cholerae isolates from clinical samples so as to be vigilant and curtail major outbreak in future. Vibrio cholerae isolates were obtained from 4.4% of the 1126 fecal specimens processed from cases of acute watery diarrhea. Majority of the isolates were identified as V. cholerae O1 biotype El Tor serotype Ogawa (98%); Phage 27 was the predominant type (77.5%). Majority of the cases were encountered during the months June-August (68%). Antibiogram over a period of 3 years showed that isolates were consistently resistant to Ampicillin (90%) and Furazolidone (88%). Low level of resistance was seen with Norfloxacin (8%), Gentamicin (8%) and Tetracycline (6%). All isolates were susceptible to Chloramphenicol. PMID:25722619

  18. [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. PMID:23035608

  19. 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.

  20. An unlikely cause of severe malnutrition in a 3-year-old girl with previous gastroschisis

    PubMed Central

    Ashton, J J; Blackburn, S; Burge, D; Beattie, R M

    2014-01-01

    A 3-year-old girl with previous gastroschisis associated with jejunal and colonic atresia presented with severe oedema, abdominal pain and diarrhoea. Clinically she was malnourished. Serum albumin and concentrations of micronutrients were low. A barium meal examination showed jejunal dilation. A stricture was suspected and the patient was taken to theatre where an 8 cm length of bowel was resected including a jejunal stricture at the point of previous atresia repair. Inside the proximal dilated jejunum was a large trichobezoar (hairball), thought to be acting as a ball valve inside the bowel. This girl made a rapid recovery after surgery. Her nutritional state improved, symptoms resolved and serum biochemistry normalised. She remains well at follow-up with normal blood results, normal albumin and no diarrhoea. PMID:25183805

  1. An unlikely cause of severe malnutrition in a 3-year-old girl with previous gastroschisis.

    PubMed

    Ashton, J J; Blackburn, S; Burge, D; Beattie, R M

    2014-01-01

    A 3-year-old girl with previous gastroschisis associated with jejunal and colonic atresia presented with severe oedema, abdominal pain and diarrhoea. Clinically she was malnourished. Serum albumin and concentrations of micronutrients were low. A barium meal examination showed jejunal dilation. A stricture was suspected and the patient was taken to theatre where an 8 cm length of bowel was resected including a jejunal stricture at the point of previous atresia repair. Inside the proximal dilated jejunum was a large trichobezoar (hairball), thought to be acting as a ball valve inside the bowel. This girl made a rapid recovery after surgery. Her nutritional state improved, symptoms resolved and serum biochemistry normalised. She remains well at follow-up with normal blood results, normal albumin and no diarrhoea. PMID:25183805

  2. Nephrotic Syndrome Following H1N1 Influenza in a 3-Year-Old Boy

    PubMed Central

    Ferrara, Pietro; Gatto, Antonio; Vitelli, Ottavio; Liberatore, Pio; del Bufalo, Francesca; Bottaro, Giorgia

    2012-01-01

    Background The pandemic influenza A/H1N1, spread through the world in 2009, producing a serious epidemic in Italy. Complications are generally limited to patients at the extremes of age (<6 months or >65 years) and those with comorbid medical illness. The most frequent complications of influenza involve the respiratory system. Case Presentation A 3-year-old boy with a recent history of upper respiratory tract infection developed a nephrotic syndrome. Together with prednisone, furosemide and albumin bolus, a therapy with oseltamivir was started since the nasopharyngeal swab resulted positive for influenza A/H1N1. Clinical conditions and laboratory findings progressively improved during hospitalization, becoming normal during a 2 month follow up. Conclusion The possibility of a renal involvement after influenza A/H1N1 infection should be considered. PMID:23056898

  3. [Thrombodynamic properties of arterial and venous blood in ischemic patients in preoperative and early postoperative periods after coronary artery bypass grafting].

    PubMed

    Kuznik, B I; Bogdanov, I G; Isakova, N V; Serebrijskij, I I; Kas'janenko, N V

    2015-01-01

    In the preoperative period ischemic patients show a significant increase in thrombodynamic properties of fibrin clots. It is more than at a half of patients in the presurgical period as in an arterial, and venus blood the spontaneous growth of a clot comes to light that is practically not observed at healthy people. In the early postoperative period ischemic patients demonstrate a general sharp decrease in thrombodynamic properties of fibrin clots, but in arterial blood, as opposed to venous blood, such properties sharply grow. Based on the data obtained it may be concluded that in ischemic patients venous blood levels cannot be used as a judgement for arterial blood fibrin clot properties. PMID:26255313

  4. The impact of early growth patterns and infant feeding on body composition at 3 years of age.

    PubMed

    Ejlerskov, Katrine T; Christensen, Line B; Ritz, Christian; Jensen, Signe M; Mølgaard, Christian; Michaelsen, Kim F

    2015-07-01

    Early excessive weight gain is positively associated with later obesity, and yet the effect of weight gain during specific periods and the impact of infant feeding practices are debated. The objective of the present study was to examine the impact of weight gain in periods of early childhood on body composition at 3 years, and whether infant feeding modified the relationship between early growth and body composition at 3 years. We studied 233 children from the prospective cohort study, SKOT (in Danish: Småbørns Kost og Trivsel). Birth weight z-scores (BWZ) and change in weight-for-age z-scores (WAZ) from 0 to 5, 5 to 9, 9 to 18 and 18 to 36 months were analysed for relations with body composition (anthropometry and bioelectrical impedance) at 3 years by multivariate regression analysis. BWZ and change in WAZ from 0 to 5 months were positively associated with BMI, fat mass index (FMI) and fat-free mass index (FFMI) at 3 years. Full breastfeeding for 6 months (compared to less than 1 month) eliminated the effect of early growth (P = 0.01). Full breastfeeding for 6 months (compared to less than 1 month) also eliminated the positive relation between BWZ and FMI (P = 0.009). No effect modification of infant feeding was found for FFMI. In conclusion, high birth weight and rapid growth from 0 to 5 months were associated with increased FMI and FFMI at 3 years. Longer duration of full breastfeeding reduced the effect of birth weight and early weight gain on fat mass. PMID:26131962

  5. 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. PMID:18805103

  6. Everolimus and early calcineurin inhibitor withdrawal: 3-year results from a randomized trial in liver transplantation.

    PubMed

    Sterneck, M; Kaiser, G M; Heyne, N; Richter, N; Rauchfuss, F; Pascher, A; Schemmer, P; Fischer, L; Klein, C G; Nadalin, S; Lehner, F; Settmacher, U; Neuhaus, P; Gotthardt, D; Loss, M; Ladenburger, S; Paulus, E M; Mertens, M; Schlitt, H J

    2014-03-01

    The feasibility of de novo everolimus without calcineurin inhibitor (CNI) therapy following liver transplantation was assessed in a multicenter, prospective, open-label trial. Liver transplant patients were randomized at 4 weeks to start everolimus and discontinue CNI, or continue their current CNI-based regimen. The primary endpoint was adjusted estimated GFR (eGFR; Cockcroft-Gault) at month 11 post randomization. A 24-month extension phase followed 81/114 (71.1%) of eligible patients to month 35 post randomization. The adjusted mean eGFR benefit from randomization to month 35 was 10.1 mL/min (95% confidence interval [CI] -1.3, 21.5 mL/min, p = 0.082) in favor of CNI-free versus CNI using Cockcroft-Gault, 9.4 mL/min/1.73 m(2) (95% CI -0.4, 18.9, p = 0.053) with Modification of Diet in Renal Disease (four-variable) and 9.5 mL/min/1.73 m(2) (95% CI -1.1, 17.9, p = 0.028) using Nankivell. The difference in favor of the CNI-free regimen increased gradually over time due to a small progressive decline in eGFR in the CNI cohort despite a reduction in CNI exposure. Biopsy-proven acute rejection, graft loss and death were similar between groups. Adverse events led to study drug discontinuation in five CNI-free patients and five CNI patients (12.2% vs. 12.5%, p = 1.000) during the extension phase. Everolimus-based CNI-free immunosuppression is feasible following liver transplantation and patients benefit from sustained preservation of renal function versus patients on CNI for at least 3 years. PMID:24502384

  7. [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. PMID:26471795

  8. 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

  9. Corticotomy-assisted rapid maxillary expansion: A novel approach with a 3-year follow-up.

    PubMed

    Echchadi, Mohamed Elmehdi; Benchikh, Basma; Bellamine, Meriem; Kim, Seong-Hun

    2015-07-01

    This case report introduces a new approach of corticotomy-assisted rapid maxillary expansion for treating a severe maxillary transverse discrepancy in a skeletally mature patient. This approach uses piezo-bone perforation in conjunction with a fixed appliance and an expander. This report describes the treatment of a 14-year-old girl with a severe maxillary transverse discrepancy. She had a straight profile, severe maxillary crowding, a maxillomandibular transverse differential index of 9 mm, and a Class I skeletal relationship. The treatment protocol consisted of surgical intervention with piezo-bone perforation and active orthodontic therapy. Immediately after the piezo-bone perforation on the lateral buccal side of the maxilla, active orthodontic therapy was started with activation of an expander. The expander was reactivated weekly. Treatment duration was 5 months 2 weeks. Proper overbite and overjet, facial balance, and occlusion were achieved. The treatment outcome was stable at the 3-year follow up. This treatment approach considerably reduced the treatment time and gained bony volume. Additionally, it transformed the periodontal biotype in contrast to conventional therapy. This approach is a good alternative for treating a severe maxillary transverse discrepancy in a skeletally mature patient, especially for a patient who does not want surgical rapid palatal expansion. PMID:26124037

  10. Conservative management of external root resorption after tooth reimplantation: a 3-year follow-up.

    PubMed

    Ionta, Franciny Querobim; de Oliveira, Gabriela Cristina; de Alencar, Catarina Ribeiro Barros; Gonçalves, Priscilla Santana Pinto; Alcalde, Murilo Priori; Minotti, Paloma Gagliardi; Machado, Maria Aparecida de Andrade Moreira; Rios, Daniela

    2016-01-01

    The aim of this case report is to describe the treatment of a 9-year-old patient who suffered external root resorption of the permanent maxillary left lateral incisor following reimplantation of the avulsed left central and lateral incisors. Sixteen days after reimplantation and splinting of the incisors in a hospital emergency department, the patient was brought to the pediatric department of a dental school for further treatment. Root canal access was created in the maxillary left lateral and central incisors, and calcium hydroxide paste was used as intracanal dressing. At the 5-month follow-up, a radiograph revealed extensive external root resorption, a communicating root canal, and a periodontal lesion affecting the left lateral incisor. Management of the root resorption included obturation of the apical third of the canal with gutta percha and the middle third with mineral trioxide aggregate (MTA). At the 3-year recall examination, the patient was asymptomatic, and no mobility or soft tissue alterations were observed clinically. There was no radiographic sign that resorption had progressed. Despite the success of treatment, observation is still required. The use of MTA may be considered an alternative treatment for external root resorption after tooth reimplantation. The technique may allow tooth preservation in children until skeletal growth and development are completed and implant treatment may be considered. PMID:27367632

  11. A Case of Dentin Dysplasia with Full Mouth Rehabilitation: A 3-year Longitudinal Study

    PubMed Central

    Gupta, Dheeraj; Likhyani, Lalit

    2014-01-01

    ABSTRACT Dentin dysplasia, a rare hereditary disorder of dentin formation, is characterized by normal enamel but atypical dentin formation along with abnormal pulpal morphology. It is inherited as an autosomal dominant trait. It has been divided into two clinical entities: type I (radicular) and type II (coronal). Early diagnosis and initiation of effective regular dental treatments may help the patients with this condition to delay or prevent the loss of the entire dentition and help them in cope up with edentulous state in early ages. The condition undoubtedly has a negative impact on the physical and psychological well-being of the affected individual. Numerous factors have to be considered during the prosthetic rehabilitation of patients with dentin dysplasia. Treatment protocol varies according to clinical case. Although literature reports suggest general guidelines for treatment planning, the present case report describes a full mouth rehabilitation of an 8-year-old female patient with dentin dysplasia. How to cite this article: Khandelwal S, Gupta D, Likhyani L. A Case of Dentin Dysplasia with Full Mouth Rehabilitation: A 3-year Longitudinal Study. Int J Clin Pediatr Dent 2014;7(2): 119-124. PMID:25356011

  12. Gestational weight gain and predicted changes in offspring anthropometrics between early infancy and 3 years

    PubMed Central

    Deierlein, Andrea L.; Siega-Riz, Anna Maria; Herring, Amy H.; Adair, Linda S.; Daniels, Julie L.

    2011-01-01

    Objective To determine how gestational weight gain (GWG), categorized using the 2009 Institute of Medicine recommendations, relates to changes in offspring weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length z-scores (WLZ) between early infancy and 3 years. Methods Women with singleton infants were recruited from the third cohort of the Pregnancy, Infection, and Nutrition Study (2001-2005). Term infants with at least one weight or length measurement during the study period were included (n=476). Multivariable linear mixed effects regression models estimated longitudinal changes in WAZ, LAZ, and WLZ associated with GWG. Results In early infancy, compared to infants of women with adequate weight gain, those of women with excessive weight gains had higher WAZ, LAZ, and WLZ. Excessive GWG≥200% of the recommended amount was associated with faster rates of change in WAZ and LAZ and noticeably higher predicted mean WAZ and WLZ that persisted across the study period. Conclusions GWG represents a modifiable behavioral factor that is associated with offspring anthropometric outcomes. More longitudinal studies that utilize maternal and pediatric body composition measures are necessary to understand the nature of this association. PMID:22434753

  13. Latent class analysis of alcohol treatment utilization patterns and 3-year alcohol related outcomes.

    PubMed

    Mowbray, Orion; Glass, Joseph E; Grinnell-Davis, Claudette L

    2015-07-01

    People who obtain treatment for alcohol use problems often utilize multiple sources of help. While prior studies have classified treatment use patterns for alcohol use, an empirical classification of these patterns is lacking. For the current study, we created an empirically derived classification of treatment use and described how these classifications were prospectively associated with alcohol-related outcomes. Our sample included 257 participants of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who first received alcohol treatment in the 3-year period prior to their baseline interview. We used latent class analysis to identify classes of treatment users based on their patterns of treatment use of 13 types of alcohol treatment. Regression models examined how classes of treatment use at baseline were associated with alcohol-related outcomes assessed at a 3-year follow-up interview. Outcomes included a continuous measure of the quantity and frequency of alcohol use and DSM-IV alcohol use disorder status. Four classes of treatment users were identified: (1) multiservice users (8.7%), (2) private professional service users (32.8%), (3) alcoholics anonymous (AA) paired with specialty addiction service users (22.0%), and (4) users of AA alone (36.5%). Those who utilized AA paired with specialty addiction services had better outcomes compared to those who used AA alone. In addition to elucidating the most common treatment utilization patterns executed by people seeking help for their alcohol problems, the results from this study suggest that increased efforts may be needed to refer individuals across sectors of care to improve treatment outcomes. PMID:25744651

  14. Rates of Mutation and Host Transmission for an Escherichia coli Clone over 3 Years

    PubMed Central

    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. PMID:22046404

  15. The Sydney Multicentre Study of Parkinson's disease: a report on the first 3 years.

    PubMed Central

    Hely, M A; Morris, J G; Rail, D; Reid, W G; O'Sullivan, D J; Williamson, P M; Genge, S; Broe, G A

    1989-01-01

    One hundred and twenty nine de novo patients with idiopathic Parkinson's disease are being followed over a 5 year period in a double-blind multicentre study comparing low-dose bromocriptine (less than 30 mg/day) with low-dose levodopa-carbidopa (less than 600/150 mg/day). Sixty six patients have been randomised to bromocriptine and 63 patients to levodopa-carbidopa. Improvement has been greater in the levodopa-carbidopa group than in the bromocriptine group. Involuntary movements have so far only occurred in patients on levodopa-carbidopa, the incidence being much lower than is usually described with conventional doses. Mild, end-of-dose failure has occurred in both treatment groups; however, no patient has developed the "on-off" phenomenon. Low-dose levodopa-carbidopa appears to be a more effective anti-Parkinsonian treatment than low-dose bromocriptine but more prone to cause dyskinesia. PMID:2647907

  16. 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. PMID:26675948

  17. Association of Maternal Short Sleep Duration with Adiposity and Cardio-Metabolic Status at 3 Years Postpartum

    PubMed Central

    Taveras, Elsie M.; Rifas-Shiman, Sheryl L.; Rich-Edwards, Janet W.; Gunderson, Erica P.; Stuebe, Alison M.; Mantzoros, Christos S.

    2011-01-01

    The purpose of this study was to examine the association of short sleep duration among women in the first year postpartum with adiposity and cardio-metabolic status at 3-years postpartum. We studied 586 women in Project Viva, a prospective cohort. At 6 months and 1 year postpartum, women reported the number of hours they slept in a 24-hour period, from which we calculated a weighted average of daily sleep. We used multivariable regression analyses to predict the independent effects of short sleep duration (≤ 5 h/d v.> 5 h/d) on adiposity, glucose metabolism, lipid metabolism, and adipokines at 3-years postpartum. Women’s mean (SD) hours of daily sleep in the first year postpartum was 6.7 (0.97) hours. After adjusting for age, race/ethnicity, education, parity, pre-pregnancy body mass index, and excessive gestational weight gain, we found that postpartum sleep ≤ 5 h/d was associated with higher postpartum weight retention (β 1.50 kg; 95% CI: 0.02, 2.86), higher subscapular + triceps skinfold thickness (β 3.94 mm; 95% CI: 1.27, 6.60) and higher waist circumference (β 3.10 cm; 95% CI: 1.25, 4.94) at 3-years postpartum. We did not observe associations of short sleep duration with measures of cardio-metabolic status at 3-years postpartum. In conclusion, short sleep duration in the first year postpartum is associated with higher adiposity at 3-years postpartum. PMID:20489690

  18. Usefulness of the Baseline Syntax Score to Predict 3-Year Outcome After Complete Revascularization by Percutaneous Coronary Intervention.

    PubMed

    Kang, Jeehoon; Park, Kyung Woo; Han, Jung-Kyu; Yang, Han-Mo; Kang, Hyun-Jae; Koo, Bon-Kwon; Kim, Hyo-Soo

    2016-09-01

    Although we strive to achieve complete revascularization (CR) in those receiving percutaneous coronary intervention, it is uncertain which of these patients are at increased risk of clinical events. In this study, we aimed to investigate whether the baseline SYNTAX score (bSS) can predict adverse clinical events in patients receiving CR. From the Efficacy of Xience/Promus Versus Cypher in Reducing Late Loss After Stenting registry, the 3-year patient-oriented composite end point (POCE; all cause death, any myocardial infarction, and any revascularization) was compared according to bSS tertiles (1 ≤ low bSS < 6, 6 ≤ mid-bSS < 10, high bSS ≥ 10). Of the 5,088 patients, CR was achieved in 2,173 by percutaneous coronary intervention. The 3-year POCE increased significantly along with bSS tertile (7.3% vs 8.4% vs 14.8%, p <0.001). Multivariate analysis showed that, despite having the same residual SS of 0, the bSS was an independent predictor of 3-year POCE (hazard ratio 1.038, 95% confidence interval 1.018 to 1.058, p <0.001 per bSS point). In subgroup analysis, bSS was a predictor for 3-year POCE in multivessel diseases (hazard ratio 1.029, 95% confidence interval 1.004 to 1.054, p = 0.025 per bSS point), whereas in single-vessel diseases, the discriminative value of bSS was less significant. Also the clinical SYNTAX score, which added age, creatinine level, and ejection fraction to the bSS, was superior to the bSS in predicting 3-year POCE (area under the curve 0.595 vs 0.649, p = 0.008). In conclusion, the bSS was an independent predictor of long-term clinical outcomes in patients receiving CR, especially in those with multivessel coronary artery disease. Adding clinical factors to the bSS could increase the predictive power of clinical outcomes. PMID:27394412

  19. [Prescription of traditional neuroleptics in the remission period for schizophrenic patients with excess of body mass caused by atypical antipsychotics].

    PubMed

    Danilov, D S; Tiul'pin, Iu G

    2007-01-01

    A sample included 61 patients, 53 men and 8 women, with ICD-10 episodic schizophrenia in the remission after treatment with atypical neuroleptics (risperidon, olanzapine, clozapine). All patients were featured by therapeutically caused excess of body mass (obesity of different degrees) that hampered the further treatment. In 31 cases (the main group) atypical neuroleptics were substituted for traditional drugs that exerted lesser influence on body mass. Haloperidol (mean dosage 4,1 mg daily) was administered to 17 patients and trifluoperazine (mean dosage 7,1 mg daily) to 14 patients. Other 30 patients (a control group) continued to receive atypical neuroleptics. Between group differences of patient's mental and somatic state were assessed using quantitative scales. It was shown that the substitution of atypical neuroleptics for traditional neuroleptic drugs allowed to stop further body mass gain and even decreased it without significant influence on psychopathological symptoms and other side-effects in patients with excess of body mass. PMID:18379518

  20. 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.

  1. Comparison of Characteristics of Patients Undergoing Heart Transplantation at the Same Hospital in Two Different Time Periods (1997-2012 and 2013-2015).

    PubMed

    Roberts, William C; Won, Vera S; Vasudevan, Anupama; Kapoor, Pranav; Ko, Jong Mi; Meyer, Dan M; Hall, Shelley A; Gonzalez-Stawinski, Gonzalo V

    2016-07-15

    Heart transplantation (HT) increases at some centers each year and decreases at others. We examined characteristics of patients having HT at the same hospital in 2 different time periods (1997-2012 and 2013-2015) by 2 different surgical groups. We compared certain clinical and morphological finding in 291 patients having HT 1997 to 2012 to finding in 228 other patients having HT from 2013 to 2015. Several significant (p <0.05) differences were found: in the most recent time period (2013-2015) compared to the earlier time period (1997-2012), the mean ages of the men were older (57 years -vs- 55 years); diabetes mellitus was more frequent (37% -vs- 21%); systemic hypertension (by history) was more frequent (59% -vs- 32%); the mean body mass index was higher (29.2 kg/m(2) -vs- 26.5 kg/m(2)), and mean heart weight was lower in both men (509 g -vs- 549 g) and women (422 g -vs- 454 g). There were insignificant (p >0.05) differences in gender, frequency of massive cardiac adiposity, underlying cardiac condition, frequency of coronary heart disease, and frequency of previous insertion of a left ventricular assist device. In conclusion, certain characteristics of patients having HT at one Texas hospital changed in several respects in 2 time periods corresponding to changes in surgeons doing the HTs. PMID:27316774

  2. Problem Periods

    MedlinePlus

    ... gov/ Home Body Getting your period Problem periods Problem periods It’s common to have cramps or feel ... doctor Some common period problems Signs of period problems top One way to know if you may ...

  3. Everolimus and Early Calcineurin Inhibitor Withdrawal: 3-Year Results From a Randomized Trial in Liver Transplantation

    PubMed Central

    Sterneck, M; Kaiser, G M; Heyne, N; Richter, N; Rauchfuss, F; Pascher, A; Schemmer, P; Fischer, L; Klein, C G; Nadalin, S; Lehner, F; Settmacher, U; Neuhaus, P; Gotthardt, D; Loss, M; Ladenburger, S; Paulus, E M; Mertens, M; Schlitt, H J

    2014-01-01

    The feasibility of de novo everolimus without calcineurin inhibitor (CNI) therapy following liver transplantation was assessed in a multicenter, prospective, open-label trial. Liver transplant patients were randomized at 4 weeks to start everolimus and discontinue CNI, or continue their current CNI-based regimen. The primary endpoint was adjusted estimated GFR (eGFR; Cockcroft-Gault) at month 11 postrandomization. A 24-month extension phase followed 81/114 (71.1%) of eligible patients to month 35 postrandomization. The adjusted mean eGFR benefit from randomization to month 35 was 10.1 mL/min (95% confidence interval [CI] −1.3, 21.5 mL/min, p = 0.082) in favor of CNI-free versus CNI using Cockcroft-Gault, 9.4 mL/min/1.73 m2 (95% CI −0.4, 18.9, p = 0.053) with Modification of Diet in Renal Disease (four-variable) and 9.5 mL/min/1.73 m2 (95% CI −1.1, 17.9, p = 0.028) using Nankivell. The difference in favor of the CNI-free regimen increased gradually over time due to a small progressive decline in eGFR in the CNI cohort despite a reduction in CNI exposure. Biopsy-proven acute rejection, graft loss and death were similar between groups. Adverse events led to study drug discontinuation in five CNI-free patients and five CNI patients (12.2% vs. 12.5%, p = 1.000) during the extension phase. Everolimus-based CNI-free immunosuppression is feasible following liver transplantation and patients benefit from sustained preservation of renal function versus patients on CNI for at least 3 years. The beneficial effect on renal function achieved by early CNI withdrawal and treatment with everolimus after liver transplantation is still evident after three years. PMID:24502384

  4. Effectiveness of Dietary Allergen Exclusion Therapy on Eosinophilic Colitis in Chinese Infants and Young Children ≤ 3 Years of Age

    PubMed Central

    Yang, Min; Geng, Lanlan; Chen, Peiyu; Wang, Fenghua; Xu, Zhaohui; Liang, Cuiping; Li, Huiwen; Fang, Tiefu; Friesen, Craig A.; Gong, Sitang; Li, Dingyou

    2015-01-01

    Eosinophilic colitis is a well recognized clinical entity mainly associated with food allergies. Empiric treatment options include dietary allergen exclusion (extensively hydrolyzed protein formula and elimination diet), anti-allergy medications (antihistamines and leukotriene receptor antagonists) and corticosteroids. We evaluated the effectiveness of dietary antigen exclusion on clinical remission of eosinophilic colitis in infants and young children. We retrospectively reviewed charts of all infants and children ≤3 years of age who were diagnosed with eosinophilic colitis (defined as mucosal eosinophilia ≥20 hpf−1) from 1 January 2011 to 31 December 2013 at a tertiary children’s hospital in China. Forty-nine children were identified with eosinophilic colitis. Elemental formula, simple elimination diet or combination therapy resulted in clinical improvement in 75%, 88.2% and 80% of patients, respectively. In conclusion, eosinophilic colitis in infants and children ≤3 years of age responded well to dietary allergen exclusion. PMID:25768952

  5. 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

  6. 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. PMID:26041449

  7. 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…

  8. 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…

  9. Allocation of Resources to Collaborators and Free-Riders in 3-Year-Olds

    ERIC Educational Resources Information Center

    Melis, Alicia P.; Altrichter, Kristin; Tomasello, Michael

    2013-01-01

    Recent studies have shown that in situations where resources have been acquired collaboratively, children at around 3 years of age share mostly equally. We investigated 3-year-olds' sharing behavior with a collaborating partner and a free-riding partner who explicitly expressed her preference not to collaborate. Children shared more equally with…

  10. Mortality over a 20-year period in patients with primary polydipsia associated with schizophrenia: a retrospective study.

    PubMed

    Hawken, Emily R; Crookall, Jake M; Reddick, Deirdre; Millson, Richard C; Milev, Roumen; Delva, Nicholas

    2009-02-01

    Primary polydipsia, excessive fluid intake without medical cause, is present in over 20% of seriously and persistently ill psychiatric inpatients. The long-term effects of primary polydipsia on longevity have not previously been examined. Inpatients in a psychiatric hospital were screened for polydipsia in 1985. Those identified to be polydipsic, the majority of whom suffered from schizophrenia, were re-evaluated in 2005 and compared with a control group of non-polydipsic patients. Chart reviews were conducted and follow-up data were obtained. Of 172 patients at the time of screening, 48 suffering from schizophrenia either had or went on to develop polydipsia; 42 non-polydipsic patients with schizophrenia from the original survey were randomly selected as controls. Primary polydipsia had a significant negative effect on longevity. The median age at death (age at which 50% of cases have died) was 59 years for polydipsic patients and 68 for non-polydipsic control patients. Adjusting for duration of schizophrenia, smoking, and diagnosis, a patient with polydipsia had a 74% greater chance of dying before a non-polydipsic patient (a hazard ratio of 2.84 [95% Confidence Interval (CI): 1.22-6.64]). Outcome was worst in patients with severe polydipsia: the median age at death was 57 years and a patient with severe polydipsia had a 75% greater chance of dying before a non-polydipsic patient (hazard ratio of 3.36 [95% CI: 1.31-8.60]). When polydipsia is associated with schizophrenia, mortality is increased in comparison to that in patients with schizophrenia who do not drink water to excess. PMID:18984069

  11. 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

  12. 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...

  13. 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

  14. 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

  15. 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…

  16. 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.

  17. 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

  18. Enhancing the executive functions of 3-year-olds in the dimensional change card sort task

    PubMed Central

    Perone, Sammy; Molitor, Stephen; Buss, Aaron T.; Spencer, John P.; Samuelson, Larissa K.

    2015-01-01

    Executive functions (EFs) 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 (DNF) model that prior experience with the post-switch dimension can enhance 3-year-old’s performance in the DCCS task. In Experiment 1A, a matching game was used to pre-expose 3-year-olds (n=36) to color. This facilitated switching from sorting by shape to color. In Experiment 1B, 3-year-olds (n=18) were pre-exposed to shape. This did not facilitate switching from sorting by color to shape. The DNF model was used to provide a mechanistic explanation for this asymmetry. PMID:25441395

  19. Disease severity of 100 patients with systemic sclerosis over a period of 14 years: using a modified Medsger scale

    PubMed Central

    Geirsson, A; Wollheim, F; Akesson, A

    2001-01-01

    OBJECTIVE—To assess organ involvement according to a modified Medsger severity scale and its relation to outcome and prognosis in patients with systemic sclerosis.
METHODS—One hundred consecutive patients observed in Lund with systemic sclerosis were followed up for a period of 14 years. The mean follow up time was 7.7 years. Initial assessment and an annual evaluation was performed for each patient, with a mean visit frequency of 5.6 per patient.
RESULTS—Age at referral, high total skin score, truncal skin involvement, low vital capacity, low static lung compliance, low Cr-EDTA clearance, and ECG abnormalities at the initial assessment predict poor outcome. A severity scoring system for five organ systems indicates a slow progression of organ dysfunction after recruitment into the study. The female: male ratio was 2:1, the mean age at onset of symptoms was 42.3 (range 3-82), and the mean age at recruitment was 47.2 years (range 17-82). Thirty patients died during the follow up period at the mean age of 61.3 years (range 33-85). The causes of death were directly related to systemic sclerosis in at least 10 patients, infections in six, cancers in nine, and other causes in four patients. The standardised mortality ratio was 3.5 and 3.7 for men and women, respectively.
CONCLUSION—A high severity score for function of vital organs was shown to predict shortened survival. In this study a severity score based on simple clinical assessment variables was able to predict poor outcome from extensive skin changes, ECG changes, and compromised lung and renal function. Organ dysfunction mainly became manifest during the first five years of the disease, whereafter organ function remained largely stable.

 PMID:11709453

  20. 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…

  1. Rationale and study design of a three-period, 58-week trial of ferric citrate as a phosphate binder in patients with ESRD on dialysis.

    PubMed

    Umanath, Kausik; Sika, Mohammed; Niecestro, Robert; Connelly, Carolyn; Schulman, Gerald; Koury, Mark J; Lewis, Julia B; Dwyer, Jamie P

    2013-01-01

    Chronic kidney disease associated mineral and bone disorders arise as a result of aberrant bone mineral metabolism in patients with advancing levels of renal dysfunction and end-stage renal disease. One of the cornerstones of treatment is the use of phosphate-binding agents. We describe the rationale and study design for a clinical trial to assess the safety and efficacy of ferric citrate as a phosphate binder. This trial is a three-period, international, multicenter, randomized, controlled clinical trial to assess the safety and efficacy of ferric citrate as a phosphate binder, consisting of a 2-week washout period, a 52-week safety assessment period in which subjects are randomized to ferric citrate or active control, and a 4-week efficacy assessment period in which subjects randomized to ferric citrate in the safety assessment period are randomized to ferric citrate or placebo. Eligible subjects include end-stage renal disease patients who have been treated with thrice-weekly hemodialysis or peritoneal dialysis for at least 3 months in dialysis clinics in the United States and Israel. Primary outcome measure will be the effect of ferric citrate vs. placebo on the change in serum phosphorus. Safety assessments will be performed by monitoring adverse events, concomitant medication use, and sequential blood chemistries (including iron parameters, phosphorus, and calcium). This three-period trial will assess the efficacy of ferric citrate as a phosphate binder. If proven safe and efficacious, ferric citrate will likely provide an additional phosphate binder to treat chronic kidney disease associated mineral and bone disorders. PMID:22702490

  2. 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

  3. [The use of a robot-assisted Gait Trainer GT1 in patients in the acute period of cerebral stroke: a pilot study].

    PubMed

    Skvortsova, V I; Ivanova, G E; Kovrazhkina, E A; Rumiantseva, N A; Staritsyn, A N; Suvorov, A Iu; Sogomonian, E K

    2008-01-01

    An aim of the study was to evaluate efficacy of using Gait Trainer GT1, a robot-assisted gait trainer with a system of body-weight support, for the rehabilitation of gait in patients in the acute period of cerebral stroke. A main group included 30 patients in the acute period of ischemic and hemorrhage stroke and a control group--20 age- and sex matched patients. Patients of both groups had daily kinesitherapy sessions with a rehabilitator. Patients of the main group had additional sessions on the Gait Trainer GT1 from the moment of functional readiness to adequate orthostatic probe. Efficacy of rehabilitation was assessed in the four following phases: the first verticalization of patient in the standing position, adaptation of patient to the standing position, walking with assistance, independent walking. Muscular power (scores) in all muscles of low extremities, muscle tonus (the Ashfort scale), amplitude of tendinous reflexes on the reflexes scale, sensory disturbances and discoordination syndromes (specially elaborated scales), pathological positions in the axial muscular system and extremities, functional status (a steadiness scale, the Berg balance scale, the Barthel scale, 5 m test) were assessed in each phase. Stabilometry was conducted for objective evaluation of vertical balance function. The duration of sessions on GT1 and a number of exercises were depended on the patient's tolerability to physical activity. Percentage of relief was determined by the ability of a patient to balance in the standing position. Each patient had 8-10 sessions. A significant improvement of the functional status: ability to balance in standing position, walking, increase of self-care skills were observed in both groups. No significant differences in the level of functional improvements were found compared to the control group. However some peculiarities of the rehabilitation of primary neurologic deficit were observed during CT1-trainings: the normalization of muscle tonus

  4. 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

  5. A multicenter, open-label extension study of velaglucerase alfa in Japanese patients with Gaucher disease: Results after a cumulative treatment period of 24months.

    PubMed

    Ida, Hiroyuki; Tanaka, Akemi; Matsubayashi, Tomoko; Murayama, Kei; Hongo, Teruaki; Lee, Hak-Myung; Mellgard, Björn

    2016-07-01

    Enzyme replacement therapy (ERT) with exogenous glucocerebrosidase is indicated to treat symptomatic Gaucher disease (GD), a rare, inherited metabolic disorder. ERT with velaglucerase alfa, which is produced in a human cell line using gene activation technology, was studied in a 12-month phase III trial in Japanese patients with type 1 or 3 GD who were switched from imiglucerase ERT (n=6); the current, open-label, 12-month extension study was designed to assess longer-term safety and efficacy. Two adult and three pediatric patients (aged <18years) were enrolled into the extension study. Every-other-week intravenous infusions were administered for 63-78weeks at average doses between 51.5 and 60.7units/kg. Three non-serious adverse events were considered related to velaglucerase alfa treatment, but no patient discontinued from the study. Six serious but non-drug-related adverse events were reported. No patient tested positive for anti-velaglucerase alfa antibodies. Hemoglobin concentrations, platelet counts, and liver and spleen volumes (normalized to body weight) in these patients were generally stable over a cumulative 24-month period from the baseline of the parent trial. The data suggest that velaglucerase alfa was well tolerated and maintained clinical stability in Japanese GD patients over 2years after switching from imiglucerase. ClinicalTrials.gov identifier NCT01842841. PMID:27241455

  6. Observational prospective study of viral infections in children undergoing allogeneic hematopoietic cell transplantation: a 3-year GETMON experience.

    PubMed

    Verdeguer, A; de Heredia, C D; González, M; Martínez, A M; Fernández-Navarro, J M; Pérez-Hurtado, J M; Badell, I; Gómez, P; González, M E; Muñoz, A; Díaz, M A

    2011-01-01

    We studied surveillance, incidence and outcome of viral infections in children undergoing allogeneic hematopoietic cell transplantation (HCT) in the main pediatric transplant units in Spain. We prospectively collected data from first year post-HCT in every consecutive allogeneic HCT performed during 3 years (N = 215): first HCT = 188 and second HCT = 27; median age = 6.6 years (0.1-20.7). Most patients had acute leukemia (N = 137) and 135 recipients (63%) were CMV seropositive. A total of 46 patients underwent cord blood transplant, 133 patients underwent HCT from alternative donors (62%) and 101 patients received anti-thymocyte globulin. Observational time was completed in 137 patients, whereas the remaining 78 died after a median survival time of 99 days (3-352). CMV was monitored in all patients; adenovirus (ADV) and human herpesvirus 6 (HHV-6) were monitored in 101 and 33 patients, respectively. We found 145 viral infections in 103 patients: CMV (n = 42), ADV (n = 32), HHV-6 (n = 7), polyomavirus (n = 20), EBV (n = 6), VZV (n=17) and others (n = 8). CMV infection was significantly higher in seropositive patients (25 vs 7%) (P = 0.02). Extensive chronic GVHD (cGVHD) was significantly associated with an increased rate of viral infections (12 of 16 patients with cGVHD had infections vs 91 of 199 without GVHD) (P = 0.035). In total, 10 patients (4.6%) died of viral infections (CMV = 5, ADV = 3, respiratory = 2). We found a high incidence of viral infection, but mortality was low. PMID:20228849

  7. 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…

  8. Determinants of physician antibiotic prescribing behavior: a 3 year cohort study in Portugal.

    PubMed

    Teixeira Rodrigues, António; Ferreira, Mónica; Piñeiro-Lamas, Maria; Falcão, Amílcar; Figueiras, Adolfo; Herdeiro, Maria T

    2016-05-01

    Objectives Antibiotic misprescription is a major driver of resistance, which is a worldwide public health problem. Therefore, our aim is to assess the influence of the determinants of physician prescribing on the quality of antibiotic use. Methods A 3 year cohort study including all primary-care physicians working in Portugal's Central Regional Health Administration (n = 1094) was conducted. We assessed the determinants of prescribing using a pre-validated, personally addressed, reply-paid, self-administered questionnaire (sent four times to non-responders, between September 2011 and February 2012) designed to collect information on physicians' attitudes to and knowledge of antibiotic prescribing as well as their socio-demographic and professional data. To evaluate antibiotic prescribing, we've calculated ESAC 12 quality indicators per physician per year, allowing us to stratify them as good or poor prescribers according to their performance on those indicators. Associations between determinants and outcomes were fitted with generalized linear mixed models. Results The overall response rate was 46.1%. Emergency activity (OR [95% CI] = 0.29 [0.16-0.54]; p < 0.05) and workload (number of patients seen per day: OR [95% CI] = 0.97 [0.94-1.00]; p < 0.05; number of patients seen per week in emergencies: OR [95% CI] = 0.98 [0.97-0.99]; p < 0.05) were both related to poor quality of antibiotic prescribing. Statistically significant odds ratios were also obtained for ignorance (IqOR [95% CI] = 2.14 [1.31-3.52]), complacency (1/IqOR [95% CI] = 1.19 [1.01-1.41]) and responsibility of others (1/IqOR [95% CI] = 1.78 [1.10-3.06]). Conclusions The above results serve to emphasize workload, working at emergency departments and physicians' attitudes identified as critical factors affecting antibiotic prescribing. This provides new insights for clinicians, researchers and policy makers when it comes to developing and improving the clinical and

  9. The Change of Grip Strength in a Patient with Congenital Myotonic Dystrophy Over a 4-year Period

    PubMed Central

    Kozuka, Naoki; Uchida, Eiji; Ninomiya, Takafumi; Tatsumi, Haruyuki; Takeda, Hidekatsu; Tachi, Nobutada

    2008-01-01

    Myotonic dystrophy (MyD) is a neuromuscular disease that is autosomal dominant and the most common form of muscular dystrophy affecting adults. The clinical features of MyD include a multisystemic disorder characterized by myotonia, progressive muscle weakness and wasting, cataracts, premature balding and mental retardation. The most severe type of MyD is classified as congenital MyD (CMyD). The muscle weakness in CMyD is very severe, but muscle development can be observed in the period of growth. However, no clinical case of this type has been reported yet. Therefore, we report on a girl with CMyD who had an increase in muscle strength over a four-year period. The girl with CMyD participated in this study from the age of 9 to the age of 12. The measurement of muscle strength was recorded as the maximum score of grip strength with the use of dynamometers. Grip strength was assessed once a year by the same two physical therapists. Grip strength of CMyD for each year was markedly weak when compared with the normal controls, but muscle strength changed within some specific growth areas. The muscle weakness in CMyD was remarkable, but the result showed that specific muscle strength of CMyD in childhood was actually increased. PMID:25792886

  10. 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. PMID:26417616

  11. Airway accidents in critical care unit: A 3-year retrospective study in a Public Teaching Hospital of Eastern India

    PubMed Central

    Dasgupta, Sugata; Singh, Shipti Shradha; Chaudhuri, Arunima; Bhattacharya, Dipasri; Choudhury, Sourav Das

    2016-01-01

    Background: Although tracheal tubes are essential devices to control and protect airway in a critical care unit (CCU), they are not free from complications. Aims: To document the incidence and nature of airway accidents in the CCU of a government teaching hospital in Eastern India. Methods: Retrospective analysis of all airway accidents in a 5-bedded (medical and surgical) CCU. The number, types, timing, and severity of airway accidents were analyzed. Results: The total accident rate was 19 in 233 intubated and/or tracheostomized patients over 1657 tube days (TDs) during 3 years. Fourteen occurred in 232 endotracheally intubated patients over 1075 endotracheal tube (ETT) days, and five occurred in 44 tracheostomized patients over 580 tracheostomy TDs. Fifteen accidents were due to blocked tubes. Rest four were unplanned extubations (UEs), all being accidental extubations. All blockages occurred during night shifts and all UEs during day shifts. Five accidents were mild, the rest moderate. No major accident led to cardiorespiratory arrest or death. All blockages occurred after 7th day of intubation. The outcome of accidents were more favorable in tracheostomy group compared to ETT group (P = 0.001). Conclusions: The prevalence of airway accidents was 8.2 accidents per 100 patients. Blockages were the most common accidents followed by UEs. Ten out of the 15 blockages and all 4 UEs were in endotracheally intubated patients. Tracheostomized patients had 5 blockages and no UEs. PMID:27076709

  12. Assessing risk factors for major adverse cardiovascular and cerebrovascular events during the perioperative period of carotid angioplasty with stenting patients

    PubMed Central

    Liu, Juan; Xu, Zhi-Qiang; Cui, Min; Li, Ling; Cheng, Yong; Zhou, Hua-Dong

    2016-01-01

    Carotid atherosclerotic stenosis is a risk factor for ischemic stroke. The rapid development of neuroimaging techniques had led to carotid angioplasty with stenting (CAS) becoming a useful, effective and minimally invasive method for the treatment of extracranial carotid artery stenosis. The aim of the present study was to identify independent risk factors to predict perioperative major adverse cerebral and cardiovascular events for CAS patients and establish a risk evaluation model. Consecutive patients treated with a standardized CAS procedure were enrolled in the present study. The patients included underwent independent neurological evaluation prior to and after the procedure and at 30 days. The rates of transient ischemic attack, stroke, myocardial infarction and mortality were recorded. A relative regression model was established to evaluate risk factors of perioperative major adverse cardiac and cerebrovascular events (MACCE). In total, 403 subjects treated with CAS were enrolled into the study at a baseline MACCE rate of 8.19%, whereas the overall stroke, myocardial infarction and mortality rate at 30 days was 3.97%. The multiple regression analysis revealed that certain factors significantly predicted the 30-day risk of treatment-related MACCE. These factors included age of ≥70 years, ulcerative plaque, severe carotid stenosis, bilateral carotid artery stenting and hemodynamic depression following CAS. The MACCE risk prediction model and risk score system were subsequently established. In conclusion, factors that significantly predicted the 30-day risk of MACCE of CAS included, age of ≥70 years, ulcerative plaque, severe carotid stenosis, bilateral carotid artery stenting and hemodynamic depression, with hemodynamic depression being a controllable factor. The established risk score system is therefore a potentially useful tool that can be employed in the prediction of MACCE after CAS. PMID:27446318

  13. Post-traumatic left ventricular aneurysm with massive hemopericardium in a child presenting 3 years after a fall.

    PubMed

    Lai, Wei-Ting; Lin, Shan-Miao; Wu, Shyr-Jao; Hwang, Haw-Kwei; Peng, Chun-Chih; Chen, Ming-Ren

    2013-12-01

    A 7-year-old boy developed a left ventricular aneurysm with massive hemopericardium 3 years ago due to a fall from a fourth-floor window. He had mild neurological sequelae including cranial nerve III palsy and abnormal electroencephalography findings at that time. He had no chest pain until recently when he presented with chest tightness and abdominal pain for 2 days prior to admission. Chest X-ray showed marked cardiomegaly. Echocardiography revealed massive pericardial effusion and a large left ventricular aneurysm. The massive hemopericardium was surgically drained, and the aneurysm was resected under cardiopulmonary bypass. He was discharged uneventfully 1 week after operation. Because symptoms and signs can vary in patients with ventricular aneurysm, we strongly suggest a close clinical follow-up, preferably with chest X-ray or echocardiography, for patients experiencing a blunt chest trauma. PMID:23597547

  14. Substrate reduction therapy with miglustat in chronic GM2 gangliosidosis type Sandhoff: results of a 3-year follow-up.

    PubMed

    Masciullo, Marcella; Santoro, Massimo; Modoni, Anna; Ricci, Enzo; Guitton, Jerome; Tonali, Pietro; Silvestri, Gabriella

    2010-12-01

    GM2 gangliosidosis type Sandhoff is caused by a defect of beta-hexosaminidase, an enzyme involved in the catabolism of gangliosides. It has been proposed that substrate reduction therapy using N-butyl-deoxynojirimycin (miglustat) may delay neurological progression, at least in late-onset forms of GM2 gangliosidosis. We report the results of a 3-year treatment with miglustat (100 mg t.i.d) in a patient with chronic Sandhoff disease manifesting with an atypical, spinal muscular atrophy phenotype. The follow-up included serial neurological examinations, blood tests, abdominal ultrasound, and neurophysiologic, cognitive, brain, and muscle MRI studies. We document some minor effects on neurological progression in chronic Sandhoff disease by miglustat treatment, confirming the necessity of phase II therapeutic trials including early-stage patients in order to assess its putative efficacy in chronic Sandhoff disease. PMID:20821051

  15. Phenotypic Variation in Different Lesions of Mycosis Fungoides Biopsied Within a Short Period of Time From the Same Patient.

    PubMed

    Kash, Natalie; Massone, Cesare; Fink-Puches, Regina; Cerroni, Lorenzo

    2016-07-01

    Phenotypic variants of mycosis fungoides (MF) include mainly the expression of cytotoxic markers by neoplastic cells (either α/β or γ/δ cytotoxic). To manage the patient properly, distinction from other cutaneous cytotoxic natural killer/T-cell lymphomas is paramount. Particularly for cutaneous γ/δ T-cell lymphoma, distinction is often based on clinicopathologic correlation (presence of tumors at first diagnosis as opposed to patches only in MF). The authors report a case of cytotoxic MF characterized by expression of TCRγ in two of three biopsies performed within a time frame of 1 week. The patient presented with patches, plaques, and 1 tumor at the time of first diagnosis; thus, distinction from cutaneous γ/δ T-cell lymphoma was not possible on clinical grounds alone. The diagnosis of MF was established, thanks to the phenotypic variations revealed by the three biopsies, with 1 lacking expression of cytotoxic proteins (TIA-1 and granzyme B) and of TCRγ. This case shows the importance to perform several biopsies in cases of cutaneous lymphoma, as morphologic and phenotypic features are variable and information gathered from a single biopsy may result in a wrong diagnosis. PMID:26885605

  16. 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

  17. Errata Corrige. Orthostatic Reactivity in Patients with Ischemic Stroke in the Chronic Period. http://dx.doi.org/10.3889/oamjms.2015.090

    PubMed Central

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

    2015-01-01

    AIM: This study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on orthostatic reactivity in patients with ischemic stroke in the chronic period (ISChP). MATERIAL AND METHODS: An active orthostatic test is used for the evaluation of the orthostatic reactions. The arterial blood pressure and heart rate were defined in the 10 minutes of supine position, before and after 1, 5 and 10 minutes of active upright position. The orthostatic autoregulation is evaluated four times - at the beginning of the study, on the 10th day, on the 1st month and three months after the start of the KT. The classification by Thulesius was used to separate the patients into two groups depending on the type of their orthostatic reactivity. RESULTS: At the beginning of the study of infringements symptomatic type orthostatic reactivity (SOR) was observed in 24 patients and hypertensive type orthostatic reactivity (HOR) was observed in the remaining 32 patients. Once applied SKTM establish improvement of orthostatic autoregulation for the groups SOR and HOR at the 10th day and the 1st month with a level of significance p <0.05. CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as an adapted exercise program at home, has significantly improved the orthostatic reactivity in patients with orthostatic dysregulation due to the ISChP.

  18. 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

  19. Allocation of resources to collaborators and free-riders in 3-year-olds.

    PubMed

    Melis, Alicia P; Altrichter, Kristin; Tomasello, Michael

    2013-02-01

    Recent studies have shown that in situations where resources have been acquired collaboratively, children at around 3 years of age share mostly equally. We investigated 3-year-olds' sharing behavior with a collaborating partner and a free-riding partner who explicitly expressed her preference not to collaborate. Children shared more equally with the collaborating partner than with the free rider. These results suggest that young children are sensitive to the contributions made by others to a collaborative effort (and possibly their reasons for not collaborating) and distribute resources accordingly. PMID:23073366

  20. Duplication 3q13.11q23: Longitudinal study in a patient over a period of more than 7 years and refinements of the breakpoints

    PubMed Central

    Eggermann, Thomas; Spengler, Sabrina; Gamerdinger, Ulrike; Denecke, Bernd; Grimm, Silke; Grimm, Manfred; Schubert, Regine; Schwanitz, Gesa

    2012-01-01

    In 2006, we reported the first case with a pure duplication of proximal 3q. In these rare aberrations, detailed clinical and developmental investigations at different ages are required to provide sufficient phenotypic documentation. Clinical and psychological differences were therefore regularly documented in our case. Supplemental genetic investigations comprised conventional karyotyping, fluorescence in-situ hybridization, single nucleotide polymorphism array analysis, and microsatellite typing. Thus, the exact position and extension of the duplication (3q13.11q23), the size (35.6 Mb), and the paternal origin could be determined. The development of our patient was followed up in detail over a period of 7.5 yr and thus enabled specific characterization of the phenotype of the patient.

  1. Dispensing death, desiring death: an exploration of medical roles and patient motivation during the period of legalized euthanasia in Australia.

    PubMed

    Street, A; Kissane, D W

    A qualitative case study was conducted to explore the clinical decision making processes that underpinned the practice of euthanasia under the Rights of the Terminally Ill (ROTI) Act. The key informant for this research was Philip Nitschke, the general practitioner responsible for the legal cases of euthanasia. His information was supported by extensive document analysis based on the public texts created by patients in the form of letters and documentaries. Further collaborating sources were those texts generated by the media, rights groups, politicians, the coroner's cort, and the literature on euthanasia and assisted suicide. A key study finding was that the ROTI legislation did not adequately provide for the specific medical situation in the Northern Territory, Australia. The medical roles, as proscribed by the legislation, carried many inherent assumptions about the health care context and the availability of appropriately qualified medical staff committed to providing euthanasia. These assumptions translated into difficulties in establishing clinical practices for the provision of euthanasia. A further finding concerned the motivations of those who requested euthanasia. This article addresses the medical roles and the motivations of those seeking euthanasia. PMID:12578011

  2. Mortality and Return to Work of Drug Abusers From Therapeutic Community Treatment 3 Years After Entry.

    PubMed

    Berg, John E.

    2003-08-01

    BACKGROUND: The outcome of therapeutic community treatment for drug abuse has been disputed with regard to mortality and rehabilitation to school or work as compared with other treatment modalities. METHOD: All patients (N = 130) admitted to a therapeutic community during 3 consecutive years (1996-1998), who had failed to stop abusing drugs after ambulatory and primary care initiatives, were assessed 1 to 4 years (mean = 36.5 months) after end of treatment. Rates of rehabilitation to school or work, changes in drug use patterns, and mortality were observed. RESULTS: Nine persons died during the observation period (the observation time to death seemed to be shorter in women than in men). The mortality rate per 100 observation years was 2.28. Among the surviving drug abusers, 39% were working or attending school at study endpoint. One fourth currently used drugs, and approximately 14% were enrolled in a methadone maintenance program. Another 13% were in treatment or prison. CONCLUSION: Drug abuse is an activity that increases the mortality rate, but among the surviving persons, a considerable number are rehabilitated, as assessed after a longer observation period. The authors suggest that this outcome could not have been attained with ambulatory general practice-driven services, even with empathic follow-up. PMID:15213778

  3. A Randomized, Double Blind, Two Period, Placebo-Controlled Crossover Trial of a Sustained-Release Methylphenidate in the Treatment of Fatigue in Cancer Patients

    PubMed Central

    Escalante, Carmen P.; Meyers, Christina; Reuben, James M.; Wang, Xuemei; Qiao, Wei; Manzullo, Ellen; Alvarez, Ricardo H.; Morrow, Phuong Khanh; Gonzalez-Angulo, Ana M.; Wang, Xin Shelley; Mendoza, Tito; Liu, Wenli; Holmes, Holly; Hwang, Jessica; Pisters, Katherine; Overman, Michael; Cleeland, Charles

    2015-01-01

    Purpose This study assessed the efficacy of methylphenidate versus placebo for cancer-related fatigue reduction. Other objectives were to analyze cytokine levels and to determine the effects of methylphenidate on other symptoms, cognitive function, work yield, and patients’ perceptions, and preferences. Methods Patients were randomly assigned (1:1) to receive methylphenidate-placebo or placebo-methylphenidate for 4 weeks. Patients crossed over after 2 weeks. Wilcoxon signed-rank tests and McNemar tests were used to assess continuous and categorical variables. The primary efficacy end point was change in the level of worst fatigue on the Brief Fatigue Inventory at the end of each 2-week period. Results The mean baseline Brief Fatigue Inventory was moderate (5.7). Methylphenidate treatment did not affect patients’ worst level of fatigue or other symptoms. Results from the Wechsler Adult Intelligence Scale Digit Symbol Test and the Hopkins Verbal Learning Test with Brief Fatigue Inventory interference questions and Brief Fatigue Inventory activity questions showed significant improvement in the methylphenidate-treated patients’ verbal learning, memory, visual perception, analysis, and scanning speed. Patients treated with methylphenidate missed significantly fewer work hours owing to health reasons and worked significantly more hours. After 4 weeks, 64% of patients reported that methylphenidate improved their cancer-related fatigue, and 58% wanted to continue treatment. Significant difference in IL-6R (positive), IL-10 (negative) and TNFα (positive) was noted between the methylphenidate and the placebo group. Discussion Low-dose methylphenidate did not improve cancer-related fatigue. Patients taking methylphenidate had better cognition and were able to work more hours. Patients tolerated methylphenidate well, and a majority felt better and wanted to continue treatment. PMID:24445757

  4. 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. PMID:14984314

  5. 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

  6. 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. PMID:26430170

  7. 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…

  8. Crusted scabies misdiagnosed as erythrodermic psoriasis in a 3-year-old girl with down syndrome.

    PubMed

    Fonseca, Vanessa; Price, Harper N; Jeffries, Michelle; Alder, Steven L; Hansen, Ronald C

    2014-01-01

    Scabies is a highly contagious infestation with the Sarcoptes scabiei var hominis mite. The variety of clinical presentations make timely, accurate diagnosis problematic. We report the case of a 3-year-old girl with Down syndrome and crusted scabies initially misdiagnosed as erythrodermic psoriasis. PMID:24138478

  9. 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…

  10. 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…

  11. 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…

  12. Interest and Agency in 2- and 3-Year-Olds' Participation in Emergent Writing

    ERIC Educational Resources Information Center

    Rowe, Deborah Wells; Neitzel, Carin

    2010-01-01

    This study investigated 2- and 3-year-olds' personal interests as a possible source of variation in preschool writing activities. Structured observations of the play behaviors of 11 preschool children in a childcare classroom were conducted one to two days per week for one school year. These data were analyzed to determine choices of play…

  13. 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…

  14. 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…

  15. 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…

  16. Modifying Primary Grade Classrooms for Inclusion: Darrell's 3 Years of Experience.

    ERIC Educational Resources Information Center

    Gormley, Kathleen A.; McDermott, Peter C.

    This 3-year study examined how primary grade teachers and their teacher assistants taught reading and the language arts to a boy with multiple disabilities in inclusive classrooms. Qualitative research strategies are used to describe and explain the boy's participation in literacy activities from kindergarten through second grade. Findings are…

  17. 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…

  18. Pequenitos en Accion. Edgewood ISD Model Program for 3-Year-Olds Replication Manual.

    ERIC Educational Resources Information Center

    Partnership for Hope, Inc., San Antonio, TX.

    This guide describes "Pequenitos en Accion" (Small Children in Action), the Edgewood (Texas) Independent School District (ISD) early childhood intervention program for Spanish-speaking 3-year-old preschool children. The program is an innovative early childhood education model involving educational programming, collaboration and integration with…

  19. 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…

  20. 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…

  1. 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…

  2. 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.…

  3. 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…

  4. A Study of Developmentally Appropriate Curriculum for 3-Year-Olds.

    ERIC Educational Resources Information Center

    Anderson, Mary F.

    Based on classroom observations, developmental assessment, individual educational planning, and research, this curriculum describes developmentally appropriate practices to assist adults who work with young children (primarily 3-year-olds) in providing quality care and education. Chapter 1 sets out the study's specific questions, procedures,…

  5. 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…

  6. 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…

  7. 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…

  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. 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…

  10. Can 2- and 3-Year-Old Children Be Trained to Perform Visual Perception Tasks?

    ERIC Educational Resources Information Center

    McGuigan, Nicola

    2007-01-01

    Children aged 2 and 3 years were exposed to a novel paradigm designed to train visual perception skills. The results indicate that children of this age could be trained to perform both percept deprivation and percept diagnosis tasks. Results are discussed with reference to engagement, a precursor to an adult-like understanding of perception.

  11. Creppy Crawlies. Developing an Early Interest in Science: A Preschool Science Curriculum. (3-Year-Olds).

    ERIC Educational Resources Information Center

    Summer, Gail L.; Giovannini, Kathleen

    This science teaching guide on insects and animals for 3-year-olds 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…

  12. Premarital Education and Training Sequence (PETS): A 3-year Follow-up of an Experimental Study.

    ERIC Educational Resources Information Center

    Bagarozzi, Dennis A.; And Others

    1984-01-01

    Reviews and critiques premarital counseling programs and discusses the development of the Premarital Education and Training Sequence (PETS). A study of the long-term effects of the PETS program (N=36) showed significant immediate differences between the experimental and control groups, but differences were not maintained at 3-year follow-up…

  13. 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…

  14. The Relation between 3-Year-Old Children's Skills and Their Hyperactivity, Inattention, and Aggression

    ERIC Educational Resources Information Center

    Friedman-Weieneth, Julie L.; Harvey, Elizabeth A.; Youngwirth, Sara D.; Goldstein, Lauren H.

    2007-01-01

    This study examines the relation between 3-year-old children's (N = 280) symptoms of inattention, hyperactivity, and aggression and their cognitive, motor, and preacademic skills. When the authors controlled for other types of attention and behavior problems, maternal ratings of hyperactivity and teacher ratings of inattention were uniquely and…

  15. 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…

  16. Standards for Day Care Centers for Infants and Children Under 3 Years of Age.

    ERIC Educational Resources Information Center

    American Academy of Pediatrics, Evanston, IL.

    The Committee on Infant and Preschool Child of the American Academy of Pediatrics has developed basic standards for quality day care for children under 3 years of age. The availability of day care provides a mother with the choice of group day care as one of the means of providing for her children. Options should include full-time or part-time day…

  17. 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 ...

  18. Effect of 3 years of treatment with a dorzolamide/timolol (1%/0.5%) combination on intraocular pressure

    PubMed Central

    Takeda, Sakurako; Mimura, Tatsuya; Matsubara, Masao

    2014-01-01

    Purpose We aimed to evaluate the effect on the intraocular pressure (IOP) of a dorzolamide/timolol (1%/0.5%) fixed combination (DTFC) ophthalmic agent for 3 years. Participants A total of 19 consecutive patients who had previously been treated with mono-therapy or any combination of a beta-blocker, carbonic anhydrase inhibitor, or prostaglandin analog, for primary open-angle glaucoma (POAG) (n=5) or normal tension glaucoma (N=14) were enrolled. Methods Patients were switched to DTFC from their prior glaucoma therapy. The IOP was measured at intervals of 4–6 weeks for 3 years. Treatment failure was defined as an increase of IOP by ≥10% from baseline after switching to DTFC. Results The average IOP decreased significantly from 14.1±2.9 mmHg at baseline to 12.2±2.2, 11.8±2.4, 12.1±2.5, 11.6±1.8, and 12.1±2.7 mmHg at 3, 6, 12, 24, and 36 months, respectively, after switching therapy (all P<0.05). The mean percent decrease of IOP was 12.0%±13.0%, 14.5%±14.2%, 12.2%±18.7%, 16.0%±12.8%, and 12.8%±15.2% at 3, 6, 12, 24, and 36 months, respectively, after switching. Univariate or multivariate analysis revealed the percent decrease of IOP was associated with the type of glaucoma (POAG) at 3 and 12 months, and with the baseline IOP at 3, 12, 24, and 36 months. Kaplan–Meier analysis demonstrated that the percentage of patients who remained on treatment with DTFC was 94.7%, 94.7%, 84.2%, 78.9%, and 78.9% at 3, 6, 12, 24, and 36 months, respectively. Cox proportional hazards analysis showed that the type of glaucoma (POAG) was associated with an increased risk of failure to control the IOP. Conclusion The IOP-lowering effect of DTFC was demonstrated for 3 years in this study. The baseline IOP had an important influence on the reduction of IOP achieved by DTFC. PMID:25228795

  19. Hypokalaemic periodic paralysis in rural northern India--most have secondary causes.

    PubMed

    Kumar, Vinod; Armstrong, Lois; Seshadri, M S; Finny, Philip

    2014-01-01

    Hypokalaemic periodic paralysis (HPP) is a life-threatening condition. Our aim was to study the clinical profile and laboratory parameters of HPP patients and to develop an algorithm to determine the causes of HPP. 84 patients presented with HPP over a 3 year period. 58 (69.0%) were found to have renal tubular acidosis (RTA). The other causes were idiopathic HPP (8 (9.5%)), acute gastroenteritis (4 (4.8%)), suspected primary hyperaldosteronism and familial HPP (2 each (2.4%)) and suspected Gitelman/Bartter Syndrome and thyrotoxic periodic paralysis (1 each (1.2%)). The number of cases peaks in the hot season. Over a third of the patients (35.7%) had recurrent episodes. 80% had secondary HPP and therefore a biochemical evaluation is mandatory. A simple algorithm was developed. Both health professionals and patients need further education regarding this problem in order to improve diagnosis and treatment and to improve compliance. PMID:24275360

  20. 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.

  1. Retrospective Analysis on the Effects of House Dust Mite Specific Immunotherapy for More Than 3 Years in Atopic Dermatitis

    PubMed Central

    Lee, Jungsoo; Lee, Hemin; Noh, Seongmin; Bae, Byung Gi; Shin, Jung U; Park, Chang Ook

    2016-01-01

    Purpose In extrinsic atopic dermatitis (AD), house dust mites (HDM) play a role in eliciting or aggravating allergic lesions. The nature of skin inflammation in AD has raised a growing interest in allergen-specific immunotherapy (SIT). Thus, we assessed clinical improvement and laboratory parameters for evaluation of the benefit of long-term SIT. Materials and Methods A total of 217 AD patients who were treated with SIT for at least 3 years were retrospectively assessed, by using their investigator global assessment, pruritus scores, loss of sleep (LOS), total serum IgE, and eosinophil counts collected. Patients were additionally classified into subgroups according to age, initial AD severity and mono- or multi-sensitization to include different individual factors in the evaluation of SIT efficacy. Lastly, we compared laboratory data of good responders to SIT with that of poor responders to SIT. Results Improvement after SIT therapy was observed in 192 out of 217 patients (88.4%). Among these patients, 138 (63.5%) achieved excellent, near-complete or complete clinical remission. Significant reduction of pruritus, LOS, and the mean value of total serum IgE were observed (p<0.01). Better outcome was found in patients younger than 12 years of age (p=0.024). Patients with moderate to severe AD showed better treatment outcomes (p=0.036). Patients sensitized only to HDM had the better response to treatment, but SIT was also effective in multi-sensitized groups (p=1.051). No significant differences in baseline laboratory results were observed between good and poor responders (p>0.05). Conclusion We emphasize the usefulness of long-term HDM SIT as a disease-modifying therapy for AD. PMID:26847292

  2. 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)

  3. Development of venous thromboembolism (VTE) in patients undergoing surgery for brain tumors: results from a single center over a 10 year period.

    PubMed

    Smith, Timothy R; Nanney, Allan D; Lall, Rishi R; Graham, Randall B; McClendon, Jamal; Lall, Rohan R; Adel, Joseph G; Zakarija, Anaadriana; Cote, David J; Chandler, James P

    2015-03-01

    Patients who undergo craniotomy for brain neoplasms have a high risk of developing venous thromboembolism (VTE), including deep vein thromboses (DVT) and pulmonary emboli (PE). The reasons for this correlation are not fully understood. This retrospective, single-center review aimed to determine the risk factors for VTE in patients who underwent neurosurgical resection of brain tumors at Northwestern University from 1999 to 2010. Our cohort included 1148 patients, 158 (13.7%) of whom were diagnosed with DVT and 38 (3.3%) of whom were diagnosed with PE. A variety of clinical factors were studied to determine predictors of VTE, including sex, ethnicity, medical co-morbidities, surgical positioning, length of hospital stay, tumor location, and tumor histology. Use of post-operative anticoagulants and hemorrhagic complications were also investigated. A prior history of VTE was found to be highly predictive of post-operative DVT (odds ratio [OR]=7.6, p=0.01), as was the patient's sex (OR=14.2, p<0.001), ethnicity (OR=0.5, p=0.04), post-operative intensive care unit days (OR=0.2, p=0.003), and tumor histology (OR=-0.16, p=0.01). Contrary to reports in the literature, the data collected did not indicate that the administration of post-operative medical prophylaxis for VTE was significant in preventing their formation (OR=-0.14, p=0.76). Hemorrhagic complications were low (2.2%) and resultant neurologic deficit was lower still (0.7%). The study indicates that patients with high-grade primary brain tumors and metastatic lesions should receive aggressive preventative measures in the post-operative period. PMID:25533212

  4. Dental Provider Attitudes Are a Barrier to Expanded Oral Health Care for Children ≤3 Years of Age

    PubMed Central

    Duong, Sophia; Fontana, Margherita

    2014-01-01

    Purpose. To describe the perspectives of general dentists regarding oral health care for children ≤3 years. Methods. Mailed survey of 444 general dentists in Michigan. Results. Although most dentists were aware of recommendations for early dental visits, only 36% recommended their own patients begin dental visits by 1 year of age. Only 37% dentists felt that screening for oral health problems can be done by medical providers, whereas 34% agreed administration of fluoride varnish by medical providers would be effective in preventing dental problems in young children. Conclusions. Dentists’ failure to recommend 1-year dental visits is due neither to lack of awareness nor to capacity problems. The limited enthusiasm for involving children’s medical providers in oral health promotion signals attitudinal barriers that must be overcome to improve children’s oral health. Primary care providers should identify and refer to dentists in their community who are willing to see young children. PMID:27335915

  5. Fifty-four-month survival in a 3-year-old child presenting with an aggressive metastatic dedifferentiated clival chordoma.

    PubMed

    Kearns, Ciléin; Kearns, Cónail

    2016-01-01

    Dedifferentiated chordoma is a rare, aggressive, chemoresistant and radioresistant malignancy arising from notochord remnants that can occur anywhere along the spine. Incidence in patients under 20 years of age is 1 per 250 million. We report a case of dedifferentiated clival chordoma presenting in a 3-year-old boy with pulmonary metastasis, which responded unusually well to chemotherapy, achieving complete metastatic clearance and debulking of the primary tumour. Proton beam therapy achieved further tumour control, with excellent quality of life for multiple years. On disease relapse, an atypical lateral transcondylar surgical approach achieved complete macroscopic clearance but there was cutaneous seeding. This, and continued primary site activity, failed to be controlled with targeted therapy, traditional chemotherapy and photon radiation, resulting in gradual neurological decline and death. Intensive management resulted in above-average survival despite diagnosis late in the disease course, which may be of value directing investigation into optimal management. PMID:27284102

  6. 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. PMID:25836010

  7. Secondary implantation of implantable collamer lens (ICL) for correction of anisometropic hyperopia in a 3-year-old pseudophakic child.

    PubMed

    Emara, Khalid E; Al Abdulsalam, Omar; Al Habash, Ahmed

    2016-01-01

    We report the first case of secondary implantation of implantable collamer lens (ICL) for correction of anisometropic hyperopia in a 3-year-old pseudophakic child. The ICL implantation was considered in our patient due to parental noncompliance for contact lens and spectacles use for one year. In terms of efficacy, the preoperative refractive error of +7.00-1.75 diopter (D) reduced to +1.00-1.75 D. The uncorrected distance visual acuity (UDVA) significantly improved from 20/400 (preoperatively) to 20/50 (postoperatively). In terms of safety, after an uneventful implantation surgery, the ICL was well tolerated, and remained well centered, with no serious postoperative complications encountered over a 22-month follow-up. PMID:26949366

  8. Secondary implantation of implantable collamer lens (ICL) for correction of anisometropic hyperopia in a 3-year-old pseudophakic child

    PubMed Central

    Emara, Khalid E.; Al Abdulsalam, Omar; Al Habash, Ahmed

    2015-01-01

    We report the first case of secondary implantation of implantable collamer lens (ICL) for correction of anisometropic hyperopia in a 3-year-old pseudophakic child. The ICL implantation was considered in our patient due to parental noncompliance for contact lens and spectacles use for one year. In terms of efficacy, the preoperative refractive error of +7.00–1.75 diopter (D) reduced to +1.00–1.75 D. The uncorrected distance visual acuity (UDVA) significantly improved from 20/400 (preoperatively) to 20/50 (postoperatively). In terms of safety, after an uneventful implantation surgery, the ICL was well tolerated, and remained well centered, with no serious postoperative complications encountered over a 22-month follow-up. PMID:26949366

  9. 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. PMID:27255804

  10. Parental styles and religious values among teenagers: a 3-year prospective analysis.

    PubMed

    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 assessing parental styles at Time 1, we also controlled for a number of Time 1 variables thought to possibly influence Time 2 religious values, namely, self-esteem, trait hope, and students' levels of conscientiousness. Time 1 measures (except self-esteem) were significantly correlated with Time 2 religious values, but only parental authoritativeness and hope significantly predicted religious values. The authors discuss these results with reference to the nature of parental styles and hope and their impact on religious values. PMID:20333897

  11. 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. PMID:22686384

  12. Predicting 3-year outcomes of early-identified children with hearing impairment

    PubMed Central

    Ching, T.Y.C.; Day, J.; Seeto, M.; Dillon, H.; Marnane, V.; Street, L.

    2013-01-01

    Problem/Objectives Permanent childhood hearing loss has major negative impacts on children’s health and development. To improve outcomes, universal newborn hearing screening (UNHS) has been implemented widely. However, high-quality evidence on its efficacy was lacking. To address this evidence gap, we conducted the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study to directly compare outcomes of early- and late-identified children. This paper investigates whether early performance measured shortly after initial amplification predicts language development at 3 years of age. Methodology This is a prospective, population-based study. We assessed outcomes at 6- and 12-months after amplification, and then at 3 and 5 years of age. Main outcome measures included directly-assessed language, receptive vocabulary, speech production; and parent-reported functional performance in everyday life. A range of demographic and audiological information was also collected at evaluation intervals. Results About 450 children participated, and 3-year outcomes scores were available for 356 participants. Multiple regression analysis revealed that early language scores or functional performance ratings were significant predictors of 3-year outcomes. Other significant predictors included the presence or absence of additional disabilities, severity of hearing loss, and age at cochlear implant activation. Conclusions Early performance, either directly-assessed language ability (PLS-4) or parent-reported functional ratings (PEACH), were significant predictors of 3-year outcomes; along with presence or absence of additional disabilities, severity of hearing loss, and age at CI activation. Earlier implantation is possible with early detection of hearing loss via UNHS. Monitoring performance after initial amplification allows preventive strategies to be implemented early to improve outcomes. PMID:24383228

  13. 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…

  14. Dystonia as acute adverse reaction to cough suppressant in a 3-year-old girl.

    PubMed

    Polizzi, A; Incorpora, G; Ruggieri, M

    2001-01-01

    Cough suppressant preparations containing mixtures of dextromethorphan or codeine with antihistamines, decongestants (sympathomimetic), expectorants and antipyretics with either sedative or anticholinergic activity have been associated with dystonic reactions in children. We report on a 3-year-old girl who presented with episodic stiffness and abnormal posturing with rigidity after arbitrary maternal administration of a mixture of methylcodeine and extract from Hedera plant. PMID:11587381

  15. Emergent retrograde tracheal intubation in a 3-year-old with stevens-johnsons syndrome.

    PubMed

    He, Michael

    2014-01-01

    A 3-year-old girl suffering from Stevens-Johnsons Syndrome with severe sloughing of the oropharyngeal mucosa was brought to the operating room for an emergent tracheostomy after multiple failed attempts to intubate the trachea in the pediatric intensive care unit. However, a retrograde tracheal intubation was successfully performed in the operating room to secure her airway, after which a tracheostomy was performed. Retrograde intubation can be a quick and effective method for securing the difficult airway. PMID:25612259

  16. Changes in body composition in apparently healthy urban Indian women up to 3 years postpartum

    PubMed Central

    Kajale, Neha A.; Khadilkar, Anuradha V.; Chiplonkar, Shashi A.; Khadilkar, Vaman

    2015-01-01

    Introduction: Dietary and life style practices differ in postpartum (PP) and nonpregnant Indian women. Effect of these practices on postpartum weight retention (PPWR) and development of cardio-metabolic risk (CMR) has been scarcely studied in urban women. Aims of this study were to (i) compare anthropometry, biochemical parameters and body composition up to 3 years PP (ii) effect of PPWR, dietary fat intake and physical activity on CMR factors. Methods: Design: Cross-sectional, 300-fullterm, apparently healthy primi-parous women (28.6 ± 3.4 years) randomly selected. 128 women within 7-day of delivery (Group-A), 88 with 1–2 years (Group-B) and 84 with 3–4-year-old-children (Group-C) were studied. Anthropometry, sociodemographic status, physical activity, diet, clinical examination, biochemical tests, body composition, at total body (TB), by dual energy X-ray absorptiometry (GE-Lunar DPX) were collected. Results: Women at 3-year PP showed higher weight retention (6.5[10] kg) than at 1-year (3.0[7] kg) (median [IQR]). Android fat % (central obesity) increased (P < 0.05) at 1-year PP (47 ± 10.0%) when compared to 1-week PP (44.3 ± 6.7%) and remained elevated at 3-year PP (45.6 ± 10.2%). Regression analysis revealed that at 1-year PP, increase in PPWR (Odd Ratio [OR] 1.8, 95% confidence interval [CI] = [1.2, 2.5], P < 0.001) and inactivity (OR 1.4, 95% CI= (0.97, 2.0), P < 0.1) were predictors for CMR. At 3-year PP, only PPWR was responsible for increase in CMR parameters (OR 1.6, 95% CI = (1.3, 2.3), P < 0.001) and not inactivity (P > 0.1). Conclusion: Postdelivery, low physical activity and higher PPWR may increase CMR in Indian women. PMID:26180762

  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. Study on local inflammatory reactions and other parameters during subcutaneous mistletoe application in HIV-positive patients and HIV-negative subjects over a period of 18 weeks.

    PubMed

    Stoss, M; van Wely, M; Musielsky, H; Gorter, R W

    1999-04-01

    Subcutaneous injections of fermented and unfermented aqueous extracts of Viscum album L. result in a local inflammatory reaction at the injection site. In this trial, the symptoms associated with this local reaction were investigated. Furthermore the occurrence of local reactions was tried to correlate with an increase in CD3/25- and CD8/38-positive lymphocyte counts, with eosinophilic granulocyte numbers, and with the formation of mistletoe lectin antibodies. Included in the trial were 30 HIV-antibody-positive patients and 17 healthy non-smokers, aged 24-51 years. The CD4 cell count in the HIV-negative subjects was > 800/microliter, compared with 200-600/microliter in the HIV-positive patients. All study participants had a Karnofsky score > or = 70. The trial subjects were observed over a period of 18 weeks. With escalation of the dose of a fermented and unfermented extract of Viscum album L. (Iscador Qu Spezial and Viscum album QuFrF), there was an increase in local reactions. Erythema at the injection site was the most frequently reported symptom. Between the doses and the symptoms induration, swelling and pruritus were marked correlations. Effects of the application of mistletoe extracts on the immune system were demonstrated by an increase in CD3/25-positive lymphocyte counts and antibodies against mistletoe-lectins. There were no changes in eosinophilic granulocytes or CD8/38-positive lymphocyte populations. For evaluation of the therapeutic applications of mistletoe extracts in HIV-positive patients it is advisable to assess primarily activation of CD3-positive lymphocytes and the patient response on the basis of the local reaction. The local inflammatory reaction at the injection site is desirable and well tolerated if the reaction is smaller than 5 cm in diameter. PMID:10337457

  19. 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

  20. 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

  1. Mitochondrial compromise in 3-year old patas monkeys exposed in utero to human-equivalent antiretroviral therapies.

    PubMed

    Liu, Yongmin; Shim Park, Eunwoo; Gibbons, Alexander T; Shide, Eric D; Divi, Rao L; Woodward, Ruth A; Poirier, Miriam C

    2016-08-01

    Antiretroviral (ARV) drug therapy, given during pregnancy for prevention of mother-to-child transmission of human immunodeficiency virus 1 (HIV-1), induces fetal mitochondrial dysfunction in some children. However, the persistence/reversibility of that dysfunction is unclear. Here we have followed Erythrocebus patas (patas) monkey offspring for up to 3 years of age (similar in development to a 15-year old human) after exposure of the dams to human-equivalent in utero ARV exposure protocols. Pregnant patas dams (3-5/exposure group) were given ARV drug combinations that included zidovudine (AZT)/lamivudine (3TC)/abacavir (ABC), or AZT/3TC/nevirapine (NVP), for the last 10 weeks (50%) of gestation. Infants kept for 1 and 3 years also received drug for the first 6 weeks of life. In offpsring at birth, 1 and 3 years of age mitochondrial morphology, examined by electron microscopy (EM), was compromised compared to the unexposed controls. Mitochondrial DNA (mtDNA), measured by hybrid capture chemiluminescence assay (HCCA) was depleted in hearts of patas exposed to AZT/3TC/NVP at all ages (P < 0.05), but not in those exposed to AZT/3TC/ABC at any age. Compared to unexposed controls, mitochondrial reserve capacity oxygen consumption rate (OCR by Seahorse) in cultured bone marrow mesenchymal fibroblasts from 3-year-old patas offspring was ∼50% reduced in AZT/3TC/ABC-exposed patas (P < 0.01), but not in AZT/3TC/NVP-exposed patas. Overall the data show that 3-year-old patas sustain persistent mitochondrial dysfunction as a result of perinatal ARV drug exposure. Environ. Mol. Mutagen. 57:526-534, 2016. © 2016 Wiley Periodicals, Inc. PMID:27452341

  2. Early response with dasatinib or imatinib in chronic myeloid leukemia: 3-year follow-up from a randomized phase 3 trial (DASISION).

    PubMed

    Jabbour, Elias; Kantarjian, Hagop M; Saglio, Giuseppe; Steegmann, Juan Luis; Shah, Neil P; Boqué, Concepción; Chuah, Charles; Pavlovsky, Carolina; Mayer, Jirí; Cortes, Jorge; Baccarani, Michele; Kim, Dong-Wook; Bradley-Garelik, M Brigid; Mohamed, Hesham; Wildgust, Mark; Hochhaus, Andreas

    2014-01-23

    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

  3. 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

  4. 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

  5. [DISORDERS OF LUNG FUNCTION IN THE EARLY POSTOPERATIVE PERIOD IN PATIENTS OPERATED ON THE ASCENDING AORTA WITH THE EXPANSION OF INTERVENTION ON THE AORTIC ARCH].

    PubMed

    Bokeria, L A; Nikitin, E S; Mironenko, V A; Rychin, S V; Vyganovskaya, N B; Makrushin, I M; Gordeev, S L

    2015-01-01

    Precapillary artery--arterial (bronchial artery--pulmonay artery) anastomoses, come into play in cases where the locking artery open and alveoli washed arterialized blood. Normally, these anastomoses are closed. Intrapulmonary shunts carry blood supply acinar hinder extraordinary circumstances (chronic pulmonary embolism, surgery, occurring in cardiopulmonary bypass, when the flaw of blood through the Iungs is suspended for the duration of cardiopulmonary bypass). Patients operated on the ascending aorta with the expansion of intervention on the nortic arch during the correction of pathology carry blood supply only the central nervous system. All other organs and systems at this time were protected by mild hypothermia. However, during circulatory arrest, required for correction of pathology acinar damage as a result of hypoxia, probably because there is no blood flow in the pulmonary artery and there is no blood flow in the bronchial arteries. Last, in the ordinary course of artificial circulation, capable due to arterio-arterial pulmonary anastomoses prevent hypoxic damage to acinar, not lead to persistent hypoxemia in the immediate postoperative period in these patients, as a result of violations of lung diffusion capacity. PMID:27019884

  6. [A Case of Fibromuscular Dysplasia in a Patient with Various Main Trunk Dissections in the Head and Neck over a Short Period].

    PubMed

    Ando, Kazuhiro; Sasaki, Osamu; Watanabe, Masatoshi; Nashimoto, Takeo; Kikuchi, Bumpei

    2016-07-01

    We report a case of subarachnoid hemorrhage(SAH)from an intracranial vertebral artery(VA)dissection in a patient with fibromuscular dysplasia(FMD)who presented with headache. A 54-year-old woman complained of spontaneous occipital headache. The dilatation of the left VA was detected on magnetic resonance angiography(MRA). She was diagnosed with left VA dissection(headache onset type). After sudden onset of headache on the second day of hospitalization, her consciousness level, as defined by the Japan Coma Scale, was 300. Computed tomography(CT)revealed SAH. Cerebral angiography showed the dilatation of the left intracranial VA and contrast material pooling, which was suspected to be a sign of dissection. We performed VA intravascular ligation by coil embolization. The postoperative course was good but postoperative MRA revealed arterial wall irregularities in both the extra cranial internal carotid artery and the right VA. Cerebral angiography showed the presence of the string-of-beads sign at these arteries. She was diagnosed with FMD. SAH might develop during the follow-up period in patients with VA dissection, even those in whom the initial symptom is headache. In addition, cases of FMD might also be complicated by various lesions of the main trunk of the cerebral artery. PMID:27384119

  7. [Assessment of the course of ischemic heart disease after placement of stents with drug covering and uncovered metal stents: data of 3 years follow-up].

    PubMed

    Buza, V V; Karpov, Iu A; Samko, A N; Deev, A D; Lopukhova, V V; Levitskiĭ, I V; Sozykin, A V

    2009-01-01

    The placement of sirolimus-eluting stents decreases the frequency of repeat revascularization procedures in patients undergoing percutaneous coronary intervention (PCI) in randomized clinical trials. However, there is uncertainty about the effectiveness of sirolimus-eluting stents, and increasing concern about their safety in routine clinical practice. From the prof. Samko PCI laboratory in Moscow, Russia, we identified 426 patients, who received either bare-metal stents alone or sirolimus-eluting stents alone during an index PCI procedure between March 1, 2002, and September 31, 2004.The primary outcomes of the study were the rates of target-lesion revascularization, myocardial infarction, death, late stent thrombosis. The 3-year rate of target-lesion revascularization was significantly lower among patients who received sirolimus-eluting stents than among those who received bare-metal stents (3.1% vs. 19 %, p=0.001). The 3-year mortality rate was not different between the bare-metal stent group and the sirolimus eluting stent group (5.9% vs. 7.2%, p=0.68), the 3-year rate of all ARC late stent thrombosis was similar in the two groups (5.9% and 7.2%, respectively; p=0.95). Sirolimus-eluting stents are effective in reducing the need for target-vessel revascularization without significantly increased rates of death, late stent thrombosis, myocardial infarction. PMID:19166395

  8. 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.

  9. Age of Achievement of Gross Motor Milestones in Infancy and Adiposity at Age 3 Years

    PubMed Central

    Neelon, Sara E. Benjamin; Oken, Emily; Taveras, Elsie M.; Rifas-Shiman, Sheryl L.; Gillman, Matthew W.

    2011-01-01

    Early life physical activity may help prevent obesity but is difficult to measure. The purpose of this study was to examine associations of age of achievement of gross motor milestones in infancy with adiposity at age 3 years. Seven forty one mother/infant dyads participated in a longitudinal study in Massachusetts. Exposures were age of attainment of 4 gross motor milestones—rolling over, sitting up, crawling, and walking. Outcomes were 3-year sum of subscapular and triceps skinfold thickness (SS + TR) for overall adiposity, their ratio (SS:TR) for central adiposity, and body mass index (BMI) z-score. We used linear regression models adjusted for confounders to examine motor milestone achievement and later adiposity. Rolling over (0.04, 95% CI: 0.008, 0.07) and sitting up (0.02, 95% CI: 0.001, 0.05) at ≥6 months were associated with increased SS:TR compared with attainment before 6 months. Walking at ≥15 months was associated with 0.98 mm higher SS + TR (95% CI: 0.05, 1.91) compared with walking before 12 months. Age at crawling was not associated with the outcomes. None of the milestones were associated with BMI z-score. Age of motor milestone achievement was only a modest predictor of adiposity. Later rolling over and sitting up were associated with greater central adiposity, and later age at walking was associated with greater overall adiposity at age 3 years. Although we controlled for birth weight and 6-month weight-for-length in our models, more detailed assessment of early adiposity prior to achievement of motor milestones is needed to help determine causality. PMID:21643834

  10. 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

  11. 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

  12. 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. PMID:24489399

  13. 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

  14. Discoid medial meniscus with a horizontal cleavage tear: a juvenile who suffered for 3 years.

    PubMed

    Chen, Jingqing; Gao, Shijun; Chen, Baicheng

    2012-09-01

    It is very rare to see medial discoid meniscus, and there have been only 82 knees in 61 cases reported to date. The investigators found discoid medial meniscus with horizontal cleavage tear in a 13-year-old juvenile who had been injured while playing basketball, and endured for 3 years. Both magnetic resonance images and the arthroscopic findings were presented. Saucerization of the torn discoid medial meniscus was performed successfully, and the clinical outcomes were satisfying according to the follow-up of 14 months. PMID:21912338

  15. Early epileptic encephalopathies including West syndrome: a 3-year retrospective study from Klang Hospital, Malaysia.

    PubMed

    Thambyayah, M

    2001-11-01

    It is difficult to give a country report from Malaysia. A study done in 1999 reported the incidence of West Syndrome to be 3% among newly diagnosed cases of epilepsy. In this 3 year retrospective hospital-based study (1997-1999), the prevalence of early epileptic encephalopathy (EEE) and West Syndrome were 4.1 and 2.5% respectively. There is difficulty classifying EEE cases into distinct sub-groups of EIEE (early infantile epileptic encephalopathy), WS (West Syndrome) and SMEI (severe myoclonic epilepsy of infancy), using a combination of clinical features, EEG and CT/MRI findings. PMID:11701263

  16. Outcomes of population based language promotion for slow to talk toddlers at ages 2 and 3 years: Let’s Learn Language cluster randomised controlled trial

    PubMed Central

    Tobin, Sherryn; Girolametto, Luigi; Ukoumunne, Obioha C; Gold, Lisa; Levickis, Penny; Sheehan, Jane; Goldfeld, Sharon; Reilly, Sheena

    2011-01-01

    Objective To determine the benefits of a low intensity parent-toddler language promotion programme delivered to toddlers identified as slow to talk on screening in universal services. Design Cluster randomised trial nested in a population based survey. Setting Three local government areas in Melbourne, Australia. Participants Parents attending 12 month well child checks over a six month period completed a baseline questionnaire. At 18 months, children at or below the 20th centile on an expressive vocabulary checklist entered the trial. Intervention Maternal and child health centres (clusters) were randomly allocated to intervention (modified “You Make the Difference” programme over six weekly sessions) or control (“usual care”) arms. Main outcome measures The primary outcome was expressive language (Preschool Language Scale-4) at 2 and 3 years; secondary outcomes were receptive language at 2 and 3 years, vocabulary checklist raw score at 2 and 3 years, Expressive Vocabulary Test at 3 years, and Child Behavior Checklist/1.5-5 raw score at 2 and 3 years. Results 1217 parents completed the baseline survey; 1138 (93.5%) completed the 18 month checklist, when 301 (26.4%) children had vocabulary scores at or below the 20th centile and were randomised (158 intervention, 143 control). 115 (73%) intervention parents attended at least one session (mean 4.5 sessions), and most reported high satisfaction with the programme. Interim outcomes at age 2 years were similar in the two groups. Similarly, at age 3 years, adjusted mean differences (intervention−control) were −2.4 (95% confidence interval −6.2 to 1.4; P=0.21) for expressive language; −0.3 (−4.2 to 3.7; P=0.90) for receptive language; 4.1 (−2.3 to 10.6; P=0.21) for vocabulary checklist; −0.5 (−4.4 to 3.4; P=0.80) for Expressive Vocabulary Test; −0.1 (−1.6 to 1.4; P=0.86) for externalising behaviour problems; and −0.1 (−1.3 to 1.2; P=0. 92) for internalising behaviour problems. Conclusion

  17. Job embeddedness factors and retention of nurses with 1 to 3 years of experience.

    PubMed

    Halfer, Diana

    2011-10-01

    An aging work force, predictions of job growth in health care, and an eventual economic recovery suggest that the current reprieve from the national nursing shortage is temporary. New graduate nurses are an important part of the work force and are needed to replace nurses who will retire in the next decade. Organizational leaders can address the forecasted work force demand by proactively investing in programs for workplace development and retention. Recent literature reports an increased focus on understanding the work experience and career support needed for new graduate nurses. Several studies report improvements in job satisfaction and retention after implementation of structured mentoring programs for new graduate nurses. However, despite successful transition programs, turnover for these same nurses after 1 to 3 years of organizational tenure remains high. Studying factors that contribute to retention and supporting careers beyond the first year of practice may have a significant effect on improving retention and will contribute new knowledge to the nursing literature. This study, undertaken at a Midwestern pediatric academic medical center, examined job factors and career development support that lead to retention of nurses with 1 to 3 years of experience. Understanding these issues may guide nursing leaders and staff development educators in investing in focused retention and career development plans during an economic recession. PMID:21667873

  18. 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

  19. Language development and everyday functioning of children with hearing loss assessed at 3 years of age

    PubMed Central

    Ching, Teresa Y. C.; Crowe, Kathryn; Martin, Vivienne; Day, Julia; Mahler, Nicole; Youn, Samantha; Street, Laura; Cook, Cassandra; Orsini, Julia

    2011-01-01

    This paper reports language ability and everyday functioning of 133 children with hearing impairment who were evaluated at 3 years of age, as part of the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. The language abilities of children were evaluated using the Preschool Language Scale (PLS-4), Peabody Picture Vocabulary Test (PPVT), Diagnostic Evaluation of Articulation and Phonology (DEAP) and Child Development Inventory (CDI). Everyday functioning of children was evaluated by interviewing parents using the Parents’ Evaluation of Aural/oral performance of Children (PEACH) questionnaire. There were significant correlations among language measures, and also between the standardized language measures and the PEACH. On average, children who had language deficits exhibited difficulties in everyday functioning. The evidence lends support to a systematic use of parents’ observations to evaluate communicative functioning of children in real life. On average, children’s language attainment decreased as hearing loss increased, more so for children of less highly educated parents. Factors that were not significantly associated with speech and language outcomes at 3 years were age of amplification and socioeconomic status. As multiple factors affect children’s outcomes, it will be possible to examine their effects on outcomes of children when all data in the LOCHI study are available. PMID:20420353

  20. Slow roll reconstruction: constraints on inflation from the 3 year WMAP data set

    NASA Astrophysics Data System (ADS)

    Peiris, Hiranya V.; Easther, Richard

    2006-10-01

    We study the constraints on the inflationary parameter space derived from the 3 year WMAP data set using 'slow roll reconstruction', using the SDSS galaxy power spectrum to gain further leverage where appropriate. This approach inserts the inflationary slow roll parameters directly into a Monte Carlo Markov chain estimate of the cosmological parameters, and uses the inflationary flow hierarchy to compute the parameters' scale dependence. We work with the first three parameters (epsi, η and ξ) and pay close attention to the possibility that the 3 year WMAP data set contains evidence for a 'running' spectral index, which is dominated by the ξ term. Mirroring the WMAP team's analysis we find that the permitted distribution of ξ is broad, and centred away from zero. However, when we require that inflationary parameters yield at least 30 additional e-folds of inflation after the largest observable scales leave the horizon, the bounds on ξ tighten dramatically. We make use of the absence of an explicit pivot scale in the slow roll reconstruction formalism to determine the dependence of the computed parameter distributions on the pivot. We show that the choice of pivot has a significant effect on the inferred constraints on the inflationary variables, and the spectral index and running derived from them. Finally, we argue that the next round of cosmological data can be expected to place very stringent constraints on the region of parameter space open to single field models of slow roll inflation.

  1. Tsunami-exposed tourist survivors: signs of recovery in a 3-year perspective.

    PubMed

    Johannesson, Kerstin Bergh; Lundin, Tom; Fröjd, Thomas; Hultman, Christina M; Michel, Per-Olof

    2011-03-01

    Long-term follow-up after disaster exposure indicates increased rates of psychological distress. However, trajectories and rates of recovery in large samples of disaster-exposed survivors are largely lacking. A group of 3457 Swedish survivors temporarily on vacation in Southeast Asia during the 2004 tsunami were assessed by postal questionnaire at 14 months and 3 years after the tsunami regarding post-traumatic stress reactions (IES-R) and general mental health (GHQ-12). There was a general pattern of resilience and recovery 3 years postdisaster. Severe exposure and traumatic bereavement were associated with increased post-traumatic stress reactions and heightened risk for impaired mental health. The rate of recovery was lower among respondents exposed to life threat and among bereaved. Severe trauma exposure and bereavement seem to have considerable long-term impact on psychological distress and appear to slow down the recovery process. Readiness among health agencies for identification of symptoms and provision of interventions might facilitate optimal recovery. PMID:21346486

  2. 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. PMID:21479943

  3. 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. PMID:24433528

  4. Lessons after 3 years of running GENIUS-TF in Gran Sasso

    NASA Astrophysics Data System (ADS)

    Krivosheina, I. V.; Klapdor-Kleingrothaus, H. V.

    2006-10-01

    After operation of GENIUS-TF over 3 years with finally six naked Ge detectors (15 kg) in liquid nitrogen in Gran Sasso, we realize serious problems for realization of a full-size GENIUS-like experiment: (i) background from 222Rn diffusing into the setup, on a level far beyond the expectation. (ii) Limited long-term stability of naked detectors in liquid nitrogen. None of the six detectors is running after 3 years with the nominal high voltage. Three of the six detectors do not work at all any more. The HDMS (Heidelberg Dark Matter Search) setup at LNGS, operates the first enriched 73Ge detector worldwide, and looks for spin-dependent WIMP-nucleon coupling at the Gran Sasso Underground Laboratory. The results (85.48 kg d) improve the best present existing limits on the WIMP neutron spin-dependent cross-section (obtained from 129Xe) for low WIMP masses (Klapdor-Kleingrothaus et al 2005 Phys. Lett. B 609 226 31).

  5. 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

  6. Functional and Radiological Outcome of Schatzker type V and VI Tibial Plateau Fracture Treatment with Dual Plates with Minimum 3 years follow-up: A Prospective Study

    PubMed Central

    Suri, Harpreet Singh; Gangrade, Kewal

    2016-01-01

    Introduction High energy intra-articular fractures involving the tibial plateau causes various problems related to management like wound dehiscence, severe comminution leading to malalignment and delayed complications like varus collapse, implant failure and arthritis of knee joint. Aim This study was done to determine functional, radiological outcome and the complications of Schatzker V and VI tibial plateau fractures treated with bipillar plating with dual plates with a regular follow-up of atleast 3 years. Materials and Methods Total 34 cases of tibial plateau fracture type V and VI treated with dual plating were studied from January 2011 to December 2013 in KIMS Hospital were followed for minimum of 3 years. The patients were operated through an anterolateral approach for lateral plate and a medial column plate was put through a minimally invasive medial approach or an open posteromedial approach. Results Total 34 patients were evaluated postoperatively thoroughly for functional outcome using The Knee Society Score and radiological outcomes by Modified Rasmussen Assessment criteria which showed 29 patients (85.29%) had excellent and 5 patients (14.71%) had good objective knee society score. 24 patients (70.59%) had excellent, 8 patients (23.53%) had good and 1patient (2.94%) were each of poor and fair functional knee society score. Eleven patients (32.35%) had excellent, 21patients (61.76%) had good and 2 patients (5.88%) had fair radiological outcome. Conclusion We conclude that open reduction and internal fixation of high-energy tibial plateau fractures with dual plates via 2 incisions gives excellent to good functional outcome with minimal soft tissue complications. Thus, a minimally invasive approach should be used which helps in preventing soft tissue problems and helps in early wound healing. Fixation done by bipillar plating is important for early mobilization of knee joint. Early mobilization leads to better range of movements and thereby better

  7. A primary Sjögren's syndrome patient with distal renal tubular acidosis, who presented with symptoms of hypokalemic periodic paralysis: Report of a case study and review of the literature.

    PubMed

    Soy, Mehmet; Pamuk, Omer Nuri; Gerenli, Murat; Celik, Yahya

    2005-11-01

    Although renal tubular acidosis (RTA), secondary to autoimmune interstitial nephritis, develops in a large proportion of patients with Sjögren's syndrome (SS), most of the subjects are asymptomatic. Here, we shall present a 39-year-old female patient who came to us with hypokalemic periodic paralysis (HPP), and who was later diagnosed with distal RTA. The patient, who had xerostomia and xerophthalmia for a long period of time, was diagnosed with primary SS from serologic and histologic findings. The patient recovered by being prescribed potassium replacement therapy. Although renal biopsy was not performed, corticosteroids were administered because HPP indicated severe interstitial nephritis. HPP did not reoccur during a 2-year follow-up period. We also review cases with SS-related distal RTA and HPP. PMID:15690142

  8. Periodic cages.

    PubMed

    Diudea, Mircea V; Nagy, Csaba L; Silaghi-Dumitrescu, Ioan; Graovac, Ante; Janezic, Dusanka; Vikić-Topić, Drazen

    2005-01-01

    Various cages are constructed by using three types of caps: f-cap (derived from spherical fullerenes by deleting zones of various size), kf-cap (obtainable by cutting off the polar ring, of size k), and t-cap ("tubercule"-cap). Building ways are presented, some of them being possible isomerization routes in the real chemistry of fullerenes. Periodic cages with ((5,7)3) covering are modeled, and their constitutive typing enumeration is given. Spectral data revealed some electronic periodicity in fullerene clusters. Semiempirical and strain energy calculations complete their characterization. PMID:15807490

  9. Thyrotoxic periodic paralysis.

    PubMed

    Balakrishnan, Rojith Karanode; Chandran, Suresh Rama; Thirumalnesan, Geetha; Doraisamy, Nedumaran

    2011-07-01

    This article aims at highlighting the importance of suspecting thyrotoxicosis in cases of recurrent periodic flaccid paralysis; especially in Asian men to facilitate early diagnosis of the former condition. A case report of a 28 year old male patient with recurrent periodic flaccid paralysis has been presented. Hypokalemia secondary to thyrotoxicosis was diagnosed as the cause of the paralysis. The patient was given oral potassium intervention over 24 hours. The patient showed complete recovery after the medical intervention and was discharged after 24 hours with no residual paralysis. Thyrotoxic periodic paralysis (TPP) is a complication of thyrotoxicosis, more common amongst males in Asia. It presents as acute flaccid paralysis in a case of hyperthyroidism with associated hypokalemia. The features of thyrotoxicosis may be subtle or absent. Thus, in cases of recurrent or acute flaccid muscle paralysis, it is important to consider thyrotoxicosis as one of the possible causes, and take measures accordingly. PMID:21966655

  10. Effects of remifentanil on the sphincter of Oddi in a 3-year-old child: a case report.

    PubMed

    Sato, Makoto; Kikuchi, Chika; Sasakawa, Tomoki; Kunisawa, Takayuki

    2016-08-01

    Opioids cause spasm of the sphincter of Oddi. Remifentanil is metabolized enzymatically throughout the body. Its context-sensitive half-time is 3 to 4minutes. The effect of remifentanil on the sphincter of Oddi is unknown, especially in children. We recently encountered a patient in whom the administration of remifentanil caused spasm of the sphincter of Oddi, which resolved rapidly after discontinuation of remifentanil. A 3-year-old girl weighing 11.3kg was scheduled to undergo common bile duct excision with ductoplasty. Her diagnosis was congenital biliary dilatation. In the operating room, after achieving the initial induction through sevoflurane (5%) and intravenous rocuronium (10mg), she was intubated and administered a continuous paravertebral block by levobupivacaine (25mg/10mL +2.5mg/h). General anesthesia was maintained with sevoflurane (2%), remifentanil (0.5 μg kg(-1) min(-1)), and oxygen (fractional inspired oxygen tension, 0.33). The first intraoperative cholangiogram obtained via the cystic duct tube showed obstruction at the terminal end of the common bile duct. We injected scopolamine butylbromide (5mg, intravenous) to relax the sphincter of Oddi. However, the next cholangiogram obtained 3minutes later still showed an obstruction. We speculated that the obstruction may have been caused by remifentanil-induced spasm of the sphincter of Oddi. Therefore, we stopped administering remifentanil; 2minutes later, we achieved satisfactory passage of the contrast material to the duodenum. The predicted plasma concentrations of remifentanil at the time of stopping its administration and at the time of disobliteration were 6.38and 2.55ng/mL, respectively. The patient's postoperative course was uneventful. In patients who have spasms of the sphincter of Oddi during the administration of remifentanil, the resultant obstruction can be treated effectively by reducing the infusion rate of remifentanil. PMID:27290986

  11. Cognitive Function at 3 Years of Age after Fetal Exposure to Antiepileptic Drugs

    PubMed Central

    Meador, Kimford J.; Baker, Gus A.; Browning, Nancy; Clayton-Smith, Jill; Combs-Cantrell, Deborah T.; Cohen, Morris; Kalayjian, Laura A.; Kanner, Andres; Liporace, Joyce D.; Pennell, Page B.; Privitera, Michael; Loring, David W.

    2009-01-01

    BACKGROUND Fetal exposure of animals to antiepileptic drugs at doses lower than those required to produce congenital malformations can produce cognitive and behavioral abnormalities, but cognitive effects of fetal exposure of humans to antiepileptic drugs are uncertain. METHODS Between 1999 and 2004, we enrolled pregnant women with epilepsy who were taking a single antiepileptic agent (carbamazepine, lamotrigine, phenytoin, or valproate) in a prospective, observational, multicenter study in the United States and the United Kingdom. The primary analysis is a comparison of neurodevelopmental outcomes at the age of 6 years after exposure to different antiepileptic drugs in utero. This report focuses on a planned interim analysis of cognitive outcomes in 309 children at 3 years of age. RESULTS At 3 years of age, children who had been exposed to valproate in utero had significantly lower IQ scores than those who had been exposed to other antiepileptic drugs. After adjustment for maternal IQ, maternal age, antiepileptic-drug dose, gestational age at birth, and maternal preconception use of folate, the mean IQ was 101 for children exposed to lamotrigine, 99 for those exposed to phenytoin, 98 for those exposed to carbamazepine, and 92 for those exposed to valproate. On average, children exposed to valproate had an IQ score 9 points lower than the score of those exposed to lamotrigine (95% confidence interval [CI], 3.1 to 14.6; P = 0.009), 7 points lower than the score of those exposed to phenytoin (95% CI, 0.2 to 14.0; P = 0.04), and 6 points lower than the score of those exposed to carbamazepine (95% CI, 0.6 to 12.0; P = 0.04). The association between valproate use and IQ was dose dependent. Children’s IQs were significantly related to maternal IQs among children exposed to carbamazepine, lamotrigine, or phenytoin but not among those exposed to valproate. CONCLUSIONS In utero exposure to valproate, as compared with other commonly used antiepileptic drugs, is associated

  12. 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

  13. Reliability of biologic indicators in a mail-return sterilization-monitoring service: a review of 3 years.

    PubMed

    Andrés, M T; Tejerina, J M; Fierro, J F

    1995-12-01

    Most mail-return sterilization-monitoring services use spore strips to test sterilizers in dental clinics, but factors such as delay caused by mailing to the laboratory could cause false negatives. The aims of this study were to determine the influence of poststerilization time and temperature on the biologic indicator recovery system and to evaluate sterilization failure and its possible causes in dental clinics subscribing to a mail-return sterilization-monitoring service. Spore strips used in independent tests revealed the poststerilization time and temperature after a 7-day delay to have no significant influence. Sixty-six dental clinics that received quarterly biologic indicators to evaluate the effectiveness of their sterilizers had sterilization failure rates of 28.7% in 1992, 18.1% in 1993, and 9.1% in 1994, a statistically significant decrease in sterilization failure during the 3-year period. The usual causes of failure were operator error in wrapping of instruments, loading, operating temperature, or exposure time. PMID:8596817

  14. [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. PMID:23405627

  15. Molecular findings from influenza A(H1N1)pdm09 detected in patients from a Brazilian equatorial region during the pandemic period

    PubMed Central

    Oliveira, Maria José Couto; Motta, Fernando do Couto; Siqueira, Marilda M; Resende, Paola Cristina; Born, Priscilla da Silva; Souza, Thiago Moreno L; Mesquita, Milene; Oliveira, Maria de Lourdes Aguiar; Carney, Sharon; de Mello, Wyller Alencar; Magalhães, Vera

    2014-01-01

    After the World Health Organization officially declared the end of the first pandemic of the XXI century in August 2010, the influenza A(H1N1)pdm09 virus has been disseminated in the human population. In spite of its sustained circulation, very little on phylogenetic data or oseltamivir (OST) resistance is available for the virus in equatorial regions of South America. In order to shed more light on this topic, we analysed the haemagglutinin (HA) and neuraminidase (NA) genes of influenza A(H1N1)pdm09 positive samples collected during the pandemic period in the Pernambuco (PE), a northeastern Brazilian state. Complete HA sequences were compared and amino acid changes were related to clinical outcome. In addition, the H275Y substitution in NA, associated with OST resistance, was investigated by pyrosequencing. Samples from PE were grouped in phylogenetic clades 6 and 7, being clustered together with sequences from South and Southeast Brazil. The D222N/G HA gene mutation, associated with severity, was found in one deceased patient that was pregnant. Additionally, the HA mutation K308E, which appeared in Brazil in 2010 and was only detected worldwide the following year, was identified in samples from hospitalised cases. The resistance marker H275Y was not identified in samples tested. However, broader studies are needed to establish the real frequency of resistance in this Brazilian region. PMID:25410995

  16. 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.

  17. Changes in plant biomass and nutrient removal over 3 years in a constructed wetland in Cairns, Australia.

    PubMed

    Greenway, M; Woolley, A

    2001-01-01

    The surface flow wetland in Cairns, Australia consists of 3 linear channels each 65 m long. Channels 1 and 2 are 5 m wide and Channel 3 is 15 m wide. The wetland was constructed in 1994 and band planted with emergent macrophyte species and alternating open water sections. The wetland was monitored for plant growth and nutrient removal until 1997. During that period HRT was 16 days in Channel 1 and 10 days in Channels 2 and 3; mass loading rates were 2.4 kg Total N and 2.0 kg Total P ha(-1) d(-1) in Channel 1 and 3.7 kg TN and 3.3 kg TP ha(-1) d(-1) in Channels 2 and 3. The aim of this work was to determine the proportion of nutrient removal that could be attributed to direct uptake by macrophytes and incorporated into plant biomass. Over the 3 year monitoring period reduction in total mass of nutrients was: Channel 1: 26% P, 85% N; Channel 2: 28% P, 87% N; Channel 3: 21% P, 81% N. Percentage reduction of FRP (Filterable Reactive Phosphorus) was similar to TP; NOx removal was 97-98%. Mass removal rates for TN and TP were higher in Channels 2 and 3 despite greater nutrient loading rates and shorter detention times. Total FRP removal was 23 kg P in Channel 1, 33 kg P in Channel 2 and 70 kg P in Channel 3 of which plant biomass accounted for 65%, 44% and 47% respectively. Total nitrogen removal was 92 kg in Channel 1,154 kg in Channel 2 and 386 kg in Channel 3 of which plant biomass accounted for 47%, 27% and 27% respectively. Thus, in this tropical surface flow wetland supporting a mixture of emergent macrophytes and floating duckweed, vegetation is an important mechanism for direct nutrient removal. PMID:11804111

  18. Bidirectionally positioned flap surgery: a case report with 3-year follow-up.

    PubMed

    Iwano, Yoshihiro; Sato, Shuichi; Ito, Koichi

    2013-01-01

    A new technique to cover recessions to take advantage of connective tissue grafts and coronally advanced flaps is proposed. A 34-year-old woman presented with a 2-mm Class I recession on the buccal aspect of her maxillary right canine. A full-thickness flap was placed coronally to cover the exposed root, and a partial thickness flap was positioned apically. Complete root coverage was obtained, and the width of keratinized tissue had increased from 2 to 4 mm at the 6-month postoperative visit. These clinical outcomes were maintained for 3 years. This single surgical approach benefits from obtaining not only complete root coverage but also increasing width of keratinized tissue, without requiring a second surgical site. PMID:23444158

  19. 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. PMID:24375005

  20. The SWAP EUV imager onboard PROBA2: 3 years of observations

    NASA Astrophysics Data System (ADS)

    West, Matthew; Berghmans, David; Seaton, Daniel

    The Sun Watcher with Active Pixels and Image Processing (SWAP) imager is an EUV solar telescope on board ESA's Project for Onboard Autonomy 2 (PROBA2) mission launched on 2 November 2009. SWAP has a spectral bandpass centered on 17.4 nm and provides images of the low solar corona over a 54x54 arcmin field-of-view with 3.2 arcsec pixels and an imaging cadence of about two minutes. SWAP is designed to monitor all space-weather-relevant events and features in the low solar corona. The SWAP telescope is designed with various innovative technologies, including an off-axis optical design and a CMOS-APS detector. I will present what has been learnt from 3 years of SWAP operations, the advantages of the CMOS detector and SWAPs setup, and a few unique PROBA2/SWAP observations.

  1. 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. PMID:20522884

  2. The 3-year Solar Wind Charge Exchange Campaign with Suzaku: preliminary results

    NASA Astrophysics Data System (ADS)

    Ursino, Eugenio; Galeazzi, Massimiliano; Liu, Wenhao; Koutroumpa, Dimitra; Kuntz, K. D.

    2016-04-01

    We performed a 3-year monitoring campaign of the Solar Wind Charge Exchange (SWCX) heliospheric emission with Suzaku. We targeted four nearby (~100 pc) high column density clouds that absorb the X-ray contribution from distant sources so that the leftover signal has local origin (and is expected to be dominated by SWCX). The targets have been selected for their position in the sky, in order to maximize the latitude and longitude range, to model how SWCX depends on the distribution of neutrals, and to follow the seasonal variations of the SWCX. Here we present the results of data analysis of the three years of observations and we show how they compare with existing models.

  3. 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.

  4. Effect of Breastfeeding Duration on Cognitive Development in Infants: 3-Year Follow-up Study

    PubMed Central

    2016-01-01

    We investigated the association between breastfeeding and cognitive development in infants during their first 3 years. The present study was a part of the Mothers’ and Children’s Environmental Health (MOCEH) study, which was a multi-center birth cohort project in Korea that began in 2006. A total of 697 infants were tested at age 12, 24, and 36 months using the Korean version of the Bayley Scales of Infant Development II (K-BSID-II). The use and duration of breastfeeding and formula feeding were measured. The relationship between breastfeeding and the mental development index (MDI) score was analyzed by multiple linear regression analysis. The results indicated a positive correlation between breastfeeding duration and MDI score. After adjusting for covariates, infants who were breastfed for ≥ 9 months had significantly better cognitive development than those who had not been breastfed. These results suggest that the longer duration of breastfeeding improves cognitive development in infants. PMID:27051242

  5. 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

  6. Suppurative Meckel Diiverticulum in a 3-Year-Old Girl Presenting with Periumbilical Cellulitis

    PubMed Central

    Park, Ji Sook; Lim, Chun Woo; Park, Taejin; Cho, Jae-Min; Youn, Hee-Shang

    2015-01-01

    Meckel diverticulum (MD) is one of the most common congenital gastrointestinal anomalies and occurs in 1.2-2% of the general population. MD usually presents with massive painless rectal bleeding, intestinal obstruction or inflammation in children and adults. Suppurative Meckel diverticulitis is uncommon in children. An experience is described of a 3-year-old girl with suppurative inflammation in a tip of MD. She complained of acute colicky abdominal pain, vomiting and periumbilical erythema. Laparoscopic surgery found a relatively long MD with necrotic and fluid-filled cystic end, which was attatched to abdominal wall caused by inflammation. Herein, we report an interesting and unusual case of a suppurative Meckel diverticulitis presenting as periumbilical cellulitis in a child. Because of its varied presentations, MD might always be considered as one of the differential diagonosis. PMID:25866736

  7. Epidermoid cyst in the floor of the mouth of a 3-year-old.

    PubMed

    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

  8. 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

  9. Effect of Breastfeeding Duration on Cognitive Development in Infants: 3-Year Follow-up Study.

    PubMed

    Lee, Hyungmin; Park, Hyewon; Ha, Eunhee; Hong, Yun-Chul; Ha, Mina; Park, Hyesook; Kim, Bung-Nyun; Lee, Boeun; Lee, Soo-Jeong; Lee, Kyung Yeon; Kim, Ja Hyeong; Jeong, Kyoung Sook; Kim, Yangho

    2016-04-01

    We investigated the association between breastfeeding and cognitive development in infants during their first 3 years. The present study was a part of the Mothers' and Children's Environmental Health (MOCEH) study, which was a multi-center birth cohort project in Korea that began in 2006. A total of 697 infants were tested at age 12, 24, and 36 months using the Korean version of the Bayley Scales of Infant Development II (K-BSID-II). The use and duration of breastfeeding and formula feeding were measured. The relationship between breastfeeding and the mental development index (MDI) score was analyzed by multiple linear regression analysis. The results indicated a positive correlation between breastfeeding duration and MDI score. After adjusting for covariates, infants who were breastfed for ≥ 9 months had significantly better cognitive development than those who had not been breastfed. These results suggest that the longer duration of breastfeeding improves cognitive development in infants. PMID:27051242

  10. Estimation of primordial spectrum with post-WMAP 3-year data

    SciTech Connect

    Shafieloo, Arman; Souradeep, Tarun

    2008-07-15

    In this paper we implement an improved (error-sensitive) Richardson-Lucy deconvolution algorithm on the measured angular power spectrum from the Wilkinson Microwave Anisotropy Probe (WMAP) 3 year data to determine the primordial power spectrum assuming different points in the cosmological parameter space for a flat {lambda}CDM cosmological model. We also present the preliminary results of the cosmological parameter estimation by assuming a free form of the primordial spectrum, for a reasonably large volume of the parameter space. The recovered spectrum for a considerably large number of the points in the cosmological parameter space has a likelihood far better than a 'best fit' power law spectrum up to {delta}{chi}{sub eff}{sup 2}{approx_equal}-30. We use discrete wavelet transform (DWT) for smoothing the raw recovered spectrum from the binned data. The results obtained here reconfirm and sharpen the conclusion drawn from our previous analysis of the WMAP 1st year data. A sharp cut off around the horizon scale and a bump after the horizon scale seem to be a common feature for all of these reconstructed primordial spectra. We have shown that although the WMAP 3 year data prefers a lower value of matter density for a power law form of the primordial spectrum, for a free form of the spectrum, we can get a very good likelihood to the data for higher values of matter density. We have also shown that even a flat cold dark matter model, allowing a free form of the primordial spectrum, can give a very high likelihood fit to the data. Theoretical interpretation of the results is open to the cosmology community. However, this work provides strong evidence that the data retains discriminatory power in the cosmological parameter space even when there is full freedom in choosing the primordial spectrum.

  11. Estimation of primordial spectrum with post-WMAP 3-year data

    NASA Astrophysics Data System (ADS)

    Shafieloo, Arman; Souradeep, Tarun

    2008-07-01

    In this paper we implement an improved (error-sensitive) Richardson-Lucy deconvolution algorithm on the measured angular power spectrum from the Wilkinson Microwave Anisotropy Probe (WMAP) 3 year data to determine the primordial power spectrum assuming different points in the cosmological parameter space for a flat ΛCDM cosmological model. We also present the preliminary results of the cosmological parameter estimation by assuming a free form of the primordial spectrum, for a reasonably large volume of the parameter space. The recovered spectrum for a considerably large number of the points in the cosmological parameter space has a likelihood far better than a “best fit” power law spectrum up to Δχeff2≈-30. We use discrete wavelet transform (DWT) for smoothing the raw recovered spectrum from the binned data. The results obtained here reconfirm and sharpen the conclusion drawn from our previous analysis of the WMAP 1st year data. A sharp cut off around the horizon scale and a bump after the horizon scale seem to be a common feature for all of these reconstructed primordial spectra. We have shown that although the WMAP 3 year data prefers a lower value of matter density for a power law form of the primordial spectrum, for a free form of the spectrum, we can get a very good likelihood to the data for higher values of matter density. We have also shown that even a flat cold dark matter model, allowing a free form of the primordial spectrum, can give a very high likelihood fit to the data. Theoretical interpretation of the results is open to the cosmology community. However, this work provides strong evidence that the data retains discriminatory power in the cosmological parameter space even when there is full freedom in choosing the primordial spectrum.

  12. Trajectories of maternal harsh parenting in the first 3 years of life

    PubMed Central

    Pears, Katherine C.; Fisher, Philip A.; Connelly, Cynthia D.; Landsverk, John L.

    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 related longitudinal risk factors (contextual and intrapersonal). Partner aggression was also tested as a time-varying predictor to examine its time-specific influence on maternal harsh parenting. Methods Longitudinal data from four assessments of a community sample of 488 at-risk mothers were analyzed using latent growth curve modeling. Maternal risk factors and harsh parenting behaviors were assessed at birth and at ages 1, 2, and 3 years. Results There was a significant increase in maternal harsh parenting from birth to age 3, particularly between ages 1 and 2. There was a significant direct effect of maternal alcohol use and abuse history on maternal harsh parenting at age 3, and maternal age was positively associated with change in maternal harsh parenting over time. In addition, partner aggression was significantly and positively associated with maternal harsh parenting at each time point. Conclusions The findings suggest possible developmental trends in the emergence of maternal harsh parenting during infancy and toddlerhood. Further investigation is needed to elucidate individual differences in the developmental patterns and to differentiate predictive factors that persist across time and factors that are unique to specific developmental stages. Practice implications The overall high prevalence rates of harsh parenting behavior and growth of such behavior in infancy and toddlerhood support the need for developmentally sensitive early intervention programs. PMID:21030081

  13. 18 CFR 225.3 - Schedule of records and periods of retention.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... COMPANIES § 225.3 Schedule of records and periods of retention. Table of Contents Corporate and General 1...) Statements of periodic deposits with fund administrators or trustees Retain records for the most recent 3 years. (b) Statements of periodic withdrawals from fund Retain records for the most recent 3 years....

  14. 18 CFR 225.3 - Schedule of records and periods of retention.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... COMPANIES § 225.3 Schedule of records and periods of retention. Table of Contents Corporate and General 1...) Statements of periodic deposits with fund administrators or trustees Retain records for the most recent 3 years. (b) Statements of periodic withdrawals from fund Retain records for the most recent 3 years....

  15. A randomised clinical trial on the influence of splinted and unsplinted oral implants in mandibular overdenture therapy. A 3-year report.

    PubMed

    Naert, I E; Gizani, S; Vuylsteke, M; van Steenberghe, D

    1997-06-01

    A randomised clinical trial was performed to investigate whether there is a need or advantage to splint two implants in the mandible retaining a hinging overdenture. Furthermore, patient satisfaction was evaluated for different attachment systems retaining the overdenture. Thirty-six edentulous patients were randomised into three groups of equal size and treated with either magnets, ball attachments or straight bars (reference group). After 3 years of observation no implants were lost in any of the groups. Besides, no statistically significant differences were noted for the peri-implant outcome. Although the bar group presented the highest retention force, the general satisfaction of the patients in the three groups did not differ. The patients with bar retentions showed less prosthetic complications of the retention elements but more at the level of the denture-supporting mucosa. Finally, the clinical outcome of all groups confirms that overdenture treatment demands regular controls with limited time intervals. PMID:9552823

  16. 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.

  17. Development of Risk Score for Predicting 3-Year Incidence of Type 2 Diabetes: Japan Epidemiology Collaboration on Occupational Health Study

    PubMed Central

    Nanri, Akiko; Nakagawa, Tohru; Kuwahara, Keisuke; Yamamoto, Shuichiro; Honda, Toru; Okazaki, Hiroko; Uehara, Akihiko; Yamamoto, Makoto; Miyamoto, Toshiaki; Kochi, Takeshi; Eguchi, Masafumi; Murakami, Taizo; Shimizu, Chii; Shimizu, Makiko; Tomita, Kentaro; Nagahama, Satsue; Imai, Teppei; Nishihara, Akiko; Sasaki, Naoko; Hori, Ai; Sakamoto, Nobuaki; Nishiura, Chihiro; Totsuzaki, Takafumi; Kato, Noritada; Fukasawa, Kenji; Huanhuan, Hu; Akter, Shamima; Kurotani, Kayo; Kabe, Isamu; Mizoue, Tetsuya; Sone, Tomofumi; Dohi, Seitaro

    2015-01-01

    Objective Risk models and scores have been developed to predict incidence of type 2 diabetes in Western populations, but their performance may differ when applied to non-Western populations. We developed and validated a risk score for predicting 3-year incidence of type 2 diabetes in a Japanese population. Methods Participants were 37,416 men and women, aged 30 or older, who received periodic health checkup in 2008–2009 in eight companies. Diabetes was defined as fasting plasma glucose (FPG) ≥126 mg/dl, random plasma glucose ≥200 mg/dl, glycated hemoglobin (HbA1c) ≥6.5%, or receiving medical treatment for diabetes. Risk scores on non-invasive and invasive models including FPG and HbA1c were developed using logistic regression in a derivation cohort and validated in the remaining cohort. Results The area under the curve (AUC) for the non-invasive model including age, sex, body mass index, waist circumference, hypertension, and smoking status was 0.717 (95% CI, 0.703–0.731). In the invasive model in which both FPG and HbA1c were added to the non-invasive model, AUC was increased to 0.893 (95% CI, 0.883–0.902). When the risk scores were applied to the validation cohort, AUCs (95% CI) for the non-invasive and invasive model were 0.734 (0.715–0.753) and 0.882 (0.868–0.895), respectively. Participants with a non-invasive score of ≥15 and invasive score of ≥19 were projected to have >20% and >50% risk, respectively, of developing type 2 diabetes within 3 years. Conclusions The simple risk score of the non-invasive model might be useful for predicting incident type 2 diabetes, and its predictive performance may be markedly improved by incorporating FPG and HbA1c. PMID:26558900

  18. 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. PMID:25906092

  19. 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

  20. Nonintubated thoracoscopic lung resection: a 3-year experience with 285 cases in a single institution

    PubMed Central

    Chen, Ke-Cheng; Cheng, Ya-Jung; Hung, Ming-Hui; Tseng, Yu-Ding

    2012-01-01

    Objective Tracheal intubation with one-lung ventilation is considered mandatory for thoracoscopic surgery. This study reported the experience of thoracoscopic lung resection without endotracheal intubation in a single institution. Methods From August 2009 through July 2012, 285 consecutive patients were treated by nonintubated thoracoscopic surgery using epidural anesthesia, intrathoracic vagal blockade, and sedation for lobectomy, segmentectomy, or wedge resection in a tertiary medical center. The feasibility and safety of this technique were evaluated. Results The final diagnosis for surgery were primary lung cancer in 159 patients (55.8%), metastatic lung cancer in 17 (6.0%), benign lung tumor in 104 (36.5%), and pneumothorax in 5 (1.8%). The operative methods consisted of conventional (83.2%) and needlescopic (16.8%) thoracoscopic surgery. The operative procedures included lobectomy in 137 patients (48.1%), wedge resection in 132 (46.3%), and segmentectomy in 16 (5.6%). Collapse of the operative lung and inhibition of coughing were satisfactory in most of the patients. Fourteen (4.9%) patients required conversion to tracheal intubation because of significant mediastinal movement [5], persistent hypoxemia [2], dense pleural adhesions [2], ineffective epidural anesthesia [2], bleeding [2], and tachypnea [1]. One patient (0.4%) was converted to thoracotomy because of bleeding. No mortality was noted in our patients. Conclusions Nonintubated thoracoscopic lung resection is technically feasible and safe in selected patients. It can be a valid alternative in managing patients with pulmonary lesions. PMID:22934136

  1. Corpus callosum atrophy as a predictor of age-related cognitive and motor impairment: a 3-year follow-up of the LADIS study cohort.

    PubMed

    Ryberg, C; Rostrup, E; Paulson, O B; Barkhof, F; Scheltens, P; van Straaten, E C W; van der Flier, W M; Fazekas, F; Schmidt, R; Ferro, J M; Baezner, H; Erkinjuntti, T; Jokinen, H; Wahlund, L-O; Poggesi, A; Pantoni, L; Inzitari, D; Waldemar, G

    2011-08-15

    The aim of this 3-year follow-up study was to investigate whether corpus callosum (CC) atrophy may predict future motor and cognitive impairment in an elderly population. On baseline MRI from 563 subjects with age-related white matter changes (ARWMC) from the Leukoaraiosis And DISability (LADIS) study, the CC was segmented and subdivided into five anterior-posterior regions (CC1-CC5). Associations between the CC areas and decline in motor performance and cognitive functions over a 3-year period were analyzed. CC atrophy at baseline was significantly associated with impaired cognitive performance (p<0.01 for CC1, p<0.05 for CC5), motor function (p<0.05 for CC2 and CC5), and walking speed (p<0.01 for CC2 and CC5, p<0.05 for CC3 and total CC), and with development of dementia at 3 years (p<0.05 for CC1) after correction for appropriate confounders (ARWMC volume, atrophy, age, gender and handedness). In conclusion, CC atrophy, an indicator of reduced functional connectivity between cortical areas, seems to contribute, independently of ARWMC load, to future cognitive and motor decline in the elderly. PMID:21621224

  2. 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

  3. Florida Initiative for Quality Cancer Care: Improvements on Colorectal Cancer Quality of Care Indicators during a 3-Year Interval

    PubMed Central

    Siegel, Erin M; Jacobsen, Paul B; Lee, Ji-Hyun; Malafa, Mokenge; Fulp, William; Fletcher, Michelle; Smith, Jesusa Corazon R; Brown, Richard; Levine, Richard; Cartwright, Thomas; Abesada-Terk, Guillermo; Kim, George; Alemany, Carlos; Faig, Douglas; Sharp, Philip; Markham, Merry-Jennifer; Shibata, David

    2015-01-01

    BACKGROUND The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments. STUDY DESIGN Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined. RESULTS Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ≥12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47% and 71%, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up. CONCLUSIONS The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for

  4. Risk Factors for Soil-Transmitted Helminth Infections during the First 3 Years of Life in the Tropics; Findings from a Birth Cohort

    PubMed Central

    Menzies, Stefanie K.; Rodriguez, Alejandro; Chico, Martha; Sandoval, Carlos; Broncano, Nely; Guadalupe, Irene; Cooper, Philip J.

    2014-01-01

    Background Soil-transmitted helminths (STH) infect more than 2 billion humans worldwide, causing significant morbidity in children. There are few data on the epidemiology and risk factors for infection in pre-school children. To investigate risk factors for infection in early childhood, we analysed data prospectively collected in the ECUAVIDA birth cohort in Ecuador. Methods and Findings Children were recruited at birth and followed up to 3 years of age with periodic collection of stool samples that were examined microscopically for STH parasites. Data on social, demographic, and environmental risk factors were collected from the mother at time of enrolment. Associations between exposures and detection of STH infections were analysed by multivariable logistic regression. Data were analysed from 1,697 children for whom a stool sample was obtained at 3 years. 42.3% had at least one STH infection in the first 3 years of life and the most common infections were caused by A. lumbricoides (33.2% of children) and T. trichiura (21.2%). Hookworm infection was detected in 0.9% of children. Risk of STH infection was associated with factors indicative of poverty in our study population such as Afro-Ecuadorian ethnicity and low maternal educational level. Maternal STH infections during pregnancy were strong risk factors for any childhood STH infection, infections with either A. lumbricoides or T. trichiura, and early age of first STH infection. Children of mothers with moderate to high infections intensities with A. lumbricoides were most at risk. Conclusions Our data show high rates of infection with STH parasites during the first 3 years of life in an Ecuadorian birth cohort, an observation that was strongly associated with maternal STH infections during pregnancy. The targeted treatment of women of childbearing age, in particular before pregnancy, with anthelmintic drugs could offer a novel approach to the prevention of STH infections in pre-school children. PMID:24587469

  5. 3-years Occurrence Variability of Concentric Gravity Waves in the Mesopause Observed by IMAP/VISI

    NASA Astrophysics Data System (ADS)

    Perwitasari, S.; Sakanoi, T.; Otsuka, Y.; Yamazaki, A.; Miyoshi, Y.; Hozumi, Y.; Saito, A.

    2015-12-01

    We report a study of 3-years occurrence variability of concentric gravity waves (CGWs) in the mesopause observed by IMAP/VISI instrument. CGWs are fascinating to be studied because of its unique characteristic that shows the direct coupling between lower and upper atmosphere. The Visible and near-Infrared Spectral Imager (VISI) of the IMAP mission was launched successfully on July 21, 2012 with H-IIB/HTV-3 and installed onto the International Space Station (ISS). IMAP/VISI is now operated in the night side hemisphere with a range of +/- 51 deg. in geographic latitude and measuring three airglow emissions of OI (630 nm), OH Meinel (730 nm) and O2 (762 nm) with a typical spatial resolution of 16 - 50 km in the nadir direction. In this study, we analyzed 3 years data taken by IMAP/VISI from October 2012 to June 2015. We found total 172 CGWs events in the O2 (762nm) airglow emissions out of 4853 data paths in 2013, 92 events out of 4809 data paths in 2014 and 46 events from 2112 data paths in 2015. The monthly occurrence probability shows a similar trend for each year, a clear seasonal dependence with the peak around March-April and August-September. The weak background winds in the middle atmosphere during the equinoxes are likely responsible for the seasonal dependence. We calculated the horizontal wavelength and radius maximum by fitting the circular wavefronts to a circle. The source of CGWs then identified from meteorological satellite data around the estimated center. The horizontal wavelength was found varying from 44-300 km and radius maximum up to 3000 km, showing that CGWs can affect large area in mesopause. In most cases, the CGWs appeared as arc-like shape instead of full circle. It indicates that the background wind filter allows the wave to propagate in a particular direction and filter out the other directions. The detailed discussion on horizontal wavelength distribution, the sources and background profiles influence on the variability of the CGWs

  6. 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

  7. 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

  8. 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

  9. 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. PMID:25660736

  10. 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. PMID:22942315

  11. Cultural differences in visual object recognition in 3-year-old children.

    PubMed

    Kuwabara, Megumi; Smith, Linda B

    2016-07-01

    Recent research indicates that culture penetrates fundamental processes of perception and cognition. Here, we provide evidence that these influences begin early and influence how preschool children recognize common objects. The three tasks (N=128) examined the degree to which nonface object recognition by 3-year-olds was based on individual diagnostic features versus more configural and holistic processing. Task 1 used a 6-alternative forced choice task in which children were asked to find a named category in arrays of masked objects where only three diagnostic features were visible for each object. U.S. children outperformed age-matched Japanese children. Task 2 presented pictures of objects to children piece by piece. U.S. children recognized the objects given fewer pieces than Japanese children, and the likelihood of recognition increased for U.S. children, but not Japanese children, when the piece added was rated by both U.S. and Japanese adults as highly defining. Task 3 used a standard measure of configural progressing, asking the degree to which recognition of matching pictures was disrupted by the rotation of one picture. Japanese children's recognition was more disrupted by inversion than was that of U.S. children, indicating more configural processing by Japanese than U.S. children. The pattern suggests early cross-cultural differences in visual processing; findings that raise important questions about how visual experiences differ across cultures and about universal patterns of cognitive development. PMID:26985576

  12. 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

  13. 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. PMID:26265404

  14. Psychiatric diagnoses among quitters versus continuing smokers 3 years after their quit day

    PubMed Central

    Piper, Megan E.; Rodock, Matthew; Cook, Jessica W.; Schlam, Tanya R.; Fiore, Michael C; Baker, Timothy B.

    2013-01-01

    Background People with psychiatric disorders are more likely to smoke and smoke more heavily than the general population, and they suffer disproportionally from smoking-related illnesses. However, little is known about how quitting versus continuing to smoke affects mental health and the likelihood of developing a psychiatric diagnosis. This study used data from a large prospective clinical trial to examine the relations of smoking cessation success with psychiatric diagnoses 1 and 3 years after the target quit day. Methods This study enrolled 1504 smokers (83.9% white; 58.2% female) in a cessation trial that involved the completion of the Composite International Diagnostic Interview to assess psychiatric diagnoses and biochemical confirmation of point-prevalence abstinence at Baseline and Years 1 and 3. Results Regression analyses showed that, after controlling for pre-quit (past-year) diagnoses, participants who were smoking at the Year 3 follow-up were more likely to have developed and maintained a substance use or major depressive disorder by that time than were individuals who were abstinent at Year 3. Conclusions Quitting smoking does not appear to negatively influence mental health in the long-term and may be protective with respect to depression and substance use diagnoses; this should encourage smokers to make quit attempts and encourage clinicians to provide cessation treatment. PMID:22995766

  15. How selective are 3-year-olds in imitating novel linguistic material?

    PubMed

    Bannard, Colin; Klinger, Jörn; Tomasello, Michael

    2013-12-01

    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 experiments, we found that children were more likely to reproduce the adjective when there were 2 different instances of the same object present in the situation than when there was only 1 or when there were 2 objects of different types present. Thus, children seemed to be sensitive to the descriptive and contrastive function of the adjectives in determining which parts of the utterances to reproduce. Nonetheless, replication of even redundant material was over 50%, suggesting a strategy of somewhat blind copying. In the 3rd experiment, we found that children were less likely to reproduce a redundant adjective when the speaker indicated gesturally that he did not intend to produce it than when he clearly produced it intentionally. We distinguish insightful imitation (the copying of a speaker's goal and means when motivated by insight into why those particular means were chosen) and blind imitation (the copying of a speaker's goal and means with no awareness of why those specific means were chosen) from mimicry. We explore the roles that these modes of imitation might play in language development. PMID:23458663

  16. Association of maternal prenatal depressive symptoms with child cognition at age 3 years.

    PubMed

    Tse, Alison C; Rich-Edwards, Janet W; Rifas-Shiman, Sheryl L; Gillman, Matthew W; Oken, Emily

    2010-05-01

    We examined the association of prenatal depressive symptoms at mid-pregnancy with child cognition at age 3 years in Project Viva, a pre-birth cohort study of 1030 mother-child pairs in eastern Massachusetts. We measured maternal depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS), a self-report measure validated for use during pregnancy. Measures of child cognition included the Peabody Picture Vocabulary Test (PPVT) and the Wide Range Achievement of Visual Motor Abilities (WRAVMA). At mid-pregnancy, 81 mothers (7.9%) scored 13 or above on the EPDS, indicating probable depression. In the unadjusted model, children born to mothers with prenatal depressive symptoms had PPVT scores that were 3.8 points lower [95% confidence interval (CI) -7.1, -0.5]. With adjustment for sociodemographic variables, the association substantially attenuated [adjusted regression coefficient b for PPVT score = -0.7 (95% CI -3.6, 2.3)]. In both unadjusted and multivariable models, prenatal depressive symptoms were not associated with WRAVMA scores [adjusted b for total WRAVMA score = -0.5 (95% CI -3.0, 2.1)]. We found no evidence to suggest that maternal prenatal depression is independently associated with early child cognition. PMID:20415752

  17. 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.

  18. A Statistical Skull Geometry Model for Children 0-3 Years Old

    PubMed Central

    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. PMID:25992998

  19. Amorphous and crystalline polyetheretherketone: Mechanical properties and tissue reactions during a 3-year follow-up.

    PubMed

    Nieminen, Tuomo; Kallela, Ilkka; Wuolijoki, Erkki; Kainulainen, Heikki; Hiidenheimo, Ilmari; Rantala, Immo

    2008-02-01

    The study was aimed to test the mechanical strength, structural stability, and tissue reactions of optically amorphous and crystalline polyetheretherketone (PEEK) plates during a 3-year follow-up in vivo and in vitro. The injection-moulded PEEK plates were implanted to the dorsal subcutis of 12 sheep, which were sacrificed at 6-156 weeks. Thereafter, the plates were subjected to tensile tests, and levels of crystallinity were assessed by differential scanning calorimetry (DSC). Histological evaluation was carried out using the paraffin technique. In vitro properties were examined with the tensile test and DSC at 0-156 weeks. Tissue reactions were mild and fairly similar for the amorphous and crystalline plates at corresponding points in time. The mechanical characteristics of the plates remained stable over the entire follow-up. The tensile yield load and elongation at the yield load of the crystalline plates were roughly double ( approximately 500 vs. 270 N and 2.4 vs. 1.4 mm, respectively) in comparison to the amorphous plates. The elongation at break load of the crystalline plates was smaller than that of the amorphous ones (6 vs. 10). The level of crystallinity in both the optically amorphous ( approximately 15%) and crystalline (32-34%) plates remained invariable during the follow-up. The in vitro and in vivo data coincided remarkably well. In conclusion, both optically amorphous and crystalline PEEK plates are suitable for the fixation of fractures and osteotomies. PMID:17618477

  20. Dietary intake by Dutch 1- to 3-year-old children at childcare and at home.

    PubMed

    Gubbels, Jessica S; Raaijmakers, Lieke G M; Gerards, Sanne M P L; Kremers, Stef P J

    2014-01-01

    The goal of the current study was to assess dietary intake in a large sample (N=1016) of Dutch toddlers (1-3 years old), both at childcare and at home. Dietary intake during two weekdays was recorded using an observation format applied by childcare staff for intake at childcare, and partially pre-coded dietary journals filled out by parents for intake at home. Children's intake of energy, macronutrients and energy balance-related food groups (fruit, vegetables, sweet snacks, savoury snacks) were compared with Dutch dietary guidelines. In addition, differences between the dietary intake by various subgroups (based on gender, age, childcare attendance, socio-economic status of childcare centre) were explored using multilevel regression analyses, adjusting for nesting of children within centres. Energy intake was high relative to dietary guidelines, and children consumed more or less equal amounts of energy at home and at childcare. Dietary fibre, fruit and vegetable and snack intakes were low. Intake at childcare mainly consisted of carbohydrates, while intake at home contained more proteins and fat. The findings imply various opportunities for childcare centres to improve children's dietary intake, such as providing fruit and vegetables at snacking moments. In addition, the findings underline the importance of assessing dietary intake over a whole day, both at childcare and at home, to allow intake to be compared with dietary guidelines. PMID:24406847

  1. 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

  2. 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. PMID:24720802

  3. 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. PMID:27162602

  4. 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

  5. A Phase II Study of Additional Four-Week Chemotherapy With Capecitabine During the Resting Periods After Six-Week Neoadjuvant Chemoradiotherapy in Patients With Locally Advanced Rectal Cancer

    PubMed Central

    Lee, Kyung Ha; Song, Min Sang; Park, Jun Boem; Kim, Jin Soo; Kang, Dae Young

    2013-01-01

    Purpose The aim of this study is to evaluate the efficacy and the safety of additional 4-week chemotherapy with capecitabine during the resting periods after a 6-week neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer. Methods Radiotherapy was delivered to the whole pelvis at a total dose of 50.4 Gy for 6 weeks. Oral capecitabine was administered at a dose of 825 mg/m2 twice daily for 10 weeks. Surgery was performed 2-4 weeks following the completion of chemotherapy. Results Between January 2010 and September 2011, 44 patients were enrolled. Forty-three patients underwent surgery, and 41 patients completed the scheduled treatment. Pathologic complete remission (pCR) was noted in 9 patients (20.9%). T down-staging and N down-staging were observed in 32 patients (74.4%) and 33 patients (76.7%), respectively. Grade 3 to 5 toxicity was noted in 5 patients (11.4%). The pCR rate was similar with the pCR rates obtained after conventional NCRT at our institute and at other institutes. Conclusion This study showed that additional 4-week chemotherapy with capecitabine during the resting periods after 6-week NCRT was safe, but it was no more effective than conventional NCRT. PMID:24278857

  6. Fluorouracil-based preoperative chemoradiotherapy with or without oxaliplatin for stage II/III rectal cancer: a 3-year follow-up study

    PubMed Central

    Jiao, Dexin; Zhang, Rui; Gong, Zhiqiang; Liu, Fang; Chen, Yue; Yu, Qinrui; Sun, Liping; Duan, Hongyan; Zhu, Shendong; Liu, Fei; Wang, Jian

    2015-01-01

    Background Fluorouracil-based preoperative chemoradiotherapy has become the standard treatment for stage II/III rectal cancer. In order to improve the overall survival (OS) and disease-free survival (DFS), we added oxaliplatin to the standard treatment, and compared the effectiveness of these two treatment patterns. Methods A total of 206 patients enrolled in the prospective study had histologically confirmed rectal cancer of clinical stage II/III during July 2007 to July 2010. They were randomized into the experimental group received oxaliplatin and capecitabine in combination with radiotherapy, and the control group received capecitabine in combination with radiotherapy. All patients received surgery in 6−10 weeks after chemoradiotherapy and adjuvant chemotherapy with mFOLFOX6. The primary endpoints were DFS and OS, and the secondary endpoints included toxicity, compliance, and histopathological response. Results The 3-year OS in the experimental group and the control group was 90.29% vs. 86.41% (P>0.05), and the 3-year DFS was 80.58% vs. 69.90% (P>0.05). The pathological complete remission (pCR) rates were 23.30% and 19.42%, respectively (P=0.497). The 3-year local recurrence rates were 4.85% vs. 5.83% (P=0.694), and the 3-year distant metastasis rates were 16.50% and 28.16%, respectively (P=0.045). There were no significant differences in most grade 3−4 toxicities between two groups, however, grade 3−4 diarrhea occurred in 16.50% (17/103) of the experimental group, compared with 6.80% (7/103) of the control group (P=0.030). Also, the total grade 3−4 acute toxicity showed a significant difference (10.68% vs. 21.36%, P=0.037). Conclusions The experimental treatment did not lead significantly improved OS and DFS, and thus longer follow-up is warranted for our patient cohort. Adding oxaliplatin to capecitabine-based preoperative chemoradiotherapy can significantly reduce metastasis, but has only minimal impact on local recurrence. Although grade 3−4

  7. Predictors for Progression of Sleep Disordered Breathing among Public Transport Drivers: A 3-Year Follow-Up Study

    PubMed Central

    Lin, Cheng-Yu; Shih, Tung-Sheng; Liou, Saou-Hsing; Lin, Ming-Hsiu; Chang, Cheng-Ping; Chou, Tzu-Chieh

    2015-01-01

    Study Objectives: Sleep-disordered breathing (SDB) is associated with an increased risk of motor vehicle crashes. This study aimed to understand SDB progression and related factors among professional drivers. Methods: A total of 524 professional male drivers from a transportation company were included in this study. These drivers completed overnight in-home pulse oximetry studies both in 2006 and in 2009. Participants with abnormal results (oxygen desaturation index [ODI] ≥ 10 events/h) comprised the SDB group. Data included questionnaire information on demographics, medical history, SDB symptoms, and anthropometric measurements. Results: A total of 318 male workers were recruited for further analysis. Fifty of these workers belonged to the SDB group. Workers with untreated SDB significantly progressed to a more severe state after three years. Baseline body mass index (BMI), baseline ODI, and change in BMI were all significant positive predictors of SDB progression (β = 0.823, 0.242, and 1.626; p = 0.047, 0.013, and 0.004, respectively). Compared with non-SDB drivers, SDB subjects showed a greater proportion of newly diagnosed cardiovascular disease (38.0%) at follow-up. Conclusions: Untreated SDB was a gradually progressive disorder in professional drivers over a three-year period. Subjects with high BMI and moderate to severe SDB should be closely monitored to allow for early detection of worsening SDB. Weight control should be highlighted in the management of SDB. Commentary: A commentary on this article appears in this issue on page 409. Citation: Lin CY, Shih TS, Liou SH, Lin MH, Chang CP, Chou TC. Predictors for progression of sleep disordered breathing among public transport drivers: a 3-year follow-up study. J Clin Sleep Med 2015;11(4):419–425. PMID:25766707

  8. Visual Performance of Tecnis ZM900 Diffractive Multifocal IOL after 2500 Implants: A 3-Year Followup

    PubMed Central

    Akaishi, Leonardo; Vaz, Rodrigo; Vilella, Graziela; Garcez, Rodrigo C.; Tzelikis, Patrick F.

    2010-01-01

    Purpose. To evaluate visual performance for near, intermediate, and distant vision; complaints of photic phenomena, and patient satisfaction with the new diffractive multifocal IOL used in eyes which underwent phacoemulsification. Methods. Two thousand and five hundred consecutive eyes undergoing Tecnis ZM900 multifocal IOL implantation were included in this retrospective analysis. The minimum followup of 3 months was required after the surgery. Patients were assessed for uncorrected near visual acuity (UNVA) at a fixed distance (33 cm), uncorrected intermediate visual acuity (UIVA) at 60 cm, and uncorrected distance visual acuity (UDVA). Using a subjective questionnaire, patients satisfaction, their independence from using glasses, and the perception of glare and halo phenomena were also evaluated at the last follow-up. Results. Two thousand and five hundred eyes of 1558 patients underwent cataract surgery and Tecnis ZM900 multifocal IOL implantation. Four hundred and eighty seven patients (31.3%) were men, and 1071 (68.7%) were women. The mean age of the patients was 66.17 years. A UDVA of 20/30 or better was achieved by 85% of eyes. A UNVA of J1 was achieved by 93.7% of eyes and that of J2 or better was achieved by 98%. A UIVA of J4 or better was achieved by 65% and J5 or better was achived by more than 82.8% of the eyes in the study. Glare and halos were reported as severe by only 6.1% and 2.12% of patients, respectively. Ninety seven percent reported complete spectacle independence and 88% stated that they are totally satisfied with their quality of vision and would choose to have the same lens implanted again after the first implant. Five percent of the eyes in the study needed a second procedure (enhancement) to achieve a better visual result. No patient underwent lens exchange. Conclusion. Excellent near, intermediate, and distant vision was observed in patients implanted with the Tecnis ZM900 diffractive multifocal IOL. Spectacle independence and a

  9. Microfracture in the hip: a matched-control study with average 3-year follow-up

    PubMed Central

    Lodhia, Parth; Gui, Chengcheng; Chandrasekaran, Sivashankar; Suarez-Ahedo, Carlos; Vemula, S. Pavan; Domb, Benjamin G.

    2015-01-01

    There is a paucity of literature regarding microfracture surgery in the hip. The purpose of this study was to compare outcomes in patients undergoing hip arthroscopy predominantly for labral tears with focal full thickness chondral damage on the acetabulum or femoral head treated with microfracture and a matched control group that did not have focal full thickness chondral damage. A prospective matched-control study was performed examining four patient-reported outcome (PRO) scores: modified Harris Hip Score (mHHS), non-arthritic hip score, Hip Outcome Score—Activities of Daily Living (HOS-ADL), and Hip Outcome Score—Sports Specific Subscale (HOS-SSS) at minimum 2 years post-operatively between 35 patients undergoing microfracture for chondral defects during hip arthroscopy and 70 patients in a control group that did not have chondral defects. The patients were matched based on gender, age within 7 years, Workman’s compensation claim, labral treatment and acetabular crossover percentage less than or greater than 20. There was no significant difference (P > 0.05) in PRO scores preoperatively between the groups. Both groups demonstrated significant improvement (P < 0.05) in all post-operative PRO scores at all time points. There was no statistically significant difference (P > 0.05) in post-operative PRO scores between the microfracture and control groups, except for HOS-ADL and the visual analog scale (VAS) score, both of which were superior in the control group (P < 0.05). Patient satisfaction was 6.9 for the microfracture group and 7.7 for the control group (P > 0.05). Arthroscopic microfracture of the hip during treatment of labral tears results in favorable outcomes that are similar to the results arthroscopic treatment of labral tears in patients without full thickness chondral damage. PMID:27011867

  10. Effects of intracranial meningioma location, size, and surgery on neurocognitive functions: a 3-year prospective study.

    PubMed

    Liouta, Evangelia; Koutsarnakis, Christos; Liakos, Faidon; Stranjalis, George

    2016-06-01

    OBJECT Current recommendations stress the need for cognitive parameters to be integrated in the evaluation of outcomes for intracranial meningioma surgery. The aim of this prospective study was to examine neurocognitive function in meningioma patients pre- and postoperatively. METHODS Patients with skull base (anterior and middle fossa) and convexity (anterior and posterior) meningiomas (n = 54) underwent neuropsychological examination prior to and 1 year after surgery. A control group (n = 52) of healthy volunteers matched for age, sex, and education underwent the same examination. Assessments included executive, memory, and motor functions with standardized testing. Patients with convexity meningiomas were clinically assessed for parietal association cortex functions. RESULTS All patients performed significantly worse (p < 0.05) in most neurocognitive domains than controls. The skull base group showed more disturbances in memory than the convexity group (p < 0.05). The anterior convexity group showed more deficits in executive function than the posterior convexity group, which presented with parietal association cortex deficits. Verbal deficits were more pronounced in the left hemisphere than in the right hemisphere. Patients with a large tumor (> 4 cm) had more severe neurocognitive deficits than those with a small tumor (< 4 cm). Postoperatively, patients showed no deterioration in neurocognitive function. Instead, significant improvement (p < 0.05) was observed in some executive, motor, and parietal association cortex functions. CONCLUSIONS According to the authors' findings, intracranial meningiomas may cause neurocognitive deficits in patients. Surgery does not cause a deterioration in cognitive function; instead, it may lead to improvements in some functions. Permanent neuropsychological postoperative deficits should be interpreted as tumor-induced rather than due to surgery. PMID:26636380

  11. High concordance of daidzein-metabolizing phenotypes in individuals measured 1 to 3 years apart.

    PubMed

    Frankenfeld, Cara L; Atkinson, Charlotte; Thomas, Wendy K; Gonzalez, Alex; Jokela, Tuija; Wähälä, Kristiina; Schwartz, Stephen M; Li, Shuying S; Lampe, Johanna W

    2005-12-01

    Particular intestinal bacteria are capable of metabolizing the soya isoflavone daidzein to equol and/or O-desmethylangolensin (O-DMA), and the presence of these metabolites in urine after soya consumption are markers of particular intestinal bacteria profiles. Prevalences of equol producers and O-DMA producers are approximately 30-50 % and 80-90 %, respectively, and limited observations have suggested that these daidzein-metabolizing phenotypes are stable within individuals over time. Characterizing stability of these phenotypes is important to understand their potential as markers of long-term exposure to particular intestinal bacteria and their associations with disease risk. We evaluated concordance within an individual for the equol-producer and O-DMA-producer phenotypes measured at two time points (T1, T2), 1-3 years apart. Phenotypes were ascertained by analysing equol and O-DMA using GC-MS in a spot urine sample collected after 3 d soya (source of daidzein) supplementation. In ninety-two individuals without recent (within 3 months before phenotyping) or current antibiotics use, 41 % were equol producers at T1 and 45 % were equol producers at T2, and 90 % were O-DMA producers at T1 and 95 % were O-DMA producers at T2. The percentage agreement for the equol-producer phenotype was 82 and for the O-DMA-producer phenotype was 89. These results indicate that these phenotypes are stable in most individuals over time, suggesting that they provide a useful biomarker for evaluating disease risk associated with harbouring particular intestinal bacteria responsible for, or associated with, the metabolism of the soya isoflavone daidzein. PMID:16351761

  12. 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. PMID:26792771

  13. 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

  14. Biomass and morphology of fine roots of sugi (Cryptomeria japonica) after 3 years of nitrogen fertilization

    PubMed Central

    Noguchi, Kyotaro; Nagakura, Junko; Kaneko, Shinji

    2013-01-01

    Increasing nitrogen (N) deposition may affect carbon and nutrient dynamics in forest ecosystems. To better understand the effects of N deposition, we need to improve our knowledge of N effects on fine roots (roots <2 mm in diameter), as they are a key factor in carbon and nutrient dynamics. In this study, we fertilized 1 × 2 m plots in a sugi (Cryptomeria japonica) stand (336 kg ha-1 y-1) for 3 years and evaluated the responses of the fine roots to high N load. After fertilization, the concentration of NO3–N in the soil of N-fertilized (NF) plots was five-times as large as that in the control plots and the effect was more remarkable in the subsurface soil than in the surface soil. The biomass of fine roots <2 mm in diameter appeared to be greater in the NF plots (88 ± 19 g m-2) than in the control plots (56 ± 14 g m-2), but this difference was not statistically significant. In both plots, 76% of the biomass was accounted for by fine roots that were <1 mm in diameter. In the surface soil, the specific root length of fine roots <1 mm in diameter was significantly greater, and the diameter of those fine roots was marginally smaller, in the NF plots than in the control plots. In addition, the concentration of N in fine roots <1 mm in diameter was marginally greater in the NF plots than in the control plots. There may have been increased production of thinner fine roots or increased root branching in the NF plots. This study suggests that, in general, high N load is likely to have positive effects on sugi in terms of fine root characteristics and the effects on fine-root morphology are more evident than the effects on fine-root biomass. PMID:24027575

  15. Predicting caregiver-reported behavior problems in cocaine-exposed children at 3 years.

    PubMed

    Warner, Tamara Duckworth; Behnke, Marylou; Hou, Wei; Garvan, Cynthia Wilson; Wobie, Kathleen; Eyler, Fonda Davis

    2006-04-01

    Predictors of caregiver-reported behavior problems for 3-year-olds with prenatal cocaine exposure (PCE) and matched controls were examined using structural equation modeling. We tested whether PCE had a direct effect on child behavior problems in a model that included other prenatal drug exposure, child sex, caregiver depression, and the quality of the child's home environment. The sample (N = 256) was drawn from a longitudinal, prospective study of children of (predominantly crack) cocaine-using women and controls matched on race, socioeconomic status, parity, and pregnancy risk. Child Behavior Problems was modeled as a latent variable composed of the 48-item Conners' Parent Report Scale Conduct Problem and Impulsive-Hyperactive scales and the Eyberg Child Behavior Inventory Intensity scale. Caregiver depression was the only significant predictor of Child Behavior Problems. Mean levels of caregiver self-reported depression and reported child behavior problems did not differ between groups. Mean depression scores were well above the recommended clinical cutoff while mean child behavior problems scores were within normal limits. The model explained 21% of the variance in caregiver-reported child behavior problems in our sample of rural African American, low SES youngsters. Non-maternal caregivers of cocaine-exposed children had significantly lower mean depression scores and mean child behavior problems ratings for 2 of 3 scales used in the study compared to biological mothers of children with PCE and controls. For all groups, much larger proportions of children were rated as having clinically significant behavior problems than would be expected based on the prevalence of behavior problems in the general population. PMID:16682870

  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. PMID:25822895

  17. 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.

  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. Etiology and Audiological Outcomes at 3 Years for 364 Children in Australia

    PubMed Central

    Dahl, Hans-Henrik M.; Ching, Teresa Y. C.; Hutchison, Wendy; Hou, Sanna; Seeto, Mark; Sjahalam-King, Jessica

    2013-01-01

    Hearing loss is an etiologically heterogeneous trait with differences in the age of onset, severity and site of lesion. It is caused by a combination of genetic and/or environmental factors. A longitudinal study to examine the efficacy of early intervention for improving child outcomes is ongoing in Australia. To determine the cause of hearing loss in these children we undertook molecular testing of perinatal “Guthrie” blood spots of children whose hearing loss was either detected via newborn hearing screening or detected later in infancy. We analyzed the GJB2 and SLC26A4 genes for the presence of mutations, screened for the mitochondrial DNA (mtDNA) A1555G mutation, and screened for congenital CMV infection in DNA isolated from dried newborn blood spots. Results were obtained from 364 children. We established etiology for 60% of children. One or two known GJB2 mutations were present in 82 children. Twenty-four children had one or two known SLC26A4 mutations. GJB2 or SLC26A4 changes with unknown consequences on hearing were found in 32 children. The A1555G mutation was found in one child, and CMV infection was detected in 28 children. Auditory neuropathy spectrum disorder was confirmed in 26 children whose DNA evaluations were negative. A secondary objective was to investigate the relationship between etiology and audiological outcomes over the first 3 years of life. Regression analysis was used to investigate the relationship between hearing levels and etiology. Data analysis does not support the existence of differential effects of etiology on degree of hearing loss or on progressiveness of hearing loss. PMID:23555729

  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. PMID:25111703

  1. Outcomes and Complications of the Midline Anterior Approach 3 Years after Lumbar Spine Surgery

    PubMed Central

    Braaksma, Brian; Weinreb, Jeffrey H.; Nalbandian, Matthew; Spivak, Jeffrey M.; Petrizzo, Anthony

    2014-01-01

    Objective. The purpose of this study was to evaluate a new questionnaire to assess outcomes related to the midline anterior lumbar approach and to identify risk factors for negative patient responses. Methods. A retrospective review of 58 patients who underwent anterior lumbar surgery at a single institution for either degenerative disc disease or spondylolisthesis in 2009 was performed. The outcome measures included our newly developed Anterior Lumbar Surgery Questionnaire (ALSQ), ODI, and EQ-5D. Results. There were 58 patients available for followup, 27 women and 31 men. The average age at surgery was 50.8 years, with an average followup of 2.92 years. The average change in ODI was 34.94 (22.7) and EQ-5D was 0.28 (0.29). The rate of complications with the anterior approach was 10.3% and there was one male patient (3.2%) with retrograde ejaculation. Determination of the effectiveness of the new ALSQ revealed that it significantly correlated to the EQ-5D and ODI (P < 0.05). Smoking was associated with a negative response on thirteen questions. BMP use was not associated with a negative response on any sexual function questions. Conclusions. Our new Anterior Lumbar Surgery Questionnaire determines patient perceived complications related to the midline anterior lumbar surgical approach. PMID:25610657

  2. A 3-year dataset of sensible and latent heat fluxes from the Tibetan Plateau, derived using eddy covariance measurements

    NASA Astrophysics Data System (ADS)

    Li, Maoshan; Babel, Wolfgang; Chen, Xuelong; Zhang, Lang; Sun, Fanglin; Wang, Binbin; Ma, Yaoming; Hu, Zeyong; Foken, Thomas

    2015-11-01

    The Tibetan Plateau (TP) has become a focus of strong scientific interest due to its role in the global water cycle and its reaction to climate change. Regional flux estimates of sensible and latent heat are important variables for linking the energy and hydrological cycles at the TP's surface. Within this framework, a 3-year dataset (2008-2010) of eddy covariance measured turbulent fluxes was compiled from four stations on the TP into a standardised workflow: corrections and quality tests were applied using an internationally comparable software package. Second, the energy balance closure ( C EB) was determined and two different closure corrections applied. The four stations (Qomolangma, Linzhi, NamCo and Nagqu) represent different locations and typical land surface types on the TP (high altitude alpine steppe with sparse vegetation, a densely vegetated alpine meadow, and bare soil/gravel, respectively). We show that the C EB differs between each surface and undergoes seasonal changes. Typical differences in the turbulent energy fluxes occur between the stations at Qomolangma, Linzhi and NamCo, while Nagqu is quite similar to NamCo. Specific investigation of the pre-monsoon, the Tibetan Plateau summer monsoon, post-monsoon and winter periods within the annual cycle reinforces these findings. The energy flux of the four sites is clearly influenced by the Tibetan Plateau monsoon. In the pre-monsoon period, sensible heat flux is the major energy source delivering heat to the atmosphere, whereas latent heat flux is greater than sensible heat flux during the monsoon season. Other factors affecting surface energy flux are topography and location. Land cover type also affects surface energy flux. The energy balance residuum indicates a typically observed overall non-closure in winter, while closure (or `turbulent over-closure') is achieved during the Tibetan Plateau summer monsoon at the Nagqu site. The latter seems to depend on ground heat flux, which is higher in the

  3. Objective Assessment of Changes in Physical Activity and Sedentary Behavior: Pre-through 3-Years Post- Bariatric Surgery

    PubMed Central

    King, Wendy C; Chen, Jia-Yuh; Bond, Dale S; Belle, Steven H; Courcoulas, Anita P; Patterson, Emma J; Mitchell, James E; Inabnet, William B; Dakin, George F; Flum, David R; Cook, Brian; Wolfe, Bruce M

    2015-01-01

    Objective To evaluate change in sedentary behavior (SB) and physical activity (PA) over three years following bariatric surgery. Methods A subset of participants in an observational study (n=473 of 2458; 79% female, median body mass index 45kg/m2) wore an activity monitor pre-surgery and at 1–3 annual post-surgery assessments. Results Over the first year, on average, sedentary time decreased from 573 (95%CI 563–582) to 545 (95%CI 534–555) min/d and moderate-to-vigorous intensity PA (MVPA) increased from 77 (95%CI: 71–84) to 106 (95%CI: 98–116) min/wk, or 7 (95%CI: 5–10) to 24 (95%CI: 18–29) min/wk in MVPA bouts ≥10 minutes. There were no changes in these parameters from years 1 to 3 (P for all>.05). The percentage of participants achieving ≥150 min/wk of bout-related MVPA was not different at year 3 [6.5% (95%CI: 3.1–12.7)] vs. pre-surgery [3.4% (95%CI: 1.8–5.0); p=.45]. Most participants followed SB and PA trajectories that paralleled mean change and were consistent with their pre-surgery position in relation to the group. Conclusions On average, bariatric surgical patients make small reductions in SB and increases in PA during the first post-surgery year, which are maintained through 3 years. Still, post-surgery PA levels fall short of PA guidelines for general health or weight control. PMID:26010326

  4. Age dependent efficacy of implantable cardioverter-defibrillator treatment: observations in 450 patients over an 11 year period

    PubMed Central

    Trappe, H.; Pfitzner, P.; Achtelik, M.; Fieguth, H.

    1997-01-01

    Objective—To determine whether implantable cardioverter-defibrillator (ICD) treatment is beneficial in elderly patients with life threatening ventricular tachyarrhythmias.
Design—Since January 1984, ICDs were implanted in 450 patients to evaluate surgical risk, complications and mean survival in relation to patient age; 81 patients (18%) were ⩽ 50 years at the time of ICD implant, 254 patients (56%) were between 51 and 64 years, and the remaining 115 (26%) were ⩾ 65 years. Epicardial lead systems were implanted in 209 patients (46%), while transvenous lead systems were implanted in 241 (54%).
Results—13 patients (3%) died perioperatively, more often after epicardial (11 of 209 patients, 5%) than after transvenous ICD implantation (one of 241 patients, < 1%) (p < 0.05). During a mean (SD) follow up of 28 (24) months (range < 1 to 114 months), 90 patients (20%) died. Of these, nine (2%) died from sudden arrhythmic death; five (1%) died suddenly, probably as a result of non-arrhythmic causes; 55 (12%) died from other cardiac causes (congestive heart failure, myocardial infarction); and 21 (5%) died from non-cardiac causes. The three, five, and seven year survival for arrhythmic mortality was 95% in patients ⩽ 50 years compared with a three year survival of 93% and a five and seven year survival of 91% in patients of 51 to 64 years, and a three, five, and seven year survival of 99% in patients ⩾ 65 years. 362 patients (80%) received ICD discharges (21 (43) shocks per patient), with a similar incidence among all three patient groups (⩽ 50 years, 80%; 51 to 64 years, 81%; ⩾ 65 years, 79%). The time interval between ICD implant and the first ICD treatment was shorter in patients ⩾ 65 years (8 (8) months) than in patients between 51 and 64 years (11 (14) months) or ⩽ 50 years (11 (11) months) (p < 0.05). Survival time following first appropriate shock was 30 (24) months in patients ⩽ 50 years, 30 (26

  5. Creating an academy of clinical excellence at Johns Hopkins Bayview Medical Center: a 3-year experience.

    PubMed

    Wright, Scott M; Kravet, Steven; Christmas, Colleen; Burkhart, Kathleen; Durso, Samuel C

    2010-12-01

    Academic health centers (AHCs) are committed to the tripartite missions of research, education, and patient care. Promotion decisions at many AHCs focus predominantly on research accomplishments, and some members of the community remain concerned about how to reward clinicians who excel in, and spend a majority of their time, caring for patients. Many clinically excellent physicians contribute substantively to all aspects of the mission by collaborating with researchers (either through intellectual discourse or enrolling participants in trials), by serving as role models for trainees with respect to ideal caring and practice, and by attracting patients to the institution. Not giving fair and appreciative recognition to these clinically excellent faculty places AHCs at risk of losing them. The Center for Innovative Medicine at Johns Hopkins set out to address this concern by defining, measuring, and rewarding clinical excellence. Prior to this initiative, little attention was directed toward the "bright spots" of excellence in patient care at Johns Hopkins Bayview. Using a scholarly approach, the authors launched a new academy; this manuscript describes the history, creation, and ongoing activities of the Miller-Coulson Academy of Clinical Excellence at Johns Hopkins University Bayview Medical Center. While membership in the academy is honorific, the members of this working academy are committed to influencing institutional culture as they collaborate on advocacy, scholarship, and educational initiatives. PMID:20978424

  6. The PREMOS/PICARD Radiometer: An overview after 3 years of observations

    NASA Astrophysics Data System (ADS)

    Cessateur, Gaël; Schmutz, Werner; Shapiro, Alexander

    Total and Spectral Solar Irradiance are key input parameters to atmospheric/oceanic and space weather models. We present here spectral solar irradiance data from the radiometer PREMOS onboard the PICARD satellite for three years, which covers covers the solar spectrum from the Ultraviolet to near-infrared. We will also introduce the algorithm COCOSIS (for Combination of COSI Spectra) which allows us to retrieve the solar variability of the irradiance. Our investigation shows that COCOSIS is highly successful at reproducing solar spectral irradiance over rotational periods for most of channels from PREMOS.

  7. [Cryotherapy, combined drug therapy and radiotherapy in the treatment of oral cavity cancer: 3 years' experience].

    PubMed

    Vercellino, V; Goia, F; Gandolfo, S; Camoletto, D

    1980-01-01

    The medium-term (three years) result of a multidisciplinary association treatment of carcinoma of the oral cavity has been reviewed. Treatment was Cryosurgery-polychemotherapy-ratiotherapy and the technique has been described along with the times of association in an introduction that has already been published in this review (see bibliography). Thirty patients were treated with the association because they refused or could not be submitted to surgery at the intital therapeutic action. All these patients present fairly extensive lesions and a three-year follow-up. Results were positive: 56.6% of patients showed disappearance of any objective or subjective sign of cancer and, in all cases, appreciable remission in terms of both extent and duration. The easiness of the technique is confirmed as well as the excellent conversation of the anatomical structures involved. However, a critical review of cases presenting partial failure suggest a classifications of oral carcinomatous lesions (for therapeutic purposes only) on the basis of which the condition can be treated with cryo-polychemo-radiotherapy alone or with a variation of this which provides for the addition of local exersis. PMID:6935521

  8. Are we aware of restless legs syndrome in COPD patients who are in an exacerbation period? Frequency and probable factors related to underlying mechanism.

    PubMed

    Aras, Gulfidan; Kadakal, Figen; Purisa, Sevim; Kanmaz, Dilek; Aynaci, Aysun; Isik, Elvan

    2011-12-01

    A few previous studies have reported that the patients with chronic obstructive pulmonary disease (COPD) have a 29.1% to 36.8% frequency of restless legs syndrome (RLS). In this study, we observed RLS symptoms in patients experiencing COPD exacerbation to better understand the relationship between the many clinical parameters of COPD and the presence of RLS and to attract the attention of specialists on the association between the two conditions. Twenty-two male patients in COPD exacerbation; 17 healthy individuals were evaluated in this study. The patients were evaluated using the 2003 RLS symptom criteria outlined by the International Restless Legs Syndrome Study Groups (IRLSSG). The Pittsburgh Sleep Quality Index and Epworth daytime sleepiness scale were used to assess the sleep quality of patients. The RLS symptoms were correlated with blood levels of laboratory and clinical parameters. Statistical analyses were performed using SPSS 17.0 statistical software packet. The Pittsburgh Sleep Quality Index and Epworth daytime sleepiness scale scores were increased in COPD patients and correlated significantly with RLS symptoms. It was found that 54.5% of COPD patients with acute exacerbations were observed to have RLS symptoms. The Pittsburgh Sleep Quality Index was significantly higher in COPD patients with RLS symptoms compared to COPD patients without RLS symptoms (p < 0.05). We did not observe any significant difference in the previously reported metabolic and clinical parameters associated with RLS in COPD patients with and without RLS. RLS symptoms increase during COPD exacerbation and lead to decreased sleep quality. PMID:22149404

  9. A pilot study to compare the cerebral hemodynamics between patients with obstructive sleep apnea syndrome (OSA) and periodic limb movement syndrome (PLMS) during nocturnal sleep with near-infrared spectroscopy (NIRS)

    NASA Astrophysics Data System (ADS)

    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Fritschi, Ursula; Hügli, Gordana; Lehner, Isabella; Qi, Ming; Khatami, Ramin

    2014-03-01

    Obstructive sleep apnea syndrome (OSA) and periodic limb movement in sleep syndrome (PLMS) are two common sleep disorders. Previous studies showed that OSA and PLMS share common features, such as increased cardio-vascular risk, both apnea events and limb movements occur periodically, they are usually associated with cortical arousals, and both of them can induce declines in peripheral oxygen saturation measured with pulse oximetry. However, the question whether apnea events and limb movements also show similar characteristics in cerebral hemodynamic and oxygenation has never been addressed. In this pilot study, we will first time compare the cerebral hemodynamic changes induced by apnea events and limb movements in patients with OSA (n=4) and PLMS (n=4) with NIRS. In patients with OSA, we found periodic oscillations in HbO2, HHb, and blood volume induced by apnea/hypopnea events, HbO2 and HHb showed reverse changing trends. By contrast, the periodic oscillations linked to limb movements were only found in HbO2 and blood volume in patients with PLMS. These findings of different cerebral hemodynamics patterns between apnea events and limb movements may indicate different regulations of nervous system between these two sleep disorders.

  10. Predicting changes in language skills between 2 and 3 years in the EDEN mother–child cohort

    PubMed Central

    Bernard, Jonathan Y.; Forhan, Anne; Charles, Marie-Aline; De Agostini, Maria; Heude, Barbara; Ramus, Franck

    2014-01-01

    Objective. To examine the factors predicting changes in language skills between 2 and 3 years. Methods. By using longitudinal data concerning 1002 children from the EDEN study, linear regression was used to predict 3-year language performance from 2-year language performance and the risk factors associated with language delays. Logistic regressions were performed to examine two change trajectories: children who fall below the 10th percentile of language skills between 2 and 3 years (declining trajectory), and those who rose above the 10th percentile (resilient trajectory). Results. The final linear model accounted for 43% of the variance in 3-year language scores, with 2-year language scores accounting for 22%. Exposure to alcohol during pregnancy, earlier birth term, lower level of parental education and lower frequency of maternal stimulation were associated with the declining trajectory. Breastfeeding was associated with the resilient trajectory. Conclusions. This study provides a better understanding of the natural history of early language delays by identifying biological and social factors that predict changes in language skills between the ages of 2 and 3 years. PMID:24749012

  11. Immunological persistence of a seasonal influenza vaccine in people more than 3 years old.

    PubMed

    Bai, Yunhua; Shi, Nianmin; Lu, Qiang; Yang, Liqing; Wang, Zhaoyun; Li, Li; Han, HuiXia; Zheng, Dongyi; Luo, FengJi; Zhang, Zheng; Ai, Xing

    2015-01-01

    To evaluate antibody persistence of Aleph inactivated split influenza vaccine, 3308 healthy Chinese people more than 3 years old were enrolled in a hemagglutination inhibition (HI) assay before vaccination, 641 were screened by HI assay negative, 437 of which received one dose of Aleph inactivated split influenza vaccine and 204 of which received one dose of control vaccine (recombinant hepatitis B). After vaccination, the receivers were collected blood at 1st month, 3rd month, 6th month and 12th month for Aleh influenza vaccine antibody persistence assess. The antibody test were determined by hemagglutination inhibition (HI) assay. There were significant difference in antibody geometric mean titer between experimental group and control at 1st month and 3rd month after vaccination. Influenza antibody could persist at least up to 3rd month. Because of the local spring influenza epidemic, we could not analyze the results of 6th and 12th month. Aleph influenza vaccines showed good immune persistence in healthy volunteers at least in the 3 months after vaccination. Influenza viruses are important human respiratory pathogens. Immunization is widely acknowledged to currently be the most effective method of minimizing the impact of pandemic influenza. Through we have checked many references about Influenza vaccine, the duration of protective antibody for influenza vaccines are still not available. Based on this situation and our previous work, (11) Influenza vaccine antibody duration analyze are necessary. This manuscript presents data on the persistence of Hemagglutination Inhibition (HI) immune response against the A/California/7/2009(H1N1), A/Peth/16/2009(H3N2) strain and B/Brisbane/60/2008. 641 were screened from 3302 volunteers by HI test of influenza A and confirmed enrollment based on the antibodies titer less than 1:10. After administered with one dose of Aleph influenza vaccine, blood samples were collected. 437 subjects (3-10 y: 131; 11-17 y: 110; 18-54 y: 69;

  12. A patient with six primary carcinomata.

    PubMed Central

    La Ferla, G.; Thomson, W. O.

    1984-01-01

    We report a patient who developed six different primary carcinomata over a period of 3 years. These were of sigmoid colon, left breast, left kidney, right breast and two basal cell carcinomata of her face. These were all excised and she remains well with no apparent metastases 5 years after her initial presentation. Although patients with multiple tumours are uncommon, recognition of such an occurrence is important to avoid attributing symptoms to metastases from a previously diagnosed tumour. Sequential primary tumours may be amenable to treatment. PMID:6093089

  13. Feeding the toddler: 12 months to 3 years--challenges and opportunities.

    PubMed

    Cowbrough, Kathy

    2010-01-01

    The toddler stage from one to three years continues to be a period of rapid growth although not as rapid as in the first year. Energy needs are high as toddlers become more active, but stomachs are still small relative to nutrient needs so food provided for this age group needs to be nutrient dense. Toddlers are beginning to exert their independence in food choices and parents may be faced with a fussy eater who refuses food that they normally like and enjoy. Parents need to be encouraged to establish a routine of three meals and two snacks a day and not to allow the toddler to set the rules for eating. Making time to enjoy eating together as a family should be a priority to help toddlers establish good eating habits for the future. PMID:20518371

  14. Developmental Trajectories in Children With and Without Autism Spectrum Disorders: The First 3 Years

    PubMed Central

    Landa, Rebecca J.; Stuart, Elizabeth A.; Gross, Alden L.; Faherty, Ashley

    2014-01-01

    Retrospective studies indicate 2 major classes of autism spectrum disorder (ASD) onset: early and later, after a period of relatively healthy development. This prospective, longitudinal study examined social, language, and motor trajectories in 235 children with and without a sibling with autism, ages 6–36 months. Children were grouped as: ASD identified by 14 months, ASD identified after 14 months, and no ASD. Despite groups’ initial similar developmental level at 6 months, ASD groups exhibited atypical trajectories thereafter. Impairment from 14 to 24 months was greater in the Early-ASD than the Later-ASD group, but comparable at 36 months. Developmental plateau and regression occurred in some children with ASD, regardless of timing of ASD diagnosis. Findings indicate a preclinical phase of varying duration for ASD. PMID:23110514

  15. 3 Years of Ammonia Monitoring in the Upper Green River Basin, Wyoming

    NASA Astrophysics Data System (ADS)

    Schwandner, F. M.; Sewell, H.; Collett, J. L.; Molenar, J. V.; Archuleta, C.; Tigges, M.; Sherman, L.; Li, Y.; Raja, S.

    2009-12-01

    A multi-year ammonia air monitoring study was conducted at Boulder, Wyoming, in the Upper Green River Basin - a region experiencing rapid natural gas development with potential consequences of air quality and visibility impacts in the adjacent Class I Bridger Wilderness. The objective of this study is to characterize the local airborne nitrogen budget, specifically concentrations of ammonia and related gases and particles over one year. Samples were collected twice per week beginning December 15, 2006, using coated annular denuders and stacked filters in a URG sampler, analyzed at Colorado State University’s Atmospheric Science Department. NH3 concentrations are variable throughout the year and below 1 ppbv for most of the monitoring period, peaking in August 2007 at 1.55 ppbv (2.8 ppbv in Aug 2008), with a yearly mean value of 0.24 ppbv in 2007 (0.30 pppv in 2008). Concentrations are below or near detectable limits from December through February in 2007, 2008, and 2009. Elevated NH3 concentrations coincide with warmer summer months. A shift in ammonium nitrate equilibrium toward the gas phase might be responsible for some of this increase, although an increase in total reduced nitrogen (ammonium + ammonia) during the summer suggests that changes in emissions and or transport patterns are likely also important contributors. Increasingly strong nitrate and nitric acid cycles lasting several days, characterize the winter months, coinciding with observations of elevated ozone. This phenomenon dies off quickly with the onset of snowmelt. Two special studies were conducted in August 2008 and February/March 2009, representing typical peak summer and late winter conditions. Summer data show diurnal patterns likely driven by photochemical reactions and temperature changes, while winter observations indicate a coincidence of increased nitrogen loading with high ozone periods during stagnant conditions lasting several days. Changes of wind direction and speed in all cases

  16. 3-Year follow-up after Lasik: assessing the risk factors for retreatment.

    PubMed

    Valdez-García, Jorge E; Hernandez-Camarena, Julio C; Martínez-Muñoz, Rosa

    2016-02-01

    The purpose of this study was to evaluate the correlation of important risk factors for LASIK retreatment and the retreatment rate. A retrospective cohort study was conducted. Records of patients who underwent LASIK between January 2011 and January 2012 at the Zambrano-Hellion Medical Center, Tec de Monterrey (México), and posteriorly underwent LASIK retreatment were identified and risk factors to receive retreatment were assessed using relative risk. Main outcomes were retreatment rate, risk factors for retreatment, and uncorrected distance visual acuity (UDVA). 482 eyes from 241 patients were available for a 36-month follow-up analysis. 68.5 % had primary myopic LASIK; 37 % were ≤ 2 diopters (D), 52 % were > 2 and < 6 D, and 11 % were ≥ 6 D of myopia. 31.5 % of the eyes had hyperopic LASIK. Retreatment was performed in 6.85 % eyes. Myopia > 6 D (RR 4.13), hyperopic refraction (RR 3.18), and age > 40 (RR 3.07) were the most important risk factors for retreatment (P = 0.004, P = 0.007, P = 0.006, respectively). UDVA was ≥ 20/40 in 92.1 % and ≥ 20/20 in 81.6 % of the retreated eyes and 82 % of the eyes within ± 0.50 D of target refraction. Increasing degrees of myopia, followed by hyperopic refraction, and age were the most important associated factors to retreatment. LASIK retreatment was safe and effective. PMID:25985886

  17. Achieving Symmetry in Unilateral DIEP Flap Breast Reconstruction: An Analysis of 126 Cases over 3 Years.

    PubMed

    Wang, Tao; He, Jinguang; Xu, Hua; Ma, Sunxiang; Dong, Jiasheng

    2015-02-01

    Many patients who prefer breast reconstruction by a deep inferior epigastric artery perforator (DIEP) flap often lack skin laxity at the lower abdomen. Recreating a symmetrical breast with various degrees of ptosis is one of the most difficult procedures. In this report, varied DIEP flap shapes were precisely designed on the basis of normal breast ptosis. The reconstructive outcomes were quantitatively evaluated for asymmetry of footprint, volume, breast projection, and nipple position by a 3-dimensional scanning system. One hundred twenty-six cases of unilateral DIEP flap breast reconstruction were successfully performed from January 2009 to July 2012. The maximal flap width ranged from 7.5 to 10.5 cm (mean, 9.0 cm), and the flap length ranged from 28 to 38 cm (mean, 32.5 cm). The discrepancy of the footprint and nipple position did not differ significantly between the reconstructed and normal breasts. However, the reconstructed side had significantly higher breast volume and projection. For patients with a relatively tight abdomen, the flap design and shaping approach we propose achieves a maximal symmetrical outcome and should be considered as a good and reliable option. PMID:25409622

  18. A descriptive and follow-up study of 40 parricidal patients hospitalized in a French secure unit over a 15-year period.

    PubMed

    Raymond, S; Léger, A S; Lachaux, B

    2015-01-01

    Parricide is rare and represents 3% of all homicides in France, and 4% of resolved homicides in North America. Consequently, related international literature is sparse, especially concerning the evolution of offenders, and most studies concern small samples or anecdotal cases. We wished to identify the main characteristics of parricidal subjects and their victims, and to assess the socioclinical evolution of the offenders after the assault. To this end, we first studied the sociodemographic, clinical and forensic characteristics of all parricidal patients admitted to France's Henri Colin secure unit between 1996 and 2010 (40 patients). We also assessed the evolution of the 36 patients who had left the secure unit, using questionnaires sent to the psychiatric hospitals where the patients were transferred. We found most offenders to be men (97.5%), with a mean age of 28 years, who were mostly single, unemployed, living with the victim prior to the assault (77.5%), and with a history of psychiatric disorder (72.5%). The population of offenders also displayed an overrepresentation of schizophrenia (87.5%), significant toxic exposure and criminal or violent history. Some patients had attempted suicide before or right after the offense. The assault was mostly committed in the parent's house with an edged weapon, and was characterized by brutality and lack of premeditation. Precipitating factors included substance use and cessation of psychotropic medication. Matricide was more frequent than patricide. At the time of this study, half of the parricidal patients were working or attending therapeutic activities, and most were actively keeping in contact with their family, living as compliant outpatients with no signs of violent behavior. The results of our study on 40 parricidal patients are consistent with data in the literature. With regard to sample evolution, family and community reintegration was relatively effective considering the seriousness of the offense. Several

  19. [Three-fold ethylene glycol poisoning over 3 years--a case report].

    PubMed

    Gardias, Waldemar; Szponar, Jarosław; Kujawa, Anna; Majewska, Magdalena; Drelich, Grzegorz; Lewandowska-Stanek, Hanna

    2012-01-01

    This paper describes a case of now 49-year-old patient with alcohol dependence syndrome, hospitalized three times in the Center of Clinical Toxicology in 2009-2012 due to ethylene glycol poisoning. Twice, the course of poisoning was defined as severe. It was complicated by respiratory failure, severe metabolic acidosis, renal failure, disorders of the central nervous system; once referred to it as a medium, complicated by renal failure. He was treated with ethyl alcohol as an inhibitor of alcohol dehydrogenase, hemodialysess and intensive symptomatic and supportive therapy. This paper shows the great effectiveness of early hemodialysis and intensive therapy even in case of multiple and severe intoxication with toxic alcohols. PMID:23243938

  20. Mercury's gravity field and ephemeris after 3 years of MESSENGER orbital observations

    NASA Astrophysics Data System (ADS)

    Genova, Antonio; Mazarico, Erwan; Goossens, Sander J.; Lemoine, Frank G.; Neumann, Gregory A.; Smith, David E.; Zuber, Maria T.; Solomon, Sean C.

    2014-05-01

    18 March 2014 will be the third anniversary of MESSENGER's insertion into orbit about Mercury. The initial orbit was highly eccentric and nearly polar, with a 12-h period and a periapsis at 200 km altitude and ~60°N latitude. The third-body perturbation of the Sun combined with the high eccentricity of the orbit led to a substantial evolution of the periapsis, which drifted slowly northward and reached an altitude of 500 km several times before orbit-corrections maneuvers returned the periapsis altitude to ~200 km. In March 2012, the mission orbital phase was extended for a second year, and the spacecraft transitioned to an 8-h orbit period one month later. A second extended mission started in March 2013, will last for another two years, and will eventually allow observations at very low altitudes (<100 km), starting in September 2014. One of the main mission goals is the determination of the interior structure of Mercury, enabled by a suite of instruments that includes the radio system and a laser altimeter. The X-band tracking system and NASA's Deep Space Network (DSN) were used to determine the gravity field of Mercury. The effective spatial resolution of the gravity field is strongly dependent on latitude, however, because of MESSENGER's eccentric orbit and its high apoapsis over the southern hemisphere (~15,000 km in the first year, ~10,000 km subsequently). The gravity field of the southern hemisphere remains largely unconstrained at short wavelengths, although the global long-wavelength field has been determined robustly. Furthermore, MESSENGER radio tracking data represent an excellent opportunity to improve Mercury's ephemeris. The current knowledge of the orbit of Mercury around the Sun has been mainly defined by direct ranging. Range measurements from the three Mercury flybys and orbital phase of MESSENGER provide a strong data set to measure the motion of Mercury's center of mass. The 1-m range accuracy potentially allows the recovery of the

  1. A 3-year study of high-cost users of health care

    PubMed Central

    Wodchis, Walter P.; Austin, Peter C.; Henry, David A.

    2016-01-01

    Background: Characterizing high-cost users of health care resources is essential for the development of appropriate interventions to improve the management of these patients. We sought to determine the concentration of health care spending, characterize demographic characteristics and clinical diagnoses of high-cost users and examine the consistency of their health care consumption over time. Methods: We conducted a retrospective analysis of all residents of Ontario, Canada, who were eligible for publicly funded health care between 2009 and 2011. We estimated the total attributable government health care spending for every individual in all health care sectors. Results: More than $30 billion in annual health expenditures, representing 75% of total government health care spending, was attributed to individual costs. One-third of high-cost users (individuals with the highest 5% of costs) in 2009 remained in this category in the subsequent 2 years. Most spending among high-cost users was for institutional care, in contrast to lower-cost users, among whom spending was predominantly for ambulatory care services. Costs were far more concentrated among children than among older adults. The most common reasons for hospital admissions among high-cost users were chronic diseases, infections, acute events and palliative care. Interpretation: Although high health care costs were concentrated in a small minority of the population, these related to a diverse set of patient health care needs and were incurred in a wide array of health care settings. Improving the sustainability of the health care system through better management of high-cost users will require different tactics for different high-cost populations. PMID:26755672

  2. Prevalence of drug resistance and culture-positive rate among microorganisms isolated from patients with ocular infections over a 4-year period

    PubMed Central

    Shimizu, Yusuke; Toshida, Hiroshi; Honda, Rio; Matsui, Asaki; Ohta, Toshihiko; Asada, Yousuke; Murakami, Akira

    2013-01-01

    Purpose To investigate the microbial isolates from patients with ocular infections and the trend in the emergence of levofloxacin-resistant strains over the past four years from 2006 to 2009 retrospectively. Patients and methods The subjects were 242 patients with ocular infections or traumas treated in our hospital including outpatients, inpatients, and emergency room patients. Most of them needed urgent care presenting with eye complaints, traumas, or decreased vision. Clinical samples were obtained from discharges, corneal, conjunctival tissues or vitreous fluid or aqueous humor, and cultured. Items for assessment included the patient’s age, the diagnosis, the prevalence of isolated bacteria, and the results of susceptibility tests for levofloxacin (LVFX) cefamezin (CEZ), gentamicin (GM) and vancomycin. This information was obtained from the patients’ medical records. Results There were 156 male patients and 86 female patients who were aged from 2 months old to 94 years old and mean age was 56.8 ± 24.2 years. Of the 242 patients, 78 (32.2%) had positive cultures. The culture-positive rate was significantly higher in male patients than female in total (P = 0.002) and in patients with corneal perforation (P = 0.005). Corneal perforation was the highest culture-positive rate (60.0%), followed by orbital cellulitis (56.5%), blepharitis (50.0%), dacryoadenitis (45.5%), conjunctivitis (38.2%), infectious corneal ulcer (28.5%) and endophthalmitis (24.7%). LVFX-resistant strains accounted for 40 out of a total of 122 strains (32.8%), and the minimum inhibitory concentration (MIC) was significantly higher in LVFX and GM compared with the other antibiotics. There were no vancomycin-resistant strains. Conclusion Attention should be paid to a possible future increase of strains with resistance to LVFX, as commonly prescribed ocular antibiotics bring emergence of resistant bacteria. Although no vancomycin-resistant strains were isolated this drug should be reserved as

  3. [A 3-year follow-up study of the incidence of campylobacteriosis in a pediatric population].

    PubMed

    Hofstetr, A; Dvoráková, A; Nikodýmová, I; Sláma, J

    1990-11-01

    The authors investigated the incidence of campylobacteriosis in the population of five paediatric health communities of the Jihlava policlinic (5831 children) for a period of three years. A total of 2408 specimens faeces from 1501 subjects were examined. Campylobacter jejuni was detected in 151 subjects (10.1%), Salmonella sp. in 47 (3.1%), Shigella sp. in 18 (1.2%), Yersinia enterocolitica in 12 (0.8%) and enteropathogenic Escherichia coli in five subjects (0.3%). The total incidence of campylobacteriosis in the investigated group was 863 cases per 100,000 subjects per year. The incidence of campylobacteriosis was seasonal with a maximum during the summer months. To elucidate the source of infection and way of transmission 323 smears from animals, animal products and from the environment were made. Seventy were positive. Campylobacterosis is transmitted to man most frequently by ingestion of primarily or secondarily contamined food, by contact with animals and even interhuman transmission cannot be ruled out. The most frequent clinical symptoms of campylobacteriosis were diarrhoea, fever, abdominal pain and vomiting. Seventeen children were hospitalized. For treatment most frequently Endiaron was used and dietotherapy. Campylobacteriosis affects significantly more frequently children of gipsy origin. PMID:2092913

  4. A Cross-sectional Study on Posttraumatic Stress Disorder and General Psychiatric Morbidity Among Adult Survivors 3 Years After the Wenchuan Earthquake, China.

    PubMed

    Zhang, Wei; Duan, Guangfeng; Xu, Qin; Jia, Zhaobao; Bai, Zhengyang; Liu, Weizhi; Pan, Xiao; Tian, Wenhua

    2015-11-01

    After the Wenchuan earthquake, a large number of studies have focused on postearthquake psychological disorders among survivors; however, most of these studies were conducted within a relatively short period. This study was conducted to examine the symptoms of posttraumatic stress disorder (PTSD) and general psychiatric morbidity among adult survivors 3 years after the Wenchuan earthquake, China. Through a multistage systematic sampling approach, a cross-sectional survey of 360 participants, 18 years or older, was conducted. The prevalence of PTSD and general psychiatric morbidity was 10.3% and 20.6%, respectively. Multivariate analysis revealed significant predictors for PTSD, including female gender and having felt guilt concerning someone's death or injury. Significant predictors for general psychiatric morbidity included unmarried status and having been in serious danger. These results suggest that mental health services should be continuously available to earthquake survivors. PMID:26316500

  5. Comparison of Plasma Glucose and Gut Hormone Levels Between Drinking Enteral Formula Over a Period of 5 and 20 Minutes in Japanese Patients With Type 2 Diabetes: A Pilot Study

    PubMed Central

    Kamiko, Kazunari; Aoki, Kazutaka; Kamiyama, Hiroshi; Taguri, Masataka; Terauchi, Yasuo

    2016-01-01

    Background A fast eating speed is reportedly associated with obesity, fatty liver, and metabolic syndrome. As a comparison of postprandial glucose levels after eating quickly or slowly has not been previously reported for Japanese patients with type 2 diabetes, we evaluated the impact of the fast or slow ingestion of an enteral formula (liquid meal) on glucose metabolism. Methods Ten Japanese patients with type 2 diabetes who had been hospitalized at our hospital were enrolled. All the subjects received an enteral formula for breakfast. The study was performed over a 2-day period in each subject (day 1: enteral formula was consumed over a 5-minute period; day 2: enteral formula was consumed over a 20-minute period). The subjects were requested to fast for at least 12 hours before eating breakfast, and blood samples were collected at 0, 30, 60, and 120 min after the start of breakfast. Results The areas under the curve (AUCs) of the plasma glucose, serum insulin, plasma active ghrelin, glucagon-like peptide-1 (GLP-1), plasma total glucose-dependent insulinotropic polypeptide (GIP), and serum total peptide YY (PYY) levels were not significantly changed by intake over a 5-minute or 20-minute period. Conclusions Eating quickly per se probably does not affect postprandial glucose excursions, but the increased energy intake resulting from eating quickly may increase the body weight and increase insulin resistance. Eating quickly may increase energy intake and worsen long-term metabolic parameters.

  6. Effectiveness of Video Self-Modeling to Promote Social Initiations by 3-Year-Olds with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Buggey, Tom

    2012-01-01

    Video Self-Modeling (VSM) provides individuals the opportunity to view themselves performing a task beyond their present functioning level through the careful editing of videos. In this study, a single-case multiple-baseline design was used to determine whether VSM would facilitate social initiations across three young children (M = 3 years 10…

  7. Impacts of a Violence Prevention Program for Middle Schools: Findings after 3 Years of Implementation. NCEE 2011-4017

    ERIC Educational Resources Information Center

    Silvia, Suyapa; Blitstein, Jonathan; Williams, Jason; Ringwalt, Chris; Dusenbury, Linda; Hansen, William

    2011-01-01

    This is the second and final report summarizing findings from an impact evaluation of a violence prevention intervention for middle schools. This report provides findings from the second and third years of the 3-year intervention. The U.S. Department of Education (ED) contracted with RTI International and its subcontractors, Pacific Institute for…

  8. "This Way!", "No! That Way!"--3-Year Olds Know that Two People Can Have Mutually Incompatible Desires

    ERIC Educational Resources Information Center

    Rakoczy, Hannes; Warneken, Felix; Tomasello, Michael

    2007-01-01

    In theory of mind research, there is a long standing dispute about whether children come to understand the subjectivity of both desires and beliefs at the same time (around age 4), or whether there is an asymmetry such that desires are understood earlier. To address this issue, 3-year olds' understanding of situations in which two persons have…

  9. The Lights Pre-Project: Implementation of the Project Approach with Children under 3 Years of Age

    ERIC Educational Resources Information Center

    Grzegorzewska, Katarzyna; Konieczna-Blicharz, Jagoda

    2011-01-01

    A group of children 18 months to 3 years old and their parents studied lights in a preschool program at the Astrid Lindgren Institute for Early Childhood Development in Poland. The goal of the preschool program is to help children gain positive social experience through safe and interesting contact with a new group of children and adults in the…

  10. 42 CFR 412.273 - Withdrawing an application, terminating an approved 3-year reclassification, or canceling a...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Withdrawing an application, terminating an approved 3-year reclassification, or canceling a previous withdrawal or termination. 412.273 Section 412.273 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS...

  11. Results of a 3-Year, Nutrition and Physical Activity Intervention for Children in Rural, Low-Socioeconomic Status Elementary Schools

    ERIC Educational Resources Information Center

    King, Kristi McClary; Ling, Jiying

    2015-01-01

    Improving children's nutrition and physical activity have become priorities in the United States. This quasi-experimental study evaluated the longitudinal effects of a 3-year, school-based, health promotion intervention (i.e. nutrition and physical education, classroom physical activity, professional development and health promotion for teachers…

  12. The Magic Shrinking Machine Revisited: The Presence of Props at Recall Facilitates Memory in 3-Year-Olds

    ERIC Educational Resources Information Center

    Dahl, Jonna J.; Kingo, Osman S.; Krøjgaard, Peter

    2015-01-01

    In a seminal study Simcock and Hayne (2002) showed that 3-year-olds were unable to use newly acquired words to describe a "magic" event experienced 6 or 12 months earlier. In the reference study the children's verbal recall was tested without props being present. Inspired by recent evidence, the original design was replicated, testing…

  13. Eudaimonic growth: Narrative growth goals predict increases in ego development and subjective well-being 3 years later.

    PubMed

    Bauer, Jack J; McAdams, Dan P

    2010-07-01

    We examine (a) the normative course of eudaimonic well-being in emerging adulthood and (b) whether people's narratives of major life goals might prospectively predict eudaimonic growth 3 years later. We define eudaimonic growth as longitudinal increases in eudaimonic well-being, which we define as the combination of psychosocial maturity and subjective well-being (SWB). College freshmen and seniors took measures of ego development (ED; to assess maturity; Loevinger, 1976) and SWB at Time 1 (T1) and again 3 years later (Time 2). ED levels increased longitudinally across that time for men and T1 freshmen, but SWB levels did not change. Participants also wrote narratives of 2 major life goals at T1 that were coded for an explicit emphasis on specific kinds of personal growth. Participants' intellectual-growth goals (especially agentic ones) predicted increases in ED 3 years later, whereas participants' socioemotional-growth goals (especially communal ones) predicted increases in SWB 3 years later. These findings were independent of the effects of Big Five personality traits-notably conscientiousness, which on its own predicted increases in SWB. We discuss (a) emerging adulthood as the last stop for normative eudaimonic growth in modern society and (b) empirical and theoretical issues surrounding the relations among narrative identity, life planning, dispositional traits, eudaimonia, and 2 paths of personal growth. PMID:20604600

  14. Why 3-Year-Old Children Get Spanked: Parent and Child Determinants as Reported by College-Educated Mothers.

    ERIC Educational Resources Information Center

    Holden, George W.; And Others

    1995-01-01

    Telephone interviews were conducted with 39 college-educated mothers of 3-year-old children to examine the conditions surrounding the occurrence of physical punishment. Responses suggest that certain types of misbehavior, notably aggression, were more likely to elicit spanking than other misbehavior. In addition, parents' positive attitudes toward…

  15. 1 to 3-Year-Old Children in Day Care Centres in Finland: An Overview of Eight Doctoral Dissertations

    ERIC Educational Resources Information Center

    Hannikainen, Maritta

    2010-01-01

    This article gives a general picture of the policy and main structural features of early childhood education services for the younger children in Finland. It also provides an overview of the research on 1 to 3-year-old children in day care centres carried out in Finland during the last 15 years, the focus being on a review of all the eight…

  16. The Internal Validity and Acceptability of the Danish SI-3: A Language-Screening Instrument for 3-Year-Olds

    ERIC Educational Resources Information Center

    Bleses, Dorthe; Vach, Werner; Jorgensen, Rune N.; Worm, Torben

    2010-01-01

    Purpose: To document the development of a new parent- and day care-administered screening instrument (the Screening Instrument for 3-Year-Olds [SI-3]) to be used in a newly implemented, educationally motivated population language screening in Denmark. The authors investigated whether the basic principles of the SI-3 were working satisfactorily and…

  17. Professional Learning Communities in Partnership: A 3-Year Journey of Action and Advocacy to Bridge the Achievement Gap

    ERIC Educational Resources Information Center

    Hoffman, Patricia; Dahlman, Anne; Zierdt, Ginger

    2009-01-01

    This article details a strategic planning model and concurrent 3-year research study focusing on the benefits of preK-16 professional development school learning communities for the participating preK-16 educational leaders in a midwestern school-university partnership network. Results of the study, along with the strategic plan's success at…

  18. Combined Individual Cognitive Behavior Therapy and Parent Training for Childhood Depression: 2- to 3-Year Follow-up

    ERIC Educational Resources Information Center

    Eckshtain, Dikla; Gaynor, Scott T.

    2013-01-01

    Fourteen children with significant depressive symptoms from an open clinical trial of Primary and Secondary Control Enhancement Training augmented with Caregiver-Child Relationship Enhancement Training, participated in a 2- to 3-year follow-up assessment. The results suggested that the significant decreases in depressive symptoms observed at…

  19. Determinants of Imitation of Hand-to-Body Gestures in 2- and 3-Year-Old Children

    ERIC Educational Resources Information Center

    Erjavec, Mihela; Horne, Pauline J.

    2008-01-01

    Twenty children, ten 2-year-olds and ten 3-year-olds, participated in an AB procedure. In the baseline phase, each child was trained the same four matching relations to criterion under intermittent reinforcement. During the subsequent imitation test, the experimenter modeled a total of 20 target gestures (six trials each) interspersed with…

  20. Poorly differentiated cutaneous carcinoma of non-sebaceous origin in a 3-year-old Mongolian gerbil (Meriones unguiculatus).

    PubMed

    Fenton, Heather; Forzán, María J; Desmarchelier, Marion; Woodland, Meghan; Sayi, Soraya; Gilroy, Cornelia V

    2016-01-01

    A 3-year-old female gerbil developed a non-healing skin wound due to a malignant neoplasm. Histology, immunohistochemistry (cytokeratin 19 positive; vimentin, estrogen, and progesterone receptor negative), and electron microscopy (no desmosomes or melanosomes) revealed an undifferentiated carcinoma with pulmonary metastasis. Unlike in previous reports, it did not arise from the abdominal pad's sebaceous gland. PMID:26740704

  1. Sustaining "Truth": Changes in Youth Tobacco Attitudes and Smoking Intentions after 3 Years of a National Antismoking Campaign

    ERIC Educational Resources Information Center

    Farrelly, Matthew C.; Davis, Kevin C.; Duke, Jennifer; Messeri, Peter

    2009-01-01

    This study examines how the American Legacy Foundation's "truth[R]" campaign and Philip Morris's "Think. Don't Smoke" (TDS) campaign have influenced youth's tobacco-related attitudes, beliefs and intentions during the first 3 years of the truth campaign. We use data from eight nationally representative cross-sectional telephone surveys of 35,074…

  2. "A Spinach with a V on It": What 3-Year-Olds See in Standard and Enhanced Blissymbols.

    ERIC Educational Resources Information Center

    Raghavendra, Parimala; Fristoe, Macalyne

    1990-01-01

    Standard or enhanced Blissymbols, designed to represent familiar actions, attributes, and objects, were shown to 20 3 year olds, who guessed their meaning. The number of their guesses that referred to the enhancements was twice as great as the number that referred to the standard Blissymbol base. (Author/JDD)

  3. The First Year Inventory: A Longitudinal Follow-Up of 12-Month-Old to 3-Year-Old Children

    ERIC Educational Resources Information Center

    Turner-Brown, Lauren M.; Baranek, Grace T.; Reznick, J Steven; Watson, Linda R.; Crais, Elizabeth R.

    2013-01-01

    The First Year Inventory is a parent-report measure designed to identify 12-month-old infants at risk for autism spectrum disorder. First Year Inventory taps behaviors that indicate risk in the developmental domains of sensory--regulatory and social--communication functioning. This longitudinal study is a follow-up of 699 children at 3 years of…

  4. Rational Action Selection in 1 1/2- to 3-Year-Olds Following an Extended Training Experience

    ERIC Educational Resources Information Center

    Klossek, Ulrike M. H.; Dickinson, Anthony

    2012-01-01

    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 1 1/2 and 3 years of age were trained over two sessions to perform actions on a touch-sensitive screen…

  5. Malignant peripheral nerve sheath tumor of the third eyelid in a 3-year-old Rhodesian Ridgeback

    PubMed Central

    vom Hagen, Franziska; Romkes, Gwendolyna; Kershaw, Olivia; Eule, J Corinna

    2015-01-01

    Key Clinical Message A 3-year-old Rhodesian Ridgeback was presented with conjunctivitis, enlargement of the third eyelid and a dorsotemporal deviation of the right eye. A mass within the third eyelid was detected and excised. The histopathologic examination showed a malignant peripheral nerve sheath tumor, which most likely is a neurofibrosarcoma based on immunohistochemistry. PMID:25678975

  6. Emotion Situation Knowledge and Autobiographical Memory in Chinese, Immigrant Chinese, and European American 3-Year-Olds

    ERIC Educational Resources Information Center

    Wang, Qi; Hutt, Rachel; Kulkofsky, Sarah; McDermott, Melissa; Wei, Ruohong

    2006-01-01

    This study examined the influence of children's emotion situation knowledge (EK) on their autobiographical memory ability at both group and individual levels. Native Chinese, Chinese immigrant, and European American 3-year-old children participated (N = 189). During a home visit, children recounted 2 personal memories of recent, 1-time events with…

  7. Replication of an Inter-Disciplinary Approach to Early Education of Handicapped Children 0-3 Years.

    ERIC Educational Resources Information Center

    Smiley, Constance J.; And Others

    Presented is the guide to the Illinois project entitled "An Inter-Disciplinary Approach to Early Education of Handicapped Children Ages 0 - 3 Years" which includes information on funding and public awareness, diagnosis and evaluation, child development-home program, speech and language, structuring the day program, job descriptions and training,…

  8. Ice Hockey Injuries in a Japanese Elite Team: A 3-Year Prospective Study

    PubMed Central

    Kuzuhara, Kenji; Shimamoto, Hideki; Mase, Yasuyoshi

    2009-01-01

    Context: As the Asian Ice Hockey League gradually expands and becomes more competitive, ice hockey-related injuries may increase. However, no reports have been published on ice hockey injuries in Japan, including the method of injury and the daily supervision of the players during the regular season. Objective: To prospectively study the incidence, types, and mechanisms of ice hockey injuries in an elite Japanese ice hockey team. Design: Prospective observational cohort study design. Setting: An elite ice hockey team, Tokyo, Japan. Patients or Other Participants: Ninety-four players during the 2002–2005 seasons. Main Outcome Measure(s): Data were collected for 3 consecutive seasons using an injury reporting form. Results: The overall game injury rate was 74.3 per 1000 player-game hours and 11.7 per 1000 player-game hours for injuries resulting in any time loss. The overall practice injury rates were 11.2 per 1000 player-practice hours and 1.1 per 1000 player-practice hours for injuries resulting in any time loss. Forwards had the highest rate of injury, followed by defensemen and then goalkeepers. Contusions were the most common injury, followed by strains, lacerations, and sprains. Conclusions: Most injuries among Japanese ice hockey players occurred during games. Game or play intensity may influence the injury rate during games. PMID:19295967

  9. Quantitative methods for tracking cognitive change 3 years after coronary artery bypass surgery.

    PubMed

    Barry, Sarah J E; Zeger, Scott L; Selnes, Ola A; Grega, Maura A; Borowicz, Louis M; McKhann, Guy M

    2005-04-01

    The analysis and interpretation of change in cognitive function test scores after coronary artery bypass grafting (CABG) present considerable statistical challenges. Application of hierarchical linear statistical models can estimate the effects of a surgical intervention on the time course of multiple biomarkers. We use an "analyze then summarize" approach whereby we estimate the intervention effects separately for each cognitive test and then pool them, taking appropriate account of their statistical correlations. The model accounts for dropouts at follow-up, the chance of which may be related to past cognitive score, by implicitly imputing the missing data from individuals' past scores and group patterns. We apply this approach to a study of the effects of CABG on the time course of cognitive function as measured by 16 separate neuropsychological test scores, clustered into 8 cognitive domains. The study includes measurements on 140 CABG patients and 92 nonsurgical controls at baseline, and at 3, 12, and 36 months. Our "analyze then summarize" method allows us to identify differences between the treatment groups in individual tests as well as in aggregate measures. It takes into account the correlation structure of the data and thereby produces more precise results than summarizing before analyzing. The methods used have application to a wide range of intervention studies in which multiple biomarkers are followed over time to quantify health effects. Software to implement the methods in the R statistical package is available from the authors at http://www.biostat.jhsph.edu/sbarry/software/ATSrcode.pdf. PMID:15797033

  10. Community vs. Clinic-based modular treatment of children with early-onset ODD or CD: A clinical trial with 3-year follow-up

    PubMed Central

    Kolko, David J.; Bukstein, Oscar G.; Padini, Dustin; Holden, Elizabeth A.; Hart, Jonathan; Dorn, Lorah D.

    2016-01-01

    This study examines the treatment outcomes of 144, 6–11 year-old, clinically referred boys and girls diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) who were randomly assigned to a modular-based treatment protocol that was applied by research study clinicians either in the community (COMM) or a clinic office (CLINIC). To examine normative comparisons, a matched sample of 69 healthy control children was included. Multiple informants completed diagnostic interviews and self-reports at six assessment timepoints (pretreatment to 3-year follow-up) to evaluate changes in the child’s behavioral and emotional problems, psychopathic features, functional impairment, diagnostic status, and service involvement. Using HLM and logistic regression models, COMM and CLINIC showed significant and comparable improvements on all outcomes. By 3-year follow-up, 36% of COMM and 47% of CLINIC patients no longer met criteria for either ODD or CD, and 48% and 57% of the children in these two respective conditions had levels of parent-rated externalizing behavior problems in the normal range. We discuss the nature and implications of these novel findings regarding the role of treatment context or setting for the treatment and long-term outcome of behavior disorders. PMID:19221871

  11. Effect of Periodic Granulocyte Colony-Stimulating Factor Administration on Endothelial Progenitor Cells and Different Monocyte Subsets in Pediatric Patients with Muscular Dystrophies

    PubMed Central

    Sienkiewicz, Dorota; Grubczak, Kamil; Okurowska-Zawada, Bożena; Paszko-Patej, Grażyna; Miklasz, Paula; Singh, Paulina; Radzikowska, Urszula; Kulak, Wojciech

    2016-01-01

    Muscular dystrophies (MD) are heterogeneous group of diseases characterized by progressive muscle dysfunction. There is a large body of evidence indicating that angiogenesis is impaired in muscles of MD patients. Therefore, induction of dystrophic muscle revascularization should become a novel approach aimed at diminishing the extent of myocyte damage. Recently, we and others demonstrated that administration of granulocyte colony-stimulating factor (G-CSF) resulted in clinical improvement of patients with neuromuscular disorders. To date, however, the exact mechanisms underlying these beneficial effects of G-CSF have not been fully understood. Here we used flow cytometry to quantitate numbers of CD34+ cells, endothelial progenitor cells, and different monocyte subsets in peripheral blood of pediatric MD patients treated with repe