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Sample records for additional clinical studies

  1. Prazosin addition to fluvoxamine: A preclinical study and open clinical trial in OCD.

    PubMed

    Feenstra, Matthijs G P; Klompmakers, André; Figee, Martijn; Fluitman, Sjoerd; Vulink, Nienke; Westenberg, Herman G M; Denys, Damiaan

    2016-02-01

    The efficacy of selective serotonin reuptake inhibitors (SRIs) in psychiatric disorders may be "augmented" through the addition of atypical antipsychotic drugs. A synergistic increase in dopamine (DA) release in the prefrontal cortex has been suggested to underlie this augmentation effect, though the mechanism of action is not clear yet. We used in vivo microdialysis in rats to study DA release following the administration of combinations of fluvoxamine (10 mg/kg) and quetiapine (10 mg/kg) with various monoamine-related drugs. The results confirmed that the selective 5-HT1A antagonist WAY-100635 (0.05 mg/kg) partially blocked the fluvoxamine-quetiapine synergistic effect (maximum DA increase dropped from 325% to 214%). A novel finding is that the α1-adrenergic blocker prazosin (1 mg/kg), combined with fluvoxamine, partially mimicked the effect of augmentation (maximum DA increase 205%; area-under-the-curve 163%). As this suggested that prazosin augmentation might be tested in a clinical study, we performed an open clinical trial of prazosin 20 mg addition to SRI in therapy-resistant patients with obsessive-compulsive disorder applying for neurosurgery. A small, non-significant reduction in Yale Brown Obsessive Compulsive Scale (Y-BOCS) scores was observed in 10 patients and one patient was classified as a responder with a reduction in Y-BOCS scores of more than 25%. We suggest that future clinical studies augmenting SRIs with an α1-adrenergic blocker in less treatment resistant cases should be considered. The clinical trial "Prazosin in combination with a serotonin reuptake inhibitor for patients with Obsessive Compulsive disorder: an open label study" was registered at 24/05/2011 under trial number ISRCTN61562706: http://www.controlled-trials.com/ISRCTN61562706. PMID:26712326

  2. A clinical comparative study of Cadiax Compact II and intraoral records using wax and addition silicone.

    PubMed

    Torabi, Kianoosh; Pour, Sasan Rasaei; Ahangari, Ahmad Hassan; Ghodsi, Safoura

    2014-01-01

    Evaluation of mandibular movements is necessary to form the occlusal anatomical contour, analyze the temporomandibular joint status, and evaluate the patient's occlusion. This clinical study was conducted to compare the mandibular recording device Cadiax Compact II with routine intraoral records for measuring condylar inclinations. The results showed that the differences between Cadiax and intraoral records were statistically significant for all measurements. Cadiax measurements had a stronger correlation with silicone records. The quantities of recorded Bennett angles were lower and the values of sagittal condylar inclination were higher with Cadiax than with routine intraoral records. PMID:25390868

  3. A digital process for additive manufacturing of occlusal splints: a clinical pilot study.

    PubMed

    Salmi, Mika; Paloheimo, Kaija-Stiina; Tuomi, Jukka; Ingman, Tuula; Mäkitie, Antti

    2013-07-01

    The aim of this study was to develop and evaluate a digital process for manufacturing of occlusal splints. An alginate impression was taken from the upper and lower jaws of a patient with temporomandibular disorder owing to cross bite and wear of the teeth, and then digitized using a table laser scanner. The scanned model was repaired using the 3Data Expert software, and a splint was designed with the Viscam RP software. A splint was manufactured from a biocompatible liquid photopolymer by stereolithography. The system employed in the process was SLA 350. The splint was worn nightly for six months. The patient adapted to the splint well and found it comfortable to use. The splint relieved tension in the patient's bite muscles. No sign of tooth wear or significant splint wear was detected after six months of testing. Modern digital technology enables us to manufacture clinically functional occlusal splints, which might reduce costs, dental technician working time and chair-side time. Maximum-dimensional errors of approximately 1 mm were found at thin walls and sharp corners of the splint when compared with the digital model. PMID:23614943

  4. A digital process for additive manufacturing of occlusal splints: a clinical pilot study

    PubMed Central

    Salmi, Mika; Paloheimo, Kaija-Stiina; Tuomi, Jukka; Ingman, Tuula; Mäkitie, Antti

    2013-01-01

    The aim of this study was to develop and evaluate a digital process for manufacturing of occlusal splints. An alginate impression was taken from the upper and lower jaws of a patient with temporomandibular disorder owing to cross bite and wear of the teeth, and then digitized using a table laser scanner. The scanned model was repaired using the 3Data Expert software, and a splint was designed with the Viscam RP software. A splint was manufactured from a biocompatible liquid photopolymer by stereolithography. The system employed in the process was SLA 350. The splint was worn nightly for six months. The patient adapted to the splint well and found it comfortable to use. The splint relieved tension in the patient's bite muscles. No sign of tooth wear or significant splint wear was detected after six months of testing. Modern digital technology enables us to manufacture clinically functional occlusal splints, which might reduce costs, dental technician working time and chair-side time. Maximum-dimensional errors of approximately 1 mm were found at thin walls and sharp corners of the splint when compared with the digital model. PMID:23614943

  5. Were There "Additional Foreseeable Risks" in the SUPPORT Study? Lessons Not Learned from the ARDSnet Clinical Trials.

    PubMed

    Silverman, Henry J; Dreyfuss, Didier

    2015-01-01

    Even though the interventions were adapted from standard clinical practice, the way they were provided meant that the care given infants in the study was distinctly different from standard care, with different risk profiles. Parents should have been informed about those differences. PMID:25530226

  6. A Study to Determine if Addition of Palatal Petechiae to Centor Criteria Adds More Significance to Clinical Diagnosis of Acute Strep Pharyngitis in Children.

    PubMed

    Nibhanipudi, Kumara V

    2016-01-01

    Objective. A study to determine if addition of palatal petechiae to Centor criteria adds more value for clinical diagnosis of acute strep pharyngitis in children. Hypothesis. In children, Centor Criteria does not cover all the symptoms and signs of acute strep pharyngitis. We hypothesize that addition of palatal petechiae to Centor Criteria will increase the possibility of clinical diagnosis of group A streptococcal pharyngitis in children. Methods. One hundred patients with a complaint of sore throat were enrolled in the study. All the patients were examined clinically using the Centor Criteria. They were also examined for other signs and symptoms like petechial lesions over the palate, abdominal pain, and skin rash. All the patients were given rapid strep tests, and throat cultures were sent. No antibiotics were given until culture results were obtained. Results. The sample size was 100 patients. All 100 had fever, sore throat, and erythema of tonsils. Twenty of the 100 patients had tonsillar exudates, 85/100 had tender anterior cervical lymph nodes, and 86/100 had no cough. In total, 9 out of the 100 patients had positive throat cultures. We observed that petechiae over the palate, a very significant sign, is not included in the Centor Criteria. Palatal petechiae were present in 8 out of the 100 patients. Six out of these 8 with palatal petechiae had positive throat culture for strep (75%). Only 7 out of 20 with exudates had positive strep culture. Sixteen out of the 100 patients had rapid strep test positive. Those 84/100 who had negative rapid strep also had negative throat culture. Statistics. We used Fisher's exact test, comparing throat culture positive and negative versus presence of exudates and palatal hemorrhages with positive and negative throat cultures and the resultant P value <.0001. Conclusion. Our study concludes that addition of petechiae over the palate to Centor Criteria will increase the possibility of diagnosing acute group A streptococcal

  7. A Study to Determine if Addition of Palatal Petechiae to Centor Criteria Adds More Significance to Clinical Diagnosis of Acute Strep Pharyngitis in Children

    PubMed Central

    Nibhanipudi, Kumara V.

    2016-01-01

    Objective. A study to determine if addition of palatal petechiae to Centor criteria adds more value for clinical diagnosis of acute strep pharyngitis in children. Hypothesis. In children, Centor Criteria does not cover all the symptoms and signs of acute strep pharyngitis. We hypothesize that addition of palatal petechiae to Centor Criteria will increase the possibility of clinical diagnosis of group A streptococcal pharyngitis in children. Methods. One hundred patients with a complaint of sore throat were enrolled in the study. All the patients were examined clinically using the Centor Criteria. They were also examined for other signs and symptoms like petechial lesions over the palate, abdominal pain, and skin rash. All the patients were given rapid strep tests, and throat cultures were sent. No antibiotics were given until culture results were obtained. Results. The sample size was 100 patients. All 100 had fever, sore throat, and erythema of tonsils. Twenty of the 100 patients had tonsillar exudates, 85/100 had tender anterior cervical lymph nodes, and 86/100 had no cough. In total, 9 out of the 100 patients had positive throat cultures. We observed that petechiae over the palate, a very significant sign, is not included in the Centor Criteria. Palatal petechiae were present in 8 out of the 100 patients. Six out of these 8 with palatal petechiae had positive throat culture for strep (75%). Only 7 out of 20 with exudates had positive strep culture. Sixteen out of the 100 patients had rapid strep test positive. Those 84/100 who had negative rapid strep also had negative throat culture. Statistics. We used Fisher’s exact test, comparing throat culture positive and negative versus presence of exudates and palatal hemorrhages with positive and negative throat cultures and the resultant P value <.0001. Conclusion. Our study concludes that addition of petechiae over the palate to Centor Criteria will increase the possibility of diagnosing acute group A streptococcal

  8. Addition polyimide end cap study

    NASA Technical Reports Server (NTRS)

    St.clair, T. L.

    1980-01-01

    The characterization of addition polyimides with various end caps for adhesive applications at 120-250 C environments is discussed. Oligometric polyimides were prepared from 3,3',4,4'-benzophenone tetracarboxylic dianhydride and 3,3'-methylenedianiline which were end-capped with functionally reactive moities which cause crosslinking when the oligomers are heated to 200-400 C. The syntheses of the oligomers are outlined. The thermolysis of the oligomers was studied by differential scanning calorimetry and the resulting polymers were characterized by differential thermal analysis and adhesive performance. The adhesive data include lap shear strengths on titanium 6-4 adherends both before and after aging for 1000 hours at 121 C and/or 232 C.

  9. Clinical Studies with Epothilones

    NASA Astrophysics Data System (ADS)

    Altmann, Karl-Heinz

    As indicated in previous chapters, epothilone research so far has delivered seven new chemical entities that have been advanced to clinical trials in humans (Fig. 1). However, the amount of clinical data publicly available at this time strongly varies between individual compounds, depending on their development stage, but also on the general publication policy of the developing company. The compound that has been most comprehensively characterized in the clinical literature is ixabepilone (BMS-247550), for which trial results have been described in a number of articles in peer-reviewed journals and which has been granted FDA approval for two clinical indications on Oct. 16, 2007. For all other compounds, most of the information on clinical trials is available only in abstract form. In all these cases it remains uncertain, whether the content of these abstracts fully reflects the content of the subsequent (poster or oral) presentations at the corresponding meeting; in fact, it seems likely that additional data will have been included in the actual meeting presentations that may not have been available at the time of abstract submission. As this is unknown to the author, such additional information cannot be considered in this chapter, which is solely based on information documented in accessible abstracts or journal publications. It should also be kept in mind that the interpretation of data from ongoing clinical trials or forward looking statements based on data from completed trials are always preliminary in character.

  10. Cytogenetic abnormalities additional to t(11;14) correlate with clinical features in leukaemic presentation of mantle cell lymphoma, and may influence prognosis: a study of 60 cases by FISH.

    PubMed

    Parry-Jones, N; Matutes, E; Morilla, R; Brito-Babapulle, V; Wotherspoon, A; Swansbury, G J; Catovsky, D

    2007-04-01

    Mantle cell lymphoma (MCL), characterised by t(11;14)(q13;q32), has a poor prognosis. Many cases have additional cytogenetic abnormalities, and often have a complex karyotype. Fluorescence in situ hybridisation (FISH) was used to study 60 cases with leukaemic presentation of MCL, to determine the frequency, clinical correlations and prognostic impact of a panel of molecular cytogenetic abnormalities: 17p13 (TP53 locus), 13q14, 12 p11.1-q11 (centromere), 6q21 and 11q23. CD38 expression, of prognostic value in chronic lymphocytic leukaemia (CLL), was also studied, and correlations with clinical and cytogenetic abnormalities sought. Eighty per cent of cases had at least one abnormality in addition to t(11;14). Deletions at 17p13 (TP53) and 13q14 were most frequent and involved the majority of the leukaemic clone. Cases with TP53 deletion were more likely to have splenomegaly and marked leucocytosis (>30 x 10(9)/l), and less likely to have lymphadenopathy than those without deletion. Deletions at 11q23 and 6q21 were associated with extranodal disease. 13q14 and 11q23 deletions showed a trend towards worse prognosis by univariate analysis. In multivariate analysis, deletions at 13q14 and 6q21 were independent predictors of poor outcome. Deletion at 17p13 did not show prognostic impact in this series. CD38, positive in two-thirds of cases, was associated with male gender and nodal disease but not with any cytogenetic abnormality, or with survival. PMID:17391491

  11. Experiences of clinical tutors with English as an additional language (EAL) students.

    PubMed

    Lu, Hongyan; Maithus, Caroline

    2012-11-01

    Clinical tutors, referred to in the international literature as clinical supervisors, facilitators, mentors or instructors, are responsible for providing and supervising workplace learning opportunities for groups of Bachelor of Nursing (BN) students. They also play a key role in assessing students. The role modeling and support provided by both clinical tutors and registered nurses (RN) or nurse preceptors helps students become familiar with the language in which nursing work is realised. As BN student cohorts in New Zealand have become more diverse in terms of cultures, ethnicities and language backgrounds, clinical tutors have to directly facilitate the development of context-specific and client-focused communication skills for students who speak English as an additional language. We undertook a study which looked at the perceptions of new nursing graduates with English as an additional language (EAL) on the development of spoken language skills for the clinical workplace. As well as interviewing graduates, we spoke to four clinical tutors in order to elicit their views on the language development of EAL students in previous cohorts. This article reports on the themes which emerged from the interviews with the tutors. These include goal setting for communication, integrating students into nursing work, making assessment less stressful, and endorsing independent learning strategies. Based on their observations and on other published research we make some suggestions about ways both clinical tutors and EAL students within their teaching groups could be supported in the development of communication skills for clinical practice. PMID:23421011

  12. Are Clinical Studies for You?

    MedlinePlus

    ... Page > Participate in Clinical Studies If you are thinking about participating in a Clinical Study at NIH, ... medical care and activities of daily living. In thinking about the risks of research, it is helpful ...

  13. Additives

    NASA Technical Reports Server (NTRS)

    Smalheer, C. V.

    1973-01-01

    The chemistry of lubricant additives is discussed to show what the additives are chemically and what functions they perform in the lubrication of various kinds of equipment. Current theories regarding the mode of action of lubricant additives are presented. The additive groups discussed include the following: (1) detergents and dispersants, (2) corrosion inhibitors, (3) antioxidants, (4) viscosity index improvers, (5) pour point depressants, and (6) antifouling agents.

  14. Clinical Significance of Additional Ablation of Atrial Premature Beats after Catheter Ablation for Atrial Fibrillation

    PubMed Central

    Kim, In-Soo; Yang, Pil-Sung; Kim, Tae-Hoon; Park, Junbeum; Park, Jin-Kyu; Uhm, Jae Sun; Joung, Boyoung; Lee, Moon Hyoung

    2016-01-01

    Purpose The clinical significance of post-procedural atrial premature beats immediately after catheter ablation for atrial fibrillation (AF) has not been clearly determined. We hypothesized that the provocation of immediate recurrence of atrial premature beats (IRAPB) and additional ablation improves the clinical outcome of AF ablation. Materials and Methods We enrolled 200 patients with AF (76.5% males; 57.4±11.1 years old; 64.3% paroxysmal AF) who underwent catheter ablation. Post-procedure IRAPB was defined as frequent atrial premature beats (≥6/min) under isoproterenol infusion (5 µg/min), monitored for 10 min after internal cardioversion, and we ablated mappable IRAPBs. Post-procedural IRAPB provocations were conducted in 100 patients. We compared the patients who showed IRAPB with those who did not. We also compared the IRAPB provocation group with 100 age-, sex-, and AF-type-matched patients who completed ablation without provocation (No-Test group). Results 1) Among the post-procedural IRAPB provocation group, 33% showed IRAPB and required additional ablation with a longer procedure time (p=0.001) than those without IRAPB, without increasing the complication rate. 2) During 18.0±6.6 months of follow-up, the patients who showed IRAPB had a worse clinical recurrence rate than those who did not (27.3% vs. 9.0%; p=0.016), in spite of additional IRAPB ablation. 3) However, the clinical recurrence rate was significantly lower in the IRAPB provocation group (15.0%) than in the No-Test group (28.0%; p=0.025) without lengthening of the procedure time or raising complication rate. Conclusion The presence of post-procedural IRAPB was associated with a higher recurrence rate after AF ablation. However, IRAPB provocation and additional ablation might facilitate a better clinical outcome. A further prospective randomized study is warranted. PMID:26632385

  15. Learn about Clinical Studies

    MedlinePlus

    ... in the care of future patients by providing information about the benefits and risks of therapeutic, preventative, or diagnostic products or interventions. Clinical trials provide the basis for the development and marketing of new drugs, biological products, and medical devices. ...

  16. Additional EIPC Study Analysis. Final Report

    SciTech Connect

    Hadley, Stanton W; Gotham, Douglas J.; Luciani, Ralph L.

    2014-12-01

    Between 2010 and 2012 the Eastern Interconnection Planning Collaborative (EIPC) conducted a major long-term resource and transmission study of the Eastern Interconnection (EI). With guidance from a Stakeholder Steering Committee (SSC) that included representatives from the Eastern Interconnection States Planning Council (EISPC) among others, the project was conducted in two phases. Phase 1 involved a long-term capacity expansion analysis that involved creation of eight major futures plus 72 sensitivities. Three scenarios were selected for more extensive transmission- focused evaluation in Phase 2. Five power flow analyses, nine production cost model runs (including six sensitivities), and three capital cost estimations were developed during this second phase. The results from Phase 1 and 2 provided a wealth of data that could be examined further to address energy-related questions. A list of 14 topics was developed for further analysis. This paper brings together the earlier interim reports of the first 13 topics plus one additional topic into a single final report.

  17. Clinical Outcome of Magnetic Resonance Imaging-Detected Additional Lesions in Breast Cancer Patients

    PubMed Central

    Ha, Gi-Won; Yi, Mi Suk; Lee, Byoung Kil; Jung, Sung Hoo

    2011-01-01

    Purpose The aim of this study was to investigate the clinical outcome of additional breast lesions identified with breast magnetic resonance imaging (MRI) in breast cancer patients. Methods A total of 153 patients who underwent breast MRI between July 2006 and March 2008 were retrospectively reviewed. Thirty-three patients (21.6&) were recommended for second-look ultrasound (US) for further characterization of additional lesions detected on breast MRI and these patients constituted our study population. Results Assessment for lesions detected on breast MRI consisted of the following: 25 benign lesions (73.5&), two indeterminate (5.9%), and seven malignant (20.6%) in 33 patients. Second-look US identified 12 additional lesions in 34 lesions (35.3%) and these lesions were confirmed by histological examination. Of the 12 lesions found in the 11 patients, six (50.0%) including one contralateral breast cancer were malignant. The surgical plan was altered in 18.2% (six of 33) of the patients. The use of breast MRI justified a change in treatment for four patients (66.7%) and caused two patients (33.3&) to undergo unwarranted additional surgical procedures. Conclusion Breast MRI identified additional multifocal or contralateral cancer which was not detected initially on conventional imaging in breast cancer patients. Breast MRI has become an indispensable modality in conjunction with conventional modalities for preoperative evaluation of patients with operable breast cancer. PMID:22031803

  18. Structure Property Studies for Additively Manufactured Parts

    SciTech Connect

    Milenski, Helen M; Schmalzer, Andrew Michael; Kelly, Daniel

    2015-08-17

    Since the invention of modern Additive Manufacturing (AM) processes engineers and designers have worked hard to capitalize on the unique building capabilities that AM allows. By being able to customize the interior fill of parts it is now possible to design components with a controlled density and customized internal structure. The creation of new polymers and polymer composites allow for even greater control over the mechanical properties of AM parts. One of the key reasons to explore AM, is to bring about a new paradigm in part design, where materials can be strategically optimized in a way that conventional subtractive methods cannot achieve. The two processes investigated in my research were the Fused Deposition Modeling (FDM) process and the Direct Ink Write (DIW) process. The objectives of the research were to determine the impact of in-fill density and morphology on the mechanical properties of FDM parts, and to determine if DIW printed samples could be produced where the filament diameter was varied while the overall density remained constant.

  19. Understanding clinical nursing education: An exploratory study.

    PubMed

    Dahlke, Sherry; O'Connor, Maureen; Hannesson, Teresa; Cheetham, Karleen

    2016-03-01

    Clinical experiences are recognized as a critical aspect of nursing education, highlighting the importance of the perspectives of those providing clinical instruction. The aim of this mixed methods descriptive study was to discover the knowledge and guidance needs of preceptors and clinical faculty who provide clinical instruction to Bachelor of Science in Nursing (BSN) students. Fifteen clinical faculty and 17 preceptors were surveyed using a questionnaire developed and piloted by the researchers. Although preceptors and clinical faculty reported a high level of knowledge and confidence in their ability to guide student nurses, they also identified the need for additional support for their teaching roles. Analysis of the qualitative data provided insights into what helped and what hindered clinical instruction, as well as what could enhance clinical instruction. The development, implementation, and evaluation of formal education and mentorship processes for preceptors and clinical faculty are recommended in order to meet these knowledge and guidance gaps. Further research is also needed to explore how to clinical instruction could be tailored to the capacity of those engaged in the experiences and to clinical environments. PMID:26775165

  20. X-linked myotubular myopathy: clinical observations in ten additional cases.

    PubMed

    Joseph, M; Pai, G S; Holden, K R; Herman, G

    1995-11-01

    X-linked myotubular myopathy (XLMTM) is a recessively inherited disorder, lethal to males in the first months of life. Since the first report in 1969, at least 90 cases have been described in the literature. Diagnosis is confirmed by muscle biopsy. Linkage studies have localized the disorder to the Xq28 region, close to the loci for X-linked hydrocephalus and MASA syndrome. We report on 10 additional cases of XLMTM from six different families. In addition to classic clinical features of XLMTM, our patients showed interesting associated findings which included birth length > 90th centile and large head circumference with or without hydrocephalus in 70%, narrow, elongated face in 80%, and slender, long digits in 60% of cases. There was concordance in the occurrence and severity of hydrocephalus in most sib pairs. These features in a "floppy" male infant serve as clues for early clinical diagnosis of XLMTM, which can then be confirmed by muscle biopsy. Development of polyhydramnios was observed in the third trimester of an at-risk dizygotic twin gestation monitored by serial sonography with confirmation of XLMTM at birth. PMID:8588581

  1. [Clinical evaluation of an oxygen concentrator and humidifier that does not require additional reservoir water].

    PubMed

    Burioka, Naoto; Nakamoto, Sachiko; Fukuoka, Yasushi; Shimizu, Eiji

    2011-02-01

    A conventional humidifier with a reservoir of water for humidification can produce micro-aerosols contaminated with bacteria. The present study was undertaken to determine the clinical efficiency of a membrane humidifier that does not require additional reservoir water. We analyzed relative room air humidity and oxygen levels obtained from 2 pressure-swing adsorption (PSA)-type oxygen concentrators with membrane humidifiers. A significant correlation was found between relative room air humidity and that of oxygen moistened by a membrane humidifier. Several patients with chronic respiratory failure experienced improvements in subjectively reported nasal dryness using an oxygen concentrator with a membrane humidifier. This device avoids the need to change reservoir water, and may improve patient quality of life in the home. PMID:21400902

  2. Clinical report of a 17q12 microdeletion with additionally unreported clinical features.

    PubMed

    Roberts, Jennifer L; Gandomi, Stephanie K; Parra, Melissa; Lu, Ira; Gau, Chia-Ling; Dasouki, Majed; Butler, Merlin G

    2014-01-01

    Copy number variations involving the 17q12 region have been associated with developmental and speech delay, autism, aggression, self-injury, biting and hitting, oppositional defiance, inappropriate language, and auditory hallucinations. We present a tall-appearing 17-year-old boy with marfanoid habitus, hypermobile joints, mild scoliosis, pectus deformity, widely spaced nipples, pes cavus, autism spectrum disorder, intellectual disability, and psychiatric manifestations including physical and verbal aggression, obsessive-compulsive behaviors, and oppositional defiance. An echocardiogram showed borderline increased aortic root size. An abdominal ultrasound revealed a small pancreas, mild splenomegaly with a 1.3 cm accessory splenule, and normal kidneys and liver. A testing panel for Marfan, aneurysm, and related disorders was negative. Subsequently, a 400 K array-based comparative genomic hybridization (aCGH) + SNP analysis was performed which identified a de novo suspected pathogenic deletion on chromosome 17q12 encompassing 28 genes. Despite the limited number of cases described in the literature with 17q12 rearrangements, our proband's phenotypic features both overlap and expand on previously reported cases. Since syndrome-specific DNA sequencing studies failed to provide an explanation for this patient's unusual habitus, we postulate that this case represents an expansion of the 17q12 microdeletion phenotype. Further analysis of the deleted interval is recommended for new genotype-phenotype correlations. PMID:24991439

  3. Additional Treatments Offer Little Benefit for Pancreatic Cancer: Study

    MedlinePlus

    ... 158633.html Additional Treatments Offer Little Benefit for Pancreatic Cancer: Study Neither extra chemotherapy drug nor add-on ... 2016 (HealthDay News) -- Additional treatments for locally advanced pancreatic cancer don't appear to boost survival, a new ...

  4. A Study of Additional Costs of Second Language Instruction.

    ERIC Educational Resources Information Center

    McEwen, Nelly

    A study was conducted whose primary aim was to identify and explain additional costs incurred by Alberta, Canada school jurisdictions providing second language instruction in 1980. Additional costs were defined as those which would not have been incurred had the second language program not been in existence. Three types of additional costs were…

  5. An academic, clinical and industrial update on electrospun, additive manufactured and imprinted medical devices.

    PubMed

    Ryan, Christina N M; Fuller, Kieran P; Larrañaga, Aitor; Biggs, Manus; Bayon, Yves; Sarasua, Jose R; Pandit, Abhay; Zeugolis, Dimitrios I

    2015-01-01

    Electrospinning, additive manufacturing and imprint lithography scaffold fabrication technologies have attracted great attention in biomedicine, as they allow production of two- and three- dimensional constructs with tuneable topographical and geometrical features. In vitro data demonstrate that electrospun and imprinted substrates offer control over permanently differentiated and stem cell function. Advancements in functionalisation strategies have further enhanced the bioactivity and reparative capacity of electrospun and additive manufactured devices, as has been evidenced in several preclinical models. Despite this overwhelming success in academic setting, only a few technologies have reached the clinic and only a fraction of them have become commercially available products. PMID:26111642

  6. Increased in vitro activity of ceftriaxone by addition of tazobactam against clinical isolates of anaerobes.

    PubMed

    Aldridge, K E; Morice, N; Schiro, D D

    1994-08-01

    A total of 461 clinical strains of anaerobes were tested using a broth microdilution test to determine the activity of the combination of ceftriaxone and tazobactam and other antimicrobials against these isolates. Ceftriaxone was combined with tazobactam in ratios of 1:1, 2:1, 4:1, and 8:1 and twofold dilutions of ceftriaxone in constant concentrations to tazobactam of 2, 4, 8, 16, and 32 micrograms/ml. Against beta-lactamase-producing strains of the Bacteroides fragilis group, B. capillosus, and Prevotella species all combinations of ceftriaxone and tazobactam showed enhanced in vitro activity and were eight- to 2048-fold more active than ceftriaxone alone. By comparison ceftriaxone and tazobactam showed superior or equal activity to ampicillin and sulbactam, piperacillin and tazobactam, amoxicillin and clavulanate, ticarcillin and clavulanate, and metronidazole against these same strains. Against beta-lactamase nonproducing strains of Porphyromonas, Fusobacterium, Clostridium, Eubacterium, Peptostreptococcus, and Veillonella parvula the addition of tazobactam produced no appreciable enhanced ceftriaxone activity. Fixed concentrations of tazobactam at 2 and 4 micrograms/ml appear to be most suitable for susceptibility testing and are within the pharmacologic profile of this inhibitor. Pharmacologic and toxicity studies will be needed to define the role of ceftriaxone and tazobactam in infectious diseases. PMID:7851086

  7. Influence of an alloy addition on the physical and clinical behaviour of glass ionomer cement

    NASA Astrophysics Data System (ADS)

    Abour, Mohamed Abour Bashir

    These in vitro studies compared the various properties of an experimental high powder liquid content glass ionomer cement (EXPT) with those of a metal addition GIC (Hi-Dense) and disperse phase amalgam (Dispersalloy). Bi-axial, four point flexural and compressive tests were used to evaluate strength. Six groups of ten specimens were constructed for each test for each material and allowed to set in an oven at 37°C for 60 minutes. Specimens were stored in distilled water at 37°C until testing at one day, one week, one, three, six months and year. It was found that the strength of Hi-Dense increased and then maintained over extended time, whereas the strength of EXPT showed a declined at 3 months. The bond strengths of the materials to both enamel and dentine were also evaluated. Ten groups of ten teeth, five for each surface for each glass ionomer materials, were prepared. Teeth were aligned leaving the enamel and dentine surfaces exposed. The mixed material was condensed into a cylinder placed on the appropriate surface. These specimens were also stored in distilled water at 37°C. It was found that Hi-Dense had a higher bond strength to enamel that increased with time. The bond strength to dentine was maintained over the test period. The erosion rate of the materials was evaluated using the lactic acid erosion test. Three groups of six specimens for each material were constructed and tested after one hour, one day and at six months. Each specimen was subjected to an impinging jet of lactic acid solution. The erosion rate was determined by weight loss and dimensional change. It was found that Hi-Dense had a high erosion resistance which was slightly better than the experimental material. The microleakage, around restorations prepared, using the glass ionomer materials, was evaluated after cyclical loading the restoration-tooth complex. It was found that there was less leakage around Hi-Dense than EXPT at both the cervical and occlusal margins. In a clinical

  8. Mutations in RIT1 cause Noonan syndrome - additional functional evidence and expanding the clinical phenotype.

    PubMed

    Koenighofer, M; Hung, C Y; McCauley, J L; Dallman, J; Back, E J; Mihalek, I; Gripp, K W; Sol-Church, K; Rusconi, P; Zhang, Z; Shi, G-X; Andres, D A; Bodamer, O A

    2016-03-01

    RASopathies are a clinically heterogeneous group of conditions caused by mutations in 1 of 16 proteins in the RAS-mitogen activated protein kinase (RAS-MAPK) pathway. Recently, mutations in RIT1 were identified as a novel cause for Noonan syndrome. Here we provide additional functional evidence for a causal role of RIT1 mutations and expand the associated phenotypic spectrum. We identified two de novo missense variants p.Met90Ile and p.Ala57Gly. Both variants resulted in increased MEK-ERK signaling compared to wild-type, underscoring gain-of-function as the primary functional mechanism. Introduction of p.Met90Ile and p.Ala57Gly into zebrafish embryos reproduced not only aspects of the human phenotype but also revealed abnormalities of eye development, emphasizing the importance of RIT1 for spatial and temporal organization of the growing organism. In addition, we observed severe lymphedema of the lower extremity and genitalia in one patient. We provide additional evidence for a causal relationship between pathogenic mutations in RIT1, increased RAS-MAPK/MEK-ERK signaling and the clinical phenotype. The mutant RIT1 protein may possess reduced GTPase activity or a diminished ability to interact with cellular GTPase activating proteins; however the precise mechanism remains unknown. The phenotypic spectrum is likely to expand and includes lymphedema of the lower extremities in addition to nuchal hygroma. PMID:25959749

  9. Addition of meloxicam to the treatment of clinical mastitis improves subsequent reproductive performance.

    PubMed

    McDougall, S; Abbeloos, E; Piepers, S; Rao, A S; Astiz, S; van Werven, T; Statham, J; Pérez-Villalobos, N

    2016-03-01

    A blinded, negative controlled, randomized intervention study was undertaken to test the hypothesis that addition of meloxicam, a nonsteroidal anti-inflammatory drug, to antimicrobial treatment of mild to moderate clinical mastitis would improve fertility and reduce the risk of removal from the herd. Cows (n=509) from 61 herds in 8 regions (sites) in 6 European countries were enrolled. Following herd-owner diagnosis of mild to moderate clinical mastitis within the first 120 d of lactation in a single gland, the rectal temperature, milk appearance, and California Mastitis Test score were assessed. Cows were randomly assigned within each site to be treated either with meloxicam or a placebo (control). All cows were additionally treated with 1 to 4 intramammary infusions of cephalexin and kanamycin at 24-h intervals. Prior to treatment and at 14 and 21 d posttreatment, milk samples were collected for bacteriology and somatic cell count. Cows were bred by artificial insemination and pregnancy status was subsequently defined. General estimating equations were used to determine the effect of treatment (meloxicam versus control) on bacteriological cure, somatic cell count, the probability of being inseminated by 21 d after the voluntary waiting period, the probability of conception to first artificial insemination, the number of artificial insemination/conception, the probability of pregnancy by 120 or 200 d postcalving, and the risk of removal by 300 d after treatment. Cox's proportional hazards models were used to test the effect of treatment on the calving to first insemination and calving to conception intervals. Groups did not differ in terms of age, clot score, California Mastitis Test score, rectal temperature, number of antimicrobial treatments given or bacteria present at the time of enrollment, but cows treated with meloxicam had greater days in milk at enrollment. Cows treated with meloxicam had a higher bacteriological cure proportion than those treated with

  10. SMARCE1, a rare cause of Coffin-Siris Syndrome: Clinical description of three additional cases.

    PubMed

    Zarate, Yuri A; Bhoj, Elizabeth; Kaylor, Julie; Li, Dong; Tsurusaki, Yoshinori; Miyake, Noriko; Matsumoto, Naomichi; Phadke, Shubha; Escobar, Luis; Irani, Afifa; Hakonarson, Hakon; Schrier Vergano, Samantha A

    2016-08-01

    Coffin-Siris syndrome (CSS, MIM 135900), is a well-described, multiple congenital anomaly syndrome characterized by coarse facial features, hypertrichosis, sparse scalp hair, and hypo/aplastic digital nails and phalanges, typically of the 5th digits. Mutations in the BAF (SWI/SNF)-complex subunits (SMARCA4, SMARCE1, SMARCB1, SMARCA2, ARID1B, and ARID1A) have been shown to cause not only CSS, but also related disorders including Nicolaides-Baraitser (MIM 601358) syndrome and ARID1B-intellectual disability syndrome (MIM 614562). At least 200 individuals with CSS have been found to have a mutation in the BAF pathway. However, to date, only three individuals with CSS have been reported to have pathogenic variants in SMARCE1. We report here three additional individuals with clinical features consistent with CSS and alterations in SMARCE1, one of which is novel. The probands all exhibited dysmorphic facial features, moderate developmental and cognitive delay, poor growth, and hypoplastic digital nails/phalanges, including digits not typically affected in the other genes associated with CSS. Two of the three probands had a variety of different organ system anomalies, including cardiac disease, genitourinary abnormalities, feeding difficulties, and vision abnormalities. The 3rd proband has not had further investigative studies. Although an increasing number of individuals are being diagnosed with disorders in the BAF pathway, SMARCE1 is the least common of these genes. This report doubles the number of probands with these mutations, and allows for better phenotypic information of this rare syndrome. © 2016 Wiley Periodicals, Inc. PMID:27264197

  11. Perilous periodontitis: a clinical study.

    PubMed

    Emmanuel, Roby V; Neelakantan, Shiba

    2011-12-01

    The aim of this study is to determine whether periodontitis in pregnant women could be a risk factor for pre term low birth weight. The oral hygiene status, periodontal status and periodontal treatment needs of mothers who birthed infants with normal birth weight and normal gestation period (group A) and mothers who birthed pre term low birth weight infants (group B) were assessed and compared. The clinical parameters used were Oral Hygiene Index--simplified (OHI-S), gingival bleeding index (GBI), probing pocket depth and Community Periodontal Index of Treatment Needs (CPITN). This article presents the study and its findings and draws conclusions as to the relationship between poor periodontal condition and pre term low birth weight. PMID:22216586

  12. Use of generalised additive models to categorise continuous variables in clinical prediction

    PubMed Central

    2013-01-01

    Background In medical practice many, essentially continuous, clinical parameters tend to be categorised by physicians for ease of decision-making. Indeed, categorisation is a common practice both in medical research and in the development of clinical prediction rules, particularly where the ensuing models are to be applied in daily clinical practice to support clinicians in the decision-making process. Since the number of categories into which a continuous predictor must be categorised depends partly on the relationship between the predictor and the outcome, the need for more than two categories must be borne in mind. Methods We propose a categorisation methodology for clinical-prediction models, using Generalised Additive Models (GAMs) with P-spline smoothers to determine the relationship between the continuous predictor and the outcome. The proposed method consists of creating at least one average-risk category along with high- and low-risk categories based on the GAM smooth function. We applied this methodology to a prospective cohort of patients with exacerbated chronic obstructive pulmonary disease. The predictors selected were respiratory rate and partial pressure of carbon dioxide in the blood (PCO2), and the response variable was poor evolution. An additive logistic regression model was used to show the relationship between the covariates and the dichotomous response variable. The proposed categorisation was compared to the continuous predictor as the best option, using the AIC and AUC evaluation parameters. The sample was divided into a derivation (60%) and validation (40%) samples. The first was used to obtain the cut points while the second was used to validate the proposed methodology. Results The three-category proposal for the respiratory rate was ≤ 20;(20,24];> 24, for which the following values were obtained: AIC=314.5 and AUC=0.638. The respective values for the continuous predictor were AIC=317.1 and AUC=0.634, with no statistically

  13. Clinical and histopathological evaluation of the effect of addition of immunotherapy with Mw vaccine to standard chemotherapy in borderline leprosy.

    PubMed

    Kamal, R; Natrajan, M; Katoch, K; Arora, M

    2012-01-01

    This study reports detailed analysis of clinical parameters and clearance of granuloma in borderline leprosy patients treated with immunotherapy and chemotherapy. It aims to assess the additive effect of immunotherapy (Mwvaccine) with standard MDT on clinical status of untreated borderline leprosy cases and on granuloma fraction of untreated borderline leprosy cases. Patients attending the OPD were serially recruited in two groups. A total of 150 cases in one treatment (trial) group (Mw vaccine plus MDT) and 120 cases in another treatment (control) group (MDT only) of border line leprosy have been included. After the formal written consent, detailed clinical examination, charting, smear examination of all untreated borderline patients of both groups was done, biopsies were taken from the active lesions of all patients of both groups at start of therapy and every six month thereafter till the completion of therapy. The same procedure was repeated every six months during the follow-up period. Standard MDT was given to all the patients of both groups according to type of disease. Mw vaccine 0.1 ml (0.5 x 10(9) bacilli) was injected intra-dermally at the start of therapy and every six months in addition to chemotherapy to the treatment group. The BT cases were followed up after 6 doses of MDT and 2 doses of Mw vaccine, and, the BB, BL cases were followed up after 24 doses of MDT plus 5 doses of Mw vaccine. Clinically, greater and faster improvement was observed in all the clinical parameters, faster attainment of smear negativity and two episodes of lepra reaction occurred in cases treated with combined chemotherapy and immunotherapy, as compared to controls (chemotherapy alone) wherein clinical improvement was slower in all parameters, slower attainment of smear negativity in bacillary index and seven showed the occurrence of reactions, histipathologically in addition to more rapid clearance of granuloma in immunotherapy treated group, a significant finding was an

  14. [Application of SAS macro to evaluated multiplicative and additive interaction in logistic and Cox regression in clinical practices].

    PubMed

    Nie, Z Q; Ou, Y Q; Zhuang, J; Qu, Y J; Mai, J Z; Chen, J M; Liu, X Q

    2016-05-10

    Conditional logistic regression analysis and unconditional logistic regression analysis are commonly used in case control study, but Cox proportional hazard model is often used in survival data analysis. Most literature only refer to main effect model, however, generalized linear model differs from general linear model, and the interaction was composed of multiplicative interaction and additive interaction. The former is only statistical significant, but the latter has biological significance. In this paper, macros was written by using SAS 9.4 and the contrast ratio, attributable proportion due to interaction and synergy index were calculated while calculating the items of logistic and Cox regression interactions, and the confidence intervals of Wald, delta and profile likelihood were used to evaluate additive interaction for the reference in big data analysis in clinical epidemiology and in analysis of genetic multiplicative and additive interactions. PMID:27188374

  15. Additional technician tasks and turnaround time in the clinical Stat laboratory

    PubMed Central

    Salinas, Maria; López-Garrigós, Maite; Flores, Emilio; Leiva-Salinas, Maria; Lillo, Rosa; Leiva-Salinas, Carlos

    2016-01-01

    Introduction Many additional tasks in the Stat laboratory (SL) increase the workload. It is necessary to control them because they can affect the service provided by the laboratory. Our aim is to calculate these tasks, study their evolution over a 10 year period, and compare turnaround times (TAT) in summer period to the rest of the year. Materials and methods Additional tasks were classified as “additional test request” and “additional sample”. We collected those incidences from the laboratory information system (LIS), and calculated their evolution over time. We also calculated the monthly TAT for troponin for Emergency department (ED) patients, as the difference between the verification and LIS registration time. A median time of 30 minutes was our indicator target. TAT results and tests workload in summer were compared to the rest of the year. Results Over a 10-year period, the technologists in the SL performed 51,385 additional tasks, a median of 475 per month. The workload was significantly higher during the summer (45,496 tests) than the rest of the year (44,555 tests) (P = 0.019). The troponin TAT did not show this variation between summer and the rest of the year, complying always with our 30 minutes indicator target. Conclusion The technicians accomplished a significant number of additional tasks, and the workload kept increasing over the period of 10 years. That did not affect the TAT results. PMID:27346970

  16. Neurobiology of early life stress: clinical studies.

    PubMed

    Heim, Christine; Nemeroff, Charles B

    2002-04-01

    A burgeoning number of clinical studies have evaluated the immediate and long-term neurobiological effects of early developmental stress, eg, child abuse and neglect or parental loss, in the past years. This review summarizes and discusses the available findings from neuroendocrine (hypothalamic-pituitary-adrenal axis, other neuroendocrine axes), neurochemical (catecholamines, serotonin, other neurotransmitters), psychophysiological (autonomic function, startle reactivity, brain electrical activity) and neuroimaging studies (brain structure, function) conducted in children or adults with a history of early life stress, with or without psychiatric disorders. Early developmental stress in humans appears to be associated with neurobiological alterations that are similar to many findings in animal models of early life stress, and likely represent the biological basis of an enhanced risk for psychopathology. Clinical studies are now beginning to explore potentially differential neurobiological effects of different types of early life stress and the existence of critical developmental periods, which may be sensitive to the neurobiological effects of specific stressors. In addition, the role of a multitude of moderating and mediating factors in the determination of individual vulnerability or resilience to the neurobiological effects of early life stress should be addressed. Findings from such studies may ultimately help to prevent the deleterious neurobiological and psychopathological consequences in the unacceptably high number of children exposed to early life stress in modern society. PMID:11953939

  17. Clinical Mental Health Counselor Handbook & Study Guide.

    ERIC Educational Resources Information Center

    Bullard, Bonnie; Lawless, Linda; Williams, Midge; Bergstrom, Deborah

    This handbook and study guide were developed as a textbook to be used as a review course for preparation for the clinical licensing examination. It presents a summary of a graduate level academic program in clinical mental health counseling. It contains 17 chapters on clinical information; 4 chapters on test taking; 2 types of sample tests; and 3…

  18. Electrostatic Levitation for Studies of Additive Manufactured Materials

    NASA Technical Reports Server (NTRS)

    SanSoucie, Michael P.; Rogers, Jan R.; Tramel, Terri

    2014-01-01

    The electrostatic levitation (ESL) laboratory at NASA's Marshall Space Flight Center is a unique facility for investigators studying high temperature materials. The laboratory boasts two levitators in which samples can be levitated, heated, melted, undercooled, and resolidified. Electrostatic levitation minimizes gravitational effects and allows materials to be studied without contact with a container or instrumentation. The lab also has a high temperature emissivity measurement system, which provides normal spectral and normal total emissivity measurements at use temperature. The ESL lab has been instrumental in many pioneering materials investigations of thermophysical properties, e.g., creep measurements, solidification, triggered nucleation, and emissivity at high temperatures. Research in the ESL lab has already led to the development of advanced high temperature materials for aerospace applications, coatings for rocket nozzles, improved medical and industrial optics, metallic glasses, ablatives for reentry vehicles, and materials with memory. Modeling of additive manufacturing materials processing is necessary for the study of their resulting materials properties. In addition, the modeling of the selective laser melting processes and its materials property predictions are also underway. Unfortunately, there is very little data for the properties of these materials, especially of the materials in the liquid state. Some method to measure thermophysical properties of additive manufacturing materials is necessary. The ESL lab is ideal for these studies. The lab can provide surface tension and viscosity of molten materials, density measurements, emissivity measurements, and even creep strength measurements. The ESL lab can also determine melting temperature, surface temperatures, and phase transition temperatures of additive manufactured materials. This presentation will provide background on the ESL lab and its capabilities, provide an approach to using the ESL

  19. BIG FROG WILDERNESS STUDY AREA AND ADDITIONS, TENNESSEE AND GEORGIA.

    USGS Publications Warehouse

    Slack, John F.; Gazdik, Gertrude C.

    1984-01-01

    A mineral-resource survey was made of the Big Frog Wilderness Study Area and additions, Tennessee-Georgia. Geochemical sampling found traces of gold, zinc, copper, and arsenic in rocks, stream sediments, and panned concentrates, but not in sufficient quantities to indicate the presence of deposits of these metals. The results of the survey indicate that there is little promise for the occurrence of metallic mineral deposits within the study area. The only apparent resources are nonmetallic commodities including rock suitable for construction materials, and small amounts of sand and gravel; however, these commodities are found in abundance outside the study area. A potential may exist for oil and natural gas at great depths, but this cannot be evaluated by the present study.

  20. Recommended Protocol for Round Robin Studies in Additive Manufacturing

    PubMed Central

    Moylan, Shawn; Brown, Christopher U.; Slotwinski, John

    2016-01-01

    One way to improve confidence and encourage proliferation of additive manufacturing (AM) technologies and parts is by generating more high quality data describing the performance of AM processes and parts. Many in the AM community see round robin studies as a way to generate large data sets while distributing the cost among the participants, thereby reducing the cost to individual users. The National Institute of Standards and Technology (NIST) has conducted and participated in several of these AM round robin studies. While the results of these studies are interesting and informative, many of the lessons learned in conducting these studies concern the logistics and methods of the study and unique issues presented by AM. Existing standards for conducting interlaboratory studies of measurement methods, along with NIST’s experience, form the basis for recommended protocols for conducting AM round robin studies. The role of round robin studies in AM qualification, some of the limitations of round robin studies, and the potential benefit of less formal collaborative experiments where multiple factors, AM machine being only one, are varied simultaneously are also discussed. PMID:27274602

  1. Universal protocol for alopecia areata clinical studies.

    PubMed

    Mesinkovska, Natasha A; Bergfeld, Wilma F

    2013-12-01

    Within the area of alopecia areata research, there is an obvious need for well-designed clinical trials of therapeutic agents. The National Alopecia Areata Foundation (NAAF) has created an initiative for the development of a unified protocol with guidelines for clinical studies. The NAAF universal protocol represents a joint effort of clinicians and investigators with experience in treating alopecia areata. This protocol will serve as a tremendous resource to facilitate future clinical studies. PMID:24326554

  2. Clinical effect of additional electroacupuncture on thoracolumbar intervertebral disc herniation in 80 paraplegic dogs.

    PubMed

    Han, Hyun-Jung; Yoon, Hun-Young; Kim, Joon-Young; Jang, Ha-Young; Lee, Bora; Choi, Seok Hwa; Jeong, Soon-Wuk

    2010-01-01

    The clinical efficacy of electroacupuncture and acupuncture in combination with medication for the treatment of thoracolumbar intervertebral disc herniation was investigated in paraplegic dogs with intact deep pain perception. To evaluate the additional effect of electroacupuncture, dogs treated with conventional medicines alone were compared to dogs treated with electroacupuncture and acupuncture and conventional medicine. Medical records of 80 dogs were reviewed for this investigation and classified into two groups undergoing different treatment methods: (1) treatment with conventional medicine alone (Group C, n = 37) and (2) treatment with conventional medicine combined with electroacupuncture and acupuncture (Group CE, n = 43). Prednisone was the conventional medicine and electroacupuncture was applied at GV07 and GV02-1 at 0.5-2.5 mV, mixed Hz of 2 and 15 Hz for 25-30 min. Acupuncture was performed locally at urinary bladder meridian points near the lesion, and bilaterally distantly at GB30, GB34, and ST36. Treatment efficacy was evaluated by post-operative neurologic function, ambulation, relapse, complication, and urinary function. Ambulation recovery was more prevalent in Group CE than Group C (p = 0.01) and recovery of ambulation and back pain relief time was shorter in Group CE compared to Group C (p = 0.011 and 0.001, respectively). Relapse rate was significantly lower in Group CE (p = 0.031). The results suggest that a combination of electroacupuncture and acupuncture with conventional medicine is more effective than conventional medicine alone in recovering ambulation, relieving back pain, and decreasing relapse. Electroacupuncture and acupuncture is thus a reasonable option for the treatment of intervertebral disc herniation in paraplegic dogs with intact deep pain perception. PMID:21061457

  3. Genotoxicity studies of the food additive ester gum.

    PubMed

    Mukherjee, A; Agarwal, K; Chakrabarti, J

    1992-07-01

    Ester gum (EG) is used in citrus oil-based beverage flavourings as a weighting or colouring agent. In the present study, concentrations of 50, 100 and 150 mg/kg body weight were administered orally to male Swiss albino mice, and sister chromatid exchange and chromosomal aberration were used as the cytogenetic endpoints to determine the genotoxic and clastogenic potential of the food additive. Although EG was weakly clastogenic and could induce a marginal increase in sister chromatid exchange frequencies, it was not a potential health hazard at the doses tested. PMID:1521837

  4. Making intelligent systems team players: Additional case studies

    NASA Technical Reports Server (NTRS)

    Malin, Jane T.; Schreckenghost, Debra L.; Rhoads, Ron W.

    1993-01-01

    Observations from a case study of intelligent systems are reported as part of a multi-year interdisciplinary effort to provide guidance and assistance for designers of intelligent systems and their user interfaces. A series of studies were conducted to investigate issues in designing intelligent fault management systems in aerospace applications for effective human-computer interaction. The results of the initial study are documented in two NASA technical memoranda: TM 104738 Making Intelligent Systems Team Players: Case Studies and Design Issues, Volumes 1 and 2; and TM 104751, Making Intelligent Systems Team Players: Overview for Designers. The objective of this additional study was to broaden the investigation of human-computer interaction design issues beyond the focus on monitoring and fault detection in the initial study. The results of this second study are documented which is intended as a supplement to the original design guidance documents. These results should be of interest to designers of intelligent systems for use in real-time operations, and to researchers in the areas of human-computer interaction and artificial intelligence.

  5. Influence of a Dopamine Pathway Additive Genetic Efficacy Score on Smoking Cessation: Results from Two Randomized Clinical Trials of Bupropion

    PubMed Central

    David, Sean P.; Strong, David R.; Leventhal, Adam M.; Lancaster, Molly A.; McGeary, John E.; Munafò, Marcus R.; Bergen, Andrew W.; Swan, Gary E.; Benowitz, Neal L.; Tyndale, Rachel F.; Conti, David V.; Brown, Richard A.; Lerman, Caryn; Niaura, Raymond

    2013-01-01

    Aims To evaluate associations of treatment and an ‘additive genetic efficacy score’ (AGES) based on dopamine functional polymorphisms with time to first smoking lapse and point prevalence abstinence at end of treatment among participants enrolled in two randomized clinical trials of smoking cessation therapies. Design Double-blind pharmacogenetic efficacy trials randomizing participants to active or placebo bupropion. Study 1 also randomized participants to cognitive-behavioral smoking cessation treatment (CBT) or this treatment with CBT for depression. Study 2 provided standardized behavioural support. Setting Two Hospital-affiliated clinics (Study 1), and two University-affiliated clinics (Study 2). Participants N=792 self-identified white treatment-seeking smokers aged ≥18 years smoking ≥10 cigarettes per day over the last year. Measurements Age, gender, Fagerström Test for Nicotine Dependence, dopamine pathway genotypes (rs1800497 [ANKK1 E713K], rs4680 [COMT V158M], DRD4 exon 3 Variable Number of Tandem Repeats polymorphism [DRD4 VNTR], SLC6A3 3' VNTR) analyzed both separately and as part of an AGES, time to first lapse, and point prevalence abstinence at end of treatment. Findings Significant associations of the AGES (hazard ratio = 1.10, 95% Confidence Interval [CI] = 1.06–1.14], p=0.0099) and of the DRD4 VNTR (HR = 1.29, 95%CI 1.17–1.41, p=0.0073) were observed with time to first lapse. A significant AGES by pharmacotherapy interaction was observed (β [SE]=−0.18 [0.07], p=0.016), such that AGES predicted risk for time to first lapse only for individuals randomized to placebo. Conclusions A score based on functional polymorphisms relating to dopamine pathways appears to predict lapse to smoking following a quit attempt, and the association is mitigated in smokers using bupropion. PMID:23941313

  6. [A Critical Condition of Clinical Studies in Japan -- A Battle of Clinical Study Groups].

    PubMed

    Furukawa, Hiroshi

    2016-04-01

    The post-marketing clinical study groups have been losing their activity due to stop of financial support. As the result, clinical study groups cannot achieve any EBM for treatment guidelines. Financial supports should be restarted immediately not to extinguish the post-marketing clinical studies and study groups. PMID:27220798

  7. RAMSEYS DRAFT WILDERNESS STUDY AREA AND ADDITION, VIRGINIA.

    USGS Publications Warehouse

    Lesure, Frank G.; Mory, Peter C.

    1984-01-01

    Mineral-resource surveys of the Ramseys Draft Wilderness Study Area and adjoining roadless area addition in George Washington National Forest in the western valley and ridge province, Augusta and Highland Counties, Virginia, were done. The surveys outlined three small areas containing anomalous amounts of copper, lead, and zinc related to stratabound red-bed copper mineralization, but these occurrences are not large and are not considered as having mineral-resource potential. The area contains abundant sandstone suitable for construction materials and shale suitable for making brick, tile, and other low-grade ceramic products, but these commodities occur in abundance outside the wilderness study area. Structural conditions are probably favorable for the accumulation of natural gas, but exploratory drilling has not been done sufficiently near the area to evaluate the gas potential.

  8. Drug Signature-based Finding of Additional Clinical Use of LC28-0126 for Neutrophilic Bronchial Asthma

    PubMed Central

    Shin, Eunji; Lee, Yong Chul; Kim, So Ri; Kim, Soon Ha; Park, Joonghoon

    2015-01-01

    In recent decades, global pharmaceutical companies have suffered from an R&D innovation gap between the increased cost of a new drug’s development and the decreased number of approvals. Drug repositioning offers another opportunity to fill the gap because the approved drugs have a known safety profile for human use, allowing for a reduction of the overall cost of drug development by eliminating rigorous safety assessment. In this study, we compared the transcriptional profile of LC28-0126, an investigational drug for acute myocardial infarction (MI) at clinical trial, obtained from healthy male subjects with molecular activity profiles in the Connectivity Map. We identified dyphilline, an FDA-approved drug for bronchial asthma, as a top ranked connection with LC28-0126. Subsequently, we demonstrated that LC28-0126 effectively ameliorates the pathophysiology of neutrophilic bronchial asthma in OVALPS-OVA mice accompanied with a reduction of inflammatory cell counts in the bronchoalveolar lavage fluid (BALF), inhibition of the release of proinflammatory cytokines, relief of airway hyperactivity, and improvement of histopathological changes in the lung. Taken together, we suggest that LC28-0126 could be a potential therapeutic for bronchial asthma. In addition, this study demonstrated the potential general utility of computational drug repositioning using clinical profiles of the investigational drug. PMID:26626943

  9. Drug Signature-based Finding of Additional Clinical Use of LC28-0126 for Neutrophilic Bronchial Asthma.

    PubMed

    Shin, Eunji; Lee, Yong Chul; Kim, So Ri; Kim, Soon Ha; Park, Joonghoon

    2015-01-01

    In recent decades, global pharmaceutical companies have suffered from an R&D innovation gap between the increased cost of a new drug's development and the decreased number of approvals. Drug repositioning offers another opportunity to fill the gap because the approved drugs have a known safety profile for human use, allowing for a reduction of the overall cost of drug development by eliminating rigorous safety assessment. In this study, we compared the transcriptional profile of LC28-0126, an investigational drug for acute myocardial infarction (MI) at clinical trial, obtained from healthy male subjects with molecular activity profiles in the Connectivity Map. We identified dyphilline, an FDA-approved drug for bronchial asthma, as a top ranked connection with LC28-0126. Subsequently, we demonstrated that LC28-0126 effectively ameliorates the pathophysiology of neutrophilic bronchial asthma in OVALPS-OVA mice accompanied with a reduction of inflammatory cell counts in the bronchoalveolar lavage fluid (BALF), inhibition of the release of proinflammatory cytokines, relief of airway hyperactivity, and improvement of histopathological changes in the lung. Taken together, we suggest that LC28-0126 could be a potential therapeutic for bronchial asthma. In addition, this study demonstrated the potential general utility of computational drug repositioning using clinical profiles of the investigational drug. PMID:26626943

  10. Oncolysis by paramyxoviruses: preclinical and clinical studies

    PubMed Central

    Matveeva, Olga V; Guo, Zong S; Senin, Vyacheslav M; Senina, Anna V; Shabalina, Svetlana A; Chumakov, Peter M

    2015-01-01

    Preclinical studies demonstrate that a broad spectrum of human malignant cells can be killed by oncolytic paramyxoviruses, which include cells of ecto-, endo-, and mesodermal origin. In clinical trials, significant reduction in size or even complete elimination of primary tumors and established metastases are reported. Different routes of viral administration (intratumoral, intravenous, intradermal, intraperitoneal, or intrapleural), and single- versus multiple-dose administration schemes have been explored. The reported side effects are grade 1 and 2, with the most common among them being mild fever. Some advantages in using paramyxoviruses as oncolytic agents versus representatives of other viral families exist. The cytoplasmic replication results in a lack of host genome integration and recombination, which makes paramyxoviruses safer and more attractive candidates for widely used therapeutic oncolysis in comparison with retroviruses or some DNA viruses. The list of oncolytic paramyxovirus representatives includes attenuated measles virus (MV), mumps virus (MuV), low pathogenic Newcastle disease (NDV), and Sendai (SeV) viruses. Metastatic cancer cells frequently overexpress on their surface some molecules that can serve as receptors for MV, MuV, NDV, and SeV. This promotes specific viral attachment to the malignant cell, which is frequently followed by specific viral replication. The paramyxoviruses are capable of inducing efficient syncytium-mediated lyses of cancer cells and elicit strong immunomodulatory effects that dramatically enforce anticancer immune surveillance. In general, preclinical studies and phase 1–3 clinical trials yield very encouraging results and warrant continued research of oncolytic paramyxoviruses as a particularly valuable addition to the existing panel of cancer-fighting approaches. PMID:26640815

  11. Clinical Applications of Evaluation Studies.

    ERIC Educational Resources Information Center

    Brown, Barry S.

    A series of followup investigations exploring the impact of methadone maintenance treatment, methadone detoxification treatment, therapeutic communities, and outpatient drug-free treatment for the drug abuser was conducted. Limitations of these modalities were revealed in the followup studies. Implications for treatment and policy include: (1)…

  12. Experimental Study of Additives on Viscosity biodiesel at Low Temperature

    NASA Astrophysics Data System (ADS)

    Fajar, Berkah; Sukarno

    2015-09-01

    An experimental investigation was performed to find out the viscosity of additive and biodiesel fuel mixture in the temperature range from 283 K to 318 K. Solutions to reduce the viscosity of biodiesel is to add the biodiesel with some additive. The viscosity was measured using a Brookfield Rheometer DV-II. The additives were the generic additive (Diethyl Ether/DDE) and the commercial additive Viscoplex 10-330 CFI. Each biodiesel blends had a concentration of the mixture: 0.0; 0.25; 0.5; 0.75; 1.0; and 1.25% vol. Temperature of biodiesel was controlled from 40°C to 0°C. The viscosity of biodiesel and additive mixture at a constant temperature can be approximated by a polynomial equation and at a constant concentration by exponential equation. The optimum mixture is at 0.75% for diethyl ether and 0.5% for viscoplex.

  13. 78 FR 12937 - Additional Safeguards for Children in Clinical Investigations of Food and Drug Administration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-26

    ... burdensome to institutions, IRBs, and the process of clinical investigation (66 FR 20589 at 20591). The... VIII. Federalism IX. References I. Background In the Federal Register of April 24, 2001 (66 FR 20589... interim rule (66 FR 20589), including the Food and Drug Administration Modernization Act of 1997...

  14. Additive Manufacturing in Production: A Study Case Applying Technical Requirements

    NASA Astrophysics Data System (ADS)

    Ituarte, Iñigo Flores; Coatanea, Eric; Salmi, Mika; Tuomi, Jukka; Partanen, Jouni

    Additive manufacturing (AM) is expanding the manufacturing capabilities. However, quality of AM produced parts is dependent on a number of machine, geometry and process parameters. The variability of these parameters affects the manufacturing drastically and therefore standardized processes and harmonized methodologies need to be developed to characterize the technology for end use applications and enable the technology for manufacturing. This research proposes a composite methodology integrating Taguchi Design of Experiments, multi-objective optimization and statistical process control, to optimize the manufacturing process and fulfil multiple requirements imposed to an arbitrary geometry. The proposed methodology aims to characterize AM technology depending upon manufacturing process variables as well as to perform a comparative assessment of three AM technologies (Selective Laser Sintering, Laser Stereolithography and Polyjet). Results indicate that only one machine, laser-based Stereolithography, was feasible to fulfil simultaneously macro and micro level geometrical requirements but mechanical properties were not at required level. Future research will study a single AM system at the time to characterize AM machine technical capabilities and stimulate pre-normative initiatives of the technology for end use applications.

  15. Therapists' Use of DBT: A Survey Study of Clinical Practice

    ERIC Educational Resources Information Center

    DiGiorgio, Kimberly E.; Glass, Carol R.; Arnkoff, Diane B.

    2010-01-01

    The purpose of this study was to examine how therapists conduct Dialectical Behavior Therapy (DBT) individual psychotherapy with clients, focusing on clinical factors that could account for decisions regarding modifications of DBT (e.g., client diagnosis, therapist theoretical orientation, and intensity of DBT training). Additionally, the study…

  16. Improving wound care simulation with the addition of odor: a descriptive, quasi-experimental study.

    PubMed

    Roberson, Donna W; Neil, Janice A; Bryant, Elizabeth T

    2008-08-01

    Improving problem-solving skills and expertise in complex clinical care provision requires engaging students in the learning process--a challenging goal when clinical practicums and supervisors are limited. High-fidelity simulation has created many new opportunities for educating healthcare professionals. Because addressing malodorous wounds is a common problem that may be difficult to "teach," a descriptive, quasi-experimental simulation study was conducted. Following completion of a wound care simulation and Laerdal's Simulation Experience Evaluation Tool by 137 undergraduate nursing students, 50 control subjects were randomly selected and 49 volunteer students (experimental group) participated in a wound care simulation after one of three cheeses with a strong odor was added to simulate a malodorous wound. Compared to the control group, study group responses were significantly better (P <0.001) for eight of the 12 survey variables tested and indicated the addition of odor was beneficial in enhancing the perceived realism and value of the simulation. Students responded that the addition of odor in the simulation laboratory improved realism and they felt better prepared to handle malodorous wounds in a clinical setting. An unanticipated outcome was the enhanced feeling of involvement associated with paired care teams as opposed to working in larger groups. The results of this study indicate that wound care education outcomes improve when nursing students are able to practice using a multi-sensorial wound care simulation model. PMID:18716340

  17. Relating clinical study design to basic research.

    PubMed

    Choh, V; Priolo, S

    1999-07-01

    Devising any research study involves careful attention to its design, as well as the development of an appropriate research question and hypothesis. Together, these attributes ensure the validity of the study in question. In most clinical or epidemiological studies, the types of research designs are often explicitly noted, whereas in papers describing basic or biological research, they are couched in different terms or, more often, are ignored, thus potentially hindering communication between basic and clinical researchers. However, given that the framework for all valid scientific research is based on sound logic, it is proposed that for each study design, a direct homology exists between clinical and basic research paradigms, despite the problem of relating epidemiological vernacular to basic research. By applying examples of basic research protocols to traditional clinical study designs, this paper shows that parallels can be drawn between the two strategies, suggesting that in the absence of a conventional nomenclature to describe basic research study designs, the use of traditional clinical design jargon is valid in describing basic research protocols. PMID:10445637

  18. The Clinical Outcome Study for dysferlinopathy

    PubMed Central

    Harris, Elizabeth; Bladen, Catherine L.; Mayhew, Anna; James, Meredith; Bettinson, Karen; Moore, Ursula; Smith, Fiona E.; Rufibach, Laura; Cnaan, Avital; Bharucha-Goebel, Diana X.; Blamire, Andrew M.; Bravver, Elena; Carlier, Pierre G.; Day, John W.; Díaz-Manera, Jordi; Eagle, Michelle; Grieben, Ulrike; Harms, Matthew; Jones, Kristi J.; Lochmüller, Hanns; Mendell, Jerry R.; Mori-Yoshimura, Madoka; Paradas, Carmen; Pegoraro, Elena; Pestronk, Alan; Salort-Campana, Emmanuelle; Schreiber-Katz, Olivia; Semplicini, Claudio; Spuler, Simone; Stojkovic, Tanya; Straub, Volker; Takeda, Shin'ich; Rocha, Carolina Tesi; Walter, M.C.

    2016-01-01

    Objective: To describe the baseline clinical and functional characteristics of an international cohort of 193 patients with dysferlinopathy. Methods: The Clinical Outcome Study for dysferlinopathy (COS) is an international multicenter study of this disease, evaluating patients with genetically confirmed dysferlinopathy over 3 years. We present a cross-sectional analysis of 193 patients derived from their baseline clinical and functional assessments. Results: There is a high degree of variability in disease onset, pattern of weakness, and rate of progression. No factor, such as mutation class, protein expression, or age at onset, accounted for this variability. Among patients with clinical diagnoses of Miyoshi myopathy or limb-girdle muscular dystrophy, clinical presentation and examination was not strikingly different. Respiratory impairment and cardiac dysfunction were observed in a minority of patients. A substantial delay in diagnosis was previously common but has been steadily reducing, suggesting increasing awareness of dysferlinopathies. Conclusions: These findings highlight crucial issues to be addressed for both optimizing clinical care and planning therapeutic trials in dysferlinopathy. This ongoing longitudinal study will provide an opportunity to further understand patterns and variability in disease progression and form the basis for trial design. PMID:27602406

  19. Penile dermatoses: a clinical and histopathological study.

    PubMed Central

    Hillman, R J; Walker, M M; Harris, J R; Taylor-Robinson, D

    1992-01-01

    OBJECTIVE--To assess the spectrum of genital dermatological conditions affecting men and compare the clinical and histopathological diagnoses. DESIGN--Prospective study over a one year period. SETTING--A central London teaching hospital. PATIENTS--Seventy one patients with unresponsive penile dermatoses attending a specific internal referral clinic within the department of genitourinary medicine and 36 patients undergoing penile biopsy following attendance at other departments within the same hospital. METHODS--Full dermatological assessment of patients attending the specific clinic. Standard histopathological methods were used in the diagnosis of biopsy specimens. OUTCOME MEASURED--Clinico-pathological diagnosis of cutaneous penile abnormalities. RESULTS--Description of the range and relative frequency of penile dermatological conditions. The most common histopathological diagnosis was of non specific dermatitis. Twenty seven percent (16 of 61) of patients attending the specific clinic and 33% (12 of 36) of men attending other departments had conditions requiring long term follow up. CONCLUSIONS--The ranges of penile dermatoses presenting to the different departments were broadly similar. Penile biopsy was shown to be a safe and clinically informative procedure. In the genitourinary clinic setting, clinical diagnosis prior to biopsy was found frequently to be inaccurate. Images PMID:1607192

  20. Health studies indicate MTBE is safe gasoline additive

    SciTech Connect

    Anderson, E.V.

    1993-09-01

    Implementation of the oxygenated fuels program by EPA in 39 metropolitan areas, including Fairbanks and Anchorage, Alaska, in the winter of 1992, encountered some unexpected difficulties. Complaints of headaches, dizziness, nausea, and irritated eyes started in Fairbanks, jumped to Anchorage, and popped up in various locations in the lower 48 states. The suspected culprit behind these complaints was the main additive for oxygenation of gasoline is methyl tert-butyl ether (MTBE). A test program, hastily organized in response to these complaints, has indicated that MTBE is a safe gasoline additive. However, official certification of the safety of MTBE is still awaited.

  1. Embedding clinical interventions into observational studies.

    PubMed

    Newman, Anne B; Avilés-Santa, M Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm James; Krucoff, Mitchell; Kuller, Lewis H; Lewis, Cora E; Robinson, Jennifer G; Taylor, Herman; Treviño, Roberto P; Weintraub, William

    2016-01-01

    Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. PMID:26611435

  2. PPB | What is a Clinical Study

    Cancer.gov

    The Pleuropulmonary blastoma (PPB) DICER1 Syndrome Study ‹an observational clinical research study‹is enrolling children with PPB and their families. In an observational study, investigators assess health outcomes in groups of participants according to a protocol or research plan.

  3. Advances in clinical study of curcumin.

    PubMed

    Yang, Chunfen; Su, Xun; Liu, Anchang; Zhang, Lin; Yu, Aihua; Xi, Yanwei; Zhai, Guangxi

    2013-01-01

    Curcumin has been estimated as a potential agent for many diseases and attracted great attention owing to its various pharmacological activities, including anti-cancer, and anti-inflammatory. Now curcumin is being applied to a number of patients with breast cancer, rheumatoid arthritis, Alzheimer's disease, colorectal cancer, psoriatic, etc. Several clinical trials have stated that curcumin is safe enough and effective. The objective of this article was to summarize the clinical studies of curcumin, and give a reference for future studies. PMID:23116307

  4. Marketing and clinical trials: a case study

    PubMed Central

    Francis, David; Roberts, Ian; Elbourne, Diana R; Shakur, Haleema; Knight, Rosemary C; Garcia, Jo; Snowdon, Claire; Entwistle, Vikki A; McDonald, Alison M; Grant, Adrian M; Campbell, Marion K

    2007-01-01

    Background Publicly funded clinical trials require a substantial commitment of time and money. To ensure that sufficient numbers of patients are recruited it is essential that they address important questions in a rigorous manner and are managed well, adopting effective marketing strategies. Methods Using methods of analysis drawn from management studies, this paper presents a structured assessment framework or reference model, derived from a case analysis of the MRC's CRASH trial, of 12 factors that may affect the success of the marketing and sales activities associated with clinical trials. Results The case study demonstrates that trials need various categories of people to buy in – hence, to be successful, trialists must embrace marketing strategies to some extent. Conclusion The performance of future clinical trials could be enhanced if trialists routinely considered these factors. PMID:18028537

  5. Megacystis-microcolon-intestinal hypoperistalsis syndrome: additional clinical, radiologic, surgical, and histopathologic aspects.

    PubMed

    Young, L W; Yunis, E J; Girdany, B R; Sieber, W K

    1981-10-01

    Four newborn infants with megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) were identified at Children's Hospital of Pittsburgh. These cases provide additional insight into the syndrome and broaden its spectrum. This report includes MMIHS in an infant boy, one long-term survivor, an apparently related complication of neonatal obstructive volvulus, evidence of small intestinal hypoperistalsis, and histopathologic findings as follows: (1) apparently increased numbers of ganglion cells in early biopsies and normal or even decreased numbers of ganglion cells in later biopsies probably due to bowel dilatation; and (2) in two of three infants at autopsy, there were many nerve trunks (a neuromalike layer in one), and there was elastosis of the urinary bladder. PMID:6974971

  6. Case Studies: Windows onto Clinical Supervision.

    ERIC Educational Resources Information Center

    Nolan, Jim; And Others

    1993-01-01

    By examining the structures and activities common to six case studies of clinical teacher supervision, this article identifies five conditions that facilitate changes in teacher thinking and behavior: development of a supportive, collegial relationship; teacher control over supervision products; continuity over time; focused, descriptive records…

  7. Additional Treatments Offer Little Benefit for Pancreatic Cancer: Study

    MedlinePlus

    ... of gastroenterology-pancreatology at Beaujon Hospital, in Clichy, France. The study was funded by the pharmaceutical company ... D., department of gastroenterology-pancreatology, Beaujon Hospital, Clichy, France; Deborah Schrag, M.D., M.P.H., chief ...

  8. NMR relaxometry study of plaster mortar with polymer additives

    SciTech Connect

    Jumate, E.; Manea, D.; Moldovan, D.; Fechete, R.

    2013-11-13

    The cement mixed with water forms a plastic paste or slurry which stiffness in time and finally hardens into a resistant stone. The addition of sand aggregates, polymers (Walocel) and/or calcium carbonate will modify dramatically the final mortar mechanic and thermal properties. The hydration processes can be observed using the 1D NMR measurements of transverse T{sub 2} relaxation times distributions analysed by a Laplace inversion algorithm. These distributions were obtained for mortar pasta measured at 2 hours after preparation then at 3, 7 and 28 days after preparation. Multiple components are identified in the T{sub 2} distributions. These can be associated with the proton bounded chemical or physical to the mortar minerals characterized by a short T{sub 2} relaxation time and to water protons in pores with three different pore sizes as observed from SEM images. The evaporation process is faster in the first hours after preparation, while the mortar hydration (bonding of water molecules to mortar minerals) can be still observed after days or months from preparation. Finally, the mechanic resistance was correlated with the transverse T{sub 2} relaxation rates corresponding to the bound water.

  9. Additional EIPC Study Analysis: Interim Report on High Priority Topics

    SciTech Connect

    Hadley, Stanton W

    2013-11-01

    Between 2010 and 2012 the Eastern Interconnection Planning Collaborative (EIPC) conducted a major long-term resource and transmission study of the Eastern Interconnection (EI). With guidance from a Stakeholder Steering Committee (SSC) that included representatives from the Eastern Interconnection States Planning Council (EISPC) among others, the project was conducted in two phases. Phase 1 involved a long-term capacity expansion analysis that involved creation of eight major futures plus 72 sensitivities. Three scenarios were selected for more extensive transmission- focused evaluation in Phase 2. Five power flow analyses, nine production cost model runs (including six sensitivities), and three capital cost estimations were developed during this second phase. The results from Phase 1 and 2 provided a wealth of data that could be examined further to address energy-related questions. A list of 13 topics was developed for further analysis; this paper discusses the first five.

  10. Reversal of dental fluorosis: A clinical study

    PubMed Central

    Mehta, Dhaval N.; Shah, Jigna

    2013-01-01

    Aim: This study was conducted to evaluate the clinical reversal of dental fluorosis with various combinations of calcium, vitamin D3, and ascorbic acid, along with changes in levels of certain biochemical parameters concerned with dental fluorosis. The role of fluoride level of drinking water in the etiology of dental fluorosis and the prevalence of dental fluorosis in both dentitions and teeth were also assessed. Materials and Methods: A total number of 50 patients with clinical features of dental fluorosis without trauma and any adverse habits were selected. Of these, in 30 co-operative patients, estimation of water fluoride level and pretreatment and post-treatment serum and urine fluoride levels were done with ion selective electrode method. The selected 30 patients were divided into three groups, that is, group A, group B, and group C, and were given various combinations of medications like calcium with vitamin D3 supplements, ascorbic acid with vitamin D3 supplements, and chlorhexidine mouthwash (placebo) for three months, respectively. These 30 patients were assessed for any change in the clinical grading of dental fluorosis. Results: No change in clinical grading of dental fluorosis was noted. Considerable reduction in serum and urine fluoride levels was noted in both group A and group B patients. Dental fluorosis was noted in permanent teeth more commonly than deciduous teeth, and permanent maxillary central incisors had the highest prevalence rate. Conclusion: This study comprises only 30 patients with three months of follow-up. So, this sample of patients and duration of follow-up period are conclusive to observe changes in biochemical parameters but not sufficient to observe changes in clinical grading. PMID:23633850

  11. Prostaglandins: a report on early clinical studies

    PubMed Central

    Hinman, J. W.

    1970-01-01

    The prostaglandins are a unique group of pharmacologically active lipids which are widely distributed in mammalian tissues and body fluids. The chemistry of this family of compounds has been established in elegant detail. Research quantities of these highly active natural compounds were obtained by enzymatic bioconversion of essential fatty acids and now studies devoted to the elucidation of their physiological roles and their clinical potential are progressing rapidly. Fields of greatest current interest in clinical medicine include renal-cardiovascular research, induction of labour and therapeutic abortion, control of the reproductive cycle (including fertility control), bronchodilation, enhancement of nasal patency and antisecretory activity. Results available to date are too preliminary for many conclusions to be drawn, but are sufficiently encouraging to assure continued and expanding efforts in several fields. PMID:4098885

  12. Pitavastatin: clinical effects from the LIVES Study.

    PubMed

    Teramoto, Tamio

    2011-11-01

    Although clinical trials provide useful information on drug safety and efficacy, results do not always reflect those observed in the real world. The Japanese long-term prospective post-marketing surveillance LIVALO Effectiveness and Safety (LIVES) Study was designed to assess the efficacy and safety of pitavastatin in clinical practice in ~20,000 patients. After 104 weeks, pitavastatin was associated with significant reductions in low-density lipoprotein-cholesterol (LDL-C) (29.1%) that largely occurred within 4 weeks of treatment initiation. In patients with abnormal triglyceride (TG) and high-density lipoprotein-cholesterol (HDL-C) levels at baseline, pitavastatin reduced TG and increased HDL-C by 22.7% and 19.9%, respectively. Overall, 88.2% of the primary prevention low-risk patients attained their Japan Atherosclerosis Society LDL-C target, compared with 82.7% of intermediate-risk patients, 66.5% of high-risk patients and 50.3% of secondary prevention patients. Only 10.4% of pitavastatin-treated patients experienced adverse events (AEs), of which approximately 84% were mild and around 1% was severe. Increases in blood creatine phosphokinase (2.7%), alanine aminotransferase (1.8%), myalgia (1.1%), aspartate aminotransferase (1.5%) and gamma-glutamyltransferase (1.0%) were the most common AEs and only 7.4% of patients discontinued pitavastatin due to AEs. Regression analysis demonstrated that age was not a significant factor for the incidence of any AE or myopathy-associated events. A subanalysis of initial LIVES data focussing on the effects of pitavastatin on HDL-C levels showed that HDL-C was elevated by 5.9% in all patients and by 24.6% in those with low (studies have shown that other statins have inconsistent effects on HDL

  13. Clinical studies with tumour necrosis factor.

    PubMed

    Spriggs, D R; Sherman, M L; Frei, E; Kufe, D W

    1987-01-01

    The mechanism of tumour necrosis factor (TNF) cytotoxicity remains unknown. The in vivo antitumour effects of TNF may be related to direct cytotoxicity, immunomodulatory effects or endothelial effects on tumour vasculature. Phase I and early Phase II clinical trials of human recombinant TNF are under way in Japan, the USA, the UK and Germany. The maximum Phase II dose for TNF has not been established. The clinical toxicity of TNF is generally similar to that of other biological agents. Systemic toxicity, including fever, chills, anorexia and nausea, has been seen in most patients treated with TNF and has not been clearly related to dose. Other toxicities have included liver function abnormalities, hypotension, transient neurological changes and haematological abnormalities. Few clinical responses have been reported but organized Phase II testing remains to be completed. Combination trials with interferons have recently been initiated. Phase II efficacy studies of TNF as a single agent and in combination are needed for an assessment of the value of this agent in cancer therapy. PMID:3330011

  14. Clinical studies in lysosomal storage diseases

    PubMed Central

    Boudes, Pol F

    2013-01-01

    Lysosomal storage disorders (LSDs) consist of over 40 diseases, some of which are amenable to treatment. In this review, we consider the regulatory context in which LSDs studies are performed, highlight design specificities and explore operational challenges. Orphan drug legislations, both in Europe and US, were effective to stimulate LSDs drug development. However, regulators flexibilities toward approval vary leading to global discrepancies in access to treatments. Study designs are constrained because few patients can be studied. This implies LSDs treatments need to demonstrate large levels of clinical efficacy. If not, an appropriate level of evidence is difficult to achieve. While biomarkers could address this issue, none have been truly accepted as primary outcome. Enrichment of study population can increase the chance of success, especially with clinical outcomes. Adaptive designs are operationally challenging. Innovative methods of analysis can be used, notably using a patient as his/her own control and responder analysis. The use of extension phases and patient registries as a source of historical comparison can facilitate data interpretation. Operationally, few patients are available per centers and multiple centers need to be initiated in multiple countries. This impacts time-lines and budget. In the future, regulators flexibility will be essential to provide patients access to innovative treatments. PMID:25003011

  15. The UK clinical aptitude test and clinical course performance at Nottingham: a prospective cohort study

    PubMed Central

    2013-01-01

    Background The UK Clinical Aptitude Test (UKCAT) was introduced in 2006 as an additional tool for the selection of medical students. It tests mental ability in four distinct domains (Verbal Reasoning, Quantitative Reasoning, Abstract Reasoning, and Decision Analysis), and the results are available to students and admission panels in advance of the selection process. Our first study showed little evidence of any predictive validity for performance in the first two years of the Nottingham undergraduate course. The study objective was to determine whether the UKCAT scores had any predictive value for the later parts of the course, largely delivered via clinical placements. Methods Students entering the course in 2007 and who had taken the UKCAT were asked for permission to use their anonymised data in research. The UKCAT scores were incorporated into a database with routine pre-admission socio-demographics and subsequent course performance data. Correlation analysis was followed by hierarchical multivariate linear regression. Results The original study group comprised 204/254 (80%) of the full entry cohort. With attrition over the five years of the course this fell to 185 (73%) by Year 5. The Verbal Reasoning score and the UKCAT Total score both demonstrated some univariate correlations with clinical knowledge marks, and slightly less with clinical skills. No parts of the UKCAT proved to be an independent predictor of clinical course marks, whereas prior attainment was a highly significant predictor (p <0.001). Conclusions This study of one cohort of Nottingham medical students showed that UKCAT scores at admission did not independently predict subsequent performance on the course. Whilst the test adds another dimension to the selection process, its fairness and validity in selecting promising students remains unproven, and requires wider investigation and debate by other schools. PMID:23442227

  16. Considerations for clinical pharmacology studies for biologics in emerging markets.

    PubMed

    Damle, Bharat; White, Robert; Wang, Huifen Faye

    2015-03-01

    Registration of innovative biologics in Emerging Markets (EMs) poses many opportunities and challenges. The BRIC-MT countries (Brazil, Russia, India, China, Mexico, and Turkey) that are the fastest growing markets and regulators in these countries have imposed certain requirements, including the need for local clinical studies, for registration of biologics. The regulatory landscape in these countries is rapidly evolving, which necessitates an up-to-date understanding of such requirements. There is growing evidence which suggests that race, after accounting for body weight differences, may not influence the pharmacokinetics of biologics to the same extent that it does for small molecules. Thus, the requirements for clinical pharmacology trials in EMs are driven mainly by regulatory needs set forth by local Ministry of Health. In addition to the clinical Phase I to III studies done in the global program that supports registration in large geographies, countries such as China require local single and multiple dose Phase I studies. Participating in global studies with clinical sites within their country may be sufficient for some markets, while other regulators may be satisfied with a Certificate of Pharmaceutical Product. This paper discusses the current requirements for registration of innovative biologics in key EMs. PMID:25707959

  17. Plantago ovata: Clinical study of overuse.

    PubMed

    Agha, Rukh-e-Nasreen; Saeed, Aftab; Nazar, Halima

    2016-03-01

    The objective of the study was to undertake evidence-base study to evaluate clinical manifestation of the over-estimated use of herbal drug Plantago ovata and to compare it with placebo for the efficacy and adverse effects. The patients of both genders were included. Blood urea, creatinine, ALT, Serum B12, CP, ESR and liver function tests were performed. The data was statistically analyzed in both groups for differential symptomatology. In anorexia test verses control results showed that Plantago ovata husk and placebo showed the affected ratio as 81 percent and 50 percent, correspondingly. Whereas in clinical performance of heart burning, pain in epigastrium, low libido, body pain, dyspepsia, fever, burning sensation in palm and sole in test drug showed affected response as adverse effect 90%, 88% and as control drug, 36%, 29%, 22%, 25%, 38%, 30%, 33%, 57%, respectively. The results were highly marked in test drug i.e. in comparison with placebo. This is clearly evident from data analysis that effect observed in test arm is far more superior hence null hypothesis was rejected clearly. Similarly serological and biochemical reports study i.e. (ALT, Vit. B1 and Vit A) revealed that there is no hepatotoxic and neurotoxic effect found in both the drugs. PMID:27087080

  18. Doxofylline and Theophylline: A Comparative Clinical Study

    PubMed Central

    Akram, MD Faiz; Nasiruddin, Mohammad; Ahmad, Zuber; Ali Khan, Rahat

    2012-01-01

    Objectives COPD is one of the major public health problems worldwide. Theophylline has been used in the treatment of COPD for decades. Doxofylline a new theophylline congener has been claimed to have better safety profile. The study was undertaken to compare theophylline and doxophylline at doses recommended and commonly used in clinical practice. Methods The study was conducted in patients of COPD in TB chest department of a medical college hospital. It was randomized, prospective and open label. A total of 154 patients were divided in two group .Group I was administered 400 mg theophylline SR once daily and group II was administered doxofylline 400 mg twice a day orally. Spirometric variables symptom score, and adverse effects were recorded on day 0, 7 and 21 of therapy. Data were compared and analysed using SPSS version 16. Results Results of the study showed that there was no statistically significant difference with respect to spirometric variables and symptom score in the two groups and there was no significant difference in two groups with respect to side effects (p>0.05). Conclusions It is concluded that doxophylline has no advantage over theophylline in terms of either efficacy or safety on the doses commonly used in current clinical practice. PMID:23373027

  19. Clinical laboratory studies in Barth Syndrome.

    PubMed

    Vernon, Hilary J; Sandlers, Yana; McClellan, Rebecca; Kelley, Richard I

    2014-06-01

    Barth Syndrome is a rare X-linked disorder characterized principally by dilated cardiomyopathy, skeletal myopathy and neutropenia and caused by defects in tafazzin, an enzyme responsible for modifying the acyl chain moieties of cardiolipin. While several comprehensive clinical studies of Barth Syndrome have been published detailing cardiac and hematologic features, descriptions of its biochemical characteristics are limited. To gain a better understanding of the clinical biochemistry of this rare disease, we measured hematologic and biochemical values in a cohort of Barth Syndrome patients. We characterized multiple biochemical parameters, including plasma amino acids, plasma 3-methylglutaconic acid, cholesterol, cholesterol synthetic intermediates, and red blood cell membrane fatty acid profiles in 28 individuals with Barth Syndrome from ages 10 months to 30 years. We describe a unique biochemical profile for these patients, including decreased plasma arginine levels. We further studied the plasma amino acid profiles, cholesterol, cholesterol synthetic intermediates, and plasma 3-methylglutaconic acid levels in 8 female carriers and showed that they do not share any of the distinct, Barth Syndrome-specific biochemical laboratory abnormalities. Our studies augment and expand the biochemical profiles of individuals with Barth Syndrome, describe a unique biochemical profile for these patients, and provide insight into the possible underlying biochemical pathology in this disorder. PMID:24751896

  20. Clinical studies of neuroinflammatory mechanisms in schizophrenia.

    PubMed

    Watkins, Crystal C; Andrews, Sarah Ramsay

    2016-09-01

    Schizophrenia is a pervasive neurodevelopmental disorder that appears to result from genetic and environmental factors. Although the dopamine hypothesis is the driving theory behind the majority of translation research in schizophrenia, emerging evidence suggests that aberrant immune mechanisms in the peripheral and central nervous system influence the etiology of schizophrenia and the pathophysiology of psychotic symptoms that define the illness. The initial interest in inflammatory processes comes from epidemiological data and historical observations, dating back several decades. A growing body of research on developmental exposure to infection, stress-induced inflammatory response, glial cell signaling, structural and functional brain changes and therapeutic trials demonstrates the impact that inflammation has on the onset and progression of schizophrenia. Research in animal models of psychosis has helped to advance clinical and basic science investigations of the immune mechanisms disrupted in schizophrenia. However, they are limited by the inability to recapitulate the human experience of hallucinations, delusions and thought disorder that define psychosis. To date, translational studies of inflammatory mechanisms in human subjects have not been reviewed in great detail. Here, we critically review clinical studies that focus on inflammatory mechanisms in schizophrenia. Understanding the neuroinflammatory mechanisms involved in schizophrenia may be essential in identifying potential therapeutic targets to minimize the morbidity and mortality of schizophrenia by interrupting disease development. PMID:26235751

  1. The Emerging Microbe Project: Developing Clinical Care Plans Based on Pathogen Identification and Clinical Case Studies.

    PubMed

    O'Donnell, Lauren A; Perry, Michael W; Doup, Dane't R

    2015-12-01

    For many students in the health sciences, including doctor of pharmacy (PharmD) students, basic and clinical sciences often appear detached from each other. In the infectious disease field, PharmD students additionally struggle with mastering the diversity of microorganisms and the corresponding therapies. The objective of this study was to design an interdisciplinary project that integrates fundamental microbiology with clinical research and decision-making skills. The Emerging Microbe Project guided students through the identification of a microorganism via genetic sequence analysis. The unknown microbe provided the basis for a patient case that asked the student to design a therapeutic treatment strategy for an infected patient. Outside of lecture, students had two weeks to identify the pathogen using nucleotide sequences, compose a microbiology report on the pathogen, and recommend an appropriate therapeutic treatment plan for the corresponding clinical case. We hypothesized that the students would develop a better understanding of the interplay between basic microbiology and infectious disease clinical practice, and that they would gain confidence and skill in independently selecting appropriate antimicrobial therapies for a new disease state. The exercise was conducted with PharmD students in their second professional year of pharmacy school in a required infectious disease course. Here, we demonstrate that the Emerging Microbe Project significantly improved student learning through two assessment strategies (assignment grades and exam questions), and increased student confidence in clinical infectious disease practice. This exercise could be modified for other health sciences students or undergraduates depending upon the level of clinical focus required of the course. PMID:26753029

  2. [Do we still need clinical studies in rheumatology?].

    PubMed

    Henkemeier, U; Alten, R; Bannert, B; Baraliakos, X; Behrens, F; Heldmann, F; Kiltz, U; Köhm, M; König, R; Leipe, J; Müller-Ladner, U; Rech, J; Riechers, E; Rubbert-Roth, A; Schmidt, R E; Schulze-Koops, H; Specker, C; Tausche, A-K; Wassenberg, S; Witt, M; Witte, T; Zernicke, J; Burkhardt, H

    2016-02-01

    Despite a large number of approved therapies demonstrating efficacy in the treatment of rheumatic diseases, only 60-85 % of patients with the indications for rheumatoid arthritis are adequately treated in Germany. Additionally, approved therapies for other immune-mediated diseases are often entirely lacking, indicating the great medical need for the development of new innovative therapies in this specialized field. The development of new drugs is expensive due to the high costs of conducting clinical trials in all phases of development up to obtaining approval; therefore, pharmaceutical companies are looking for ways to save costs in the particular developmental stages. Although the classical regions for drug development (i.e. western Europe, the USA and Japan) offer both a high level of data quality and a good infrastructure to conduct clinical trials due to high standards of education and quality, clinical trials are expensive in these regions. Beside high costs, the comparatively low recruitment rates in these regions are one of the main reasons for the shifting of drug developmental stages from classical regions to eastern European, Latin American and Asian countries, which provide services for drug development and high recruitment rates for comparatively less money. However, there are many strong arguments for the participation of regions in western Europe, especially German sites in clinical trials. In this article these arguments are discussed and possible solutions and strategies for conducting and compensation of study centers in Germany for clinical trials in the field of rheumatology are provided. PMID:26680367

  3. Case studies in clinical practice development.

    PubMed

    Chopra, Romi; Lipman, John; Murphy, Timothy P

    2005-03-01

    By asking identical questions of several successful practitioners of clinical interventional radiology, a snapshot of the current and future status of interventional radiology as a clinical discipline is presented. PMID:21326672

  4. Institutional ethics review of clinical study agreements.

    PubMed

    DuVal, G

    2004-02-01

    Clinical Study Agreements (CSAs) can have profound effects both on the protection of human subjects and on the independence of investigators to conduct research with scientific integrity. Sponsors, institutions, and even investigators may fail to give adequate attention to these issues in the negotiation of CSAs. Despite the key role of CSAs in structuring ethically important aspects of research, they remain largely unregulated and unreviewed for adherence to ethical norms. Academic institutions routinely enter into research contracts that fail to meet adequate ethical standards. This is a failing that can have serious consequences. Accordingly, it is necessary that some independent body have the authority both to review research contracts for compliance with norms of subject protection and ethical integrity, and to reject studies that fail to meet ethical standards. Such review should take place prior to the start of research, not later. Because of its expertise and authority, the institutional ethics review board (IRB or REB) is the appropriate body to undertake such review. Much recent commentary has focused on contractual restrictions on the investigator's freedom to publish research findings. The Olivieri experience, and that of other investigators, has brought freedom of publication issues into sharp focus. Clinical study agreements also raise a number of other ethical issues relating to human subjects and research integrity, however, including disclosures relating to patient safety, data analysis and reporting, budget, confidentiality, and premature termination of the study. This paper describes the ethical issues at stake in structuring such agreements and suggests ethical standards to guide institutional ethics review. PMID:14872068

  5. [Cardiac myxoma in the elderly. Clinical study].

    PubMed

    Pentimone, F; Del Corso, L; Siuti, E; Verunelli, F; Bortolotti, U; Salvatore, L

    1997-01-01

    Cardiac mixoma in the elderly. A clinical study. The clinical features of 13 cardiac myxomas surgically resected are presented. The mean age at presentation was 68 years. Ten were in the left atrium, 5 near the fossa ovalis, 3 at the base of the atrial septum, 1 at the inferior wall and 1 on the anterior leaflet of mitral valve, 3 were in the right atrium, 1 of these was accompanied with a myxoma at the apex of left ventricle. The ECG and the chest X-ray were normal in 9 and in 8 patients, respectively. In 3 patients, the diagnosis was occasionally made by routine 2-dimensional echocardiography. 5 patients presented with fever of unknown origin, arthralgias, weakness, weight loss. None had intracardiac or extracardiac recurrence in the 73 months follow-up. The presentation with constitutional symptoms only like fever of UO, may mimic collagen and neoplastic diseases, vasculitis, lymphomas: the 2-dimensional echocardiography is mandatory to esclude a cardiac myxoma in the elderly. PMID:9213810

  6. Controlled outcome studies of child clinical hypnosis.

    PubMed

    Adinolfi, Barbara; Gava, Nicoletta

    2013-08-01

    Background Hypnosis is defined as "as an interaction in which the hypnotist uses suggested scenarios ("suggestions") to encourage a person's focus of attention to shift towards inner experiences". Aim of the work The focus of this review is to summarize the findings of controlled outcome studies investigating the potential of clinical hypnosis in pediatric populations. We will examine the following themes: anesthesia, acute and chronic pain, chemotherapy-related distress, along with other specific medical issues. Results Hypnosis is an effective method to reduce pain and anxiety before, during and after the administration of anesthetics, during local dental treatments, invasive medical procedures and in burn children. Hypnosis can be successfully used to manage recurrent headaches, abdominal pain, irritable bowel syndrome and chemotherapy-related distress. Hypnosis has an important role in managing symptoms and improving the quality of life of children suffering from asthma and cystic fibrosis and in facilitating the treatment of insomnia in school-age children. Finally, hypnosis can be effectively used for the treatment of some habitual disorders such as nocturnal enuresis and dermatologic conditions, including atopic dermatitis and chronic eczema Conclusions Clinical hypnosis seems to be a useful, cheap and side-effects free tool to manage fear, pain and several kinds of stressful experiences in pediatric populations. Children who receive self-hypnosis trainings achieve significantly greater improvements in their physical health, quality of life, and self-esteem. PMID:24165457

  7. Clinical studies of intestinal folate conjugases.

    PubMed

    Halsted, C H; Beer, W H; Chandler, C J; Ross, K; Wolfe, B M; Bailey, L; Cerda, J J

    1986-03-01

    Clinical differences between the two human intestinal mucosal folate conjugases were assessed by measurement of their activities in normal individuals and in patients with chronic diarrhea of differing causes. Intracellular folate conjugase (ICFC) was 15-fold more active than brush border folate conjugase (BBFC) in jejunal mucosa from seven obese patients undergoing elective gastric bypass surgery. The activity of ICFC was similar among normal volunteers and patients with diarrhea of unknown origin (DUO), gluten-sensitive enteropathy (GSE), inflammatory bowel disease (IBD), and the short bowel syndrome (IBD-SBS). By contrast, BBFC, sucrase, and lactase were decreased significantly in GSE, and BBFC was increased in IBD-SBS. The activity of BBFC correlated with lactase and with sucrase in the normal subjects and in patients with DUO, whereas no correlations were found with the activity of ICFC in any group. Our clinical studies confirm that ICFC and BBFC are different enzymes. ICFC is not affected by intestinal disease, whereas the activity of jejunal BBFC, like that of other brush border enzymes, is decreased by mucosal injury and is also capable of adapting to distal small intestinal disease or surgical resection. PMID:3081671

  8. No effect of additional screw fixation of a cementless, all-polyethylene press-fit socket on migration, wear, and clinical outcome.

    PubMed

    Minten, Michiel J M; Heesterbeek, Petra J C; Spruit, Maarten

    2016-08-01

    Background and purpose - Additional screw fixation of the all-polyethylene press-fit RM cup (Mathys) has no additional value for migration, in the first 2 years after surgery. However, the medium-term and long-term effects of screw fixation remain unclear. We therefore evaluated the influence of screw fixation on migration, wear, and clinical outcome at 6.5 years using radiostereometric analysis (RSA). Patients and methods - This study involved prolonged follow-up from a previous randomized controlled trial (RCT). We analyzed RSA radiographs taken at baseline and at 1-, 2-, and 6.5-year follow-up. Cup migration and wear were assessed using model-based RSA software. Wear was calculated as translation of the femoral head model in relation to the cup model. Total translation, rotation, and wear were calculated mathematically from results of the orthogonal components. Results - 27 patients (15 with screw fixation and 12 without) were available for follow-up at 6.5 (5.6-7.2) years. Total translation (0.50 mm vs. 0.56 mm) and rotation (1.01 degrees vs. 1.33 degrees) of the cup was low, and was not significantly different between the 2 groups. Wear increased over time, and was similar between the 2 groups (0.58 mm vs. 0.53 mm). Wear rate (0.08 mm/year vs. 0.09 mm/year) and clinical outcomes were also similar. Interpretation - Our results indicate that additional screw fixation of all-polyethylene press-fit RM cups has no additional value regarding medium-term migration and clinical outcome. The wear rate was low in both groups. PMID:27299418

  9. Fulminant liver failure: clinical and experimental study.

    PubMed

    Slapak, M

    1975-11-01

    Clinical experience of some newer methods of hepatic support is described. The results are unpredictable and far from satisfactory. The need for an animal model in which potential therapeutic methods can be studied is emphasized. Such a model based on carefully imposed ischaemic insult to the liver in the absence of portacaval shunting is described. It is suggested that bacterial presence in the bowel together with a depression of the liver reticuloendothelial function plays an important part in the early and rapid mortality of acute liver failure. Temporary auxiliary liver transplantation using an allograft or a closely related primate heterograft seem to be the 2 best available methods of hepatic support for potentially reversible acute liver failure. PMID:812415

  10. Clinical studies of styrene workers: initial findings.

    PubMed Central

    Lorimer, W V; Lilis, R; Nicholson, W J; Anderson, H; Fischbein, A; Daum, S; Rom, W; Rice, C; Selikoff, I J

    1976-01-01

    Styrene monomer is a high volume chemical used chiefly in production of polystyrene. A clinical survey of 493 production workers was undertaken at the oldest and largest monomer production, polymerization, and extrusion facility in the U.S. Relative exposure durations and levels were obtained from occupational histories. Significant differences between the high and low exposure groups were found with regard to history of acute prenarcotic symptoms, acute lower respiratory symptoms, prevalence of FEV 1/FV less than 75 per cent, and elevated GCTP. Other liver function tests, chest x-ray, FVC less than 80 per cent, and hematological parameters showed no distinct pattern. A concomitant mortality study has been mounted and is in progress. PMID:1026403

  11. [Clinical study on cefprozil in pediatrics].

    PubMed

    Iwai, N; Miyazu, M; Nakamura, H; Kasai, K

    1992-11-01

    Clinical efficacy and safety of cefprozil (CFPZ, BMY-28100), a newly developed oral cephalosporin, were studied in our pediatric department. Clinical effectiveness, bacteriological effectiveness and side effects were studied in 116 pediatric patients with ages ranging 4 months to 11 years. CFPZ was given 4.6-14.1 mg/kg daily in 3 times for 3-10 days. Clinical efficacies were evaluated in 112 patients, and the therapeutic effectiveness were excellent in 1 and good in 6 for 7 patients with acute pharyngitis, excellent in 24 and good in 26 for acute purulent tonsillitis, excellent in 3, good in 8 and fair in 1 for acute bronchitis, excellent in 21, good in 7, fair in 1 and poor in 1 for acute pneumonia, excellent in 1 acute purulent parotitis, excellent in 2 and good in 7 for acute UTI, good in 1 impetigo, fair in 1 periproctal abscess and good in 1 acute enteritis. The effectiveness rate was 96.4%. Bacteriologically, 4 strains of Staphylococcus aureus (beta-lactamase producing strains), 1 strain of Staphylococcus epidermidis (beta-lactamase producing strain), 2 strains of Streptococcus pneumoniae, 2 strains of Streptococcus agalactiae, 4 strains of beta-Streptococcus, 1 strain of Klebsiella pneumoniae (beta-lactamase producing strain) and 1 strain of Salmonella C2 were all disappeared, and of 22 strains of Streptococcus pyogenes, 20 strains were disappeared, 1 was decreased and 1 was unknown, of 5 strains of Escherichia coli (3 beta-lactamase producing strains), 4 were disappeared and 1 was decreased, of 29 strains of Haemophilus influenzae (14 beta-lactamase producing strains), 14 were disappeared, 11 were decreased, 3 persisted and 1 was unknown and of 2 strains of Haemophilus parainfluenzae (1 beta-lactamase producing strain), 1 was disappeared and 1 persisted. The bacteriological eradication rates for Gram-positive bacteria and Gram-negative bacteria were 97.1% and 56.8%, respectively, and the drug was especially effective against Gram-positive bacteria. No side

  12. Addition of Rice Bran Arabinoxylan to Curcumin Therapy May Be of Benefit to Patients With Early-Stage B-Cell Lymphoid Malignancies (Monoclonal Gammopathy of Undetermined Significance, Smoldering Multiple Myeloma, or Stage 0/1 Chronic Lymphocytic Leukemia): A Preliminary Clinical Study.

    PubMed

    Golombick, Terry; Diamond, Terrence H; Manoharan, Arumugam; Ramakrishna, Rajeev

    2016-06-01

    Hypothesis Prior studies on patients with early B-cell lymphoid malignancies suggest that early intervention with curcumin may lead to delay in progressive disease and prolonged survival. These patients are characterized by increased susceptibility to infections. Rice bran arabinoxylan (Ribraxx) has been shown to have immunostimulatory, anti-inflammatory, and proapoptotic effects. We postulated that addition of Ribraxx to curcumin therapy may be of benefit. Study design Monoclonal gammopathy of undetermined significance (MGUS)/smoldering multiple myeloma (SMM) or stage 0/1 chronic lymphocytic leukemia (CLL) patients who had been on oral curcumin therapy for a period of 6 months or more were administered both curcumin (as Curcuforte) and Ribraxx. Methods Ten MGUS/SMM patients and 10 patients with stage 0/1 CLL were administered 6 g of curcumin and 2 g Ribraxx daily. Blood samples were collected at baseline and at 2-month intervals for a period of 6 months, and various markers were monitored. MGUS/SMM patients included full blood count (FBC); paraprotein; free light chains/ratio; C-reactive protein (CRP)and erythrocyte sedimentation rate (ESR); B2 microglobulin and immunological markers. Markers monitored for stage 0/1 CLL were FBC, CRP and ESR, and immunological markers. Results Of 10 MGUS/SMM patients,5 (50%) were neutropenic at baseline, and the Curcuforte/Ribraxx combination therapy showed an increased neutrophil count, varying between 10% and 90% among 8 of the 10 (80%) MGUS/SMM patients. An additional benefit of the combination therapy was the potent effect in reducing the raised ESR in 4 (44%) of the MGUS/SMM patients. Conclusion Addition of Ribraxx to curcumin therapy may be of benefit to patients with early-stage B-cell lymphoid malignancies. PMID:27154182

  13. Addition of prednisolone and heparin in patients with failed IVF/ICSI cycles: a preliminary report of a clinical trial.

    PubMed

    Siristatidis, Charalampos; Chrelias, Charalampos; Creatsa, Maria; Varounis, Christos; Vrachnis, Nikos; Iliodromiti, Zoe; Kassanos, Demetrios

    2013-09-01

    Through a non-randomized clinical trial, we examined the theoretical benefit of the coadministration of low molecular weight heparin (LMWH) and prednisolone on pregnancy outcomes in women with previously failed IVF/ICSI cycles. Fifteen women constituted the study group, and were compared with 19 women receiving LMWH alone and another 18 women with no drugs. Our finding that the combination of the two drugs produced positive differences in terms of embryo quality, pregnancy and live birth rates points to the necessity for adequately powered randomized trials. PMID:23834353

  14. Impact of contacting study authors to obtain additional data for systematic reviews: diagnostic accuracy studies for hepatic fibrosis

    PubMed Central

    2014-01-01

    Background Seventeen of 172 included studies in a recent systematic review of blood tests for hepatic fibrosis or cirrhosis reported diagnostic accuracy results discordant from 2 × 2 tables, and 60 studies reported inadequate data to construct 2 × 2 tables. This study explores the yield of contacting authors of diagnostic accuracy studies and impact on the systematic review findings. Methods Sixty-six corresponding authors were sent letters requesting additional information or clarification of data from 77 studies. Data received from the authors were synthesized with data included in the previous review, and diagnostic accuracy sensitivities, specificities, and positive and likelihood ratios were recalculated. Results Of the 66 authors, 68% were successfully contacted and 42% provided additional data for 29 out of 77 studies (38%). All authors who provided data at all did so by the third emailed request (ten authors provided data after one request). Authors of more recent studies were more likely to be located and provide data compared to authors of older studies. The effects of requests for additional data on the conclusions regarding the utility of blood tests to identify patients with clinically significant fibrosis or cirrhosis were generally small for ten out of 12 tests. Additional data resulted in reclassification (using median likelihood ratio estimates) from less useful to moderately useful or vice versa for the remaining two blood tests and enabled the calculation of an estimate for a third blood test for which previously the data had been insufficient to do so. We did not identify a clear pattern for the directional impact of additional data on estimates of diagnostic accuracy. Conclusions We successfully contacted and received results from 42% of authors who provided data for 38% of included studies. Contacting authors of studies evaluating the diagnostic accuracy of serum biomarkers for hepatic fibrosis and cirrhosis in hepatitis C patients

  15. Uremic pruritus. Clinical and experimental studies.

    PubMed

    Ståhle-Bäckdahl, M

    1989-01-01

    The aim of the study was to investigate clinical aspects of pruritus in maintenance hemodialysis patients and to evaluate factors of putative pathogenic importance. 60-65% of the patients in a maintenance hemodialysis program during a two-year period suffered from itching. Patients with pruritus tended to have been on dialysis treatment longer than those without pruritus (p = 0.05), otherwise there was no difference in clinical data or routine laboratory tests. Measurement of itch intensity continuously over one week in 28 patients using a computerized method showed that itching peaked at night after two days without dialysis, was relatively high during treatment and lowest during the day following dialysis. Our results suggest that the accumulation of pruritogens between dialysis sessions influences the intensity of itching. Most patients had "dry" skin. Recording of the stratum corneum water content by measurement of electrical capacitance, in 31 patients (19 with pruritus) and 12 controls, disclosed no significant difference between dialysis patients and controls, but a tendency that pruritic patients had a lower water content than the other subjects. In different body areas, there was a positive correlation in all groups between the clinical estimation of xerosis and hydration. Serum concentrations of parathyroid hormone (PTH) were significantly higher in dialysis patients with pruritus than in those without, but there was no correlation between the degree of symptoms and the PTH level. Indirect immunohistochemistry revealed no immunoreactivity for different parts of the PTH molecule in skin biopsies from uremic patients. Intradermal injections of PTH fragments did not evoke itching or other cutaneous reactions in patients or controls. Our results do not support PTH as a peripheral mediator of uremic itching. Flare reactions induced by intradermal histamine injections were significantly smaller in 26 dialysis patients (18 with pruritus) than in 9 healthy

  16. Treatment of Onychomycosis – a Clinical Study

    PubMed Central

    Pajaziti, Laura; Vasili, Ermira

    2015-01-01

    Introduction: Onychomycosis is a fungal infection of the nail unit. Anatomical and physiological characteristics of the nail apparatus impose the need for long-term treatment to achieve complete cure. Goal: The main goal of this project is to study the effectiveness of several treatment protocols for onychomycosis based on Scoring Clinical Index for Onychomycosis (SCIO). Material and methods: The study included 133 patients with onychomycosis, diagnosed by KOH microscopy and culture. Based on disease severity, patients were grouped into groups with SCIO values: 6-9, and 12-16. These groups were randomly subdivided to 5 subgroups according to the given treatment protocols: fluconazole 150 mg 1x weekly, itraconazole continual therapy, itraconazole pulse therapy, terbinafine 250 mg/d, and terbinafine + ciclopirox 8% lacquer, respectively. The cure rate was evaluated at the end of 48 week. Results: The obtained cure rates according to the above mentioned protocols were: 92.30%, 81.81%, 83.33%, 90.90%, and 100%, respectively for groups of patients with SCIO values 6 – 9. Within patients with SCIO values 12-16, were achieved cure rates as follows: 78.57%, 78.57%, 75%, 80%, and 86.66%. Conclusions: There was no statistically significant difference in cure rate between five treatment protocols applied in this study. In patients with high SCIO values is expected a decrease in cure rate. PMID:26261386

  17. Erythroderma: A clinical study of 97 cases

    PubMed Central

    Akhyani, Maryam; Ghodsi, Zahra S; Toosi, Siavash; Dabbaghian, Hossein

    2005-01-01

    Background Erythroderma is a rare skin disorder that may be caused by a variety of underlying dermatoses, infections, systemic diseases and drugs. Methods We reviewed the clinical, laboratory and biopsy material of 97 patients diagnosed with erythroderma who were treated in our department over a 6-year period (1996 through 2002). Results The male-female ratio was 1.85:1. The mean age at diagnosis was 46.2 years. The most common causative factors were dermatoses (59.7%), followed by drug reactions (21.6%), malignancies (11.3%) and idiopathic causes (7.2%). Carbamazepine was the most common drug (57.1%). The best clinicopathologic correlation was found in cutaneous T-cell lymphoma and pityriasis rubra pilaris related erythroderma. Apart from scaling and erythema that were present in all patients, pruritus was the most common finding (97.5%), followed by fever (33.6%), lymphadenopathy (21.3%), edema (14.4%) and hyperkeratosis (7.2%). Conclusion This study outlines that underlying etiologic factors of erythroderma may show geographic variations. Our series had a high percentage of erythroderma secondary to preexisting dermatoses and a low percentage of idiopathic cases. There was no HIV-infected patient among our series based on multiple serum antibody tests. The clinical features of erythroderma were identical, irrespective of the etiology. The onset of the disease was usually insidious except in drug-induced erythroderma, where it was acute. The group associated with the best prognosis was that related to drugs. PMID:15882451

  18. Dyslexia: advances in clinical and imaging studies.

    PubMed

    Koeda, Tatsuya; Seki, Ayumi; Uchiyama, Hitoshi; Sadato, Norihiro

    2011-03-01

    The aim of this report is to describe the characteristics of Japanese dyslexia, and to demonstrate several of our studies about the extraction of these characteristic and their neurophysiological and neuroimaging abnormalities, as well as advanced studies of phonological awareness and the underlying neural substrate. Based on these results, we have proposed a 2-step approach for remedial education (e-learning web site: http://www.dyslexia-koeda.jp/). The first step is decoding, which decreases reading errors, and the second is vocabulary learning, which improves reading fluency. This 2-step approach is designed to serve first grade children. In addition, we propose the RTI (response to intervention) model as a desirable system for remedial education. PMID:21146943

  19. Clinical study of the stunned myocardium.

    PubMed

    Sone, T; Tsuboi, H; Sassa, H

    1991-09-01

    Clinical features of 37 cases of stunned myocardium were studied. Mean duration of asynergy was 22.6 +/- 15.7 days. In all 11 cases of unstable angina without any significant serum creatine kinase leakage, the duration of asynergy was within 14 days. Related coronary lesions were reperfused (spontaneously or by interventional therapy) to TIMI grade II or higher. Transient Q waves were observed in 39% of all cases. Negative T waves tended to be prolonged, and persisted after disappearance of asynergy in 74% of all cases. 201Tl uptake in the stunned area varied widely between individual cases (ranging from "absent" to "normal"), although it became normal in all cases in the chronic stage. Mal-distribution of 99mTc-pyrophosphate (PYP) to the endocardial side of the stunned area was observed in 33%. In 186 cases of acute coronary syndrome, we studied whether or not reversibility of ischemia-disturbed myocardium could be predicted by simultaneous dual isotope SPECT, and found that 201Tl-uptake in the chronic stage significantly improved in the region showing absence of 99mTc-PYP accumulation or maldistribution of 99mTc-PYP to the endocardial side, while reversibility of the region showing transmural 99mTc-PYP accumulation and a dought pattern was poor. Ischemia-associated myocardial damage recovered to various degrees, and dual isotope SPECT was useful in evaluating the reversibility of such damage already at the acute stage. PMID:1834873

  20. Bioplastique at 6 years: clinical outcome studies.

    PubMed

    Ersek, R A; Gregory, S R; Salisbury, A V

    1997-11-01

    Bioplastique is a biphasic polymer for the permanent augmentation of some soft tissues. It was developed in 1987, and clinical studies at this institution were begun in 1990. The combination of low molecular weight polyvinylpyrrolidone and solid polymer particles allows the implantation of permanent polymer spheres through a small needle under local anesthesia. In this study 127 cases are reviewed of consecutive patients who have received Bioplastique for scar revision, wrinkles, and augmentation for soft-tissue defects at 6 years after application. All patients who had not been in for follow-up recently were contacted by mail and questioned on the permanence of augmentation and migration of particles. About 30 percent of the patients were unreachable and had their charts reviewed for permanence and migration of particles. In eight of these cases, Bioplastique was removed because of overcorrection, two of them may have had infection. Bioplastique has gained wide use throughout the world and although some complications have been reported, in general, it functions quite well when used in selected cases. PMID:9385974

  1. Additional follow-up telephone counselling and initial smoking relapse: a longitudinal, controlled study

    PubMed Central

    Wu, Lei; He, Yao; Jiang, Bin; Zuo, Fang; Liu, Qinghui; Zhang, Li; Zhou, Changxi

    2016-01-01

    Objectives Smoking cessation services can help smokers to quit; however, many smoking relapse cases occur over time. Initial relapse prevention should play an important role in achieving the goal of long-term smoking cessation. Several studies have focused on the effect of extended telephone support in relapse prevention, but the conclusions remain conflicting. Design and setting From October 2008 to August 2013, a longitudinal, controlled study was performed in a large general hospital of Beijing. Participants The smokers who sought treatment at our smoking cessation clinic were non-randomised and divided into 2 groups: face-to-face individual counselling group (FC group), and face-to-face individual counselling plus telephone follow-up counselling group (FCF group). No pharmacotherapy was offered. Outcomes The timing of initial smoking relapse was compared between FC and FCF groups. Predictors of initial relapse were investigated during the first 180 days, using the Cox proportional hazards model. Results Of 547 eligible male smokers who volunteered to participate, 457 participants (117 in FC group and 340 in FCF group) achieved at least 24 h abstinence. The majority of the lapse episodes occurred during the first 2 weeks after the quit date. Smokers who did not receive the follow-up telephone counselling (FC group) tended to relapse to smoking earlier than those smokers who received the additional follow-up telephone counselling (FCF group), and the log-rank test was statistically significant (p=0.003). A Cox regression model showed that, in the FCF group, being married, and having a lower Fagerström test score, normal body mass index and doctor-diagnosed tobacco-related chronic diseases, were significantly independent protective predictors of smoking relapse. Conclusions Within the limitations of this study, it can be concluded that additional follow-up telephone counselling might be an effective strategy in preventing relapse. Further research is still

  2. [Clinical and histopathologic study of salivary mucoceles].

    PubMed

    Kang, S K; Kim, K S

    1989-11-01

    Mucoceles are commonly occurring lesions of the oral mucous membrane and the most common lesion involving minor salivary tissue. The incidence of mucoceles is understandable since accessary salivary gland tissue is widely distributed throughout the oral mucous membrane and trauma to the mucosa, which causes their formation, occurs frequently. But only a few studies have been reported that describe its detailed features. This is a retrospective study on the salivary mucoceles in the oral mucous membrane and based on clinical chart, biopsy request and photomicroscopic finding of 112 patients treated by Dept. of Oral Surgery in Seoul National University Hospital, during the period of last 10 years. The results were as following. 1. The age range of the 112 patients was 2 to 60 years, with a peak incidence in the second decade and a gradual decline thereafter. Of the 112 patients, 49 (44%) were males and 63 (56%) were females, the male-to-female ratio being 1:1.29. 2. The majority of these lesions were located on the lower lip but occurred with lesser frequently on the buccal mucosa, floor of the mouth, tongue, retromolar region, upper lip. 3. Of the 112 patients, 107 (95%) were treated by excision and only 5 were treated by marsupialization. 18 of 112 cases had recurrence and the recurrence rate in this study was 16%. 4. Only 3 of the 112 cases revealed an epithelial lining. This incidence indicates that the mucus-extravasation by the damage of excretory duct rather than the ductal dilatation by mucus-retention may play a critical role in the production of these lesions. 5. In 81 cases (72.3%) minor salivary gland were included in the excision biopsy, specimen. Changes observed in the glandular tissue were atrophy and infiltration of chronic inflammatory cell, but the secretory function of gland was thought to be normal in most cases because the changes were mild. PMID:2489621

  3. Updates on clinical studies of selenium supplementation in radiotherapy

    PubMed Central

    2014-01-01

    To establish guidelines for the selenium supplementation in radiotherapy we assessed the benefits and risks of selenium supplementation in radiotherapy. Clinical studies on the use of selenium in radiotherapy were searched in the PubMed electronic database in January 2013. Sixteen clinical studies were identified among the 167 articles selected in the initial search. Ten articles were observational studies, and the other 6 articles reported studies on the effects of selenium supplementation in patients with cancer who underwent radiotherapy. The studies were conducted worldwide including European, American and Asian countries between 1987 and 2012. Plasma, serum or whole blood selenium levels were common parameters used to assess the effects of radiotherapy and the selenium supplementation status. Selenium supplementation improved the general conditions of the patients, improved their quality of life and reduced the side effects of radiotherapy. At the dose of selenium used in these studies (200–500 μg/day), selenium supplementation did not reduce the effectiveness of radiotherapy, and no toxicities were reported. Selenium supplementation may offer specific benefits for several types of cancer patients who undergo radiotherapy. Because high-dose selenium and long-term supplementation may be unsafe due to selenium toxicity, more evidence-based information and additional research are needed to ensure the therapeutic benefits of selenium supplementation. PMID:24885670

  4. Patient advocacy from the clinical nurses' viewpoint: a qualitative study

    PubMed Central

    Davoodvand, Shirmohammad; Abbaszadeh, Abbas; Ahmadi, Fazlollah

    2016-01-01

    One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses. This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. The nurses worked in intensive care units (ICUs), coronary care units (CCUs), and emergency units. The study participants were selected via purposeful sampling. The data was collected through semi-structured interviews and analyzed using content analysis. Data analysis showed that patient advocacy consisted of the two themes of empathy with the patient (including understanding, being sympathetic with, and feeling close to the patient) and protecting the patients (including patient care, prioritization of patients’ health, commitment to the completion of the care process, and protection of patients' rights). The results of this study suggest that nurses must be empathetic toward and protective of their patients. The results of the present study can be used in health care delivery, nursing education, and nursing management and planning systems to help nurses accomplish their important role as patient advocates. It is necessary to further study the connections between patient advocacy and empathy. PMID:27471588

  5. Clinical studies in orthodontics--an overview of NIDR-sponsored clinical orthodontic studies in the US.

    PubMed

    Baumrind, S

    1998-11-01

    A number of clinical trials sponsored by the National Institutes of Health (NIH) use rigorous methods of data acquisition and analysis previously developed in fundamental biology and the physical sciences. The naive expectation that these trials would lead relatively rapidly to definitive answers concerning the therapeutic strategies and techniques under study is dispelled. This presentation focuses on delineating differences between the study of central tendencies and individual variation, more specifically on the strategy to study this variation: measure additional sources of variance within each patient at more timepoints and perhaps with greater precision. As rigorous orthodontic research is still in its infancy, the problem of defining the proper mix between prospective and retrospective trials is discussed. In view of the high costs of prospective clinical trials, many of the questions germane to orthodontics can be answered by well-conducted retrospective trials, assuming that properly randomized sampling procedures are employed. Definitive clinical trials are likely to require better theoretical constructs, better instrumentation, and better measures than now available. Reasons for concern are the restricted resources available and the fact that current mensurational approaches may not detect many of the individual differences. The task of constructing sharable databases and record bases stored in digital form and available either remotely from servers, or locally from CD-ROMs or optical disks, is crucial to the optimization of future investigations. PMID:10321134

  6. Using Clinical Gait Case Studies to Enhance Learning in Biomechanics

    ERIC Educational Resources Information Center

    Chester, Victoria

    2011-01-01

    Clinical case studies facilitate the development of clinical reasoning strategies through knowledge and integration of the basic sciences. Case studies have been shown to be more effective in developing problem-solving abilities than the traditional lecture format. To enhance the learning experiences of students in biomechanics, clinical case…

  7. Study of wood plastic composite in the presence of nitrogen containing additives

    NASA Astrophysics Data System (ADS)

    Ali, K. M. Idriss; Khan, Mubarak A.; Husain, M. M.

    1994-10-01

    Effect of nitrogen-containing additives in the study of wood plastic composites of MMA with simul and mango wood of Bangladesh has been investigated. Nine different additives were used and the additives containing carboamide group induce the highest tensile strength to the composite.

  8. Study of mandible reconstruction using a fibula flap with application of additive manufacturing technology

    PubMed Central

    2014-01-01

    Background This study aimed to establish surgical guiding techniques for completing mandible lesion resection and reconstruction of the mandible defect area with fibula sections in one surgery by applying additive manufacturing technology, which can reduce the surgical duration and enhance the surgical accuracy and success rate. Methods A computer assisted mandible reconstruction planning (CAMRP) program was used to calculate the optimal cutting length and number of fibula pieces and design the fixtures for mandible cutting, registration, and arrangement of the fibula segments. The mandible cutting and registering fixtures were then generated using an additive manufacturing system. The CAMRP calculated the optimal fibula cutting length and number of segments based on the location and length of the defective portion of the mandible. The mandible cutting jig was generated according to the boundary surface of the lesion resection on the mandible STL model. The fibular cutting fixture was based on the length of each segment, and the registered fixture was used to quickly arrange the fibula pieces into the shape of the defect area. In this study, the mandibular lesion was reconstructed using registered fibular sections in one step, and the method is very easy to perform. Results and conclusion The application of additive manufacturing technology provided customized models and the cutting fixtures and registered fixtures, which can improve the efficiency of clinical application. This study showed that the cutting fixture helped to rapidly complete lesion resection and fibula cutting, and the registered fixture enabled arrangement of the fibula pieces and allowed completion of the mandible reconstruction in a timely manner. Our method can overcome the disadvantages of traditional surgery, which requires a long and different course of treatment and is liable to cause error. With the help of optimal cutting planning by the CAMRP and the 3D printed mandible resection jig and

  9. Eurythmy Therapy in clinical studies: a systematic literature review

    PubMed Central

    Büssing, Arndt; Ostermann, Thomas; Majorek, Magdalena; Matthiessen, Peter F

    2008-01-01

    Background We aimed to overview the current literature on eurythmy therapy (EYT) which is an integral part of Anthroposophic Medicine. EYT can be described as a movement therapy in which speech movements are transposed into exercises which address the patient's capability to soul expression and strengthen his salutogenetic resources. Methods We searched several databases such as Cochrane, EMBASE, NCCAM, NLM, DIMDI, CAMbase, and Medline for case-control studies, cohort studies and randomised controlled trials on the treatment effects of EYT in a clinical setting. In a second search we included journal databases from Karger, Kluwer, Springer, Thieme, and Merkurstab archive. Results We found 8 citations which met the inclusion criterion: 4 publications referring to a prospective cohort study without control group (the AMOS study), and 4 articles referring to 2 explorative pre-post studies without control group, 1 prospective, non-randomized comparative study, and 1 descriptive study with a control group. The methodological quality of studies ranged in from poor to good, and in sample size from 5 to 898 patients. In most studies, EYT was used as an add-on, not as a mono-therapy. The studies described positive treatment effects with clinically relevant effect sizes in most cases. Conclusion Indications, study designs and the usage of additional treatments within the identified studies were quite heterogeneous. Despite of this, EYT can be regarded as a potentially relevant add-on in a therapeutic concept, although its specific relevance remains to be clarified. Well performed controlled studies on this unique treatment are highly recommended. PMID:18377647

  10. [Attempt to standardize clinical tests for the purpose of quality management in the field of clinical studies and clinical trials].

    PubMed

    Ishibashi, Midori; Komiyama, Yasushi; Furuta, Koh

    2011-10-01

    The purpose of this study was to contribute to the quality management in the fields of clinical studies and clinical trials. To accomplish this purpose we tried to make guidelines for nationwide standardization of clinical tests. This study was performed by multidisciplinary personnel such as medical doctors, medical technologist, CRC, and representatives of pharmaceutical companies and/or clinical laboratory testing companies. The study was also focused on two fields of clinical tests such as pre-analytical and post-analytical phase. Each member shared various incidents and tried to make solutions. In post-analytical area in particular, further discussion concerning CDISC and SS-MIX was done. Based on these efforts, a tentative guideline was made. PMID:22184881

  11. The clinical significance and management of patients with incomplete coronary angiography and the value of additional computed tomography coronary angiography.

    PubMed

    Pregowski, Jerzy; Kepka, Cezary; Kruk, Mariusz; Mintz, Gary S; Kalinczuk, Lukasz; Ciszewski, Michal; Kochanowski, Lukasz; Wolny, Rafal; Chmielak, Zbigniew; Jastrzębski, Jan; Klopotowski, Mariusz; Zalewska, Joanna; Demkow, Marcin; Karcz, Maciej; Witkowski, Adam

    2014-04-01

    To assess the anatomical background and significance of incomplete invasive coronary angiography (ICA) and to evaluate the value of coronary computed tomography angiography (CTA) in this scenario. The current study is an analysis of high volume center experience with prospective registry of coronary CTA and ICA. The target population was identified through a review of the electronic database. We included consecutive patients referred for coronary CTA after ICA, which did not visualize at least one native coronary artery or by-pass graft. Between January 2009 and April 2013, 13,603 diagnostic ICA were performed. There were 45 (0.3 %) patients referred for coronary CTA after incomplete ICA. Patients were divided into 3 groups: angina symptoms without previous coronary artery by-pass grafting (CABG) (n = 11,212), angina symptoms with previous CABG (n = 986), and patients prior to valvular surgery (n = 925). ICA did not identify by-pass grafts in 21 (2.2 %) patients and in 24 (0.2 %) cases of native arteries. The explanations for an incomplete ICA included: 11 ostium anomalies, 2 left main spasms, 5 access site problems, 5 ascending aorta aneurysms, and 2 tortuous take-off of a subclavian artery. However, in 20 (44 %) patients no specific reason for the incomplete ICA was identified. After coronary CTA revascularization was performed in 11 (24 %) patients: 6 successful repeat ICA and percutaneous intervention and 5 CABG. Incomplete ICA constitutes rare, but a significant clinical problem. Coronary CTA provides adequate clinical information in these patients. PMID:24623270

  12. [Clinical studies of pediatric malabsorption syndromes].

    PubMed

    Hosoyamada, Takashi

    2006-11-01

    Multiple cases with various types of pediatric malabsorption syndromes were evaluated. The clinical manifestations, laboratory findings, pathophysiology, and histopathological descriptions of each patient were analyzed in an effort to clear the pathogenesis of the malabsorption syndromes and the treatments were undertaken. The cases studied, included one patient with cystic fibrosis, two with lactose intolerance with lactosuria (Durand type), one with primary intestinal lymphangiectasia, two with familial hypobetalipoproteinemia, one with Hartnup disease, one with congenital chroride diarrhea, one with acrodermatitis enteropathica, one with intestinal nodular lymphoid hyperplasia (NLH), five with intractable diarrhea of early infancy and four with glycogenosis type Ia. Each case description and outcome is described below: 1. A 15-year-old Japanese boy with cystic fibrosis presented with severe symptoms, including pancreatic insufficiency, bronchiectasis, pneumothorax and hemoptysis. His prognosis was poor. Analysis of the CFTR genes of this patient revealed a homozygous large deletion from intron 16 to 17b. 2. In the sibling case of Durand type lactose intolerance, the subjects'disaccaridase activity of the small bowel, including lactase, were within normal limits. The results of per oral and per intraduodenal lactose tolerance tests confirmed lactosuria in both. These observations suggested, not only an abnormal gastric condition, but also duodenal and intestinal mucosal abnormal permeability of lactose. 3. In the case of primary intestinal lymphangiectasia, the subject had a lymphedematous right arm and hand, a grossly coarsened mucosal pattern of the upper gastrointestinal tract (identified via radiologic examination) and the presence of lymphangiectasia (confirmed via duodenal mucosal biopsy). The major laboratory findings were hypoalbuminemia, decreased immunoglobulin levels and lymphopenia resulting from loss of lymph fluid and protein into the gastro

  13. Additional Therapy with a Mistletoe Product during Adjuvant Chemotherapy of Breast Cancer Patients Improves Quality of Life: An Open Randomized Clinical Pilot Trial.

    PubMed

    Tröger, Wilfried; Zdrale, Zdravko; Tišma, Nevena; Matijašević, Miodrag

    2014-01-01

    Background. Breast cancer patients receiving adjuvant chemotherapy often experience a loss of quality of life. Moreover chemotherapy may induce neutropenia. Patients report a better quality of life when additionally treated with mistletoe products during chemotherapy. Methods. In this prospective randomized open-label pilot study 95 patients were randomized into three groups. All patients were treated with an adjuvant chemotherapy. The primary objective of the study was quality of life, the secondary objective was neutropenia. Here we report the comparison of HxA (n = 34) versus untreated control (n = 31). Results. In the explorative analysis ten of 15 scores of the EORTC QLQ-C30 showed a better quality of life in the HxA group compared to the control group (P < 0.001 to P = 0.038 in Dunnett-T3 test). The difference was clinically relevant (difference of at least 5 points, range 5.4-12.2) in eight of the ten scores. Neutropenia occurred in 7/34 HxA patients and in 8/31 control patients (P = 0.628). Conclusions. This pilot study showed an improvement of quality of life by treating breast cancer patients with HxA additionally to CAF. Although the open design may be a limitation, the findings show the feasibility of a confirmatory study using the methods described here. PMID:24701238

  14. Additional Therapy with a Mistletoe Product during Adjuvant Chemotherapy of Breast Cancer Patients Improves Quality of Life: An Open Randomized Clinical Pilot Trial

    PubMed Central

    Tröger, Wilfried; Ždrale, Zdravko; Tišma, Nevena; Matijašević, Miodrag

    2014-01-01

    Background. Breast cancer patients receiving adjuvant chemotherapy often experience a loss of quality of life. Moreover chemotherapy may induce neutropenia. Patients report a better quality of life when additionally treated with mistletoe products during chemotherapy. Methods. In this prospective randomized open-label pilot study 95 patients were randomized into three groups. All patients were treated with an adjuvant chemotherapy. The primary objective of the study was quality of life, the secondary objective was neutropenia. Here we report the comparison of HxA (n = 34) versus untreated control (n = 31). Results. In the explorative analysis ten of 15 scores of the EORTC QLQ-C30 showed a better quality of life in the HxA group compared to the control group (P < 0.001 to P = 0.038 in Dunnett-T3 test). The difference was clinically relevant (difference of at least 5 points, range 5.4–12.2) in eight of the ten scores. Neutropenia occurred in 7/34 HxA patients and in 8/31 control patients (P = 0.628). Conclusions. This pilot study showed an improvement of quality of life by treating breast cancer patients with HxA additionally to CAF. Although the open design may be a limitation, the findings show the feasibility of a confirmatory study using the methods described here. PMID:24701238

  15. Triptan nonresponder studies: implications for clinical practice.

    PubMed

    Dodick, David W

    2005-02-01

    The maximum absolute response rate with oral triptans, as measured in clinical trials by the incidence of relief from migraine pain at 2 hours after taking medication, is approximately 70%. Therefore around 30% of patients fail to respond to a particular triptan. Nonresponse is likely to be due to a variety of factors, including low and inconsistent absorption, use of the medication late in an attack, inadequate dosing, and variability in individual response. Evidence from recent clinical trials, however, confirms the common clinical observation that patients with a poor response to one triptan can benefit from subsequent treatment with a different triptan. Two-hour pain-relief rates of 25% to 81% using alternative triptans (naratriptan, almotriptan, eletriptan, zolmitriptan, and rizatriptan) have been reported in patients who were described as poor responders to sumatriptan. Physicians should remain vigilant in assessing the response to acute therapy and take advantage of simple clinical questionnaires that have been developed to facilitate the recognition of those patients who require and may benefit from a change in acute therapy. PMID:15705122

  16. A study of clinically related open source software projects.

    PubMed

    Hogarth, Michael A; Turner, Stuart

    2005-01-01

    Open source software development has recently gained significant interest due to several successful mainstream open source projects. This methodology has been proposed as being similarly viable and beneficial in the clinical application domain as well. However, the clinical software development venue differs significantly from the mainstream software venue. Existing clinical open source projects have not been well characterized nor formally studied so the 'fit' of open source in this domain is largely unknown. In order to better understand the open source movement in the clinical application domain, we undertook a study of existing open source clinical projects. In this study we sought to characterize and classify existing clinical open source projects and to determine metrics for their viability. This study revealed several findings which we believe could guide the healthcare community in its quest for successful open source clinical software projects. PMID:16779056

  17. Effect of hyaluronan on periodontitis: A clinical and histological study

    PubMed Central

    Gontiya, Gauri; Galgali, Sushama R.

    2012-01-01

    Background: Conventional, non-surgical periodontal therapy consists of supra- and subgingival tooth debridement. However, it is a technically demanding procedure and is not always efficient at eradicating all periodontal pathogens and in reducing inflammation. Therefore, local subgingival application of other chemotherapeutic agents may be used as an adjunct to non-surgical therapy. The aim of this study was to investigate the clinical and histological outcomes of local subgingival application of 0.2% hyaluronic acid gel (GENGIGEL®) as an adjunct to scaling and root planing (SRP) in chronic periodontitis patients. Materials and Methods: One hundred and twenty sites were chosen from 26 patients with chronic periodontitis (criteria being periodontal pockets ≥5mm). Experimental sites additionally received HA gel subgingivally at baseline, 1st, 2nd, and 3rd week. Clinical parameters were re-assessed at 4th, 6th, and 12th week. At 4th week recall, a gingival biopsy was obtained from test and control site for histologic examination. Results: Intra-group analysis of all the clinical parameters at all sites from baseline to 4th, 6th, and 12th week showed statistically significant changes. Experimental sites showed statistically significant improvement in Gingival index and Bleeding index at 6th and 12th week when compared with control sites. However, no statistically significant differences were observed in the PPD and RAL between control and experimental sites at 4th, 6th, and 12th week time interval. No statistically significant association was found between the histological grading of the sites that received HA treatment. Conclusion: Subgingival placement of 0.2% HA gel along with SRP provided a significant improvement in gingival parameters. However, no additional benefit was found in periodontal parameters. Histologically, experimental sites showed reduced inflammatory infiltrate, but it was not statistically significant. PMID:23055583

  18. [Clinical studies of cefoperazone in neurosurgery].

    PubMed

    Kitamura, K; Shimizu, T; Abe, H; Suzuki, J; Tanaka, R; Nagai, H; Yamamoto, S; Handa, H; Nishimoto, A; Matsuoka, K

    1986-01-01

    A multicenter trial consisting of 164 institutions through out Japan, has been conducted to study the transfer of cefoperazone (CPZ) into the cerebrospinal fluid (CSF), and the clinical effectiveness of CPZ as a therapeutic or prophylactic agent in neurosurgery. The levels of CPZ in serum and CSF were determined in 96 patients. After initial dose of 2 g CPZ (intravenous drip infusion for 30 minutes), the serum level of CPZ after 1 hour was 124.5 +/- 6.6 micrograms/ml (Mean +/- S.E.), and even after 6 hours, it maintained as high as 47.8 +/- 16.6 micrograms/ml. The peak CPZ levels in CSF in patients with normal or minimal impairment in blood-CSF-barrier (BCB) (group I) and in those of localized impairment in BCB (group II) were 1.0 +/- 0.5 micrograms/ml at 2 hours and 3.0 +/- 1.8 micrograms/ml at 3 hours, respectively. The highest CSF level was seen in patients with meningitis (group III) and showed 5.0 +/- 2.4 micrograms/ml at 6 hours. After multiple dose of 2 g CPZ (intravenous drip infusion for 30 minutes), the serum kinetics of CPZ were not significantly different from those obtained after initial dose. However, the CPZ levels in CSF were higher than those observed after initial dose in all 3 groups and were higher than MIC75 against relevant pathogens for meningitis such as Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus. Moreover, in group III peak level of CPZ in CSF exceeded the MIC75 against Pseudomonas aeruginosa which is also frequently isolated from patients with meningitis in neurosurgery. As a therapeutic agent CPZ administered as sole agent was effective in 42 out of 55 cases (76.4%) in meningitis, in 78 out of 116 cases (67.2%) in pneumonia and in 36 out of 47 cases (76.6%) in urinary tract infection (UTI). Its efficacy rate against all infections treated was 72.2% (184/255). Regarding CPZ's prophylactic use, 39 out of 514 cases (7.6%) were judged as having or possibly having infections as follows; meningitis (13/514, 2

  19. Increased Risk of Additional Cancers Among Patients with Gastrointestinal Stromal Tumors: A Population-Based Study

    PubMed Central

    Murphy, James D.; Ma, Grace L.; Baumgartner, Joel M.; Madlensky, Lisa; Burgoyne, Adam M.; Tang, Chih-Min; Martinez, Maria Elena; Sicklick, Jason K.

    2015-01-01

    Purpose Most gastrointestinal stromal tumors (GIST) are considered non-hereditary or sporadic. However, single-institution studies suggest that GIST patients develop additional malignancies with increased frequencies. We hypothesized that we could gain greater insight into possible associations between GIST and other malignancies using a national cancer database inquiry. Methods Patients diagnosed with GIST (2001–2011) in the Surveillance, Epidemiology, and End Results database were included. Standardized prevalence ratios (SPRs) and standardized incidence ratios (SIRs) were used to quantify cancer risks incurred by GIST patients before and after GIST diagnoses, respectively, when compared with the general U.S. population. Results Of 6,112 GIST patients, 1,047 (17.1%) had additional cancers. There were significant increases in overall cancer rates: 44% (SPR=1.44) before diagnosis and 66% (SIR=1.66) after GIST diagnoses. Malignancies with significantly increased occurrence both before/after diagnoses included other sarcomas (SPR=5.24/SIR=4.02), neuroendocrine-carcinoid tumors (SPR=3.56/SIR=4.79), non-Hodgkin’s lymphoma (SPR=1.69/SIR=1.76), and colorectal adenocarcinoma (SPR=1.51/SIR=2.16). Esophageal adenocarcinoma (SPR=12.0), bladder adenocarcinoma (SPR=7.51), melanoma (SPR=1.46), and prostate adenocarcinoma (SPR=1.20) were significantly more common only before GIST. Ovarian carcinoma (SIR=8.72), small intestine adenocarcinoma (SIR=5.89), papillary thyroid cancer (SIR=5.16), renal cell carcinoma (SIR=4.46), hepatobiliary adenocarcinomas (SIR=3.10), gastric adenocarcinoma (SIR=2.70), pancreatic adenocarcinoma (SIR=2.03), uterine adenocarcinoma (SIR=1.96), non-small cell lung cancer (SIR=1.74), and transitional cell carcinoma of the bladder (SIR=1.65) were significantly more common only after GIST. Conclusion This is the first population-based study to characterize the associations and temporal relationships between GIST and other cancers, both by site and

  20. Sports Neurology in Clinical Practice: Case Studies.

    PubMed

    Seifert, Tad

    2016-08-01

    With regard to persistent posttraumatic headache, there is legitimate concern that duration of symptoms may have an impact on the efficacy of future treatment attempts. Without neuropathologic confirmation, a clinical diagnosis of chronic traumatic encephalopathy cannot be made with a high degree of confidence. Sport-related headaches are challenging in a return-to-play context, because it is often unclear whether an athlete has an exacerbation of a primary headache disorder, has new-onset headache unrelated to trauma, or is in the recovery phase after concussion. Regular physical exercise may prove beneficial to multiple neurologic disease states. PMID:27445251

  1. 7 CFR 1710.253 - Engineering and cost studies-addition of generation capacity.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 11 2013-01-01 2013-01-01 false Engineering and cost studies-addition of generation... TO ELECTRIC LOANS AND GUARANTEES Construction Work Plans and Related Studies § 1710.253 Engineering... engineering and cost studies as specified by RUS. The studies shall cover a period from the beginning of...

  2. 7 CFR 1710.253 - Engineering and cost studies-addition of generation capacity.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Engineering and cost studies-addition of generation... TO ELECTRIC LOANS AND GUARANTEES Construction Work Plans and Related Studies § 1710.253 Engineering... engineering and cost studies as specified by RUS. The studies shall cover a period from the beginning of...

  3. A clinical study of Noonan syndrome.

    PubMed Central

    Sharland, M; Burch, M; McKenna, W M; Paton, M A

    1992-01-01

    Clinical details are presented on 151 individuals with Noonan syndrome (83 males and 68 females, mean age 12.6 years). Polyhydramnios complicated 33% of affected pregnancies. The commonest cardiac lesions were pulmonary stenosis (62%), and hypertrophic cardiomyopathy (20%), with a normal echocardiogram present in only 12.5% of all cases. Significant feeding difficulties during infancy were present in 76% of the group. Although the children were short (50% with a height less than 3rd centile), and underweight (43% with a weight less than 3rd centile), the mean head circumference of the group was on the 50th centile. Motor milestone delay was usual, the cohort having a mean age of sitting unsupported of 10 months and walking of 21 months. Abnormal vision (94%) and hearing (40%) were frequent findings, but 89% of the group were attending normal primary or secondary schools. Other associations included undescended testicles (77%), hepatosplenomegaly (50%), and evidence of abnormal bleeding (56%). The mean age at diagnosis of Noonan syndrome in this group was 9.0 years. Earlier diagnosis of this common condition would aid both clinical management and genetic counselling. Images Figure 1 Figure 2 Figure 3 PMID:1543375

  4. Document Clustering of Clinical Narratives: a Systematic Study of Clinical Sublanguages

    PubMed Central

    Patterson, Olga; Hurdle, John F.

    2011-01-01

    It is widely believed that different clinical domains use their own sublanguage in clinical notes, complicating natural language processing, but this has never been demonstrated on a broad selection of note types. Starting from formal sublanguage theory, we constructed a feature space based on vocabulary and semantic types used in 17 different clinical domains by three author types (physicians, nurses, and social workers) in both the in- and outpatient settings. We supplied the resulting vectors to CLUTO, a robust clustering tool suitable for this high-dimensional space. Our results confirm that note types with a broad clinical scope, e.g, History & Physicals and Discharge Summaries, cluster together, while note types with a narrow clinical scope form surprisingly pure, disjoint sublanguages. A reasonable conclusion from this study is that any tool relying on term statistics or semantics trained on one clinical note type may not work well on any other. PMID:22195171

  5. Early Additional Immune-Modulators for Mycoplasma pneumoniae Pneumonia in Children: An Observation Study

    PubMed Central

    Lee, Sung-Churl; Rhim, Jung-Woo; Shin, Myung-Seok; Kang, Jin-Han

    2014-01-01

    Background Mycoplasma pneumoniae (MP) pneumonia is a self-limiting disease, but some patients complain of progressive pneumonia, despite of appropriate antibiotic treatment. We aimed to introduce the role of immune-modulators (corticosteroid and/or intravenous immunoglobulin, IVIG) treatment for childhood MP pneumonia based on previous our experiences. Materials and Methods A retrospective case series analysis for 183 children with MP pneumonia was performed. MP pneumonia patients were diagnosed by two Immunoglobulin M (IgM) tests: the micro-particle agglutination method (≥1:40) and the cold agglutination test (≥1:4), and were examined twice at the initial admission and at discharge. Among 183 MP pneumonia patients, 90 patients with persistent fever for over 48 hours after admission or those with severe respiratory symptoms and signs received additional prednisolone (82 patients, 1 mg/kg/day) or intravenous methylprednisolone (8 patients, 5-10 mg/kg/day) with antibiotics. Four patients with aggravated clinical symptoms and chest radiographic findings after corticosteroid treatment received IVIG (1 g/kg/day, 1-2 doses). Results Mean age of 183 patients was 5.5 ± 3.2 years (6 months-15 years), and the male: female ratio was 1.1:1 (96:87). Fifty-seven patients (31%) were seroconverters and 126 seropositive patients showed increased diagnostic IgM antibody titres during admission (over 4 folds). The majority of the patients who received corticosteroids (86/90 cases) showed rapid defervescence within 48 hours with improved clinical symptoms, regardless of the used antibiotics. Also, 4 patients who received additional IVIG improved both clinically and radiographically within 2 days without adverse reaction. Conclusions In the era of macrolide-resistant MP strains, early additional immune-modulator therapy with antibiotics might prevent from the disease progression and reduce the disease morbidity without adverse reaction. PMID:25566403

  6. Self-Esteem, Oral Health Behaviours, and Clinical Oral Health Status in Chinese Adults: An Exploratory Study

    ERIC Educational Resources Information Center

    Chin, Luzy Siu-Hei; Chan, Joanne Chung-Yan

    2013-01-01

    Objectives: This is an exploratory study to examine the relations among self-esteem, oral health behaviours and clinical oral health status in Chinese adults. In addition, gender differences in clinical oral health status and oral health behaviours were explored. Methods: Participants were 192 patients from a private dental clinic in Hong Kong…

  7. Congenital myopathies: clinical and immunohistochemical study.

    PubMed

    Thaha, Fazil; Gayathri, N; Nalini, A

    2011-01-01

    Congenital myopathies (CMs), a group of relatively non-progressive disorders presents with weakness and hypotonia of varying severity, morphologically recognized by specific structural abnormalities within the myofiber. This report presents the clinical and Histopathological features of 40 patients with CMs. Centronuclear myopathy was the commonest (40%) followed by congenital fiber type disproportion (37.5%). Other less common CMs included: myotubular myopathy (5%), nemaline myopathy (5%), central core disease (5%), multicore disease (2.5%) and congenital myopathy with tubular aggregate (5%). Immunolabeling to desmin corresponded to morphological changes within the myofibers while vimentin was negative in all the patients. There is no combined role of these proteins in the disease process. PMID:22234203

  8. Allan-Herndon syndrome. I. Clinical studies.

    PubMed Central

    Stevenson, R E; Goodman, H O; Schwartz, C E; Simensen, R J; McLean, W T; Herndon, C N

    1990-01-01

    A large family with X-linked mental retardation, originally reported in 1944 by Allan, Herndon, and Dudley, has been reinvestigated. Twenty-nine males have been affected in seven generations. Clinical features include severe mental retardation, dysarthria, ataxia, athetoid movements, muscle hypoplasia, and spastic paraplegia with hyperreflexia, clonus, and Babinski reflexes. The facies appear elongated with normal head circumference, bitemporal narrowing, and large, simple ears. Contractures develop at both small and large joint. Statural growth is normal and macroorchidism does not occur. Longevity is not impaired. High-resolution chromosomes, serum creatine kinase, and amino acids are normal. This condition, termed the Allan-Herndon syndrome, appears distinct from other X-linked disorders having mental retardation, muscle hypoplasia, and spastic paraplegia. Images Figure 2 Figure 3 PMID:2393019

  9. Oral mucocele: A clinical and histopathological study

    PubMed Central

    More, Chandramani B; Bhavsar, Khushbu; Varma, Saurabh; Tailor, Mansi

    2014-01-01

    Background: Oral mucocele is the most common benign minor (accessory) salivary gland lesion, caused due to mechanical trauma to the excretory duct of the gland. Clinically they are characterized by single or multiple, soft, fluctuant nodule, ranging from the normal color of the oral mucosa to deep blue. It affects at any age and is equally present in both sexes with highest incidence in second decade of life. They are classified as extravasation or retention type. Objectives: To analyze the data between 2010 and 2011 of, clinically and histopathologically diagnosed 58 oral mucoceles for age, gender, type, site, color, cause, symptoms and dimension. Results: Oral mucoceles were highly prevalent in the age group of 15-24 years, were seen in 51.72% of males and 48.28% of females, with a ratio of 1.07:1. The extravasation type (84.48%) was more common than the retention type (15.52%). The most common affected site was lower lip (36.20%) followed by ventral surface of the tongue (25.86%). The lowest frequency was observed in floor of mouth, upper lip and palate. The maximum numbers of mucoceles were asymptomatic (58.62%), and the color of the overlying mucosa had color of adjacent normal mucosa (48.28%). It was also observed that most of the mucoceles had diameter ranging from 5 to 14 mm. The causative factors of the lesion were lip biting (22.41%), trauma (5.18%) and numerous lesions (72.41%). Conclusion: Oral Mucoceles are frequently seen in an oral medicine service, mainly affecting young people and lower lip, measuring around 5 to 14 mm and the extravasation type being the most common. PMID:25364184

  10. Identifying the Basis for Clinical Decisions - A Feasibility Study.

    PubMed

    Hurlen, Petter; Ofstad, Eirik; Gulbrandsen, Pål

    2016-01-01

    This study explored the possibility of defining a set of terms to describe and identify the basis for clinical decisions in a set of transcriptions from clinical encounters with previously identified decisions. The paper presents the considerations behind the exploratory study and considerations for further work. PMID:27577435

  11. An Alternative Study of Transfer of Learning in Clinical Evaluation.

    ERIC Educational Resources Information Center

    Patel, Vimla; Cranton, Patricia A.

    The use of an alternative methodology to study transfer of learning in clinical instruction during medical school was investigated. The environment in which clinical instruction takes place was examined, after which hypotheses were proposed and tested in a quasi-experimental design. The first phase of the study, an ethnographic analysis of the…

  12. Multimodality molecular imaging--from target description to clinical studies.

    PubMed

    Schober, O; Rahbar, K; Riemann, B

    2009-02-01

    This highlight lecture was presented at the closing session of the Annual Congress of the European Association of Nuclear Medicine (EANM) in Munich on 15 October 2008. The Congress was a great success: there were more than 4,000 participants, and 1,597 abstracts were submitted. Of these, 1,387 were accepted for oral or poster presentation, with a rejection rate of 14%. In this article a choice was made from 100 of the 500 lectures which received the highest scores by the scientific review panel. This article outlines the major findings and trends at the EANM 2008, and is only a brief summary of the large number of outstanding abstracts presented. Among the great number of oral and poster presentations covering nearly all fields of nuclear medicine some headlines have to be defined highlighting the development of nuclear medicine in the 21st century. This review focuses on the increasing impact of molecular and multimodality imaging in the field of nuclear medicine. In addition, the question may be asked as to whether the whole spectrum of nuclear medicine is nothing other than molecular imaging and therapy. Furthermore, molecular imaging will and has to go ahead to multimodality imaging. In view of this background the review was structured according to the single steps of molecular imaging, i.e. from target description to clinical studies. The following topics are addressed: targets, radiochemistry and radiopharmacy, devices and computer science, animals and preclinical evaluations, and patients and clinical evaluations. PMID:19130054

  13. A direct anatomical study of additional renal arteries in a Colombian mestizo population.

    PubMed

    Saldarriaga, B; Pérez, A F; Ballesteros, L E

    2008-05-01

    Traditional anatomy describes each kidney as receiving irrigation from a single renal artery. However, current literature reports great variability in renal blood supply, the number of renal arteries mentioned being the most frequently found variation. Such variation has great implications when surgery is indicated, such as in renal transplants, uroradiological procedures, renovascular hypertension, renal trauma and hydronephrosis. This article pretends to determine the frequency of additional renal arteries and their morphological expression in Colombian population in a cross-sectional study. A total of 196 of renal blocks were analysed from autopsies carried out in the Bucaramanga Institute of Forensic Medicine, Colombia; these renal blocks were processed by the injection- corrosion technique. The average age of the people being studied was 33.8 +/- 15.6 years; 85.4% of them were male and the rest female. An additional renal artery was found in 22.3% of the whole population and two additional ones were found in 2.6% of the same sample. The additional renal artery was most frequently found on the left side. The additional artery arose from the aorta's lateral aspect (52.4%); these additional arteries usually entered the renal parenchyma through the hilum. No difference was established according to gender. Nearly a third of the Colombian population presents one additional renal artery and about 3% of the same population presents two additional renal arteries. Most of them reached the kidney through its hilar region. PMID:18521812

  14. Recommendations for conducting controlled clinical studies of dental restorative materials.

    PubMed

    Hickel, R; Roulet, J-F; Bayne, S; Heintze, S D; Mjör, I A; Peters, M; Rousson, V; Randall, R; Schmalz, G; Tyas, M; Vanherle, G

    2007-03-01

    designs, guidelines for design, randomization, number of subjects, characteristics of participants, clinical assessment, standards and calibration, categories for assessment, criteria for evaluation, and supplemental documentation. Part 2 of the review considers categories of assessment for esthetic evaluation, functional assessment, biological responses to restorative materials, and statistical analysis of results. The overall review represents a considerable effort to include a range of clinical research interests over the past years. As part of the recognition of the importance of these suggestions, the review is being published simultaneously in identical form in both the "Journal of Adhesive Dentistry" and the "Clinical Oral Investigations." Additionally an extended abstract will be published in the "International Dental Journal" giving a link to the web full version. This should help to introduce these considerations more quickly to the scientific community. PMID:17262225

  15. The administration of music therapy training clinics: a descriptive study.

    PubMed

    Abbott, Elaine A

    2006-01-01

    A two-part study was conducted to describe issues and administrative practices related to university and college affiliated music therapy training clinics. First, all 72 AMTA academic directors were surveyed in order to discover (a) which programs had a clinic, and (b) the reasons why other directors did not operate a clinic. Second, 12 survey respondents, who reported that they were involved with a training clinic, participated in in-depth interviews discussing: (a) their motivations for establishing a clinic, (b) the possible effects of a clinic on the community, (c) the individuals and groups involved in clinic operations, d) clinic space and equipment, (e) policy and procedure topics, (f) specific administrative practices related to clients and students, (g) finances, (h) research (i) quality assurance, (j) dual roles, and (k) liability issues. The administrative practices described by the interviewees varied greatly across clinics and provided a wealth of information that could be considered both useful and thought provoking for those interested in operating a music therapy clinic. PMID:16671838

  16. Additional short-term plutonium urinary excretion data from the 1945-1947 plutonium injection studies

    SciTech Connect

    Moss, W.D.; Gautier, M.A.

    1986-01-01

    The amount of plutonium excreted per day following intravenous injection was shown to be significantly higher than predicted by the Langham power function model. Each of the Los Alamos National Laboratory notebooks used to record the original analytical data was studied for details that could influence the findings. It was discovered there were additional urine excretion data for case HP-3. This report presents the additional data, as well as data on case HP-6. (ACR)

  17. Congenital Rubella: Clinical and Related Studies

    ERIC Educational Resources Information Center

    Menser, Margaret A.

    1977-01-01

    Briefly described are four studies currently being undertaken in Australia to determine the effectiveness of vaccination in the prevention of rubella and to examine the relationship between rubella and diabetes. (CL)

  18. Clinical experimental stress studies: methods and assessment.

    PubMed

    Bali, Anjana; Jaggi, Amteshwar Singh

    2015-01-01

    Stress is a state of threatened homeostasis during which a variety of adaptive processes are activated to produce physiological and behavioral changes. Stress induction methods are pivotal for understanding these physiological or pathophysiological changes in the body in response to stress. Furthermore, these methods are also important for the development of novel pharmacological agents for stress management. The well-described methods to induce stress in humans include the cold pressor test, Trier Social Stress Test, Montreal Imaging Stress Task, Maastricht Acute Stress Test, CO2 challenge test, Stroop test, Paced Auditory Serial Addition Task, noise stress, and Mannheim Multicomponent Stress Test. Stress assessment in humans is done by measuring biochemical markers such as cortisol, cortisol awakening response, dexamethasone suppression test, salivary α-amylase, plasma/urinary norepinephrine, norepinephrine spillover rate, and interleukins. Physiological and behavioral changes such as galvanic skin response, heart rate variability, pupil size, and muscle and/or skin sympathetic nerve activity (microneurography) and cardiovascular parameters such as heart rate, blood pressure, and self-reported anxiety are also monitored to assess stress response. This present review describes these commonly employed methods to induce stress in humans along with stress assessment methods. PMID:26020552

  19. Case Study: Learner Physiotherapists' Perceptions of Clinical Education.

    ERIC Educational Resources Information Center

    Harris, Duncan; Naylor, Sandra

    1992-01-01

    Describes a study conducted in the United Kingdom to discover what processes learner physiotherapists experience in clinical education and whether their experience is comparable to that of other students in medical professions. The need for feedback is addressed, and the role of the clinical educator is discussed. A form for student assessment is…

  20. Clinical data quality problems and countermeasure for real world study.

    PubMed

    Zhang, Runshun; Wang, Yinghui; Liu, Baoyan; Song, Guangli; Zhou, Xuezhong; Fan, Shizhen; Pan, Xishui

    2014-09-01

    Real world study (RWS) has become a hotspot for clinical research. Data quality plays a vital role in research achievement and other clinical research fields. In this paper, the common quality problems in the RWS of traditional Chinese medicine are discussed, and a countermeasure is proposed. PMID:25129380

  1. 7 CFR 1710.253 - Engineering and cost studies-addition of generation capacity.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 11 2014-01-01 2014-01-01 false Engineering and cost studies-addition of generation capacity. 1710.253 Section 1710.253 Agriculture Regulations of the Department of Agriculture (Continued... TO ELECTRIC LOANS AND GUARANTEES Construction Work Plans and Related Studies § 1710.253...

  2. Evaluating Drugs and Food Additives for Public Use: A Case Studies Approach.

    ERIC Educational Resources Information Center

    Merritt, Sheridan V.

    1980-01-01

    Described is a case study used in an introductory college biology course that provides a basis for generating debate on an issue concerning the regulation of controversial food additives and prescription drugs. The case study contained within this article deals with drug screening, specifically with information related to thalidomide. (CS)

  3. [Process of perversion. Methodological and clinical study].

    PubMed

    Marchais, P

    1975-07-01

    Studies in classical psychiatry and psychoanalysis have reduced perversions to pathological phenomena, by lessening the moral criterion progressively. The applying of a comprehensive method of study of acquired perversions incites to consider various levels of observation. Henceforth properties common to each of these levels appears permitting thus to isolate a general process of perversion. This process, which keeps undeniable links with mental pathology, must however be differentiated, for it is not necessarily to be assimilated or reduced to the latter. Besides, it entails notable consequences on the social and cultural level. PMID:1233902

  4. Clinicians’ experiences of becoming a clinical manager: a qualitative study

    PubMed Central

    2012-01-01

    Background There has been an increased interest in recruiting health professionals with a clinical background to management positions in health care. We know little about the factors that influence individuals’ decisions to engage in management. The aim of this study is to explore clinicians’ journeys towards management positions in hospitals, in order to identify potential drivers and barriers to management recruitment and development. Methods We did a qualitative study which included in-depth interviews with 30 clinicians in middle and first-line management positions in Norwegian hospitals. In addition, participant observation was conducted with 20 of the participants. The informants were recruited from medical and surgical departments, and most had professional backgrounds as medical doctors or nurses. Interviews were analyzed by systemic text condensation. Results We found that there were three phases in clinicians’ journey into management; the development of leadership awareness, taking on the manager role and the experience of entering management. Participants’ experiences suggest that there are different journeys into management, in which both external and internal pressure emerged as a recurrent theme. They had not anticipated a career in clinical management, and experienced that they had been persuaded to take the position. Being thrown into the position, without being sufficiently prepared for the task, was a common experience among participants. Being left to themselves, they had to learn management “on the fly”. Some were frustrated in their role due to increasing administrative workloads, without being able to delegate work effectively. Conclusions Path dependency and social pressure seems to influence clinicians’ decisions to enter into management positions. Hospital organizations should formalize pathways into management, in order to identify, attract, and retain the most qualified talents. Top managers should make sure that necessary

  5. A study of clinical and information management processes in the surgical pre-assessment clinic

    PubMed Central

    2014-01-01

    Background Establishing day-case surgery as the preferred hospital admission route for all eligible patients requires adequate preoperative assessment of patients in order to quickly distinguish those who will require minimum assessment and are suitable for day-case admission from those who will require more extensive management and will need to be admitted as inpatients. Methods As part of a study to elucidate clinical and information management processes within the patient surgical pathway in NHS Scotland, we conducted a total of 10 in-depth semi-structured interviews during 4 visits to the Dumfries & Galloway Royal Infirmary surgical pre-assessment clinic. We modelled clinical processes using process-mapping techniques and analysed interview data using qualitative methods. We used Normalisation Process Theory as a conceptual framework to interpret the factors which were identified as facilitating or hindering information elucidation tasks and communication within the multi-disciplinary team. Results The pre-assessment clinic of Dumfries & Galloway Royal Infirmary was opened in 2008 in response to clinical and workflow issues which had been identified with former patient management practices in the surgical pathway. The preoperative clinic now operates under well established processes and protocols. The use of a computerised system for managing preoperative documentation substantially transformed clinical practices and facilitates communication and information-sharing among the multi-disciplinary team. Conclusion Successful deployment and normalisation of innovative clinical and information management processes was possible because both local and national strategic priorities were synergistic and the system was developed collaboratively by the POA staff and the health-board IT team, resulting in a highly contextualised operationalisation of clinical and information management processes. Further concerted efforts from a range of stakeholders are required to fully

  6. Fitting additive hazards models for case-cohort studies: a multiple imputation approach.

    PubMed

    Jung, Jinhyouk; Harel, Ofer; Kang, Sangwook

    2016-07-30

    In this paper, we consider fitting semiparametric additive hazards models for case-cohort studies using a multiple imputation approach. In a case-cohort study, main exposure variables are measured only on some selected subjects, but other covariates are often available for the whole cohort. We consider this as a special case of a missing covariate by design. We propose to employ a popular incomplete data method, multiple imputation, for estimation of the regression parameters in additive hazards models. For imputation models, an imputation modeling procedure based on a rejection sampling is developed. A simple imputation modeling that can naturally be applied to a general missing-at-random situation is also considered and compared with the rejection sampling method via extensive simulation studies. In addition, a misspecification aspect in imputation modeling is investigated. The proposed procedures are illustrated using a cancer data example. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26194861

  7. A clinical pathologic study of mercurialentis medicamentosus.

    PubMed Central

    Garron, L K; Wood, I S; Spencer, W H; Hayes, T L

    1976-01-01

    Thirty-one patients who used eye drops containing the preservative, phenylmercuric nitrate for from 3 to 15 years, developed a brownish pigmentation of the anterior capsule of the pupillary area. Light and electron microscopic studies on two lenses demonstrated deposits of dense particulate material resembling melanin pigment on and in the anterior capsule of the lens in the area of the pupil. Special studies, including electron microprobe analysis and neutron activation analysis established the presence of mercury in a lens with mercurialentis. No mercury was found in two lenses used as controls. Images FIGURE 1 FIGURE 2 A FIGURE 2 B FIGURE 3 FIGURE 4 A FIGURE 4 B FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 8 FIGURE 9 A FIGURE 9 B FIGURE 9 C PMID:867632

  8. [TG-FTIR study on pyrolysis of wheat-straw with abundant CaO additives].

    PubMed

    Han, Long; Wang, Qin-Hui; Yang, Yu-Kun; Yu, Chun-Jiang; Fang, Meng-Xiang; Luo, Zhong-Yang

    2011-04-01

    Biomass pyrolysis in presence of abundant CaO additives is a fundamental process prior to CaO sorption enhanced gasification in biomass-based zero emission system. In the present study, thermogravimetric Fourier transform infrared (TG-FTIR) analysis was adopted to examine the effects of CaO additives on the mass loss process and volatiles evolution of wheat-straw pyrolysis. Observations from TG and FTIR analyses simultaneously demonstrated a two-stage process for CaO catalyzed wheat-straw pyrolysis, different from the single stage process for pure wheat-straw pyrolysis. CaO additives could not only absorb the released CO2 but also reduce the yields of tar species such as toluene, phenol, and formic acid in the first stage, resulting in decreased mass loss and maximum mass loss rate in this stage with an increase in CaO addition. The second stage was attributed to the CaCO3 decomposition and the mass loss and maximum mass loss rate increased with increasing amount of CaO additives. The results of the present study demonstrated the great potential of CaO additives to capture CO2 and reduce tars yields in biomass-based zero emission system. The gasification temperature in the system should be lowered down to avoid CaCO3 decomposition. PMID:21714234

  9. Impact of enzalutamide on quality of life in men with metastatic castration-resistant prostate cancer after chemotherapy: additional analyses from the AFFIRM randomized clinical trial

    PubMed Central

    Cella, D.; Ivanescu, C.; Holmstrom, S.; Bui, C. N.; Spalding, J.; Fizazi, K.

    2015-01-01

    Background To present longitudinal changes in Functional Assessment of Cancer Therapy-Prostate (FACT-P) scores during 25-week treatment with enzalutamide or placebo in men with progressive metastatic castration-resistant prostate cancer (mCRPC) after chemotherapy in the AFFIRM trial. Patients and methods Patients were randomly assigned to enzalutamide 160 mg/day or placebo. FACT-P was completed before randomization, at weeks 13, 17, 21, and 25, and every 12 weeks thereafter while on study treatment. Longitudinal changes in FACT-P scores from baseline to 25 weeks were analyzed using a mixed effects model for repeated measures (MMRM), with a pattern mixture model (PMM) applied as secondary analysis to address non-ignorable missing data. Cumulative distribution function (CDF) plots were generated and different methodological approaches and models for handling missing data were applied. Due to the exploratory nature of the analyses, adjustments for multiple comparisons were not made. AFFIRM is registered with ClinicalTrials.gov, number NCT00974311. Results The intention-to-treat FACT-P population included 938 patients (enzalutamide, n = 674; placebo n = 264) with evaluable FACT-P assessments at baseline and ≥1 post-baseline assessment. After 25 weeks, the mean FACT-P total score decreased by 1.52 points with enzalutamide compared with 13.73 points with placebo (P < 0.001). In addition, significant treatment differences at week 25 favoring enzalutamide were evident for all FACT-P subscales and indices, whether analyzed by MMRM or PMM. CDF plots revealed differences favoring enzalutamide compared with placebo across the full range of possible response levels for FACT-P total and all disease- and symptom-specific subscales/indices. Conclusion In men with progressive mCRPC after docetaxel-based chemotherapy, enzalutamide is superior to placebo in health-related quality-of-life outcomes, regardless of analysis model or threshold selected for meaningful response. Clinical

  10. SHEEP MOUNTAIN WILDERNESS STUDY AREA AND CUCAMONGA WILDERNESS AND ADDITIONS, CALIFORNIA.

    USGS Publications Warehouse

    Evans, James G.; Ridenour, James

    1984-01-01

    The Sheep Mountain Wilderness Study Area and Cucamonga Wilderness and additions encompass approximately 104 sq mi of the eastern San Gabriel Mountains, Los Angeles and San Bernardino Counties, California. A mineral survey indicates areas of probable and substantiated tungsten and gold resource potential for parts of the Sheep Mountain Wilderness Study Area and an area of probable tungsten and gold resource potential in the Cucamonga Wilderness and additions. The rugged topography, withdrawal of lands from mineral entry to protect watershed, and restricted entry of lands during periods of high fire danger have contributed to the continuing decline in mineral exploration. The geologic setting precludes the presence of energy resources.

  11. Influence of Polarization on Carbohydrate Hydration: A Comparative Study Using Additive and Polarizable Force Fields.

    PubMed

    Pandey, Poonam; Mallajosyula, Sairam S

    2016-07-14

    Carbohydrates are known to closely modulate their surrounding solvent structures and influence solvation dynamics. Spectroscopic investigations studying far-IR regions (below 1000 cm(-1)) have observed spectral shifts in the libration band (around 600 cm(-1)) of water in the presence of monosaccharides and polysaccharides. In this paper, we use molecular dynamics simulations to gain atomistic insight into carbohydrate-water interactions and to specifically highlight the differences between additive (nonpolarizable) and polarizable simulations. A total of six monosaccharide systems, α and β anomers of glucose, galactose, and mannose, were studied using additive and polarizable Chemistry at HARvard Macromolecular Mechanics (CHARMM) carbohydrate force fields. Solvents were modeled using three additive water models TIP3P, TIP4P, and TIP5P in additive simulations and polarizable water model SWM4 in polarizable simulations. The presence of carbohydrate has a significant effect on the microscopic water structure, with the effects being pronounced for proximal water molecules. Notably, disruption of the tetrahedral arrangement of proximal water molecules was observed due to the formation of strong carbohydrate-water hydrogen bonds in both additive and polarizable simulations. However, the inclusion of polarization resulted in significant water-bridge occupancies, improved ordered water structures (tetrahedral order parameter), and longer carbohydrate-water H-bond correlations as compared to those for additive simulations. Additionally, polarizable simulations also allowed the calculation of power spectra from the dipole-dipole autocorrelation function, which corresponds to the IR spectra. From the power spectra, we could identify spectral signatures differentiating the proximal and bulk water structures, which could not be captured from additive simulations. PMID:27266974

  12. Review of clinical studies on clobazam

    PubMed Central

    Koeppen, D.

    1979-01-01

    1 Clobazam was compared with placebo and diazepam in 45 double-blind studies. 2 Clobazam dosage ranged from 5 mg daily (paediatric patients) to 120 mg daily (psychiatric inpatients). Usual daily dosage in out-patient therapy ranged from 20-30 mg clobazam. 3 Treatment duraton varied from a few days up to 3.5 years. The usual duration of treatment was 2-4 weeks. 4 Clobazam was shown to be an efficacious and well tolerated anxiolytic agent in various neurotic and psychosomatic disorders. 5 Dosages showing distinct anxiolytic effects in out-patient therapy did not impair psychomotor performance. PMID:35197

  13. Hypoxemia in pulmonary embolism, a clinical study

    PubMed Central

    Wilson, James E.; Pierce, Alan K.; Johnson, Robert L.; Winga, Edward R.; Harrell, W. Ross; Curry, George C.; Mullins, Charles B.

    1971-01-01

    The cause of hypoxemia was studied in 21 patients with no previous heart or lung disease shortly after an episode of acute pulmonary embolism. The diagnosis was based on pulmonary angiography demonstrating distinct vascular filling defects or “cutoffs.” It was found that virtually all of the hypoxemia in patients with previously normal heart and lungs could be accounted for on the basis of shunt-like effect. The magnitude of the shunting did not correlate with the percent of the pulmonary vascular bed occluded nor with the mean pulmonary artery pressure. The shunts tended to gradually recede over about a month after embolism. Patients without pulmonary infarction were able to inspire 80-111% of their predicted inspiratory capacities, and this maneuver temporarily diminished the observed shunt. Patients with pulmonary infarcts were able to inhale only to 60-69% of predicted inspiratory capacity, and this did not reverse shunting. These data suggest that the cause of right-to-left shunting in patients with pulmonary emboli is predominantly atelectasis. When the elevation of mean pulmonary artery pressure was compared to cardiac index per unit of unoccluded lung, it fell within the range of pulmonary hypertension predicted from published data obtained in patients with exercise in all except one case. This observation suggests that pulmonary vasoconstriction following embolism is not important in humans, although these data are applicable only during the time interval in which our patients were studied and in patients receiving heparin. PMID:5101776

  14. Clinical cosmobiology: The Lithuanian study 1990 1992

    NASA Astrophysics Data System (ADS)

    Stoupel, Eliyahu; Petrauskiene, Jadviga; Kalediene, Ramune; Abramson, Evgeny; Sulkes, Jacqueline

    1995-12-01

    The numbers of deaths from ischaemic heart disease (IHD), stroke (CVA), all accidents except vehicular, vehicular accidents and suicide (overall total, totals for men and women) per month for 36 months (1990 1992) in Lithuania were analysed in relation to: (1) month of the year (1 12); (2) geomagnetic activity; and (3) solar activity. A total of 122227 deaths (64490 men and 57737 women) was studied, and the results compared with those obtained in an earlier study in Israel, differing geographically and climatically from Lithuania. It was shown that the time of year, solar activity, and geomagnetic activity were related to the monthly death distribution, especially regarding death from IHD and suicide. Age and gender differences were apparent in the relationship between death distribution and physical environmental factors. At age >70 years, many of these relationships change. The monthly distribution of deaths from IHD and suicide are adversely correlated with solar activity and with each other. Differences are presumed in serotoninergic effects as caused by environmental influences.

  15. Facilitating case studies in massage therapy clinical education.

    PubMed

    Baskwill, Amanda

    2013-01-01

    The integration of evidence into reflective health care practice has been on the rise in recent years and is a phenomenon that has affected all health care professions, including massage therapy. Clinical case studies are a research design that follows one patient or subject, making the studies ideal for use in clinical practice. They are valuable for communicating information from clinical practice to the broader community. Case studies have face validity that may be more valuable to individual practitioners than homogeneous randomized controlled trials, as the practitioner may recognize a complex patient in the case report. At Humber College, Student Massage Therapists (SMTs) create, conduct, and communicate results of a clinical case study prior to graduation. This article describes the process and experience. PMID:23730397

  16. Dementia in Ageing Mental Defectives: A Clinical and Neuropathological Study.

    ERIC Educational Resources Information Center

    Reid, A. H.; And Others

    1978-01-01

    The study was aimed at establishing the prevalence and clinical features of the psychoses of senescence (senile, presenile, and cerebral arteriosclerotic dementias) in 155 mentally retarded patients over the age of 45. (SBH)

  17. How to evaluate study methodology in published clinical research.

    PubMed

    Stoddard, G J; Ring, W H

    1993-01-01

    When reading a clinical research article, the clinician must judge if the reported findings and conclusions are valid before applying them to patient care. This concern is legitimate given the wide range of study validity in the clinical literature. In this article, the authors present many validity markers that signify the quality of the information reported from a study, such as authorship, bias, confounding, statistics, randomization, controls, blinding, and the logical framework of scientific investigations. PMID:8478779

  18. Oral hybrid verrucous carcinoma: a clinical study.

    PubMed

    Gokavarapu, Sandhya; Rao S, L M Chandrasekhara; Tantravahi, Uma Sankar; Gundimeda, Sandhya Devi; Rao, T Subramaneshwar; Murthy, Sudha

    2014-12-01

    Hybrid Verrucous Carcinoma is an uncommon tumour wherein Verrucous Carcinoma (VC) is coexisting with conventional Squamous Cell Carcinoma (SCC) within same maternal field. The heterogeneous nature, infrequency of occurrence and the difficulties associated with diagnosis and management of this tumor is discussed through a retrospective study. Patients of primary hybrid VC treated from Jan 2010 to May 2013 at a tertiary institute were analyzed on multivariate cox regression model. During the above mentioned period; 37 patients of hybrid VC were reported; 18(48.6 %) were male and 19(51.3 %) were female. Age ranged between 33 years to 78 years. Median follow up period was 32 months. T stage status and Stage grouping was not statistically significant for mortality (p value: 0.338). In the multivariate cox-regression model, the presence of second primary oral cancer was significantly associated with mortality, adjusted HR; 23.10 (95 % CI: 1.73, 307.65) (p = 0.017). Tumour staging is often unreliable in predicting prognosis of hybrid VC, occurrence of second primary oral cancer and recurrence appears to be significant factors effecting prognosis. PMID:25767335

  19. [Clinical study of occupational uroepithelial cancer].

    PubMed

    Hamasaki, T; Aramaki, K; Hida, T; Inatomi, H; Fujimoto, N; Okamura, T; Ozu, K; Sugita, A

    1996-12-01

    We studied 438 persons who were engaged in the production and use of aromatic amines (benzidine sulfate, beta-naphthylamine, alpha-naphthylamine and dianisidine). Among these 438 persons, 88 new cases of occupational uroepithelial cancer had occurred from 1949 to 1995. The incident rate of occupational uroepithelial cancer was 20.1%. The average exposure period of these 88 cases to the aromatic amines was 7.40 years (range, 0.75-26.75), and the incidence rate of tumors increased with the length of exposure to aromatic amines. The average latent period was 26.79 years (range, 1.33-48.50), and the average age of first onset was 52.59 (range, 24-79). Recently it has been determined that the longer the latent period, the older the age of first onset. Of these 88 cases, the tumor sites were bladder in 67 cases (76.1%) and upper urinary tract (renal pelvis and/or ureter) in 5 cases (5.7%). The other 16 cases (18.2%) were the bladder and upper urinary tract. The screening examination for chemical workers using urinary cytology was begun in 1962. In our cases, urine cytology was a useful method for diagnosing occupational uroepithelial cancer. As for initial treatment of the 88 cases, transurethral surgery was most frequently performed, that is on 58 cases (65.9%). However, eight cases (9.1%) had to undergo a total nephroureterectomy, and six cases (6.8%) had a total cystectomy. Recurrence was observed in 61 cases (69.3%) out of the 88 patients with an average of 1.81 times. The other organic cancers developed in 39 cases (8.9%) out of 438 workers who were exposed to aromatic amines and in 8 cases out of 88 patients (9.1%). Prognosis of the 88 patients is that, the number of alive and dead is 51 (58.0%) and 37 (42.0%) respectively on December 31, 1995. Twenty-eight patients (31.8%) died of uroepithelial cancer, and five patients (5.7%) died of other organic cancers. The survival rates of 5, 10, 15 and 20 years was 87.9%, 74.0%, 65.9% and 56.3%, respectively. From these

  20. Generating Scenarios of Addition and Subtraction: A Study of Japanese University Students

    ERIC Educational Resources Information Center

    Kinda, Shigehiro

    2013-01-01

    Students are presented with problems involving three scenario types of addition and subtraction in elementary mathematics: one dynamic ("Change") and two static ("Combine, Compare"). Previous studies have indicated that the dynamic type is easier for school children, whereas the static types are more difficult and comprehended only gradually…

  1. 7 CFR 1710.253 - Engineering and cost studies-addition of generation capacity.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 11 2011-01-01 2011-01-01 false Engineering and cost studies-addition of generation capacity. 1710.253 Section 1710.253 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GENERAL AND PRE-LOAN POLICIES AND PROCEDURES COMMON TO ELECTRIC LOANS AND...

  2. 7 CFR 1710.253 - Engineering and cost studies-addition of generation capacity.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 11 2012-01-01 2012-01-01 false Engineering and cost studies-addition of generation capacity. 1710.253 Section 1710.253 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GENERAL AND PRE-LOAN POLICIES AND PROCEDURES COMMON TO ELECTRIC LOANS AND...

  3. Experimental study of combustion of decane, dodecane and hexadecane with polymeric and nano-particle additives

    NASA Astrophysics Data System (ADS)

    Ghamari, Mohsen; Ratner, Albert

    2015-11-01

    Recent studies have shown that adding combustible nano-particles could have promising effects on increasing burning rate of liquid fuels. Combustible nano-particles could enhance the heat conduction and mixing within the droplet. Polymers have also higher burning rate than regular hydrocarbon fuels because of having the flame closer to the droplet surface. Therefore adding polymeric additive could have the potential to increase the burning rate. In this study, combustion of stationary fuel droplets of n-Decane, n-Dodecane and n-Hexadecane doped with different percentages of a long chain polymer and also a very fine nano carbon was examined and compared with the pure hydrocarbon behavior. In contrast with hydrocarbon droplets with no polymer addition, several zones of combustion including a slow and steady burning zone, a strong swelling zone and a final fast and fairly steady combustion zone were also detected. In addition, increasing polymer percentage resulted in a more extended swelling zone and shorter slow burning zone in addition to a shorter total burning time. Addition of nano-particles also resulted in an overall increased burning rate and shortened burning time which is due to enhanced heat conduction within the droplet.

  4. Enhancing Patient Safety Using Clinical Nursing Data: A Pilot Study.

    PubMed

    Choi, Jeeyae; Choi, Jeungok E

    2016-01-01

    To enhance patient safety from falls, many hospital information systems have been implemented to collect clinical data from the bedside and have used the information to improve fall prevention care. However, most of them use administrative data not clinical nursing data. This necessitated the development of a web-based Nursing Practice and Research Information Management System (NPRIMS) that processes clinical nursing data to measure nurses' delivery of fall prevention care and its impact on patient outcomes. This pilot study developed computer algorithms based on a falls prevention protocol and programmed the prototype NPRIMS. It successfully measured the performance of nursing care delivered and its impact on patient outcomes using clinical nursing data from the study site. Results of the study revealed that NPRIMS has the potential to pinpoint components of nursing processes that are in need of improvement for preventing patient from falls. PMID:27332171

  5. Pedagogical strategies used in clinical medical education: an observational study

    PubMed Central

    2010-01-01

    Background Clinical teaching is a complex learning situation influenced by the learning content, the setting and the participants' actions and interactions. Few empirical studies have been conducted in order to explore how clinical supervision is carried out in authentic situations. In this study we explore how clinical teaching is carried out in a clinical environment with medical students. Methods Following an ethnographic approach looking for meaning patterns, similarities and differences in how clinical teachers manage clinical teaching; non-participant observations and informal interviews were conducted during a four month period 2004-2005. The setting was at a teaching hospital in Sweden. The participants were clinical teachers and their 4th year medical students taking a course in surgery. The observations were guided by the aim of the study. Observational notes and notes from informal interviews were transcribed after each observation and all data material was analysed qualitatively. Results Seven pedagogical strategies were found to be applied, namely: 1) Questions and answers, 2) Lecturing, 3) Piloting, 4) Prompting, 5) Supplementing, 6) Demonstrating, and 7) Intervening. Conclusions This study contributes to previous research in describing a repertoire of pedagogical strategies used in clinical education. The findings showed that three superordinate qualitatively different ways of teaching could be identified that fit Ramsden's model. Each of these pedagogical strategies encompass different focus in teaching; either a focus on the teacher's knowledge and behaviour or the student's behaviour and understanding. We suggest that an increased awareness of the strategies in use will increase clinical teachers' teaching skills and the consequences they will have on the students' ability to learn. The pedagogical strategies need to be considered and scrutinized in further research in order to verify their impact on students' learning. PMID:20105340

  6. Practicing nurses perspectives of clinical scholarship: a qualitative study

    PubMed Central

    2013-01-01

    Background There is a scarcity of research published on clinical scholarship. Much of the conceptualisation has been conducted in the academy. Nurse academics espouse that the practice of nursing must be built within a framework of clinical scholarship. A key concept of clinical scholarship emerging from discussions in the literature is that it is an essential component of enabling evidence–based nursing and the development of best practice standards to provide for the needs of patients/clients. However, there is no comprehensive definition of clinical scholarship from the practicing nurses. The aim of this study was to contribute to this definitional discussion on the nature of clinical scholarship in nursing. Methods Naturalistic inquiry informed the method. Using an interpretative approach 18 practicing nurses from Australia, Canada and England were interviewed using a semi-structured format. The audio-taped interviews were transcribed and the text coded for emerging themes. The themes were sorted into categories and the components of clinical scholarship described by the participants compared to the scholarship framework of Boyer [JHEOE 7:5-18, 2010]. Results Clinical scholarship is difficult to conceptualise. Two of the essential elements of clinical scholarship are vision and passion. The other components of clinical scholarship were building and disseminating nursing knowledge, sharing knowledge, linking academic research to practice and doing practice-based research. Conclusion Academic scholarship dominated the discourse in nursing. However, in order for nursing to develop and to impact on health care, clinical scholarship needs to be explored and theorised. Nurse educators, hospital-based researchers and health organisations need to work together with academics to achieve this goal. Frameworks of scholarship conceptualised by nurse academics are reflected in the findings of this study with their emphasis on reading and doing research and translating it

  7. A Systematic Review of Studies Comparing Diagnostic Clinical Prediction Rules with Clinical Judgment

    PubMed Central

    Sanders, Sharon; Doust, Jenny; Glasziou, Paul

    2015-01-01

    Background Diagnostic clinical prediction rules (CPRs) are developed to improve diagnosis or decrease diagnostic testing. Whether, and in what situations diagnostic CPRs improve upon clinical judgment is unclear. Methods and Findings We searched MEDLINE, Embase and CINAHL, with supplementary citation and reference checking for studies comparing CPRs and clinical judgment against a current objective reference standard. We report 1) the proportion of study participants classified as not having disease who hence may avoid further testing and or treatment and 2) the proportion, among those classified as not having disease, who do (missed diagnoses) by both approaches. 31 studies of 13 medical conditions were included, with 46 comparisons between CPRs and clinical judgment. In 2 comparisons (4%), CPRs reduced the proportion of missed diagnoses, but this was offset by classifying a larger proportion of study participants as having disease (more false positives). In 36 comparisons (78%) the proportion of diagnoses missed by CPRs and clinical judgment was similar, and in 9 of these, the CPRs classified a larger proportion of participants as not having disease (fewer false positives). In 8 comparisons (17%) the proportion of diagnoses missed by the CPRs was greater. This was offset by classifying a smaller proportion of participants as having the disease (fewer false positives) in 2 comparisons. There were no comparisons where the CPR missed a smaller proportion of diagnoses than clinical judgment and classified more participants as not having the disease. The design of the included studies allows evaluation of CPRs when their results are applied independently of clinical judgment. The performance of CPRs, when implemented by clinicians as a support to their judgment may be different. Conclusions In the limited studies to date, CPRs are rarely superior to clinical judgment and there is generally a trade-off between the proportion classified as not having disease and the

  8. Anatomically ordered tapping interferes more with one-digit addition than two-digit addition: a dual-task fMRI study.

    PubMed

    Soylu, Firat; Newman, Sharlene D

    2016-02-01

    Fingers are used as canonical representations for numbers across cultures. In previous imaging studies, it was shown that arithmetic processing activates neural resources that are known to participate in finger movements. Additionally, in one dual-task study, it was shown that anatomically ordered finger tapping disrupts addition and subtraction more than multiplication, possibly due to a long-lasting effect of early finger counting experiences on the neural correlates and organization of addition and subtraction processes. How arithmetic task difficulty and tapping complexity affect the concurrent performance is still unclear. If early finger counting experiences have bearing on the neural correlates of arithmetic in adults, then one would expect anatomically and non-anatomically ordered tapping to have different interference effects, given that finger counting is usually anatomically ordered. To unravel these issues, we studied how (1) arithmetic task difficulty and (2) the complexity of the finger tapping sequence (anatomical vs. non-anatomical ordering) affect concurrent performance and use of key neural circuits using a mixed block/event-related dual-task fMRI design with adult participants. The results suggest that complexity of the tapping sequence modulates interference on addition, and that one-digit addition (fact retrieval), compared to two-digit addition (calculation), is more affected from anatomically ordered tapping. The region-of-interest analysis showed higher left angular gyrus BOLD response for one-digit compared to two-digit addition, and in no-tapping conditions than dual tapping conditions. The results support a specific association between addition fact retrieval and anatomically ordered finger movements in adults, possibly due to finger counting strategies that deploy anatomically ordered finger movements early in the development. PMID:26410214

  9. A synchrotron study of microstructure gradient in laser additively formed epitaxial Ni-based superalloy

    NASA Astrophysics Data System (ADS)

    Xue, Jiawei; Zhang, Anfeng; Li, Yao; Qian, Dan; Wan, Jingchun; Qi, Baolu; Tamura, Nobumichi; Song, Zhongxiao; Chen, Kai

    2015-10-01

    Laser additive forming is considered to be one of the promising techniques to repair single crystal Ni-based superalloy parts to extend their life and reduce the cost. Preservation of the single crystalline nature and prevention of thermal mechanical failure are two of the most essential issues for the application of this technique. Here we employ synchrotron X-ray microdiffraction to evaluate the quality in terms of crystal orientation and defect distribution of a Ni-based superalloy DZ125L directly formed by a laser additive process rooted from a single crystalline substrate of the same material. We show that a disorientation gradient caused by a high density of geometrically necessary dislocations and resultant subgrains exists in the interfacial region between the epitaxial and stray grains. This creates a potential relationship of stray grain formation and defect accumulation. The observation offers new directions on the study of performance control and reliability of the laser additive manufactured superalloys.

  10. Microstructural Study Of Zinc Hot Dip Galvanized Coatings with Titanium Additions In The Zinc Melt

    NASA Astrophysics Data System (ADS)

    Konidaris, S.; Pistofidis, N.; Vourlias, G.; Pavlidou, E.; Stergiou, A.; Stergioudis, G.; Polychroniadis, E. K.

    2007-04-01

    Zinc hot-dip galvanizing is a method for protecting iron and steel against corrosion. Galvanizing with pure Zn or Zn with additions like Ni, Al, Pb and Bi has been extensively studied, but there is a lack of scientific information about other additions. The present work examines the effect of a 0.5 wt% Ti addition in the Zn melt. The samples were exposed to accelerated corrosion in a salt spray chamber (SSC). The microstructure and chemical composition of the coatings were determined by Optical Microscopy, XRD and SEM associated with an EDS Analyzer. The results indicate that the coatings have a typical morphology, while Zn-Ti phases were also detected.

  11. A synchrotron study of microstructure gradient in laser additively formed epitaxial Ni-based superalloy

    PubMed Central

    Xue, Jiawei; Zhang, Anfeng; Li, Yao; Qian, Dan; Wan, Jingchun; Qi, Baolu; Tamura, Nobumichi; Song, Zhongxiao; Chen, Kai

    2015-01-01

    Laser additive forming is considered to be one of the promising techniques to repair single crystal Ni-based superalloy parts to extend their life and reduce the cost. Preservation of the single crystalline nature and prevention of thermal mechanical failure are two of the most essential issues for the application of this technique. Here we employ synchrotron X-ray microdiffraction to evaluate the quality in terms of crystal orientation and defect distribution of a Ni-based superalloy DZ125L directly formed by a laser additive process rooted from a single crystalline substrate of the same material. We show that a disorientation gradient caused by a high density of geometrically necessary dislocations and resultant subgrains exists in the interfacial region between the epitaxial and stray grains. This creates a potential relationship of stray grain formation and defect accumulation. The observation offers new directions on the study of performance control and reliability of the laser additive manufactured superalloys. PMID:26446425

  12. A synchrotron study of microstructure gradient in laser additively formed epitaxial Ni-based superalloy

    SciTech Connect

    Xue, Jiawei; Zhang, Anfeng; Li, Yao; Qian, Dan; Wan, Jingchun; Qi, Baolu; Tamura, Nobumichi; Song, Zhongxiao; Chen, Kai

    2015-10-08

    Laser additive forming is considered to be one of the promising techniques to repair single crystal Ni-based superalloy parts to extend their life and reduce the cost. Preservation of the single crystalline nature and prevention of thermal mechanical failure are two of the most essential issues for the application of this technique. Here we employ synchrotron X-ray microdiffraction to evaluate the quality in terms of crystal orientation and defect distribution of a Ni-based superalloy DZ125L directly formed by a laser additive process rooted from a single crystalline substrate of the same material. We show that a disorientation gradient caused by a high density of geometrically necessary dislocations and resultant subgrains exists in the interfacial region between the epitaxial and stray grains. This creates a potential relationship of stray grain formation and defect accumulation. In conclusion, the observation offers new directions on the study of performance control and reliability of the laser additive manufactured superalloys.

  13. Summary of Previous Chamber or Controlled Anthrax Studies and Recommendations for Possible Additional Studies

    SciTech Connect

    Piepel, Gregory F.; Amidan, Brett G.; Morrow, Jayne B.

    2010-12-29

    This report and an associated Excel file(a) summarizes the investigations and results of previous chamber and controlled studies(b) to characterize the performance of methods for collecting, storing and/or transporting, extracting, and analyzing samples from surfaces contaminated by Bacillus anthracis (BA) or related simulants. This report and the Excel are the joint work of the Pacific Northwest National Laboratory (PNNL) and the National Institute of Standards and Technology (NIST) for the Department of Homeland Security, Science and Technology Directorate. The report was originally released as PNNL-SA-69338, Rev. 0 in November 2009 with limited distribution, but was subsequently cleared for release with unlimited distribution in this Rev. 1. Only minor changes were made to Rev. 0 to yield Rev. 1. A more substantial update (including summarizing data from other studies and more condensed summary tables of data) is underway

  14. Additional diagnostic and clinical value of anti-cyclic citrullinated peptide antibodies compared with rheumatoid factor isotypes in rheumatoid arthritis.

    PubMed

    Vallbracht, Inka; Helmke, Klaus

    2005-07-01

    In the past decade significant advantages have been made in the treatment of rheumatoid arthritis (RA) and therapeutic strategies have changed a lot. These days, highly effective disease modifying anti-rheumatic drugs enable intervention early in the disease process, in order to prevent major joint damage. For years, serological support in the diagnosis of RA has been limited to the presence of rheumatoid factors, although not very specific for RA. During the last years a variety of circulating non-RF antibodies have been discovered and reported to be of potential diagnostic value. CCP2 proved to be a very disease-specific and even sensitive marker for RA. In addition to the diagnostic properties, CCP showed to be a good prognostic marker, CCP helps to predict the erosive or nonerosive progression of the disease, and CCP is already present early in the disease. This diagnostic tool enables the clinician to choose the optimal therapeutic management for each single RA patient. PMID:16081030

  15. Studies of levels of biogenic amines in meat samples in relation to the content of additives.

    PubMed

    Jastrzębska, Aneta; Kowalska, Sylwia; Szłyk, Edward

    2016-01-01

    The impact of meat additives on the concentration of biogenic amines and the quality of meat was studied. Fresh white and red meat samples were fortified with the following food additives: citric and lactic acids, disodium diphosphate, sodium nitrite, sodium metabisulphite, potassium sorbate, sodium chloride, ascorbic acid, α-tocopherol, propyl 3,4,5-trihydroxybenzoate (propyl gallate) and butylated hydroxyanisole. The content of spermine, spermidine, putrescine, cadaverine, histamine, tyramine, tryptamine and 2-phenylethylamine was determined by capillary isotachophoretic methods in meat samples (fresh and fortified) during four days of storage at 4°C. The results were applied to estimate the impact of the tested additives on the formation of biogenic amines in white and red meat. For all tested meats, sodium nitrite, sodium chloride and disodium diphosphate showed the best inhibition. However, cadaverine and putrescine were characterised by the biggest changes in concentration during the storage time of all the additives. Based on the presented data for the content of biogenic amines in meat samples analysed as a function of storage time and additives, we suggest that cadaverine and putrescine have a significant impact on meat quality. PMID:26515667

  16. Nursing Students' Clinical Experience With Death: A Pilot Study.

    PubMed

    Heise, Barbara A; Gilpin, Laura C

    2016-01-01

    Although debriefing in simulation settings is routine in nursing education, debriefing does not routinely take place in clinical settings with nursing students after a patient has died. This pilot study sought to explore nursing students' perceptions of their first experience with the death of a patient. Students reported emotional distress and feelings of inadequacy with regard to communicating with and supporting the family of the dying patient. Only half the students sampled reported debriefing by their clinical instructor or staff. Nurse educators must include debriefing and student support following a patient death in the clinical setting. PMID:27209870

  17. The Auckland skin clinic tinea pedis and erythrasma study.

    PubMed

    Allen, S; Christmas, T I; McKinney, W; Parr, D; Oliver, G F

    1990-08-22

    Three hundred consecutive patients attending the Auckland Hospital dermatology clinic were examined clinically and microbiologically for evidence of interdigital or plantar mycological or bacterial infection. One hundred and nine patients were shown by laboratory investigation to have an infection. Of these, only 89 displayed clinical signs of infection. Erythrasma, a desquamative condition caused by Corynebacterium minutissimum, was the commonest infection in this study. The commonest dermatophyte isolated was Trichophyton mentagrophytes var interdigitale. There was a significant rise in the incidence of both types of infection with age. PMID:2385417

  18. Clinical Trial and Research Study Recruiters' Verbal Communication Behaviors.

    PubMed

    Morgan, Susan E; Mouton, Ashton; Occa, Aurora; Potter, Jonell

    2016-07-01

    The lack of accrual to research studies and clinical trials is a persistent problem with serious consequences: Advances in medical science depend on the participation of large numbers of people, including members of minority and underserved populations. The current study examines a critical determinant of accrual: the approach of patients by professional recruiters who request participation in research studies and clinical trials. Findings indicate that recruiters use a number of verbal strategies in the communication process, including translating study information (such as simplifying, using examples, and substituting specific difficult or problematic words), using linguistic reframing or metaphors, balancing discussions of research participation risks with benefits, and encouraging potential participants to ask questions. The identification of these verbal strategies can form the basis of new communication protocols that will help medical and nonmedical professionals communicate more clearly and effectively with patients and other potential participants about research studies and clinical trials, which should lead to increased accrual in the future. PMID:27259754

  19. a Study on the Role of Sintering Additives for Fabrication of sic Ceramic

    NASA Astrophysics Data System (ADS)

    Yoon, Han Ki; Lee, Young Ju; Cho, Ho Jun; Kim, Tae Gyu

    Silicon carbide (SiC) materials have been extensively studied for high temperature components in advanced energy system and advanced gas turbine. The SiC ceramics have been fabricated by a NITE (Nano Infiltration Transient Eutectic Phase) Process, using Nano-SiC powder. The sintering additives used for forming liquid phase under sintering process, used the sintering additives ratios were an Al2O3-Y2O3 system or add SiO2 contents. A major R&D focus for the SiC ceramics is the production to obtain high purity SiC ceramics. In this study, we investigated roles of the sintering additives(Al2O3:Y2O3) to fabrication of the SiC ceramics. The effects of SiO2 contents and density properties of the SiC ceramics were also investigated. To investigate the effects of SiO2, Al2O3/Y2O3 composition were fixed and then SiO2 ratios were changed as several kinds, and to confirm the effects of sintering additives ratios (Al2O3:Y2O3) they were changed between 4:6 and 6:4 in x wt.%.

  20. Using epidemiology to regulate food additives: saccharin case-control studies.

    PubMed

    Cordle, F; Miller, S A

    1984-01-01

    The increasing use of nonnutritive sweeteners and the widely publicized 1969 ban on cyclamate led to additional investigations in rodents of the carcinogenic potential of saccharin. Preliminary results of a long-term feeding study indicated formation of bladder tumors in rodents, and collective experimental evidence has demonstrated that high doses of the synthetic sweetener saccharin can cause bladder cancer in rodents. Based on the results of that and other rodent studies indicating an increased risk of bladder cancer associated with saccharin, the Commissioner of the Food and Drug Administration announced the agency's intention to propose a ban on saccharin. This intention was made known in April 1977 under the Delaney Clause of the Food, Drug, and Cosmetic Act. The clause essentially states that no additive shall be deemed safe if it is found to induce cancer in man or animals, or if it is found, after tests appropriate for the evaluation of the safety of food additives, to induce cancer in man or animals. Also in 1977, a group of epidemiologists began to assess the available epidemiologic information to determine the potential human risk. This report describes the assessment of several human epidemiologic studies available then and the results of more recent epidemiologic studies. PMID:6431484

  1. Comparative study of clinical pulmonary surfactants using atomic force microscopy

    PubMed Central

    Zhang, Hong; Fan, Qihui; Wang, Yi E.; Neal, Charles R.; Zuo, Yi Y.

    2016-01-01

    Clinical pulmonary surfactant is routinely used to treat premature newborns with respiratory distress syndrome, and has shown great potential in alleviating a number of neonatal and adult respiratory diseases. Despite extensive study of chemical composition, surface activity, and clinical performance of various surfactant preparations, a direct comparison of surfactant films is still lacking. In this study, we use atomic force microscopy to characterize and compare four animal-derived clinical surfactants currently used throughout the world, i.e., Survanta, Curosurf, Infasurf and BLES. These modified-natural surfactants are further compared to dipalmitoyl phosphatidylcholine (DPPC), a synthetic model surfactant of DPPC:palmitoyl-oleoyl phosphatidylglycerol (POPG) (7:3), and endogenous bovine natural surfactant. Atomic force microscopy reveals significant differences in the lateral structure and molecular organization of these surfactant preparations. These differences are discussed in terms of DPPC and cholesterol contents. We conclude that all animal-derived clinical surfactants assume a similar structure of multilayers of fluid phospholipids closely attached to an interfacial monolayer enriched in DPPC, at physiologically relevant surface pressures. This study provides the first comprehensive survey of the lateral structure of clinical surfactants at various surface pressures. It may have clinical implications on future application and development of surfactant preparations. PMID:21439262

  2. [Financial conflict of interest in clinical psychiatry studies: a review].

    PubMed

    Ulaş, Halis; Binbay, Tolga; Alptekin, Köksal

    2008-01-01

    Pharmaceutical industry revenues from global pharmaceutical sales have increased 7% to $602 billion in 2005. Approximately 15% of these revenues were spent on clinical research and drug development studies. Because of the huge budget allocated to research and development studies the number of studies being conducted by pharmaceutical companies has increased. The impact of the pharmaceutical industry on clinical trials has been affected by financial conflicts of interest between researchers and the industry. Conflict of interest refers to a situation in which it appears that a researcher's personal financial interest could significantly affect the design, conduct, and/or reporting of such research. Financial conflict of interest has been reported to be frequent in clinical trials in general medicine. It is estimated that 89%-98% of comparative drug treatment studies are funded by pharmaceutical companies. It was reported that favorable outcomes for the firms conducting these studies were significantly more common in industry-funded studies than in non-industry funded ones. These biased outcomes were due to conscious or unconscious decisions about the design, data analysis, and publishing of the studies. Biased outcomes of industry-funded studies have diminished the integrity of academic institutions, pharmaceutical companies, researchers, and scientific journals; therefore, various precautions have been taken in order to reduce the effect of conflict of interest on study outcomes. The aim of this review was to evaluate the effect of conflict of interest on outcomes in clinical psychiatry studies. PMID:19110984

  3. The Emerging Microbe Project: Developing Clinical Care Plans Based on Pathogen Identification and Clinical Case Studies

    PubMed Central

    O’Donnell, Lauren A.; Perry, Michael W.; Doup, Dane’t R.

    2015-01-01

    For many students in the health sciences, including doctor of pharmacy (PharmD) students, basic and clinical sciences often appear detached from each other. In the infectious disease field, PharmD students additionally struggle with mastering the diversity of microorganisms and the corresponding therapies. The objective of this study was to design an interdisciplinary project that integrates fundamental microbiology with clinical research and decision-making skills. The Emerging Microbe Project guided students through the identification of a microorganism via genetic sequence analysis. The unknown microbe provided the basis for a patient case that asked the student to design a therapeutic treatment strategy for an infected patient. Outside of lecture, students had two weeks to identify the pathogen using nucleotide sequences, compose a microbiology report on the pathogen, and recommend an appropriate therapeutic treatment plan for the corresponding clinical case. We hypothesized that the students would develop a better understanding of the interplay between basic microbiology and infectious disease clinical practice, and that they would gain confidence and skill in independently selecting appropriate antimicrobial therapies for a new disease state. The exercise was conducted with PharmD students in their second professional year of pharmacy school in a required infectious disease course. Here, we demonstrate that the Emerging Microbe Project significantly improved student learning through two assessment strategies (assignment grades and exam questions), and increased student confidence in clinical infectious disease practice. This exercise could be modified for other health sciences students or undergraduates depending upon the level of clinical focus required of the course. PMID:26753029

  4. Study of asphalt/asphaltene precipitation during addition of solvents to West Sak crude

    SciTech Connect

    Jiang, J.C.; Patil, S.L.; Kamath, V.A. )

    1990-07-01

    In this study, experimental data on the amount of asphalt and asphaltene precipitation due to addition of solvents to West Sak crude were gathered. The first set of tests were conducted for two types of West Sak stock tank oils. Solvents used include: ethane, carbon dioxide, propane, n-butane, n-pentane, n-heptane, Prudhoe Bay natural gas (PBG) and natural gas liquids (NGL). Effect of solvent to oil dilution ratio on the amount of precipitation was studied. Alteration of crude oil composition due to asphalt precipitation was measured using gas-liquid chromatography. A second set of experiments were conducted to measure asphaltene precipitation due to addition of CO{sub 2} to live (recombined) West Sak crude.

  5. A Study of Aluminum Combustion in Solids, Powders, Foams, Additively-Manufactured Lattices, and Composites

    NASA Astrophysics Data System (ADS)

    Black, James; Trammell, Norman; Batteh, Jad; Curran, Nicholas; Rogers, John; Littrell, Donald

    2015-06-01

    This study examines the fireball characteristics, blast parameters, and combustion efficiency of explosively-shocked aluminum-based materials. The materials included structural and non-structural aluminum forms - such as solid cylinders, foams, additively-manufactured lattices, and powders - and some polytetrafluoroethylene-aluminum (PTFE-Al) composites. The materials were explosively dispersed in a small blast chamber, and the blast properties and products were measured with pressure transducers, thermocouples, slow and fast ultraviolet/visible spectrometers, and high-speed video.

  6. Spectra-temporal patterns underlying mental addition: an ERP and ERD/ERS study.

    PubMed

    Ku, Yixuan; Hong, Bo; Gao, Xiaorong; Gao, Shangkai

    2010-03-12

    Functional neuroimaging data have shown that mental calculation involves fronto-parietal areas that are composed of different subsystems shared with other cognitive functions such as working memory and language. Event-related potential (ERP) analysis has also indicated sequential information changes during the calculation process. However, little is known about the dynamic properties of oscillatory networks in this process. In the present study, we applied both ERP and event-related (de-)synchronization (ERS/ERD) analyses to EEG data recorded from normal human subjects performing tasks for sequential visual/auditory mental addition. Results in the study indicate that the late positive components (LPCs) can be decomposed into two separate parts. The earlier element LPC1 (around 360ms) reflects the computing attribute and is more prominent in calculation tasks. The later element LPC2 (around 590ms) indicates an effect of number size and appears larger only in a more complex 2-digit addition task. The theta ERS and alpha ERD show modality-independent frontal and parietal differential patterns between the mental addition and control groups, and discrepancies are noted in the beta ERD between the 2-digit and 1-digit mental addition groups. The 2-digit addition (both visual and auditory) results in similar beta ERD patterns to the auditory control, which may indicate a reliance on auditory-related resources in mental arithmetic, especially with increasing task difficulty. These results coincide with the theory of simple calculation relying on the visuospatial process and complex calculation depending on the phonological process. PMID:20105450

  7. Mineral resources of the Buffalo Hump and Sand Dunes Addition Wilderness Study Areas, Sweetwater County, Wyoming

    SciTech Connect

    Gibbons, A.B.; Barbon, H.N.; Kulik, D.M. ); McDonnell, J.R. Jr. )

    1990-01-01

    The authors present a study to assess the potential for undiscovered mineral resources and appraise the identified resources of the Buffalo Hump and Sand Dunes Addition Wilderness Study Areas, southwestern Wyoming, There are no mines, prospects, or mineralized areas nor any producing oil or gas wells; however, there are occurrences of coal, claystone and shale, and sand. There is a moderate resource potential for oil shale and natural gas and a low resource potential for oil, for metals, including uranium, and for geothermal sources.

  8. FTD and ALS--translating mouse studies into clinical trials.

    PubMed

    Ittner, Lars M; Halliday, Glenda M; Kril, Jillian J; Götz, Jürgen; Hodges, John R; Kiernan, Matthew C

    2015-06-01

    Frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) are related neurodegenerative disorders, which are characterized by a rapid decline in cognitive and motor functions, and short survival. Although the clinical and neuropathological characterization of these diseases has progressed--in part--through animal studies of pathogenetic mechanisms, the translation of findings from rodent models to clinical practice has generally not been successful. This article discusses the gap between preclinical animal studies in mice and clinical trials in patients with FTD or ALS. We outline how to better design preclinical studies, and present strategies to improve mouse models to overcome the translational shortfall. This new approach could help identify drugs that are more likely to achieve a therapeutic benefit for patients. PMID:25939274

  9. Additional Treatment Services in a Cocaine Treatment Study: Level of Services Obtained and Impact on Outcome

    PubMed Central

    Worley, Matthew; Gallop, Robert; Gibbons, Mary Beth Connolly; Ring-Kurtz, Sarah; Present, Julie; Weiss, Roger D.; Crits-Christoph, Paul

    2009-01-01

    The objective of this study was to examine the level of additional treatment services obtained by patients enrolled in the NIDA Cocaine Collaborative Study, a multi-center efficacy trial of four treatments for cocaine dependence, and to determine whether these services impact treatment outcome. Cocaine-dependent patients (N = 487) were recruited at five sites and randomly assigned to six months of one of four psychosocial treatments. Assessments were made at baseline, monthly during treatment, and at follow-ups at 9, 12, 15, and 18 months post-randomization. On average, patients received little or no additional treatment services during active treatment (first 6 months), but the rate of obtaining most services increased during the follow-up phase (month 7 to 18). In general, the treatment groups did not differ in the rates of obtaining non-protocol services. For all treatment groups, patients with greater psychiatric severity received more medical and psychiatric services during active treatment and follow-up. Use of treatment services was unrelated to drug use outcomes during active treatment. However, during the follow-up period, increased use of psychiatric medication, 12-step attendance, and 12-step participation was related to less drug use. The results suggest that during uncontrolled follow-up phases, additional non-protocol services may potentially confound the interpretation of treatment group comparisons in drug use outcomes. PMID:18463998

  10. Recovery of clinical but not radiographic outcomes by the delayed addition of adalimumab to methotrexate-treated Japanese patients with early rheumatoid arthritis: 52-week results of the HOPEFUL-1 trial

    PubMed Central

    Ishiguro, Naoki; Takeuchi, Tsutomu; Miyasaka, Nobuyuki; Mukai, Masaya; Matsubara, Tsukasa; Uchida, Shoji; Akama, Hideto; Kupper, Hartmut; Arora, Vipin; Tanaka, Yoshiya

    2014-01-01

    Objective. The aim of this study was to compare efficacy outcomes of initial treatment with adalimumab + MTX vs adalimumab addition following 26 weeks of MTX monotherapy in Japanese early RA patients naive to MTX with high disease activity. Methods. Patients completing the 26-week, randomized, placebo-controlled trial of adalimumab + MTX were eligible to receive 26 weeks of open-label adalimumab + MTX. Patients were assessed for mean change from baseline in the 28-joint DAS with ESR (DAS28-ESR) and modified total Sharp score (mTSS), and for the proportions of patients achieving clinical, functional or radiographic remission. Results. Of 333 patients assessed, 278 (137 from the initial adalimumab + MTX and 141 from the initial placebo + MTX groups) completed the 52-week study. Significant differences in clinical and functional parameters observed during the 26-week blinded period were not apparent following the addition of open-label adalimumab to MTX. Open-label adalimumab + MTX slowed radiographic progression through week 52 in both groups, but patients who received adalimumab + MTX throughout the study exhibited less radiographic progression than those who received placebo + MTX during the first 26 weeks (mean ΔmTSS at week 52 = 2.56 vs 3.30, P < 0.001). Conclusion. Delayed addition of adalimumab in Japanese MTX-naive early RA patients did not impact clinical and functional outcomes at week 52 compared with the earlier addition of adalimumab. However, the accrual of significant structural damage during blinded placebo + MTX therapy contributed to the persistence of differences between the treatment strategies, suggesting that Japanese patients at risk for aggressive disease should benefit from the early inclusion of adalimumab + MTX combination therapy. Trial registration. ClinicalTrials.gov (http://clinicaltrials.gov/), NCT00870467. PMID:24441150

  11. Nutritional Risk, Micronutrient Status and Clinical Outcomes: A Prospective Observational Study in an Infectious Disease Clinic

    PubMed Central

    Dizdar, Oguzhan Sıtkı; Baspınar, Osman; Kocer, Derya; Dursun, Zehra Bestepe; Avcı, Deniz; Karakükcü, Cigdem; Çelik, İlhami; Gundogan, Kursat

    2016-01-01

    Malnutrition has been associated with increased morbidity and mortality. The objective of this study was to determine the nutritional status and micronutrient levels of hospitalized patients in an infectious disease clinic and investigate their association with adverse clinical outcomes. The nutritional status of the study participants was assessed using the Nutritional Risk Screening 2002 (NRS 2002) and micronutrient levels and routine biochemical parameters were tested within the first 24 h of the patient’s admission. The incidence of zinc, selenium, thiamine, vitamin B6, vitamin B12 deficiency were 66.7% (n = 40), 46.6% (n = 29), 39.7% (n = 27), 35.3% (n = 24), 14.1% (n = 9), respectively. Selenium levels were significantly higher in patients with urinary tract infections, but lower in soft tissue infections. Copper levels were significantly higher in patients with soft tissue infections. In the Cox regression models, lower albumin, higher serum lactate dehydrogenase levels and higher NRS-2002 scores were associated with increased death. Thiamine, selenium, zinc and vitamin B6 deficiencies but not chromium deficiencies are common in infectious disease clinics. New associations were found between micronutrient levels and infection type and their adverse clinical outcomes. Hypoalbuminemia and a high NRS-2002 score had the greatest accuracy in predicting death, systemic inflammatory response syndrome and sepsis on admission. PMID:26938553

  12. Nutritional Risk, Micronutrient Status and Clinical Outcomes: A Prospective Observational Study in an Infectious Disease Clinic.

    PubMed

    Dizdar, Oguzhan Sıtkı; Baspınar, Osman; Kocer, Derya; Dursun, Zehra Bestepe; Avcı, Deniz; Karakükcü, Cigdem; Çelik, İlhami; Gundogan, Kursat

    2016-03-01

    Malnutrition has been associated with increased morbidity and mortality. The objective of this study was to determine the nutritional status and micronutrient levels of hospitalized patients in an infectious disease clinic and investigate their association with adverse clinical outcomes. The nutritional status of the study participants was assessed using the Nutritional Risk Screening 2002 (NRS 2002) and micronutrient levels and routine biochemical parameters were tested within the first 24 h of the patient's admission. The incidence of zinc, selenium, thiamine, vitamin B6, vitamin B12 deficiency were 66.7% (n = 40), 46.6% (n = 29), 39.7% (n = 27), 35.3% (n = 24), 14.1% (n = 9), respectively. Selenium levels were significantly higher in patients with urinary tract infections, but lower in soft tissue infections. Copper levels were significantly higher in patients with soft tissue infections. In the Cox regression models, lower albumin, higher serum lactate dehydrogenase levels and higher NRS-2002 scores were associated with increased death. Thiamine, selenium, zinc and vitamin B6 deficiencies but not chromium deficiencies are common in infectious disease clinics. New associations were found between micronutrient levels and infection type and their adverse clinical outcomes. Hypoalbuminemia and a high NRS-2002 score had the greatest accuracy in predicting death, systemic inflammatory response syndrome and sepsis on admission. PMID:26938553

  13. Study designs in dermatology: A review for the clinical dermatologist.

    PubMed

    Silverberg, Jonathan I

    2015-11-01

    A working knowledge of common research study designs and their advantages and disadvantages is necessary for critical reading of the literature by clinicians. However, understanding study designs and related statistical methodologies may be perceived as being complex and difficult to execute. This review aims to provide a practical foundation for basic study designs and to help physicians identify pitfalls that commonly occur in clinical studies and their level of evidence. Topics covered include the pros and cons of observational versus prospectively controlled studies, case-control, cohort, randomized controlled studies, adaptive controlled trials and metaanalyses, and the role of matching in studies. PMID:26475532

  14. A synchrotron study of microstructure gradient in laser additively formed epitaxial Ni-based superalloy

    DOE PAGESBeta

    Xue, Jiawei; Zhang, Anfeng; Li, Yao; Qian, Dan; Wan, Jingchun; Qi, Baolu; Tamura, Nobumichi; Song, Zhongxiao; Chen, Kai

    2015-10-08

    Laser additive forming is considered to be one of the promising techniques to repair single crystal Ni-based superalloy parts to extend their life and reduce the cost. Preservation of the single crystalline nature and prevention of thermal mechanical failure are two of the most essential issues for the application of this technique. Here we employ synchrotron X-ray microdiffraction to evaluate the quality in terms of crystal orientation and defect distribution of a Ni-based superalloy DZ125L directly formed by a laser additive process rooted from a single crystalline substrate of the same material. We show that a disorientation gradient caused bymore » a high density of geometrically necessary dislocations and resultant subgrains exists in the interfacial region between the epitaxial and stray grains. This creates a potential relationship of stray grain formation and defect accumulation. In conclusion, the observation offers new directions on the study of performance control and reliability of the laser additive manufactured superalloys.« less

  15. Isomeric Selective Studies of the Dominant Addition Channel in OH Initiated Oxidation of Isoprene

    NASA Astrophysics Data System (ADS)

    Ghosh, B.; Bugarin, A.; Connell, B.; North, S. W.

    2009-12-01

    We report the first isomeric selective study of the dominant isomeric pathway in the OH initiated oxidation of isoprene in the presence of O2 and NO using the Laser Photolysis-Laser Induced Fluorescence (LP-LIF) technique. The photolysis of monodeuterated/non deuterated 2-iodo-2-methyl-but-3-en-1-ol results exclusively in the dominant OH-isoprene addition product, providing important insight into the oxidation mechanism. Based on kinetic analysis of OH cycling experiments we have determined the rate constant for O2 addition to the hydroxy alkyl radical to be (1.0±0.5) × 10^(-12) cm^(3) s^(-1) and we find a value of (8.05±2.3) × 10^(-12) cm^(3) s^(-1) for the overall reaction rate constant of the hydroxy peroxy radical with NO. We also report the first clear experimental evidence of the (E-) form of the δ-hydroxyalkoxy channel through isotopic labeling experiments and quantify its branching ratio to be 0.1±0.025. Since it corresponds to missing carbon balance in isoprene oxidation, we have been able to identify some of the missing carbon balance. Since our measured isomeric selective rate constants for the dominant outer channel in OH initiated isoprene chemistry are similar to the overall rate constants derived from non isomeric kinetics, we predict that the remaining outer addition channel will have similar reactivity. We have extended this study to the OH initiated oxidation of 1,3-butadiene. We have obtained isomeric selective rate constants on the dominant channel of the butadiene oxidation chemistry and measured the branching ratio for the δ-hydroxyalkoxy channel. These results on butadiene studies will be discussed.

  16. Effect of Ozonised water on Chronic Periodontitis - A Clinical Study

    PubMed Central

    Katti, Sandeep S; Chava, Vijay Kumar

    2013-01-01

    Background: The aim of the study was to study the clinical effects of ozonated water on periodontal tissues. Materials & Methods: In the present study 30 subjects were selected with age ranging from 20 to 60 yearsand pocket depth of ≥5mm. Two sites were selected in each patient whichwere divided into two groups. Group 1(control group-irrigation with saline) and Group 2(study group-irrigation with ozonized water) and clinical parameters were recorded at baseline, 15 days and 30 days. Results: When the comparison of mean values of Plaque Index and Gingival Index between the groups and at different time intervals were made, statistically significant difference were observed at 30 days at 5% level. When the mean values of clinical attachment level on mesial and distal site was compared between the groups, statistical significance was observed at 5% level and 1% level respectively.Similarly statistical significance at 5% level was observed at 15 and 30 days on buccal site. Conclusion: Subgingival irrigation with ozonized water is beneficial adjunct treatment modality to enhance periodontal health with significant role in periodontal therapy. How to cite this article: Katti SS, Chava VK. Effect of Ozonised water on Chronic Periodontitis - A Clinical Study. J Int Oral Health 2013;5(5):79-84. PMID:24324309

  17. Factors affecting clinical reasoning of occupational therapists: a qualitative study

    PubMed Central

    Shafaroodi, Narges; Kamali, Mohammad; Parvizy, Soroor; Mehraban, Afsoon Hassani; O’Toole, Giyn

    2014-01-01

    Background: Clinical reasoning is generally defined as the numerous modes of thinking that guide clinical practice but little is known about the factors affecting how occupational therapists manage the decision-making process. The aim of this qualitative study was to explore the factors influencing the clinical reasoning of occupational therapists. Methods: Twelve occupational therapy practitioners working in mental and physical dysfunction fields participated in this study. The sampling method was purposeful and interviews were continued until data saturation. All the interviews were recorded and transcribed. The data were analyzed through a qualitative content analysis method. Results: There were three main themes. The first theme: socio-cultural conditions included three subthemes: 1- client beliefs; 2- therapist values and beliefs; 3- social attitude to disability. The second theme: individual attributions included two subthemes 1- client attributions; 2- therapist attributions. The final theme was the workplace environment with the three subthemes: 1- knowledge of the managers of rehabilitation services, 2- working in an inter-professional team; 3- limited clinical facilities and resources. Conclusion: In this study, the influence of the attitudes and beliefs of client, therapist and society about illness, abilities and disabilities upon reasoning was different to previous studies. Understanding these factors, especially the socio-cultural beliefs basis can play a significant role in the quality of occupational therapy services. Accurate understanding of these influential factors requires more extensive qualitative and quantitative studies. PMID:25250253

  18. Second Mesiobuccal Canal Treatment in a Predoctoral Dental Clinic: A Retrospective Clinical Study.

    PubMed

    Coelho, Marcelo Santos; Parker, Jeffrey M; Tawil, Peter Z

    2016-06-01

    The aim of this retrospective clinical study was to evaluate the location and treatment of second canals in mesiobuccal roots (MB2) of first and second maxillary molars in a predoctoral endodontic clinic by the graduating classes of 2008 to 2015. These results were compared to similar clinical studies. Included in the study were 368 root canal treatments performed by 310 third- and fourth-year dental students at one U.S. dental school. All cases were done under faculty supervision, and the students were instructed to use dental loupe magnification. Students' evaluation sheets were used to deteremine the total MB2 canals treated in first and second maxillary molars. The results showed that, overall, 72.55% of the teeth had an MB2 canal treated. The frequency was higher in first molars (75.91%) than in second molars (56.92%) (p<0.05). Third-year students were able to detect 39 MB2 canals in 57 maxillary molars (68.42%), while fourth-year students detected 228 MB2 canals in 311 teeth (73.31%) (p>0.05). Under proper supervision by experienced endodontists, these dental students were capable of treating MB2 canals in maxillary molars. The frequency of MB2 canals located and treated by dental students with the assistance of experienced professionals was higher in first than in second molars. No significant difference was found between third- and fourth-year students. The incidence of MB2 canals located and treated in this study was found to be similar to that in other clinical studies. PMID:27251355

  19. Pregabalin in Childhood Epilepsy: A Clinical Trial Study

    PubMed Central

    MOLLAMOHAMMADI, Mohsen; TONKABONI, Seyed Hassan; PIRZADEH, Zahra; Vahedian, Mostafa

    2014-01-01

    Objective The prevalence of active epilepsy is about 0.5–1%, and approximately 70% of patients are cured with first anti-epileptic drugs and the remaining patients need multiple drugs. Pregabalin as an add-on therapy has a postive effect on refractory seizures in adults. To the best of our knowledge, there is no research with this drug in childhood epilepsy. We use pregabalin in children with refractory seizures as an add-on therapy. The objective of this study is to evaluate the effects of pregabalin in the reduction of seizures for refractory epilepsy. Material & Methods Forty patients with refractory seizures who were referred to Mofid Children’s Hospital and Hazrat Masoumeh Hospital were selected. A questionnaire based on patient record forms, demographic data (age, gender,…), type of seizure, clinical signs, EEG record, imaging report, drugs that had been used, drugs currently being used, and the number of seizures before and after Pregabalin treatment was completed. We checked the number of seizures after one and four months. Results After one month, 26.8% of patients had more than a 50% reduction in seizures and 14.6% of these patients were seizure-free; 12.2% had a 25–50% reduction; and approximately 61% had less than a 25% reduction or no change in seizures. After the fourth month, 34.1% of patients had more than a 50% reduction in seizures and 24.4% of these patients were seizure-free. Additionally, 65.9% of patients had less than 50% reduction in seizures (9.8% between 25–50% and 56.1% less than 25% or without improvement). Conclusion We recommend Pregabalin as an add-on therapy for refractory seizures (except for myoclonic seizures) for children. PMID:25657772

  20. Immunotoxic effects of the color additive caramel color III: immune function studies in rats.

    PubMed

    Houben, G F; Penninks, A H; Seinen, W; Vos, J G; Van Loveren, H

    1993-01-01

    Administration of the color additive caramel color III (AC) may cause a reduction in total white blood cell counts in rats due to reduced lymphocyte counts. Beside lymphopenia, several other effects in rat have been described. The effects are caused by the imidazole derivative 2-acetyl-4(5)-(1,2,3,4-tetrahydroxybutyl)imidazole (THI) and occur in rats fed a diet low in vitamin B6. In the present paper, immune function studies on AC and THI with rats fed a diet low, but not deficient in vitamin B6 are presented and discussed. Rats were exposed to 0.4 or 4% AC or to 5.72 ppm THI in drinking water during and for 28 days prior to the start of immune function assays. Resistance to Trichinella spiralis was examined in an oral infection model and clearance of Listeria monocytogenes upon an intravenous infection was studied. In addition, natural cell-mediated cytotoxicity of splenic and nonadherent peritoneal cells and the antibody response to sheep red blood cells were studied. From the results it is concluded that exposure of rats to AC or THI influenced various immune function parameters. Thymus-dependent immunity was suppressed, while parameters of the nonspecific resistance were also affected, as shown by a decreased natural cell-mediated cytotoxicity in the spleen and an enhanced clearance of L. monocytogenes. PMID:8432426

  1. Communicating their individual results to participants in an environmental exposure study: Insights from clinical ethics

    SciTech Connect

    Deck, W.; Kosatsky, T. |

    1999-02-01

    A study measuring the uptake of chemical contaminants among sport fishers who consume fish caught in the St. Lawrence river is currently being conducted in Montreal, Canada. In this study, blood, hair, and urine collected from local sport fishers is being tested for heavy metals and persistent organochlorine chemicals. The objective of this study was to formulate a framework for determining what information to communicate to individual subjects of a study measuring biomarkers of exposure, consistent with the principles of ethical clinical and research practice. Methods consisted of review of the scope of environmental exposure studies, including the use of biomarker measurement in clinical medicine and environmental research and the relevant principles of clinical ethics and research practice. An exposure biomarker study is designed to elucidate constitutional, behavioral, and environmental determinants of tissue concentrations of exogenous substances. Ethical clinical and research practice, aiming to maximize autonomy and beneficence and to minimize harm, requires that study findings concerning the determinants of exposure be communicated to study participants. In addition, investigators should reference clinical action levels beyond which individual biomarker results are routinely communicated to participants. When biomarkers have no known relation to risk, or when levels fall below action levels, it may be preferable not co communicate individual results, if this arrangement has been formalized at the time of informed consent.

  2. Genome-wide association study of clinically defined gout identifies multiple risk loci and its association with clinical subtypes

    PubMed Central

    Matsuo, Hirotaka; Yamamoto, Ken; Nakaoka, Hirofumi; Nakayama, Akiyoshi; Sakiyama, Masayuki; Chiba, Toshinori; Takahashi, Atsushi; Nakamura, Takahiro; Nakashima, Hiroshi; Takada, Yuzo; Danjoh, Inaho; Shimizu, Seiko; Abe, Junko; Kawamura, Yusuke; Terashige, Sho; Ogata, Hiraku; Tatsukawa, Seishiro; Yin, Guang; Okada, Rieko; Morita, Emi; Naito, Mariko; Tokumasu, Atsumi; Onoue, Hiroyuki; Iwaya, Keiichi; Ito, Toshimitsu; Takada, Tappei; Inoue, Katsuhisa; Kato, Yukio; Nakamura, Yukio; Sakurai, Yutaka; Suzuki, Hiroshi; Kanai, Yoshikatsu; Hosoya, Tatsuo; Hamajima, Nobuyuki; Inoue, Ituro; Kubo, Michiaki; Ichida, Kimiyoshi; Ooyama, Hiroshi; Shimizu, Toru; Shinomiya, Nariyoshi

    2016-01-01

    Objective Gout, caused by hyperuricaemia, is a multifactorial disease. Although genome-wide association studies (GWASs) of gout have been reported, they included self-reported gout cases in which clinical information was insufficient. Therefore, the relationship between genetic variation and clinical subtypes of gout remains unclear. Here, we first performed a GWAS of clinically defined gout cases only. Methods A GWAS was conducted with 945 patients with clinically defined gout and 1213 controls in a Japanese male population, followed by replication study of 1048 clinically defined cases and 1334 controls. Results Five gout susceptibility loci were identified at the genome-wide significance level (p<5.0×10−8), which contained well-known urate transporter genes (ABCG2 and SLC2A9) and additional genes: rs1260326 (p=1.9×10−12; OR=1.36) of GCKR (a gene for glucose and lipid metabolism), rs2188380 (p=1.6×10−23; OR=1.75) of MYL2-CUX2 (genes associated with cholesterol and diabetes mellitus) and rs4073582 (p=6.4×10−9; OR=1.66) of CNIH-2 (a gene for regulation of glutamate signalling). The latter two are identified as novel gout loci. Furthermore, among the identified single-nucleotide polymorphisms (SNPs), we demonstrated that the SNPs of ABCG2 and SLC2A9 were differentially associated with types of gout and clinical parameters underlying specific subtypes (renal underexcretion type and renal overload type). The effect of the risk allele of each SNP on clinical parameters showed significant linear relationships with the ratio of the case–control ORs for two distinct types of gout (r=0.96 [p=4.8×10−4] for urate clearance and r=0.96 [p=5.0×10−4] for urinary urate excretion). Conclusions Our findings provide clues to better understand the pathogenesis of gout and will be useful for development of companion diagnostics. PMID:25646370

  3. The need for annual echocardiography to detect cabergoline-associated valvulopathy in patients with prolactinoma: a systematic review and additional clinical data.

    PubMed

    Caputo, Carmela; Prior, David; Inder, Warrick J

    2015-11-01

    Present recommendations by the US Food and Drug Administration advise that patients with prolactinoma treated with cabergoline should have an annual echocardiogram to screen for valvular heart disease. Here, we present new clinical data and a systematic review of the scientific literature showing that the prevalence of cabergoline-associated valvulopathy is very low. We prospectively assessed 40 patients with prolactinoma taking cabergoline. Cardiovascular examination before echocardiography detected an audible systolic murmur in 10% of cases (all were functional murmurs), and no clinically significant valvular lesion was shown on echocardiogram in the 90% of patients without a murmur. Our systematic review identified 21 studies that assessed the presence of valvular abnormalities in patients with prolactinoma treated with cabergoline. Including our new clinical data, only two (0·11%) of 1811 patients were confirmed to have cabergoline-associated valvulopathy (three [0·17%] if possible cases were included). The probability of clinically significant valvular heart disease is low in the absence of a murmur. On the basis of these findings, we challenge the present recommendations to do routine echocardiography in all patients taking cabergoline for prolactinoma every 12 months. We propose that such patients should be screened by a clinical cardiovascular examination and that echocardiogram should be reserved for those patients with an audible murmur, those treated for more than 5 years at a dose of more than 3 mg per week, or those who maintain cabergoline treatment after the age of 50 years. PMID:25466526

  4. Participants’ perception of pharmaceutical clinical research: a cross-sectional controlled study

    PubMed Central

    González-Saldivar, Gerardo; Rodríguez-Gutiérrez, René; Viramontes-Madrid, José Luis; Salcido-Montenegro, Alejandro; Carlos-Reyna, Kevin Erick Gabriel; Treviño-Alvarez, Andrés Marcelo; Álvarez-Villalobos, Neri Alejandro; González-González, José Gerardo

    2016-01-01

    Background There is scarce scientific information assessing participants’ perception of pharmaceutical research in developed and developing countries concerning the risks, safety, and purpose of clinical trials. Methods To assess the perception that 604 trial participants (cases) and 604 nonparticipants (controls) of pharmaceutical clinical trials have about pharmaceutical clinical research, we surveyed participants with one of four chronic diseases from 12 research sites throughout Mexico. Results Participation in clinical trials positively influences the perception of pharmaceutical clinical research. More cases (65.4%) than controls (50.7%) perceived that the main purpose of pharmaceutical research is to cure more diseases and to do so more effectively. In addition, more cases considered that there are significant benefits when participating in a research study, such as excellent medical care and extra free services, with this being the most important motivation to participate for both groups (cases 52%, controls 54.5%). We also found a sense of trust in their physicians to deal with adverse events, and the perception that clinical research is a benefit to their health, rather than a risk. More controls believed that clinical trial participants’ health is put at risk (57% vs 33.3%). More cases (99.2%) than controls (77.5%) would recommend participating in a clinical trial, and 90% of cases would enroll in a clinical trial again. Conclusion Participation in clinical trials positively influences the perception that participants have about pharmaceutical clinical research when compared to nonparticipants. This information needs to be conveyed to clinicians, public health authorities, and general population to overcome misconceptions. PMID:27199549

  5. Recommendations for planning pilot studies in clinical and translational research.

    PubMed

    Moore, Charity G; Carter, Rickey E; Nietert, Paul J; Stewart, Paul W

    2011-10-01

    Advances in clinical and translation science are facilitated by building on prior knowledge gained through experimentation and observation. In the context of drug development, preclinical studies are followed by a progression of phase I through phase IV clinical trials. At each step, the study design and statistical strategies are framed around research questions that are prerequisites for the next phase. In other types of biomedical research, pilot studies are used for gathering preliminary support for the next research step. However, the phrase "pilot study" is liberally applied to projects with little or no funding, characteristic of studies with poorly developed research proposals, and usually conducted with no detailed thought of the subsequent study. In this article, we present a rigorous definition of a pilot study, offer recommendations for the design, analysis and sample size justification of pilot studies in clinical and translational research, and emphasize the important role that well-designed pilot studies play in the advancement of science and scientific careers. PMID:22029804

  6. Clinical outcome of gliosarcoma compared with glioblastoma multiforme: a clinical study in Chinese patients.

    PubMed

    Zhang, Guobin; Huang, Shengyue; Zhang, Junting; Wu, Zhen; Lin, Song; Wang, Yonggang

    2016-04-01

    Gliosarcoma (GSM) is a rare biphasic neoplasms of the central nervous system composed of a glioblastoma multiforme (GBM) admixed with a sarcomatous component. In clinical practice GSM is generally managed similarly to GBM. However, there are conflicting reports regarding their clinical aggressiveness, cell line of origin and possible prognosis compared with those of GBM. The objective of this study was to compare clinic-pathological features in GSM patients with the GBM patients during the same study period. 518 patients with GBM were treated at our hospital between 2008 and 2013, among them 51 were GSM. In this series the GSMs represented 9.8 % of all GBMs and included 58.8 % male with a median age of 44.7 years. The locations, all supratentorial, included temporal in 41.2 %, frontal in 25.5 %, parietal in 19.6 %, and occipital in 13.7 %. All patients underwent tumor resection followed by post-operative radiation and adjuvant chemotherapy. The O6-methylguanine-DNA methyltransferase promoter methylation studies were significantly more frequent in the GBMs than GSMs (80.1 % vs. 44.7 %, P < 0.001). The median progression free survival and overall survival for the patients with GSM were 8.0 and 13.0 months, respectively, as compared with 9.0 and 14.0 months in the GBM group (log rank test P = 0.001 and 0.004, respectively). The Cox proportional hazards regression model indicated that the extent of tumor resection (HR = 1.518, P = 0.009) and pathological types (HR = 0.608, P = 0.002) were the significant prognostic factors in our own series. With regard to clinical features and outcomes, GSM and GBM cannot be distinguished clinically. GSM in China may be managed similarly to GBM, with maximal safe surgical resection followed by chemo-radiotherapy. Our study adds further evidence to support GSM as a unique clinical entity with a likely worse prognosis than GBM. PMID:26725096

  7. Guidelines for the Design and Conduct of Clinical Studies in Knee Articular Cartilage Repair

    PubMed Central

    Mithoefer, Kai; Saris, Daniel B.F.; Farr, Jack; Kon, Elizaveta; Zaslav, Kenneth; Cole, Brian J.; Ranstam, Jonas; Yao, Jian; Shive, Matthew; Levine, David; Dalemans, Wilfried; Brittberg, Mats

    2011-01-01

    Objective: To summarize current clinical research practice and develop methodological standards for objective scientific evaluation of knee cartilage repair procedures and products. Design: A comprehensive literature review was performed of high-level original studies providing information relevant for the design of clinical studies on articular cartilage repair in the knee. Analysis of cartilage repair publications and synopses of ongoing trials were used to identify important criteria for the design, reporting, and interpretation of studies in this field. Results: Current literature reflects the methodological limitations of the scientific evidence available for articular cartilage repair. However, clinical trial databases of ongoing trials document a trend suggesting improved study designs and clinical evaluation methodology. Based on the current scientific information and standards of clinical care, detailed methodological recommendations were developed for the statistical study design, patient recruitment, control group considerations, study endpoint definition, documentation of results, use of validated patient-reported outcome instruments, and inclusion and exclusion criteria for the design and conduct of scientifically sound cartilage repair study protocols. A consensus statement among the International Cartilage Repair Society (ICRS) and contributing authors experienced in clinical trial design and implementation was achieved. Conclusions: High-quality clinical research methodology is critical for the optimal evaluation of current and new cartilage repair technologies. In addition to generally applicable principles for orthopedic study design, specific criteria and considerations apply to cartilage repair studies. Systematic application of these criteria and considerations can facilitate study designs that are scientifically rigorous, ethical, practical, and appropriate for the question(s) being addressed in any given cartilage repair research project

  8. Sports Medicine. Clinical Rotation. Instructor's Packet and Student Study Packet.

    ERIC Educational Resources Information Center

    Texas Univ., Austin. Extension Instruction and Materials Center.

    The materials in this packet are for a course designed to provide individualized classroom study for a specific area of clinical rotation--sports medicine. The instructor's manual describes the learning objectives together with a list of reference materials that should be provided for completion of the student worksheets, and lists suggested…

  9. Experiencing Virtual Patients in Clinical Learning: A Phenomenological Study

    ERIC Educational Resources Information Center

    Edelbring, Samuel; Dastmalchi, Maryam; Hult, Hakan; Lundberg, Ingrid E.; Dahlgren, Lars Owe

    2011-01-01

    Computerised virtual patients (VPs) are increasingly being used in medical education. With more use of this technology, there is a need to increase the knowledge of students' experiences with VPs. The aim of the study was to elicit the nature of virtual patients in a clinical setting, taking the students' experience as a point of departure.…

  10. A water soluble additive to suppress respirable dust from concrete-cutting chainsaws: a case study.

    PubMed

    Summers, Michael P; Parmigiani, John P

    2015-01-01

    Respirable dust is of particular concern in the construction industry because it contains crystalline silica. Respirable forms of silica are a severe health threat because they heighten the risk of numerous respirable diseases. Concrete cutting, a common work practice in the construction industry, is a major contributor to dust generation. No studies have been found that focus on the dust suppression of concrete-cutting chainsaws, presumably because, during normal operation water is supplied continuously and copiously to the dust generation points. However, there is a desire to better understand dust creation at low water flow rates. In this case study, a water-soluble surfactant additive was used in the chainsaw's water supply. Cutting was performed on a free-standing concrete wall in a covered outdoor lab with a hand-held, gas-powered, concrete-cutting chainsaw. Air was sampled at the operator's lapel, and around the concrete wall to simulate nearby personnel. Two additive concentrations were tested (2.0% and 0.2%), across a range of fluid flow rates (0.38-3.8 Lpm [0.1-1.0 gpm] at 0.38 Lpm [0.1 gpm] increments). Results indicate that when a lower concentration of additive is used exposure levels increase. However, all exposure levels, once adjusted for 3 hours of continuous cutting in an 8-hour work shift, are below the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) of 5 mg/m(3). Estimates were made using trend lines to predict the fluid flow rates that would cause respirable dust exposure to exceed both the OSHA PEL and the American Conference of Governmental Industrial Hygienists (ACGIH®) threshold limit value (TLV). PMID:25714034

  11. HDL and Atherosclerosis Regression: Evidence from Pre-clinical and Clinical Studies

    PubMed Central

    Feig, Jonathan E.; Hewing, Bernd; Smith, Jonathan D.; Hazen, Stanley L.; Fisher, Edward A.

    2014-01-01

    High density lipoprotein particles (HDL) transport, among other molecules, cholesterol (HDL-C). In epidemiologic studies, plasma HDL-C levels have an inverse relationship to the risk of atherosclerotic cardiovascular disease (CVD). It has been assumed that this reflects the protective functions of HDL, which include their ability to promote cholesterol efflux. Yet, a number of recent pharmacological and genetic studies have failed to demonstrate that increased plasma levels of HDL-C resulted in decreased CVD risk, giving rise to a controversy over whether plasma levels of HDL-C reflect HDL function, or that HDL is even as protective as assumed. On balance, the evidence from pre-clinical and (limited) clinical studies show that HDL can promote the regression of atherosclerosis when the levels of functional particles are increased from endogenous or exogenous sources. The data show that regression results from a combination of reduced plaque lipid and macrophage contents, as well as from a reduction in its inflammatory state. While more research will be needed on basic mechanisms and to establish that these changes translate clinically to reduced CVD events, that HDL can regress plaques suggests that the recent trial failures do not eliminate HDL from consideration as an atheroprotective agent, but emphasizes the important distinction between HDL function and plasma levels of HDL-C. PMID:24385513

  12. The clinical and biochemical study of pesticide sprayers.

    PubMed

    Srivastava, A K; Gupta, B N; Mathur, A K; Mathur, N; Mahendra, P N; Bharti, R S

    1991-07-01

    Clinical, haematological and biochemical studies of 34 subjects, occupationally exposed to different types of pesticides, were conducted. The findings have been compared with those observed in 14 control subjects. Inhibition of cholinesterase activity was observed in the exposed group. Serum alkaline phosphatase was also found to be raised. Radiological examination revealed pneumonitic patches in the chest skiagrams of three exposed subjects. Paraesthesia with hyporeflexia was also found in 8.8% of exposed subjects. The findings suggest that exposure to multiple pesticides over many years affects the normal functioning of different organ systems and may produce characteristic clinical effects. PMID:1679651

  13. Metadata-driven Ad Hoc Query of Clinical Studies Data

    PubMed Central

    Deshpande, Aniruddha M.; Nadkarni, Prakash M.

    2001-01-01

    The Entity-Attribute-Value (EAV) data representation is widely used in both clinical patient record systems (CPRSs) and clinical study data management systems (CSDMS). Both of these systems are heterogeneous in that many types of data are also represented conventionally, a situation that complicates data display, editing and ad hoc query. Seamless functioning of such systems mandates the presence of developer-defined metadata (data describing the rest of the database) that records, among other things, how individual parameters are represented within the system. We illustrate a web-based ad hoc query tool that relies on the metadata to generate syntactically and semantically correct SQL.

  14. Augmenting a Waste Glass Mixture Experiment Study with Additional Glass Components and Experimental Runs

    SciTech Connect

    Piepel, Gregory F. ); Cooley, Scott K. ); Peeler, David K.; Vienna, John D. ); Edwards, Tommy B.

    2002-01-01

    A glass composition variation study (CVS) for high-level waste (HLW) stored in Idaho is being statistically designed and performed in phases over several years. The purpose of the CVS is to investigate and model how HLW-glass properties depend on glass composition. The resulting glass property-composition models will be used to develop desirable glass formulations and for other purposes. Phases 1 and 2 of the CVS have been completed and are briefly described. This paper focuses on the CVS Phase 3 experimental design, which was chosen to augment the Phase 1 and 2 data with additional data points, as well as to account for additional glass components not studied in Phases 1 and/or 2. In total, 16 glass components were varied in the Phase 3 experimental design. The paper describes how these Phase 3 experimental design augmentation challenges were addressed using the previous data, preliminary property-composition models, and statistical mixture experiment and optimal experimental design methods and software.

  15. Role of sulfite additives in wine induced asthma: single dose and cumulative dose studies

    PubMed Central

    Vally, H; Thompson, P

    2001-01-01

    BACKGROUND—Wine appears to be a significant trigger for asthma. Although sulfite additives have been implicated as a major cause of wine induced asthma, direct evidence is limited. Two studies were undertaken to assess sulfite reactivity in wine sensitive asthmatics. The first study assessed sensitivity to sulfites in wine using a single dose sulfited wine challenge protocol followed by a double blind, placebo controlled challenge. In the second study a cumulative dose sulfited wine challenge protocol was employed to establish if wine sensitive asthmatics as a group have an increased sensitivity to sulfites.
METHODS—In study 1, 24 asthmatic patients with a strong history of wine induced asthma were screened. Subjects showing positive responses to single blind high sulfite (300 ppm) wine challenge were rechallenged on separate days in a double blind, placebo controlled fashion with wines of varying sulfite levels to characterise their responses to these drinks. In study 2, wine sensitive asthmatic patients (n=12) and control asthmatics (n=6) were challenged cumulatively with wine containing increasing concentrations of sulfite in order to characterise further their sensitivity to sulfites in wine.
RESULTS—Four of the 24 self-reporting wine sensitive asthmatic patients were found to respond to sulfite additives in wine when challenged in a single dose fashion (study 1). In the double blind dose-response study all four had a significant fall in forced expiratory volume in one second (FEV1) (>15% from baseline) following exposure to wine containing 300 ppm sulfite, but did not respond to wines containing 20, 75 or 150 ppm sulfite. Responses were maximal at 5 minutes (mean (SD) maximal decline in FEV1 28.7 (13)%) and took 15-60 minutes to return to baseline levels. In the cumulative dose-response study (study 2) no significant difference was observed in any of the lung function parameters measured (FEV1, peak expiratory flow (PEF), mid phase forced expiratory

  16. Characterization studies on the additives mixed L-arginine phosphate monohydrate (LAP) crystals

    NASA Astrophysics Data System (ADS)

    Haja Hameed, A. S.; Karthikeyan, C.; Ravi, G.; Rohani, S.

    2011-04-01

    L-arginine phosphate monohydrate (LAP), potassium thiocyanate (KSCN) mixed LAP (LAP:KSCN) and sodium sulfite (Na 2SO 3) mixed LAP (LAP:Na 2SO 3) single crystals were grown by slow cooling technique. The effect of microbial contamination and coloration on the growth solutions was studied. The crystalline powders of the grown crystals were examined by X-ray diffraction and the lattice parameters of the crystals were estimated. From the FTIR spectroscopic analysis, various functional group frequencies associated with the crystals were assigned. Vickers microhardness studies were done on {1 0 0} faces for pure and additives mixed LAP crystals. From the preliminary surface second harmonic generation (SHG) results, it was found that the SHG intensity at (1 0 0) face of LAP:KSCN crystal was much stronger than that of pure LAP.

  17. The guanidine and maleic acid (1:1) complex. The additional theoretical and experimental studies

    NASA Astrophysics Data System (ADS)

    Drozd, Marek; Dudzic, Damian

    2012-04-01

    On the basis of experimental literature data the theoretical studies for guanidinium and maleic acid complex with using DFT method are performed. In these studies the experimental X-ray data for two different forms of investigated crystal were used. During the geometry optimization process one equilibrium structure was found, only. According to this result the infrared spectrum for one theoretical molecule was calculated. On the basis of potential energy distribution (PED) analysis the clear-cut assignments of observed bands were performed. For the calculated molecule with energy minimum the highest occupied molecular orbital (HOMO) and the lowest unoccupied molecular orbital (LUMO) were obtained and graphically illustrated. The energy difference (GAP) between HOMO and LUMO was analyzed. Additionally, the nonlinear properties of this molecule were calculated. The α and β (first and second order) hyperpolarizability values are obtained. On the basis of these results the title crystal was classified as new second order NLO generator.

  18. Musculoskeletal demands on flamenco dancers: a clinical and biomechanical study.

    PubMed

    Bejjani, F J; Halpern, N; Pio, A; Dominguez, R; Voloshin, A; Frankel, V H

    1988-04-01

    The flamenco dancer acts on the floor like a drummer. The percussive footwork and vibration patterns created during dancing impose unusual demands on the musculoskeletal system. This study investigated the clinical and biomechanical aspects of this task. Using the electrodynogram and skin-mounted accelerometers, foot pressures as well as hip and knee vibrations were recorded in 10 female dancers after a thorough clinical evaluation. A health questionnaire was also distributed to 29 dancers. Foot pressures and acceleration data reveal the percussive nature of the dance. Some clinical findings, like calluses, are related to pressure distribution. Urogenital disorders, as well as back and neck pain, may be related to the vibrations generated by the flamenco dance form. The hip joint seems to absorb most of the impacts. "Vibration-pressure" diagrams are suggested as a useful tool for evaluating a dancer's biomechanical behavior, as well as the effect of floors and footwear on this behavior. PMID:3366430

  19. [Clinical studies on pivmecillinam in urinary tract infections (author's transl)].

    PubMed

    Amano, M; Kiuchi, H; Suzuki, M; Morinaga, O; Tanaka, H

    1979-09-01

    Pivmecillinam (PMPC), semisynthetic penicillin for oral use, was studied clinically and following results were obtained. 1) Twenty-eight patients with acute simple cystitis treated with the drug 200 mg/day for 4 days, clinical results were excellent in 23 cases and moderate in 5 cases. Six patients with chronic simple cystitis treated with the drug 400 mg/day for 7 days, clinical results were excellent in 4 cases, moderate in 1 case and poor in 1 case. Eight patients with complicated urinary tract infections treated with the drug 400 mg/day for 7 days, clinical results were excellent in 2 cases, moderate in 2 cases and poor in 4 cases. Overall effectiveness amounted to 88.1%. 2) Pivmecillinam was clinically effective in patients infected by Gram-negative bacteria except Pseudomonas aeruginosa. 3) No side effects were observed in all cases. The effectiveness of PMPC for acute simple cystitis was compared with that of talampicillin (TAPC), ampicillin (ABPC), amoxicillin (AMPC) and pivampicillin (PVPC) reported previously and PMPC was assessed as the most useful agent in these. Then, pivmecillinam should be chosen firstly as a chemotherapeutic agent for acute simple cystitis. PMID:228097

  20. A study of clinical opinion and practice regarding circumcision

    PubMed Central

    Farshi, Z; Atkinson, K; Squire, R

    2000-01-01

    AIM—To establish clinical opinion regarding appropriate indications for circumcision and to examine actual clinical practice.
METHODS—A questionnaire was sent to all NHS hospital consultants in the Yorkshire region of the UK identified as having a role to play in the management of boys (under 16 years of age) requiring circumcision. Retrospective data on actual clinical practice during a three month study period were also collected via a simple proforma.
RESULTS—Of 153 questionnaires sent, 64 were returned. Responses revealed varying opinions regarding appropriate indications for circumcision within each consultant group, and between paediatricians and surgeons. Surgeons were generally more inclined to recommend circumcision for each of the indications listed in the questionnaire. Analysis of clinical practice revealed that almost two thirds of procedures were carried out for phimosis, and nearly half of these children were under the age of 5years.
CONCLUSION—There are differences in the clinical opinions of surgeons and paediatricians on what constitutes an appropriate indication for circumcision. Paediatricians' opinions are generally more in line with current evidence than those of surgeons, possibly resulting in many unnecessary circumcisions.

 PMID:11040144

  1. Clinical trials transparency and the Trial and Experimental Studies Transparency (TEST) act.

    PubMed

    Logvinov, Ilana

    2014-03-01

    Clinical trial research is the cornerstone for successful advancement of medicine that provides hope for millions of people in the future. Full transparency in clinical trials may allow independent investigators to evaluate study designs, perform additional analysis of data, and potentially eliminate duplicate studies. Current regulatory system and publishers rely on investigators and pharmaceutical industries for complete and accurate reporting of results from completed clinical trials. Legislation seems to be the only way to enforce mandatory disclosure of results. The Trial and Experimental Studies Transparency (TEST) Act of 2012 was introduced to the legislators in the United States to promote greater transparency in research industry. Public safety and advancement of science are the driving forces for the proposed policy change. The TEST Act may benefit the society and researchers; however, there are major concerns with participants' privacy and intellectual property protection. PMID:24440100

  2. Parasitological and clinical studies on human scabies in Cairo.

    PubMed

    Sarwat, M A; el Okbi, L M; el Sayed, M M; el Okbi, S M; el Deeb, H K

    1993-12-01

    This study is a parasitological and clinical study on human scabies. This study was carried out on 100 patients attending the Dermatology Outpatient Clinic at Ain Shams University Hospitals, including 54 males and 46 females. All patients were subjected to detailed history taking, complete dermatological examination including Skin Scraping Test and Burrow Ink Test. Younger patients attended the dermatology clinic earlier than older patients, who usually delayed their visits until complications occurred. Scratching, erythematous papules and secondary infected lesions were the commonest lesions. The hands, wrist and external genitalia were the most frequently affected sites while the feet, ankles, knees and back were the least affected. Burrows could only be detected in 40% of patients. The most frequent sites were the web spaces, external genitalia, and finger sides. Burrow Ink Test was positive among 85% of patients with burrows while mites could be identified by Skin Scraping Test in 55% of patients. The most frequent clinical manifestations in the parasitologically positive patients were itching, burrows, and papules, and the most frequent sites were the web spaces, and the finger sides. Multiple sites affection was the characteristic feature among the preschool age children who represented 14% of cases. PMID:8308357

  3. A combined toxicity study of zinc oxide nanoparticles and vitamin C in food additives

    NASA Astrophysics Data System (ADS)

    Wang, Yanli; Yuan, Lulu; Yao, Chenjie; Ding, Lin; Li, Chenchen; Fang, Jie; Sui, Keke; Liu, Yuanfang; Wu, Minghong

    2014-11-01

    At present, safety evaluation standards for nanofood additives are made based on the toxic effects of a single additive. Since the size, surface properties and chemical nature influence the toxicity of nanomaterials, the toxicity may have dramatically changed when nanomaterials are used as food additives in a complex system. Herein, we investigated the combined toxicity of zinc oxide nanoparticles (ZnO NPs) and vitamin C (Vc, ascorbic acid). The results showed that Vc increased the cytotoxicity significantly compared with that of the ZnO only NPs. When the cells were exposed to ZnO NPs at a concentration less than 15 mg L-1, or to Vc at a concentration less than 300 mg L-1, there was no significant cytotoxicity, both in the case of gastric epithelial cell line (GES-1) and neural stem cells (NSCs). However, when 15 mg L-1 of ZnO NPs and 300 mg L-1 of Vc were introduced to cells together, the cell viability decreased sharply indicating significant cytotoxicity. Moreover, the significant increase in toxicity was also shown in the in vivo experiments. The dose of the ZnO NPs and Vc used in the in vivo study was calculated according to the state of food and nutrition enhancer standard. After repeated oral exposure to ZnO NPs plus Vc, the injury of the liver and kidneys in mice has been indicated by the change of these indices. These findings demonstrate that the synergistic toxicity presented in a complex system is essential for the toxicological evaluation and safety assessment of nanofood.At present, safety evaluation standards for nanofood additives are made based on the toxic effects of a single additive. Since the size, surface properties and chemical nature influence the toxicity of nanomaterials, the toxicity may have dramatically changed when nanomaterials are used as food additives in a complex system. Herein, we investigated the combined toxicity of zinc oxide nanoparticles (ZnO NPs) and vitamin C (Vc, ascorbic acid). The results showed that Vc increased the

  4. Exploring Factors Affecting Undergraduate Medical Students' Study Strategies in the Clinical Years: A Qualitative Study

    ERIC Educational Resources Information Center

    Al Kadri, Hanan M. F.; Al-Moamary, Mohamed S.; Elzubair, Margaret; Magzoub, Mohi Eldien; AlMutairi, Abdulrahman; Roberts, Christopher; van der Vleuten, Cees

    2011-01-01

    The aim of this study is to explore the effects of clinical supervision, and assessment characteristics on the study strategies used by undergraduate medical students during their clinical rotations. We conducted a qualitative phenomenological study at King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Saudi…

  5. A study of pyrazines in cigarettes and how additives might be used to enhance tobacco addiction

    PubMed Central

    Alpert, Hillel R; Agaku, Israel T; Connolly, Gregory N

    2016-01-01

    Background Nicotine is known as the drug that is responsible for the addicted behaviour of tobacco users, but it has poor reinforcing effects when administered alone. Tobacco product design features enhance abuse liability by (A) optimising the dynamic delivery of nicotine to central nervous system receptors, and affecting smokers’ withdrawal symptoms, mood and behaviour; and (B) effecting conditioned learning, through sensory cues, including aroma, touch and visual stimulation, to create perceptions of pending nicotine reward. This study examines the use of additives called ‘pyrazines’, which may enhance abuse potential, their introduction in ‘lights’ and subsequently in the highly market successful Marlboro Lights (Gold) cigarettes and eventually many major brands. Methods We conducted internal tobacco industry research using online databases in conjunction with published scientific literature research, based on an iterative feedback process. Results Tobacco manufacturers developed the use of a range of compounds, including pyrazines, in order to enhance ‘light’ cigarette products’ acceptance and sales. Pyrazines with chemosensory and pharmacological effects were incorporated in the first ‘full-flavour, low-tar’ product achieving high market success. Such additives may enhance dependence by helping to optimise nicotine delivery and dosing and through cueing and learned behaviour. Conclusions Cigarette additives and ingredients with chemosensory effects that promote addiction by acting synergistically with nicotine, increasing product appeal, easing smoking initiation, discouraging cessation or promoting relapse should be regulated by the US Food and Drug Administration. Current models of tobacco abuse liability could be revised to include more explicit roles with regard to non-nicotine constituents that enhance abuse potential. PMID:26063608

  6. The wish to hasten death: a review of clinical studies.

    PubMed

    Monforte-Royo, Cristina; Villavicencio-Chávez, Christian; Tomás-Sábado, Joaquín; Balaguer, Albert

    2011-08-01

    It is common for patients who are faced with physical or psychological suffering, particularly those in the advanced stages of a disease, to have some kind of wish to hasten death (WTHD). This paper reviews and summarises the current state of knowledge about the WTHD among people with end-stage disease, doing so from a clinical perspective and on the basis of published clinical research. Studies were identified through a search strategy applied to the main scientific databases. Clinical studies show that the WTHD has a multi-factor aetiology. The literature review suggests-perhaps in line with better management of physical pain-that psychological and spiritual aspects, including social factors, are the most important cause of such a wish. One of the difficulties facing clinical research is the lack of terminological and conceptual precision in defining the construct. Indeed, studies frequently blur the distinction between a generic wish to die, a WTDH (whether sporadic or persistent over time), the explicit expression of a wish to die, and a request for euthanasia or physician-assisted suicide. A notable contribution to knowledge in this field has been made by scales designed to evaluate the WTHD, although the problems of conceptual definition may once again limit the conclusions, which can be drawn from the results. Studies using qualitative methodology have also provided new information that can help in understanding such wishes. Further clinical research is needed to provide a complete understanding of this phenomenon and to foster the development of suitable care plans. PMID:20821377

  7. Understanding Orthopaedic Registry Studies: A Comparison with Clinical Studies.

    PubMed

    Inacio, Maria C S; Paxton, Elizabeth W; Dillon, Mark T

    2016-01-01

    Orthopaedic registries are valuable for monitoring patient outcomes in real-world settings. Registries are useful for identifying procedure incidence and device utilization, evaluating outcomes, determining patients at risk for complications and reoperations, identifying devices in recall situations, assessing comparative effectiveness of procedures and devices, and providing data for research studies. In the present report, we describe how orthopaedic registries can be used to conduct research and how they compare with randomized controlled trials (RCTs) in regard to methodology. Using an example, a comparison of the performance of mobile and fixed bearings in total knee arthroplasty, we evaluate the differences between, and the similarities of, RCTs and registry cohort studies with regard to how they are conducted and how their findings are reported. Orthopaedic registry studies differ from RCTs in many ways and offer certain advantages. The strengths and limitations of registry cohort studies and RCTs must be understood to properly evaluate the literature. PMID:26738910

  8. Electrochemotherapy in pancreatic adenocarcinoma treatment: pre-clinical and clinical studies

    PubMed Central

    Leongito, Maddalena; Granata, Vincenza; Barbieri, Antonio; del Vecchio, Vitale; Falco, Michela; Nasto, Aurelio; Albino, Vittorio; Piccirillo, Mauro; Palaia, Raffaele; Amore, Alfonso; Giacomo, Raimondo di; Lastoria, Secondo; Setola, Sergio Venanzio; Fusco, Roberta; Petrillo, Antonella; Izzo, Francesco

    2016-01-01

    Background Pancreatic adenocarcinoma is currently one of the deadliest cancers with high mortality rate. This disease leads to an aggressive local invasion and early metastases, and is poorly responsive to treatment with chemotherapy or chemo-radiotherapy. Radical resection is still the only curative treatment for pancreatic cancer, but it is generally accepted that a multimodality strategy is necessary for its management. Therefore, new alternative therapies have been considered for local treatment. Conclusions Chemotherapeutic resistance in pancreatic cancer is associated to a low penetration of drugs into tumour cells due to the presence of fibrotic stroma surrounding cells. In order to increase the uptake of chemotherapeutic drugs into tumour cells, electrochemotherapy can be used for treatment of pancreatic adenocarcinoma leading to an increased tumour response rate. This review will summarize the published papers reported in literature on the efficacy and safety of electrochemotherapy in pre-clinical and clinical studies on pancreatic cancer. PMID:27069445

  9. A Mechanistic Study of Halogen Addition and Photoelimination from π-Conjugated Tellurophenes.

    PubMed

    Carrera, Elisa I; Lanterna, Anabel E; Lough, Alan J; Scaiano, Juan C; Seferos, Dwight S

    2016-03-01

    The ability to drive reactivity using visible light is of importance for many disciplines of chemistry and has significant implications for sustainable chemistry. Identifying photochemically active compounds and understanding photochemical mechanisms is important for the development of useful materials for synthesis and catalysis. Here we report a series of photoactive diphenyltellurophene compounds bearing electron-withdrawing and electron-donating substituents synthesized by alkyne coupling/ring closing or palladium-catalyzed ipso-arylation chemistry. The redox chemistry of these compounds was studied with respect to oxidative addition and photoelimination of bromine, which is of importance for energy storage reactions involving X2. The oxidative addition reaction mechanism was studied using density functional theory, the results of which support a three-step mechanism involving the formation of an initial η(1) association complex, a monobrominated intermediate, and finally the dibrominated product. All of the tellurophene derivatives undergo photoreduction using 430, 447, or 617 nm light depending on the absorption properties of the compound. Compounds bearing electron-withdrawing substituents have the highest photochemical quantum efficiencies in the presence of an alkene trap, with efficiencies of up to 42.4% for a pentafluorophenyl-functionalized tellurophene. The photoelimination reaction was studied in detail through bromine trapping experiments and laser flash photolysis, and a mechanism is proposed. The photoreaction, which occurs by release of bromine radicals, is competitive with intersystem crossing to the triplet state of the brominated species, as evidenced by the formation of singlet oxygen. These findings should be useful for the design of new photochemically active compounds supported by main-group elements. PMID:26853739

  10. Ethical considerations of study participants in dental caries clinical trials.

    PubMed

    Horowitz, H S

    1976-03-01

    During the past 30 years there has been increasing concern for ethical considerations that pertain to the conduct of human biomedical research. Consequently, many national and international medical and dental organizations and agencies have developed regulations, policies or ethical guidelines for the protection of human subjects who take part in clinical investigations. In the United States, more than 500 research institutions have established permanent committees to review research in humans conducted by their institutions. Members of these committees must represent a broad range of backgrounds, interests, and concerns. Prospective study subjects must be able to make an informed decision on whether to participate in any study, without any element of force, deceit, duress, or other form of constraint or coercion. Obtaining informed consent for studies of children, the mentally infirm, and persons with restricted civil freedom presents special problems. Ethical considerations also raise questions on appropriate designs for clinical studies, e.g. use of untreated controls. Dental studies, particularly those testing caries-preventive agents, raise special questions of design, informed consent, ethical procedures and the use of diagnostic radiographs. The director of a clinical study is responsible for the conduct of all personnel connected with the investigation. PMID:767047

  11. Clinical risk factors for the development of consecutive exotropia: a comparative clinical study

    PubMed Central

    Taylan Sekeroglu, Hande; Erkan Turan, Kadriye; Karakaya, Jale; Sener, Emin Cumhur; Sanac, Ali Sefik

    2016-01-01

    AIM To compare a group of patients with consecutive exotropia with patients who had ≤10 prism diopters (PD) esotropia or no deviation postoperatively in terms of probable clinical risk factors for the development of consecutive exotropia. METHODS The study recruited fourteen patients who developed consecutive exodeviation during follow-up period after the correction of esotropia who were categorized as group 1 and thirty-one patients who had still ≤10 PD esotropia or no deviation at the final visit that were considered as group 2. Clinical risk factors leading the development of consecutive deviation were analyzed as the main outcome measures. RESULTS The mean age of patients was 4.57±3.11y in group 1 and 5.10±3.52y in group 2 (P=0.634). There was no significant difference of preoperative near and distant deviations among two groups (P=0.835, 0.928 respectively). The mean amount of medial rectus recession and lateral rectus resection was similar in both groups (P=0.412, 0.648 respectively). Convergence insufficiency and neurological diseases were more frequent in group 1 (P=0.007, 0.045). Accompanying neurological disease was found to be as a significant factor increasing the risk of the development of consecutive exotropia significantly [odds ratios (OR): 5.75 (1.04-31.93)]. CONCLUSION Accompanying neurological disease appears to be a significant clinical risk factor for the development of consecutive exodeviation during postoperative follow-up after the correction of esotropia. However, larger studies are needed in order to interpret the results to the clinical practice and to ascertain other concurrent risk factors. PMID:27366693

  12. Resources allocation in healthcare for cancer: a case study using generalised additive mixed models.

    PubMed

    Musio, Monica; Sauleau, Erik A; Augustin, Nicole H

    2012-11-01

    Our aim is to develop a method for helping resources re-allocation in healthcare linked to cancer, in order to replan the allocation of providers. Ageing of the population has a considerable impact on the use of health resources because aged people require more specialised medical care due notably to cancer. We propose a method useful to monitor changes of cancer incidence in space and time taking into account two age categories, according to healthcar general organisation. We use generalised additive mixed models with a Poisson response, according to the methodology presented in Wood, Generalised additive models: an introduction with R. Chapman and Hall/CRC, 2006. Besides one-dimensional smooth functions accounting for non-linear effects of covariates, the space-time interaction can be modelled using scale invariant smoothers. Incidence data collected by a general cancer registry between 1992 and 2007 in a specific area of France is studied. Our best model exhibits a strong increase of the incidence of cancer along time and an obvious spatial pattern for people more than 70 years with a higher incidence in the central band of the region. This is a strong argument for re-allocating resources for old people cancer care in this sub-region. PMID:23242683

  13. Covalent binding of aniline to humic substances. 2. 15N NMR studies of nucleophilic addition reactions

    USGS Publications Warehouse

    Thorn, K.A.; Pettigrew, P.J.; Goldenberg, W.S.; Weber, E.J.

    1996-01-01

    Aromatic amines are known to undergo covalent binding with humic substances in the environment. Although previous studies have examined reaction conditions and proposed mechanisms, there has been no direct spectroscopic evidence for the covalent binding of the amines to the functional groups in humic substances. In order to further elucidate the reaction mechanisms, the Suwannee River and IHSS soil fulvic and humic acids were reacted with 15N-labeled aniline at pH 6 and analyzed using 15N NMR spectrometry. Aniline underwent nucleophilic addition reactions with the quinone and other carbonyl groups in the samples and became incorporated in the form of anilinohydroquinone, anilinoquinone, anilide, imine, and heterocyclic nitrogen, the latter comprising 50% or more of the bound amine. The anilide and anilinohydroquinone nitrogens were determined to be susceptible to chemical exchange by ammonia. In the case of Suwannee River fulvic acid, reaction under anoxic conditions and pretreatment with sodium borohydride or hydroxylamine prior to reaction under oxic conditions resulted in a decrease in the proportion of anilinohydroquinone nitrogen incorporated. The relative decrease in the incorporation of anilinohydroquinone nitrogen with respect to anilinoquinone nitrogen under anoxic conditions suggested that inter- or intramolecular redox reactions accompanied the nucleophilic addition reactions.

  14. Toxicogenomics concepts and applications to study hepatic effects of food additives and chemicals

    SciTech Connect

    Stierum, Rob . E-mail: stierum@voeding.tno.nl; Heijne, Wilbert; Kienhuis, Anne; Ommen, Ben van; Groten, John

    2005-09-01

    Transcriptomics, proteomics and metabolomics are genomics technologies with great potential in toxicological sciences. Toxicogenomics involves the integration of conventional toxicological examinations with gene, protein or metabolite expression profiles. An overview together with selected examples of the possibilities of genomics in toxicology is given. The expectations raised by toxicogenomics are earlier and more sensitive detection of toxicity. Furthermore, toxicogenomics will provide a better understanding of the mechanism of toxicity and may facilitate the prediction of toxicity of unknown compounds. Mechanism-based markers of toxicity can be discovered and improved interspecies and in vitro-in vivo extrapolations will drive model developments in toxicology. Toxicological assessment of chemical mixtures will benefit from the new molecular biological tools. In our laboratory, toxicogenomics is predominantly applied for elucidation of mechanisms of action and discovery of novel pathway-supported mechanism-based markers of liver toxicity. In addition, we aim to integrate transcriptome, proteome and metabolome data, supported by bioinformatics to develop a systems biology approach for toxicology. Transcriptomics and proteomics studies on bromobenzene-mediated hepatotoxicity in the rat are discussed. Finally, an example is shown in which gene expression profiling together with conventional biochemistry led to the discovery of novel markers for the hepatic effects of the food additives butylated hydroxytoluene, curcumin, propyl gallate and thiabendazole.

  15. Assessment of Nano Cellulose from Peach Palm Residue as Potential Food Additive: Part II: Preliminary Studies.

    PubMed

    Andrade, Dayanne Regina Mendes; Mendonça, Márcia Helena; Helm, Cristiane Vieira; Magalhães, Washington L E; de Muniz, Graciela Ines Bonzon; Kestur, Satyanarayana G

    2015-09-01

    High consumption of dietary fibers in the diet is related to the reduction of the risk of non-transmitting of chronic diseases, prevention of the constipation etc. Rich diets in dietary fibers promote beneficial effects for the metabolism. Considering the above and recognizing the multifaceted advantages of nano materials, there have been many attempts in recent times to use the nano materials in the food sector including as food additive. However, whenever new product for human and animal consumption is developed, it has to be tested for their effectiveness regarding improvement in the health of consumers, safety aspects and side effects. However, before it is tried with human beings, normally such materials would be assessed through biological tests on a living organism to understand its effect on health condition of the consumer. Accordingly, based on the authors' finding reported in a previous paper, this paper presents body weight, biochemical (glucose, cholesterol and lipid profile in blood, analysis of feces) and histological tests carried out with biomass based cellulose nano fibrils prepared by the authors for its possible use as food additive. Preliminary results of the study with mice have clearly brought out potential of these fibers for the said purpose. PMID:26344977

  16. Human transcriptome array for high-throughput clinical studies

    PubMed Central

    Xu, Weihong; Seok, Junhee; Mindrinos, Michael N.; Schweitzer, Anthony C.; Jiang, Hui; Wilhelmy, Julie; Clark, Tyson A.; Kapur, Karen; Xing, Yi; Faham, Malek; Storey, John D.; Moldawer, Lyle L.; Maier, Ronald V.; Tompkins, Ronald G.; Wong, Wing Hung; Davis, Ronald W.; Xiao, Wenzhong; Toner, Mehmet; Warren, H. Shaw; Schoenfeld, David A.; Rahme, Laurence; McDonald-Smith, Grace P.; Hayden, Douglas; Mason, Philip; Fagan, Shawn; Yu, Yong-Ming; Cobb, J. Perren; Remick, Daniel G.; Mannick, John A.; Lederer, James A.; Gamelli, Richard L.; Silver, Geoffrey M.; West, Michael A.; Shapiro, Michael B.; Smith, Richard; Camp, David G.; Qian, Weijun; Tibshirani, Rob; Lowry, Stephen; Calvano, Steven; Chaudry, Irshad; Cohen, Mitchell; Moore, Ernest E.; Johnson, Jeffrey; Baker, Henry V.; Efron, Philip A.; Balis, Ulysses G. J.; Billiar, Timothy R.; Ochoa, Juan B.; Sperry, Jason L.; Miller-Graziano, Carol L.; De, Asit K.; Bankey, Paul E.; Herndon, David N.; Finnerty, Celeste C.; Jeschke, Marc G.; Minei, Joseph P.; Arnoldo, Brett D.; Hunt, John L.; Horton, Jureta; Cobb, J. Perren; Brownstein, Bernard; Freeman, Bradley; Nathens, Avery B.; Cuschieri, Joseph; Gibran, Nicole; Klein, Matthew; O'Keefe, Grant

    2011-01-01

    A 6.9 million-feature oligonucleotide array of the human transcriptome [Glue Grant human transcriptome (GG-H array)] has been developed for high-throughput and cost-effective analyses in clinical studies. This array allows comprehensive examination of gene expression and genome-wide identification of alternative splicing as well as detection of coding SNPs and noncoding transcripts. The performance of the array was examined and compared with mRNA sequencing (RNA-Seq) results over multiple independent replicates of liver and muscle samples. Compared with RNA-Seq of 46 million uniquely mappable reads per replicate, the GG-H array is highly reproducible in estimating gene and exon abundance. Although both platforms detect similar expression changes at the gene level, the GG-H array is more sensitive at the exon level. Deeper sequencing is required to adequately cover low-abundance transcripts. The array has been implemented in a multicenter clinical program and has generated high-quality, reproducible data. Considering the clinical trial requirements of cost, sample availability, and throughput, the GG-H array has a wide range of applications. An emerging approach for large-scale clinical genomic studies is to first use RNA-Seq to the sufficient depth for the discovery of transcriptome elements relevant to the disease process followed by high-throughput and reliable screening of these elements on thousands of patient samples using custom-designed arrays. PMID:21317363

  17. A Clinical Study of Miliary Brain Tuberculomas in China.

    PubMed

    Yang, Ming; Zhang, Jia-Tang; Yao, Yan; Tan, Qing-Che; Gao, Ting; Tian, Cheng-Lin; Huang, Xusheng; Yu, Sheng-Yuan

    2016-05-20

    Brain tuberculomas can exhibit many different clinical and radiological patterns. However, disseminated or miliary brain tuberculomas are very rare. Miliary brain tuberculomas have specific clinical prognostic implications. Seven patients diagnosed with miliary brain tuberculomas between December 2004 and August 2012 were evaluated retrospectively. Their clinical features, cranial magnetic resonance imaging (MRI) characteristics, treatments, and outcomes were reviewed. The median patient age was 42 years (range, 22-66 years). Six patients presented with fever, 5 with headache, 4 with papilledema, and 3 with diplopia. MRI studies revealed multiple brain lesions. MRI showed 20-50 lesions at the same level. These lesions measured approximately 2-4 mm in diameter and exhibited ring or nodular enhancement after gadolinium injection. All patients began to recover within 2 weeks of initiating antitubercular therapy (ATT). The number of lesions visible on MRI scans was halved within a month, and all lesions had healed without sequelae after 18 months of regular ATT. Miliary brain tuberculoma is a rare form of central nervous system tuberculosis. Some special characteristics of miliary brain tuberculomas are as follows: First, the presence of mild atypical clinical manifestations and almost normal laboratory findings; second, severe radiological features and 20-50 lesions at the same level on MRI scans; and third, a good response to standard ATT. Finally, they are benign; for instance, no patients died in our study. Early diagnosis and treatment can result in full recovery. PMID:26255731

  18. Comparative study of dimensional accuracy of different impression techniques using addition silicone impression material.

    PubMed

    Penaflor, C F; Semacio, R C; De Las Alas, L T; Uy, H G

    1998-01-01

    This study compared dimensional accuracy of the single, double with spacer, double with cut-out and double mix impression technique using addition silicone impression material. A typhodont containing Ivorine teeth model with six (6) full-crown tooth preparations were used as the positive control. Two stone replication models for each impression technique were made as test materials. Accuracy of the techniques were assessed by measuring four dimensions on the stone dies poured from the impression of the Ivorine teeth model. Results indicated that most of the measurements for the height, width and diameter slightly decreased and a few increased compared with the Ivorine teeth model. The double with cut-out and double mix technique presents the least difference from the master model as compared to the two latter impression techniques. PMID:10202524

  19. Spectroscopic studies of nucleic acid additions during seed-mediated growth of gold nanoparticles

    PubMed Central

    Tapp, Maeling; Sullivan, Rick; Dennis, Patrick; Naik, Rajesh R.

    2015-01-01

    The effect of adding nucleic acids to gold seeds during the growth stage of either nanospheres or nanorods was investigated using UV-Vis spectroscopy to reveal any oligonucleotide base or structure-specific effects on nanoparticle growth kinetics or plasmonic signatures. Spectral data indicate that the presence of DNA duplexes during seed ageing drastically accelerated nanosphere growth while the addition of single-stranded polyadenine at any point during seed ageing induces nanosphere aggregation. For seeds added to a gold nanorod growth solution, single-stranded polythymine induces a modest blue-shift in the longitudinal peak wavelength. Moreover, a particular sequence comprised of 50% thymine bases was found to induce a faster, more dramatic blue-shift in the longitudinal peak wavelength compared to any of the homopolymer incubation cases. Monomeric forms of the nucleic acids, however, do not yield discernable spectral differences in any of the gold suspensions studied. PMID:25960601

  20. Study on Friction and Wear Properties of Silver Matrix Brush Material with Different Additives

    NASA Astrophysics Data System (ADS)

    Chen, Xiaoli; Wang, Wenfang; Hong, Yu; Wu, Yucheng

    2013-07-01

    Friction and wear processes of AgCuX (G, CF and AlN) composites-CuAgV alloy friction pair and effects of different additive content in silver based composite on friction and wear behavior are studied in this paper. The microstructure of the brush wear surface is observed by SEM. The results show that when graphite content is up to 9 wt.%, Ag-Cu-CF-G composite exhibits the best wear properties; when the content of aluminum nitride is up to 0.5 wt.%, Ag-Cu-AlN-G composites has the most comprehensive performance. The wear loss of both composites arises with the increase of both pressure and speed, but when speed reaches a critical value, the increased amplitude of wear loss tends to be steady.

  1. Prevalence and clinical predictors of pulmonary tuberculosis among isolated inpatients: a prospective study.

    PubMed

    Lagrange-Xélot, M; Porcher, R; Gallien, S; Wargnier, A; Pavie, J; de Castro, N; Molina, J-M

    2011-04-01

    Guidelines help to prevent the transmission of Mycobacterium tuberculosis in healthcare settings, but may also result in the unnecessary isolation of many patients. We performed a prospective study to assess the prevalence and identify clinical predictors of culture-proven tuberculosis among inpatients isolated for suspected pulmonary tuberculosis (PTB) at our hospital. We also wished to validate a pre-existing clinical decision rule to improve our isolation policy. From August 2005 to January 2007, 134 patients isolated on admission to the ward for suspicion of PTB were prospectively enrolled. The admitting team made the decision to isolate patients on the basis of clinical and radiological findings, without the use of the clinical decision rule, and graded the overall suspicion of PTB. Twenty-six of the 134 isolated patients had PTB (prevalence: 19.4%), as well as one patient not isolated at admission. Univariate analysis revealed that PTB was significantly associated with young age, lack of human immunodeficiency virus (HIV) infection, weight loss, night sweats, fever, upper lobe disease and, especially, cavitary lesions on chest X-ray (adjusted OR 25.4, p <0.0001). Low suspicion of PTB by the admitting team and low clinical decision rule score had negative predictive values of 98.5% and 95.8% for PTB, respectively. Use of the clinical decision rule in addition to the team assessment would have led to the isolation of the patient with PTB not isolated on admission, and avoided 16 (14.8%) unnecessary isolations. In conclusion, the prevalence of PTB among isolated inpatients was high, and the use of a clinical decision rule in addition to clinical impression might improve isolation decisions. PMID:20459437

  2. Genetic assessment of additional endophenotypes from the Consortium on the Genetics of Schizophrenia Family Study.

    PubMed

    Greenwood, Tiffany A; Lazzeroni, Laura C; Calkins, Monica E; Freedman, Robert; Green, Michael F; Gur, Raquel E; Gur, Ruben C; Light, Gregory A; Nuechterlein, Keith H; Olincy, Ann; Radant, Allen D; Seidman, Larry J; Siever, Larry J; Silverman, Jeremy M; Stone, William S; Sugar, Catherine A; Swerdlow, Neal R; Tsuang, Debby W; Tsuang, Ming T; Turetsky, Bruce I; Braff, David L

    2016-01-01

    The Consortium on the Genetics of Schizophrenia Family Study (COGS-1) has previously reported our efforts to characterize the genetic architecture of 12 primary endophenotypes for schizophrenia. We now report the characterization of 13 additional measures derived from the same endophenotype test paradigms in the COGS-1 families. Nine of the measures were found to discriminate between schizophrenia patients and controls, were significantly heritable (31 to 62%), and were sufficiently independent of previously assessed endophenotypes, demonstrating utility as additional endophenotypes. Genotyping via a custom array of 1536 SNPs from 94 candidate genes identified associations for CTNNA2, ERBB4, GRID1, GRID2, GRIK3, GRIK4, GRIN2B, NOS1AP, NRG1, and RELN across multiple endophenotypes. An experiment-wide p value of 0.003 suggested that the associations across all SNPs and endophenotypes collectively exceeded chance. Linkage analyses performed using a genome-wide SNP array further identified significant or suggestive linkage for six of the candidate endophenotypes, with several genes of interest located beneath the linkage peaks (e.g., CSMD1, DISC1, DLGAP2, GRIK2, GRIN3A, and SLC6A3). While the partial convergence of the association and linkage likely reflects differences in density of gene coverage provided by the distinct genotyping platforms, it is also likely an indication of the differential contribution of rare and common variants for some genes and methodological differences in detection ability. Still, many of the genes implicated by COGS through endophenotypes have been identified by independent studies of common, rare, and de novo variation in schizophrenia, all converging on a functional genetic network related to glutamatergic neurotransmission that warrants further investigation. PMID:26597662

  3. Clinical Utility of Combinatorial Pharmacogenomics-Guided Antidepressant Therapy: Evidence from Three Clinical Studies.

    PubMed

    Altar, C Anthony; Carhart, Joseph; Allen, Josiah D; Hall-Flavin, Daniel; Winner, Joel; Dechairo, Bryan

    2015-10-01

    DNA of 258 patients with treatment-resistant depression was collected in three 8-10 week, two-arm, prospective clinical trials. Forty-four allelic variations were measured in genes for the cytochrome P450 (CYP) enzymes CYP2D6, CYPC19, and CYP1A2, the serotonin transporter (SLC6A4), and the 5-HT2A receptor (HTR2A). The combinatorial pharmacogenomic (CPGx™) GeneSight test results were provided to clinicians to support medication changes from baseline (guided arm), or they were provided at the end of each study to clinicians of unguided patients who were treated as usual (TAU). TAU subjects who at baseline were prescribed medications genetically discordant for them showed only a 12% symptom improvement, far less than the 32.5% or 28.5% improvements of the TAU subjects on yellow-category ('use with caution'; p = 0.002) or green-category medications ('use as recommended'; p = 0.02), respectively. The odds of a clinical response were increased 2.3-fold among all GeneSight-guided compared to all TAU subjects (p = 0.004), and overall, the guided group had a 53% greater improvement in depressive symptoms (p = 0.0002), a 1.7-fold relative improvement in response (p = 0.01), and a number needed to treat for one clinical response above that seen in the TAU group of 6.07. PMID:27606312

  4. Serum Potassium and Glucose Regulation in the ADDITION-Leicester Screening Study

    PubMed Central

    Carter, Patrice; Bodicoat, Danielle H.; Quinn, Lauren M.; Zaccardi, Francesco; Webb, David R.; Khunti, Kamlesh; Davies, Melanie J.

    2015-01-01

    Introduction. Previous observational studies have shown conflicting results between plasma K+ concentrations and risk of type 2 diabetes. To help clarify the evidence we aimed to determine whether an association existed between serum K+ and glucose regulation within a UK multiethnic population. Methods. Participants were recruited as part of the ADDITION Leicester study, a population based screening study. Individuals from primary care between the age of 40 and 75 years if White European or 25 and 75 years if South Asian or Afro Caribbean were recruited. Tests for associations between baseline characteristics and K+ quartiles were conducted using linear regression models. Results. Data showed individuals in the lowest K+ quartile had significantly greater 2-hour glucose levels (0.53 mmol/L, 95% CI: 0.36 to 0.70, P ≤ 0.001) than those in the highest K+ quartile. This estimation did not change with adjustment for potential confounders. Conversely, participants in the lowest K+ quartile had a 0.14% lower HbA1c (95% CI −0.19 to −0.10: P ≤ 0.001) compared to those in the highest K+ quartile. Conclusion. This cross-sectional analysis demonstrated that lower K+ was associated with greater 2 hr glucose. The data supports the possibility that K+ may influence glucose regulation and further research is warranted. PMID:25883988

  5. Study of triallyl phosphate as an electrolyte additive for high voltage lithium-ion cells

    NASA Astrophysics Data System (ADS)

    Xia, J.; Madec, L.; Ma, L.; Ellis, L. D.; Qiu, W.; Nelson, K. J.; Lu, Z.; Dahn, J. R.

    2015-11-01

    The role of triallyl phosphate as an electrolyte additive in Li(Ni0.42Mn0.42Co0.16)O2/graphite pouch cells was studied using ex-situ gas measurements, ultra high precision coulometry, automated storage experiments, electrochemical impedance spectroscopy, long-term cycling and X-ray photoelectron spectroscopy. Cells containing triallyl phosphate produced less gas during formation, cycling and storage than control cells. The use of triallyl phosphate led to higher coulombic efficiency and smaller charge endpoint capacity slippage during ultra high precision charger testing. Cells containing triallyl phosphate showed smaller potential drop during 500 h storage at 40 °C and 60 °C and the voltage drop decreased as the triallyl phosphate content in the electrolyte increased. However, large amounts of triallyl phosphate (>3% by weight in the electrolyte) led to large impedance after cycling and storage. Symmetric cell studies showed large amounts of triallyl phosphate (5% or more) led to significant impedance increase at both negative and positive electrodes. X-ray photoelectron spectroscopy studies suggested that the high impedance came from the polymerization of triallyl phosphate molecules which formed thick solid electrolyte interphase films at the surfaces of both negative and positive electrodes. An optimal amount of 2%-3% triallyl phosphate led to better capacity retention during long term cycling.

  6. Autism and genetics: Clinical approach and association study with two markers of HRAS gene

    SciTech Connect

    Herault, J.; Petit, E.; Cherpi, C.

    1995-08-14

    Twin studies and familial aggregation studies indicate that genetic factors could play a role in infantile autism. In an earlier study, we identified a possible positive association between autism and a c-Harvey-ras (HRAS) oncogene marker at the 3{prime} end of the coding region. In an attempt to confirm this finding, we studied a larger population, well-characterized clinically and genetically. We report a positive association between autism and two HRAS markers, the 3{prime} marker used in the initial study and an additional marker in exon 1. 46 refs., 1 fig., 2 tabs.

  7. One-year clinical results of Er,Cr:YSGG laser application in addition to scaling and root planing in patients with early to moderate periodontitis.

    PubMed

    Kelbauskiene, Solveiga; Baseviciene, Nomeda; Goharkhay, Kawe; Moritz, Andreas; Machiulskiene, Vita

    2011-07-01

    In 30 patients with periodontitis, a total of 278 teeth exhibiting bleeding on probing, subgingival calculus, and a probing depth between 3-6 mm were examined. For each participant, two treatment types were alternatively applied on the contralateral quadrants: scaling and root planing (SRP) as control, and SRP followed by Er,Cr:YSGG laser application (SRP+laser), as a test method. Five clinical parameters: plaque level, bleeding on probing, probing depth, gingival recession and clinical attachment level were examined at baseline and at 2, 3, 6, 12 months after treatment. Of the total of 1,668 sites examined in all patients, 1,088 sites were found with a probing depth of 3-6 mm. In these sites, differences in clinical parameters between SRP and SRP+laser-treated quadrants were analyzed, assuming the level of p < 0.05 as significant. After 2 months from baseline, the mean probing depth reduction and the clinical attachment level gain were significantly greater in SRP+laser than in SRP quadrants, and remained so throughout the study (p < 0.001). A marked reduction of the bleeding scores occurred in all examined sites, irrespective of the treatment method. However, after 12 months, significantly less teeth exhibited bleeding on probing in SRP+laser quadrants than in SRP quadrants (p < 0.001). The mean plaque and gingival recession levels did not differ between the SRP and SRP+laser quadrants neither before nor after the treatment. The periodontal procedures either using Er,Cr:YSGG laser after SRP or SRP alone, lead to significant improvements in all clinical parameters investigated. However, laser application, as an adjunct to SRP, appeared to be more advantageous. PMID:20549280

  8. Dissociated vertical deviation-a clinical and laboratory study.

    PubMed Central

    Helveston, E M

    1980-01-01

    The previously reported nomenclature and clinical characteristics of dissociated vertical deviation have been recorded. The incidence and characteristics of DVD have been determined by evaluation of 1,000 consecutive strabismus or nystagmus patients, and with selected chart study carried out on the 111 DVD patients found in this series. Electro-oculographic studies of selected patients with DVD provided objective evidence of the speed and amplitude of the ocular movements in DVD. Bell phenomenon, strabismus sursoadductorius and the Bielschowsky phenomenon were recorded and compared to clinical findings of strabismus patients with DVD. The technique for the results of surgery for DVD were described. Dissociated vertical deviation was characterized as a component of the overall strabismus picture. Images FIGURE 1 A FIGURE 1 B FIGURE 1 C FIGURE 1 D FIGURE 1 E FIGURE 2 A FIGURE 2 B FIGURE 2 C FIGURE 3 A FIGURE 3 B FIGURE 3 C FIGURE 4 A FIGURE 4 B PMID:7020216

  9. Pilot Study of a Clinical Pathway Implementation in Rectal Cancer

    PubMed Central

    Uña, Esther; López-Lara, Francisco

    2010-01-01

    Background: Rectal cancer is a highly prevalent disease which needs a multidisciplinary approach to be treated. The absence of specific protocols implies a significant and unjustifiable variability among the different professionals involved in this disease. The purpose is to develop a clinical pathway based on the analysis process and aims to reduce this variability and to reduce unnecessary costs. Methods: We created a multidisciplinary team with contributors from every clinical area involved in the diagnosis and treatment in this disease. We held periodic meetings to agree on a protocol based on the best available clinical practice guidelines. Once we had agreed on the protocol, we implemented its use as a standard in our institution. Every patient older than 18 years who was diagnosed with rectal cancer was considered a candidate to be treated via the pathway. Results: We evaluated 48 patients during the course of this study. Every parameter measured was improved after the implementation of the pathway, except the proportion of patients with 12 nodes or more analysed. The perception that our patients had about this project was very good. Conclusions: Clinical pathways are needed to improve the quality of health care. This kind of project helps reduce hospital costs and optimizes the use of limited resources. On the other hand, unexplained variability is also reduced, with consequent benefits for the patients. PMID:21151842

  10. Myopathies of endocrine disorders: A prospective clinical and biochemical study

    PubMed Central

    Sharma, Vikas; Borah, Papori; Basumatary, Lakshya J.; Das, Marami; Goswami, Munindra; Kayal, Ashok K.

    2014-01-01

    Introduction: Major categories of endocrine myopathy include those associated with: Adrenal dysfunction (as in Cushing's disease or steroid myopathy); thyroid dysfunction (as in myxedema coma or thyrotoxic myopathy); vitamin D deficiency; parathyroid dysfunction; and pituitary dysfunction. Steroid myopathy is the most common endocrine myopathy. Objective: To study the etiology, varied presentations, and outcome after therapy of patients with endocrine myopathies. Materials and Methods: Myopathy was evaluated by the standard clinical procedures: Detailed clinical history, manual muscle strength testing, and creatine phosphokinase (CPK). Endocrine disorders were diagnosed as per clinical features and biochemical parameters. The treatment was given to patients as per underlying endocrine disease. Myopathy was assessed before and after treatment. Results: Out of the 37 patients who were diagnosed with endocrine myopathies, thyroid dysfunction was the most common cause (17 cases), followed by vitamin D deficiency in nine, adrenal dysfunction in six, parathyroid dysfunction in three, and pituitary dysfunction in two. Some patients had atypical presentation (repeated falls in one, tongue fasciculations in one, neck weakness in five, one with ptosis and facial weakness, asymmetrical onset in one, and calf hypertrophy in one. The serum creatine kinase (CK) concentration did not correlate with muscle weakness. Following the treatment regimen which was specific for a given myopathy, 26 patients recovered fully. Conclusion: We found varied clinical presentations of endocrine myopathies. All the patients with neuromuscular complaints should be investigated for endocrine causes because significant number of them recovers fully with specific treatment. PMID:25221399

  11. [Clinical and microbiological study of adult periodontal disease].

    PubMed

    Nogueira Moreira, A; Fernández Canigia, L; Furman, C; Chiappe, V; Marcantoni, M; Bianchini, H

    2001-01-01

    The aim of this study was to carry out a microbiological evaluation of sites with and without clinical evidence of moderate and severe periodontitis and their correlation with clinical parameters. A total of 52 disease sites and 10 healthy sites were selected according to clinical criteria. The following clinical indexes were measured for all the sites: plaque index, gingival index, blood on probing, depth on probing and insertion level. Samples of subgingival plaque were collected for culture and for differential counts of microbial morphotypes. In disease sites the most frequently isolated were: Prevotella intermedia/nigrescens (65%), Porphyromonas gingivalis (23%), Actinobacillus actinomycetemcomitans (23%), Fusobacterium nucleatum (10%) and Peptostreptococcus sp. (31%). The aerobic gram-positive microflora was predominant in healthy sites. Significant differences were observed in microbial morphotypes between healthy and disease sites: cocci 18.71% and 78.90%, motile rods 46.12% and 16.70%, total spirochetes 26.48% and 2.80%, respectively. The presence of motile rods, spirochetes and P. intermedia/nigrescens were the parameters with most sensitivity to suspect periodontal disease. There were significant differences in the subgingival microflora between healthy and disease sites in patients with moderate and severe periodontitis. PMID:11594003

  12. Experimental Study of Disruption of Columnar Grains During Rapid Solidification in Additive Manufacturing

    NASA Astrophysics Data System (ADS)

    Manogharan, Guha; Yelamanchi, Bharat; Aman, Ronald; Mahbooba, Zaynab

    2016-03-01

    Over the years, many studies have been conducted to study and analyze the grain structures of metal alloys during additive manufacturing to improve mechanical properties. In particular, columnar grains are observed predominantly during rapid solidification of molten metal. This leads to lower mechanical properties and requires expensive secondary heat-treatment processes. This study is aimed at disrupting the formation of columnar grain growth during rapid solidification using ultrasonic vibration and analyzes the effects on grain structure and mechanical properties. A gas-metal arc welder mounted on a Rep-Rap-based low-cost metal 3 Dimension printer was used to deposit ER70S-6 mild steel layers on a plate. A contact-type ultrasonic transducer with a control system to vary the frequency and power of the vibration was used. The effects of ultrasonic vibration were determined from the statistical analysis of microstructure and micro-indentation techniques on the deposited layer and heat-affected zone. It was found that both frequency and interaction between frequency and power had significant impact on the refinement of average grain size up to 10.64% and increased the number of grains by approximately 41.78%. Analysis of micro-indentation tests showed that there was an increase of approximately 14.30% in micro-hardness due to the applied frequency during rapid solidification. A pole diagram shows that application of vibration causes randomization of grain orientation. Along with the results from this study, further efforts in modeling and experimentation of multi-directional vibrations would lead to a better understanding of disrupting columnar grains in applications that use mechanical vibrations, such as welding, directed energy deposition, brazing, etc.

  13. Evidence of clinical competence by simulation, a hermeneutical observational study.

    PubMed

    Lejonqvist, Gun-Britt; Eriksson, Katie; Meretoja, Riitta

    2016-03-01

    Making the transition from theory to practise easier in nursing education through simulation is widely implemented all over the world, and there is research evidence of the positive effects of simulation. The pre-understanding for this study is based on a definition of clinical competence as encountering, knowing, performing, maturing and developing, and the hypothesis is that these categories should appear in simulated situations. The aim of the study was to explore the forms and expressions of clinical competence in simulated situations and furthermore to explore if and how clinical competence could be developed by simulation. An observational hermeneutic study with a hypothetic-deductive approach was used in 18 simulated situations with 39 bachelor degree nursing students. In the situations, the scenarios, the actors and the plots were described. The story told was "the way from suffering to health" in which three main plots emerged. The first was, doing as performing and knowing, which took the shape of knowing what to do, acting responsibly, using evidence and equipment, appearing confident and feeling comfortable, and sharing work and information with others. The second was, being as encountering the patient, which took the shape of being there for him/her and confirming by listening and answering. The third plot was becoming as maturing and developing which took the shape of learning in co-operation with other students. All the deductive categories, shapes and expressions appeared as dialectic patterns having their negative counterparts. The study showed that clinical competence can be made evident and developed by simulation and that the challenge is in encountering the patient and his/her suffering. PMID:26763209

  14. Evidenced-based review of clinical studies on endodontic diagnosis.

    PubMed

    2009-08-01

    The practice of endodontics requires excellence in diagnostic skills. The importance of this topic has been underscored by a recent 2008 AAE-sponsored symposium on endodontic diagnosis, which will be highlighted in a special issue of the Journal of Endodontics. In this minireview, we focus on recent clinical studies that emphasize different aspects related to the diagnosis of disorders of the pulp-dentin complex. PMID:19631854

  15. Peyronie's disease: a case study with clinical implications.

    PubMed

    Fisher, D Eileen; Lofton, Susan P; Hale, Theresa; Durant, Norma; Grant, LaVerne F

    2008-04-01

    Peyronie's disease involves the development of fibrous plaques in the connective tissue of the penis usually near the dorsal midline of the penile shaft in middle-aged and older men. This case study describes a 57-year-old man who presented with a history of prostatitis and complaints of anxiety related to penile pain and erectile difficulties. The diagnostic work-up and clinical interaction are described. PMID:18488585

  16. Neurophysiology versus clinical genetics in Rett syndrome: A multicenter study.

    PubMed

    Halbach, Nicky; Smeets, Eric E; Julu, Peter; Witt-Engerström, Ingegerd; Pini, Giorgio; Bigoni, Stefania; Hansen, Stig; Apartopoulos, Flora; Delamont, Robert; van Roozendaal, Kees; Scusa, Maria F; Borelli, Paolo; Candel, Math; Curfs, Leopold

    2016-09-01

    Many studies have attempted to establish the genotype-phenotype correlation in Rett syndrome (RTT). Cardiorespiratory measurements provide robust objective data, to correlate with each of the different clinical phenotypes. It has important implications for the management and treatment of this syndrome. The aim of this study was to correlate the genotype with the quantitative cardiorespiratory data obtained by neurophysiological measurement combined with a clinical severity score. This international multicenter study was conducted in four European countries from 1999 to 2012. The study cohort consisted of a group of 132 well-defined RTT females aged between 2 and 43 years with extended clinical, molecular, and neurophysiological assessments. Diagnosis of RTT was based on the consensus criteria for RTT and molecular confirmation. Genotype-phenotype analyses of clinical features and cardiorespiratory data were performed after grouping mutations by the same type and localization or having the same putative biological effect on the MeCP2 protein, and subsequently on eight single recurrent mutations. A less severe phenotype was seen in females with CTS, p.R133C, and p.R294X mutations. Autonomic disturbances were present in all females, and not restricted to nor influenced by one specific group or any single recurrent mutation. The objective information from non-invasive neurophysiological evaluation of the disturbed central autonomic control is of great importance in helping to organize the lifelong care for females with RTT. Further research is needed to provide insights into the pathogenesis of autonomic dysfunction, and to develop evidence-based management in RTT. © 2016 Wiley Periodicals, Inc. PMID:27354166

  17. Synthesis, Characterization, Molecular Modeling, and DNA Interaction Studies of Copper Complex Containing Food Additive Carmoisine Dye.

    PubMed

    Shahabadi, Nahid; Akbari, Alireza; Jamshidbeigi, Mina; Khodarahmi, Reza

    2016-06-01

    A copper complex of carmoisine dye; [Cu(carmoisine)2(H2O)2]; was synthesized and characterized by using physico-chemical and spectroscopic methods. The binding of this complex with calf thymus (ct) DNA was investigated by circular dichroism, absorption studies, emission spectroscopy, and viscosity measurements. UV-vis results confirmed that the Cu complex interacted with DNA to form a ground-state complex and the observed binding constant (2× 10(4) M(-1)) is more in keeping with the groove bindings with DNA. Furthermore, the viscosity measurement result showed that the addition of complex causes no significant change on DNA viscosity and it indicated that the intercalation mode is ruled out. The thermodynamic parameters are calculated by van't Hoff equation, which demonstrated that hydrogen bonds and van der Waals interactions played major roles in the reaction. The results of circular dichroism (CD) suggested that the complex can change the conformation of DNA from B-like form toward A-like conformation. The cytotoxicity studies of the carmoisine dye and its copper complex indicated that both of them had anticancer effects on HT-29 (colon cancer) cell line and they may be new candidates for treatment of the colon cancer. PMID:27152751

  18. Percutaneous Dorsal Instrumentation of Vertebral Burst Fractures: Value of Additional Percutaneous Intravertebral Reposition—Cadaver Study

    PubMed Central

    Krüger, Antonio; Schmuck, Maya; Noriega, David C.; Ruchholtz, Steffen; Baroud, Gamal; Oberkircher, Ludwig

    2015-01-01

    Purpose. The treatment of vertebral burst fractures is still controversial. The aim of the study is to evaluate the purpose of additional percutaneous intravertebral reduction when combined with dorsal instrumentation. Methods. In this biomechanical cadaver study twenty-eight spine segments (T11-L3) were used (male donors, mean age 64.9 ± 6.5 years). Burst fractures of L1 were generated using a standardised protocol. After fracture all spines were allocated to four similar groups and randomised according to surgical techniques (posterior instrumentation; posterior instrumentation + intravertebral reduction device + cement augmentation; posterior instrumentation + intravertebral reduction device without cement; and intravertebral reduction device + cement augmentation). After treatment, 100000 cycles (100–600 N, 3 Hz) were applied using a servohydraulic loading frame. Results. Overall anatomical restoration was better in all groups where the intravertebral reduction device was used (p < 0.05). In particular, it was possible to restore central endplates (p > 0.05). All techniques decreased narrowing of the spinal canal. After loading, clearance could be maintained in all groups fitted with the intravertebral reduction device. Narrowing increased in the group treated with dorsal instrumentation. Conclusions. For height and anatomical restoration, the combination of an intravertebral reduction device with dorsal instrumentation showed significantly better results than sole dorsal instrumentation. PMID:26137481

  19. Density functional theory study of the effects of alloying additions on sulfur adsorption on nickel surfaces

    NASA Astrophysics Data System (ADS)

    Malyi, Oleksandr I.; Chen, Zhong; Kulish, Vadym V.; Bai, Kewu; Wu, Ping

    2013-01-01

    Reactions of hydrogen sulfide (H2S) with Nickel/Ytrria-doped zirconia (Ni/YDZ) anode materials might cause degradation of the performance of solid oxide fuel cells when S containing fuels are used. In this paper, we employ density functional theory to investigate S adsorption on metal (M)-doped and undoped Ni(0 0 1) and Ni(1 1 1) surfaces. Based on the performed calculations, we analyze the effects of 12 alloying additions (Ag, Au, Al, Bi, Cd, Co, Cu, Fe, Sn, Sb, V, and Zn) on the temperature of transition between clean (S atoms do not adsorb on the surfaces) and contaminated (S atoms can adsorb on the surfaces spontaneously) M-doped Ni surfaces for different concentrations of H2S in the fuel. Predicted results are consistent with many experimental studies relevant to S poisoning of both Ni/YDZ and M-doped Ni/YDZ anode materials. This study is important to understand S poisoning phenomena and to develop new S tolerant anode materials.

  20. Evaluating outpatient transition clinics: a mixed-methods study protocol

    PubMed Central

    Sattoe, Jane N T; Peeters, Mariëlle A C; Hilberink, Sander R; Ista, Erwin; van Staa, AnneLoes

    2016-01-01

    Introduction To support young people in their transition to adulthood and transfer to adult care, a number of interventions have been developed. One particularly important intervention is the transition clinic (TC), where paediatric and adult providers collaborate. TCs are often advocated as best practices in transition care for young people with chronic conditions, but little is known about TC models and effects. The proposed study aims to gain insight into the added value of a TC compared with usual care (without a TC). Methods and analysis We propose a mixed-methods study with a retrospective controlled design consisting of semistructured interviews among healthcare professionals, observations of consultations with young people, chart reviews of young people transferred 2–4 years prior to data collection and questionnaires among the young people included in the chart reviews. Qualitative data will be analysed through thematic analysis and results will provide insights into structures and daily routines of TCs, and experienced barriers and facilitators in transitional care. Quantitatively, within-group differences on clinical outcomes and healthcare use will be studied over the four measurement moments. Subsequently, comparisons will be made between intervention and control groups on all outcomes at all measurement moments. Primary outcomes are ‘no-show after transfer’ (process outcome) and ‘experiences and satisfaction with the transfer’ (patient-reported outcome). Secondary outcomes consider clinical outcomes, healthcare usage, self-management outcomes and perceived quality of care. Ethics The Medical Ethical Committee of the Erasmus Medical Centre approved the study protocol (MEC-2014-246). Dissemination Study results will be disseminated through peer-reviewed journals and conferences. The study started in September 2014 and will continue until December 2016. The same study design will be used in a national study in 20 diabetes settings (2016

  1. Physiologic endpoints for clinical studies for cystic fibrosis.

    PubMed

    Stanojevic, Sanja; Ratjen, Felix

    2016-07-01

    The cystic fibrosis (CF) drug development pipeline promises many exciting new treatments for patients with CF, all which will require clinical studies to prove their benefits on CF lung disease. Historically many pivotal CF studies have used the Forced Expiratory Volume in 1s (FEV1) as the primary outcome measure, and after demonstrating significant improvements in the treatment group relative to placebo have led to regulatory approval of therapies for routine clinical care. Widespread implementation of these therapies has subsequently led to significant improvements in outcomes for patients with CF. While preserving lung function has obvious benefits to CF patients, as more patients maintain FEV1 in the normal range, it has become increasingly difficult to conduct clinical trials using FEV1 as the primary outcome measure. With multiple concurrent trials competing to enroll from the same pool of patients, there is a need for novel approaches to study end points as well as new physiological outcomes for CF therapeutic trials. In this review we will discuss some of the limitations of FEV1 in the current era of CF care, describe alternative physiological endpoints and outline areas for further research. PMID:27316663

  2. Additional weight load increases freezing of gait episodes in Parkinson's disease; an experimental study.

    PubMed

    Mensink, Senja H G; Nonnekes, Jorik; van Bon, Geert; Snijders, Anke H; Duysens, Jacques; Weerdesteyn, Vivian; Bloem, Bastiaan R; Oude Nijhuis, Lars B

    2014-05-01

    Freezing of gait is an episodic gait disorder,characterized by the inability to generate effective forward stepping movements. The pathophysiology underlying freezing of gait remains insufficiently understood, and this hampers the development of better treatment strategies.Preliminary evidence suggests that impaired force control during walking may contribute to freezing episodes, with difficulty to unload the swing leg and initiate the swing phase. Here, we used external loading to manipulate force control and to investigate its influence on freezing of gait.Twelve Parkinson's disease patients with freezing of gait performed three contrasting tasks: (1) loaded gait while wearing a belt fortified with lead weights; (2) weight supported gait using a parachute harness connected to a rigid metal cable running above the gait trajectory; and (3)normal gait. Gait tasks were used to provoke freezing episodes, including rapid 360° turns. Freezing episodes were quantified using blinded, videotaped clinical assessment. Furthermore, ground reaction forces and body kinematics were recorded. Loading significantly increased the mean number of freezing episodes per trial compared to the normal gait condition (P<0.05), but the effect of weight support was not consistent. Loading particularly increased the number of freezing episodes during rapid short steps. Step length was significantly smaller during loaded gait compared to normal gait (P<0.05), but changes in anticipatory postural adjustments were not different.Our results may point to impaired force control playing a key role in freezing of gait. Future studies should further investigate the mechanism, i.e., the contribution of deficient load feedback, and evaluate which forms of weight support might offer treatment opportunities. PMID:24658705

  3. Novel approaches to incorporating pharmacoeconomic studies into phase III clinical trials for Alzheimer's disease.

    PubMed

    Fillit, H; Cummings, J; Neumann, P; McLaughlin, T; Salavtore, P; Leibman, C

    2010-10-01

    The societal and individual costs of Alzheimer's disease are significant, worldwide. As the world ages, these costs are increasing rapidly, while health systems face finite budgets. As a result, many regulators and payers will require or at least consider phase III cost-effectiveness data (in addition to safety and efficacy data) for drug approval and reimbursement, increasing the risks and costs of drug development. Incorporating pharmacoeconomic studies in phase III clinical trials for Alzheimer's disease presents a number of challenges. We propose several specific suggestions to improve the design of pharmacoeconomic studies in phase III clinical trials. We propose that acute episodes of care are key outcome measures for pharmacoeconomic studies. To improve the possibility of detecting a pharmacoeconomic impact in phase III, we suggest several strategies including; study designs for enrichment of pharmacoeconomic outcomes that include co-morbidity of patients; reducing variability of care that can affect pharmacoeconomic outcomes through standardized care management; employing administrative claims data to better capture meaningful pharmacoeconomic data; and extending clinical trials in open label follow-up periods in which pharmacoeconomic data are captured electronically by administrative claims. Specific aspects of power analysis for pharmacoeconomic studies are presented. The particular pharmacoeconomic challenges caused by the use of biomarkers in clinical trials, the increasing use of multinational studies, and the pharmacoeconomic challenges presented by biologicals in development for Alzheimer's disease are discussed. In summary, since we are entering an era in which pharmacoeconomic studies will be essential in drug development for supporting regulatory approval, payor reimbursement and integration of new therapies into clinical care, we must consider the design and incorporation of pharmacoeconomic studies in phase III clinical trials more seriously

  4. Is the clinical course of HIV-1 changing? Cohort study.

    PubMed Central

    Sinicco, A.; Fora, R.; Raiteri, R.; Sciandra, M.; Bechis, G.; Calvo, M. M.; Gioannini, P.

    1997-01-01

    OBJECTIVE: To assess whether the clinical course of HIV infection has changed from 1985 to 1995. DESIGN: Cohort Study. SETTING: Infectious disease clinic. SUBJECTS: 285 patients recruited from September 1985 to January 1995 with < or = 12 months between the dates of their last seronegative and first seropositive test result and with first follow up visit in the six months after seroconversion and at least 12 months' follow up. Patients were grouped according to the date of seroconversion. MAIN OUTCOME MEASURES: Time to CD4 cell count of < 500, 400, and 200 x 10(6) cells/l, and clinical outcome defining AIDS; variation in cell count per day between consecutive visits, and ratio between this variation and time from estimated date of seroconversion at each visit. RESULTS: The groups were similar in age, number with acute primary HIV infection, CD4 cell count at intake, and cell count at the beginning of antiretroviral treatment; they differed in sex ratio, risk factors for HIV, probability of CD4 cell decline to < 500, 400, and 200 x 10(6) cells/l. and risk of developing AIDS. Acute infection, seroconversion after December 1989, and serum beta 2 microglobulin > 296 nmol/l were independent predictors of poor clinical course. The speed of CD4 cell decline, expressed as cell variation divided by the number of days between consecutive visits, increased with more recent seroconversion (P = 0.02). Ratio between the speed of CD4 cell decline and time from estimated date of seroconversion at each visit was also higher in the patients who seroconverted after December 1989. CONCLUSIONS: The faster disease progression and the higher speed of CD4 cell decline at early stages in the patients with recently acquired HIV infection suggest changes in the clinical course of HIV infection. PMID:9154026

  5. Using laser diagnostics for studying the injection of a dry additive

    NASA Astrophysics Data System (ADS)

    Tokunov, Iu. M.; Zhilin, V. G.; Liuliukin, V. I.; Mostinskii, I. L.; Putin, Iu. A.

    1987-02-01

    In MHD generators using an ionizing additive, the uniform injection of the additive into the combustion chamber and the dispersity of the injected particles are important. Some of the problems associated with the injection of an ionizing additive can be alleviated by using dry additives. In the experiment reported here, an He-Ne laser was used to monitor the injection of potash powder with an average size of 40 microns. It is shown that laser diagnostics can be successfully used to determine the mean particle diameter and variation of the powder flow rate with time.

  6. Evaluation of additional head of biceps brachii: a study with autopsy material.

    PubMed

    Ballesteros, L E; Forero, P L; Buitrago, E R

    2014-05-01

    Additional head of the biceps brachii (AHBB) has been reported in different population groups with a frequency of 1-25%. The purpose of this study was to determine the incidence and morphologic expression of the AHBB as determined in a sample of the Colombian population. An exploration was conducted with 106 arms corresponding to unclaimed corpses autopsied at Institute of Legal and Forensic Medicine of Bucaramanga, Colombia. Using medial incision involvingskin, subcutaneous tissue, and brachial fascia, the heads of the biceps and their innervating branches were visualised. One AHBB was observed in 21 (19.8%) of the arms evaluated, with non-significant difference (p = 0.568) per side of presentation: 11 (52.4%) cases on the right side and 10 (47.6%) on the left side. All AHBBs were originated in the infero-medial segment of the humerus, with a mean thickness of 17.8 ± 6.8 mm. In 4 (19%) cases the fascicle was thin, less than 10 mm; in 7 (33.3%) cases it was of medium thickness, between 11 and 20 mm, whereas in 47.6% it was longer than 20 mm. The length of the AHBB was 118.3 ± 26.8 mm; its motor point supplied by the musculocutaneous nerve was located at 101.3 ± 20.9 mm of the bi-epicondylar line. The incidence of AHBB in this study is located at the upper segment of what has been reportedin the literature and could be a morphologic trait of the Colombian population; in agreement with prior studies, the origin was the infero-medial surface of the humerus. PMID:24902098

  7. Xanthelasma Palpebrarum with Arcus Cornea: A Clinical and Biochemical Study

    PubMed Central

    Nair, Pragya Ashok; Patel, Chaitali R; Ganjiwale, Jaishree D; Diwan, Nilofar Gulamsha; Jivani, Nidhi Bhimjibhai

    2016-01-01

    Background: Xanthelasma palpebrarum (XP) is characterized by sharply demarcated yellowish flat plaques on upper and lower eyelids. It is commonly seen in women with a peak incidence at 30–50 years. It is also considered as the cutaneous marker of underlying atherosclerosis along with the disturbed lipid metabolism. XP and corneal arcus are associated with increased levels of serum cholesterol and low-density lipoprotein (LDL) cholesterol. Aims and Objectives: To study the clinical pattern of XP, its relationship with lipid profile and association with arcus cornea. Materials and Methods: This study was conducted at Department of Dermatology and Opthalmology, between August 2013 and January 2015. Patients with clinical diagnosis of XP who visited skin outpatient department and willing to undergo lipid profile test and eye examination were included in the study. Data regarding demographics, clinical findings, family history, and past history were noted along with the lipid profile details. Data of age-matched healthy controls were taken for comparison. The clinical profile of the participants was presented using frequency and proportions. Gender wise analysis comparing the lipid profile in cases with XP and without XP was done using independent sample t-test. Results: Total 49 patients of XP, 81.6% were females. Maximum, 35% patients were among 50–60 years of age and 69.4% were homemakers by occupation. The average lipid values were-cholesterol 210.57 mg%, triglyceride 123.06 mg%. LDL 142.79 mg% and VLDL 30.95 mg% among patients of XP. Arcus cornea was found in 20% cases of XP. Conclusions: Patients of XP requires proper investigation at the onset and regular follow-up thereafter for any altered lipid profile and early diagnosis of coronary artery disease. PMID:27293250

  8. Hypnotherapy of a pain disorder: a clinical case study.

    PubMed

    Artimon, Henrieta Mihaela

    2015-01-01

    Hypnotherapy's effectiveness in improving and controlling chronic pain of various etiologies has been demonstrated by studies; the mechanism by which hypnosis does this is more complex than a simple induction of muscle relaxation. This study reveals, in addition to this mechanism, a deeper dimension of hypnotherapy from the vantage of a patient with a medical-surgical background, diagnosed with a pain disorder and major severe depressive disorder in addition to incurable painful symptoms, through treatment associated with hypnoanalysis. Following psychotherapy, which included some elements of cognitive-behavioral therapy, a complete remission of the anxious-depressive mood and the painful symptoms was achieved. PMID:25719524

  9. Comparison of clinical and dental panoramic findings: a practice-based crossover study

    PubMed Central

    2013-01-01

    Background Aim was to compare clinical findings with x-ray findings using dental panoramic radiography (DPR). In addition, type and frequency of secondary findings in x-rays were investigated. Methods Patients were selected on the basis of available DPRs (not older than 12 months). No therapeutic measures were permitted between the DPR and the clinical findings. The clinical findings were carried out by several investigators who had no knowledge of the purpose of the study. A calibrated investigator established the x-ray findings, independently and without prior knowledge of the clinical findings. The evaluation parameters for each tooth were: missing, healthy, carious, restorative or prosthetically sufficient or insufficient treatment. Type and frequency of additional findings in the DPR were documented, e.g. quality of a root canal filling and apical changes. Results Findings of 275 patients were available. Comparison showed a correspondence between clinical and radiographic finding in 93.6% of all teeth (n = 7,789). The differences were not significant (p > 0.05). Regarding carious as well as insufficiently restored or prosthetically treated teeth, respectively there were significant differences between the two methods (p < 0.05). The DPRs showed additional findings: root fillings in 259 teeth and 145 teeth with periapical changes. Conclusions With reference to the assessment of teeth, there was no difference between the two methods. However, in the evaluation of carious as well as teeth with insufficiently restorative or prosthetic treatment, there was a clear discrepancy between the two methods. Therefore, it would have been possible to have dispensed with x-rays. Nevertheless, additional x-ray findings were found. PMID:24066660

  10. [Caries occurrence and periodontal condition in 100 dental students in their clinical semester. A clinical study].

    PubMed

    Kern, M; Jonas, I

    1988-06-01

    The purpose of this study was to examine the prevalence of caries and periodontal condition of 100 randomly selected clinical dental students (73 males, 27 females) in the age range of 22-37 years (means = 26.1 +/- 3.3 years). The statistical analysis revealed the following results: DMF-T Index (Klein & Palmer 1940) = 12.61 +/- 5.41 Plaque Index (Silness & Löe 1964) = 0.37 +/- 0.23 Gingiva Index (Löe & Silness 1963) = 0.39 +/- 0.20 Periodontal pocket depth = 1.65 +/- 0.27 mm. In relation to the results of other studies, clinical dental students had a decreased DMF-T Index and were in a better state of oral health and restaurations as compared to other groups of the same age. Female students had significantly less carious teeth, plaque and gingival disease than the male students. Increasing age had a highly significant correlation to DMF-T Index. Gingiva Index and pocket depth, whereas Plaque Index was correlated to a lesser degree. Plaque was confirmed as the essential factor of gingival disease. PMID:3273778

  11. Governance for clinical decision support: case studies and recommended practices from leading institutions

    PubMed Central

    Sittig, Dean F; Ash, Joan S; Bates, David W; Feblowitz, Joshua; Fraser, Greg; Maviglia, Saverio M; McMullen, Carmit; Nichol, W Paul; Pang, Justine E; Starmer, Jack; Middleton, Blackford

    2011-01-01

    Objective Clinical decision support (CDS) is a powerful tool for improving healthcare quality and ensuring patient safety; however, effective implementation of CDS requires effective clinical and technical governance structures. The authors sought to determine the range and variety of these governance structures and identify a set of recommended practices through observational study. Design Three site visits were conducted at institutions across the USA to learn about CDS capabilities and processes from clinical, technical, and organizational perspectives. Based on the results of these visits, written questionnaires were sent to the three institutions visited and two additional sites. Together, these five organizations encompass a variety of academic and community hospitals as well as small and large ambulatory practices. These organizations use both commercially available and internally developed clinical information systems. Measurements Characteristics of clinical information systems and CDS systems used at each site as well as governance structures and content management approaches were identified through extensive field interviews and follow-up surveys. Results Six recommended practices were identified in the area of governance, and four were identified in the area of content management. Key similarities and differences between the organizations studied were also highlighted. Conclusion Each of the five sites studied contributed to the recommended practices presented in this paper for CDS governance. Since these strategies appear to be useful at a diverse range of institutions, they should be considered by any future implementers of decision support. PMID:21252052

  12. The 15-item Systemic Clinical Outcome and Routine Evaluation (SCORE-15) Scale: Portuguese Validation Studies.

    PubMed

    Vilaça, Margarida; de Sousa, Bruno; Stratton, Peter; Relvas, Ana Paula

    2015-01-01

    This study reports on the validity of the 15-item Portuguese version of the Systemic Clinical Outcome Routine Evaluation (SCORE-15; Vilaça, Silva, & Relvas, 2014), a brief and comprehensive measure of family functioning. Previous studies with SCORE-15 show that this version replicates the three-factor solution found for the original English version: Family strengths, Family communication and Family difficulties. In addition to reviewing previous studies, this article analyses the discriminant, convergent and predictive validity of the Portuguese SCORE-15. To do so, the SCORE-15 was administered to family members attending systemic family or couple's therapy at the start of the first and fourth sessions and also to a group of non-clinical individuals. Overall, data are reported from 618 participants, including 136 from families attending systemic therapy and 482 community family members. Comparisons of community and clinical samples (discriminant validity) showed statistically significant differences for the total scale and subscales (p < .001), with the community participants presenting healthier family functioning than the clinical ones. Analyses using SCORE-15 and the Quality of Life - adult version, another family measure applied simultaneously (convergent validity), indicate that both scales are significantly (p < .01) and moderately (r = -.47) correlated. Mean score analysis of SCORE-15's therapeutic sensitivity to change (predictive validity) showed that only the Family communication subscale was sensitive to statistically significant improvement (p < .05) from session 1 to session 4, whereas the SCORE-15's reliability change index points to its ability to detect clinical improvements (RCI = 14%). PMID:26585316

  13. Removing barriers to participation in clinical trials, a conceptual framework and retrospective chart review study

    PubMed Central

    2012-01-01

    Background Enrollment in interventional therapeutic clinical trials is a small fraction of all patients who might participate given reasonable access. Methods A hierarchical approach is utilized in measuring staged participation from trial availability to patient enrollment. Our framework suggests that concern for justice comes in the design and eligibility criteria for clinical trials; attention to beneficence is given in the eligibility and physician triage stages. The remaining four stages rely on respect for persons. An example is given where reasons for nonparticipation or barriers to participation in prostate cancer clinical trials are examined within the framework. In addition, medical oncology patients with an initial six month consultation are tracked from one stage to the next by race using the framework to assess participation comparability. Results We illustrated seven transitions from being a patient to enrollment in a clinical trial in a small study of prostate cancer cases who consulted SKCCC Medical Oncology Department in early 2010. Pilot data suggest transition probabilities as follows: 65% availability, 84% eligibility, 92% patient triage, 89% trials discussed, 45% patient interested, 63% patient consented, and 92% patient enrolled. The average transition probability was 77.7%. The average transition probability, patient-trial-fit was 50%; opportunity was 51%, and acceptance was 66.7%. Trial availability, patient interest and patient consented were three transitions that were below the average; none were statistically significant. Conclusions The framework may serve to streamline comprehensive reporting of clinical trial participation to the benefit of patients and the ethical conduct of clinical trials. PMID:23227880

  14. Coonhound paralysis. Further clinical studies and electron microscopic observations.

    PubMed

    Cummings, J F; de Lahunta, A; Holmes, D F; Schultz, R D

    1982-01-01

    Prior study of coonhound paralysis (CHP) revealed an acute polyradiculoneuritis in raccoon-hunting dogs with clinical and pathologic features resembling those of Guillain-Barré syndrome (GBS). In the present series of five cases, the clinical features were investigated with emphasis on electrodiagnostic and CSF findings, and pathologic changes were evaluated with both the light and electron microscope. The demonstration of motor nerve conduction delay and CSF albuminocytologic dissociation in affected dogs further supported the clinical similarity of CHP and GBS. As in GBS, affected roots and nerves contained mononuclear cell infiltrates, segmental myelin changes and axon degeneration. Despite these general pathologic similarities, the present study suggested that axon damage was a more consistent finding in CHP than in GBS. In contrast to ultrastructural findings in GBS, the demyelinating process in CHP did not appear dependent upon macrophages for its initiation. Swelling, separation and vesiculation of myelin occurred around axons of reduced diameter often in the absence of proximate macrophages. Macrophages, rather than initiating demyelination, appeared to be superimposed on existing damage. In this regard, the observed changes resembled those reported in galactocerebroside-induced EAN and sera-mediated in vivo demyelination. PMID:7072488

  15. Multiplex component-based allergen microarray in recent clinical studies.

    PubMed

    Patelis, A; Borres, M P; Kober, A; Berthold, M

    2016-08-01

    During the last decades component-resolved diagnostics either as singleplex or multiplex measurements has been introduced into the field of clinical allergology, providing important information that cannot be obtained from extract-based tests. Here we review recent studies that demonstrate clinical applications of the multiplex microarray technique in the diagnosis and risk assessment of allergic patients, and its usefulness in studies of allergic diseases. The usefulness of ImmunoCAP ISAC has been validated in a wide spectrum of allergic diseases like asthma, allergic rhinoconjunctivitis, atopic dermatitis, eosinophilic esophagitis, food allergy and anaphylaxis. ISAC provides a broad picture of a patient's sensitization profile from a single test, and provides information on specific and cross-reactive sensitizations that facilitate diagnosis, risk assessment, and disease management. Furthermore, it can reveal unexpected sensitizations which may explain anaphylaxis previously categorized as idiopathic and also display for the moment clinically non-relevant sensitizations. ISAC can facilitate a better selection of relevant allergens for immunotherapy compared with extract testing. Microarray technique can visualize the allergic march and molecular spreading in the preclinical stages of allergic diseases, and may indicate that the likelihood of developing symptomatic allergy is associated with specific profiles of sensitization to allergen components. ISAC is shown to be a useful tool in routine allergy diagnostics due to its ability to improve risk assessment, to better select relevant allergens for immunotherapy as well as detecting unknown sensitization. Multiplex component testing is especially suitable for patients with complex symptomatology. PMID:27196983

  16. Multiple Hypotheses Testing Procedures in Clinical Trials and Genomic Studies

    PubMed Central

    Pan, Qing

    2013-01-01

    We review and compare multiple hypothesis testing procedures used in clinical trials and those in genomic studies. Clinical trials often employ global tests, which draw an overall conclusion for all the hypotheses, such as SUM test, Two-Step test, Approximate Likelihood Ratio test (ALRT), Intersection-Union Test (IUT), and MAX test. The SUM and Two-Step tests are most powerful under homogeneous treatment effects, while the ALRT and MAX test are robust in cases with non-homogeneous treatment effects. Furthermore, the ALRT is robust to unequal sample sizes in testing different hypotheses. In genomic studies, stepwise procedures are used to draw marker-specific conclusions and control family wise error rate (FWER) or false discovery rate (FDR). FDR refers to the percent of false positives among all significant results and is preferred over FWER in screening high-dimensional genomic markers due to its interpretability. In cases where correlations between test statistics cannot be ignored, Westfall-Young resampling method generates the joint distribution of P-values under the null and maintains their correlation structure. Finally, the GWAS data from a clinical trial searching for SNPs associated with nephropathy among Type 1 diabetic patients are used to illustrate various procedures. PMID:24350232

  17. Cancer therapy with phytochemicals: evidence from clinical studies

    PubMed Central

    Hosseini, Azar; Ghorbani, Ahmad

    2015-01-01

    Cancer is still one of the major causes of mortality in both developing and developed countries. At present, in spite of intensive interventions, a large number of patients suffer from poor prognosis. Therefore, the effort for finding new anticancer agents with better efficacy and lesser side effects has been continued. According to the traditional recommendations and experimental studies, numerous medicinal plants have been reported to have anticancer effect. Also antiproliferative, pro-apoptotic, anti-metastatic and anti-angiogenic effects of several phytochemicals have been shown in in vitro experiments or animal studies. However, only a small number have been tested in cancerous patients and limited evidence exists for their clinical effectiveness. Also, regarding some phytochemicals, only beneficial effects on cancer-related symptoms or on quality of life have been reported and no positive results exist for their antitumor actions. This review was focused on the phytochemicals whole beneficial effects on various types of cancer have been supported by clinical trials. Based on the literature review, curcumin, green tea, resveratrol and Viscum album were the satisfactory instances of clinical evidence for supporting their anticancer effects. The main findings of these phytochemicals were also summarized and discussed. PMID:25949949

  18. On model selections for repeated measurement data in clinical studies.

    PubMed

    Zou, Baiming; Jin, Bo; Koch, Gary G; Zhou, Haibo; Borst, Stephen E; Menon, Sandeep; Shuster, Jonathan J

    2015-05-10

    Repeated measurement designs have been widely used in various randomized controlled trials for evaluating long-term intervention efficacies. For some clinical trials, the primary research question is how to compare two treatments at a fixed time, using a t-test. Although simple, robust, and convenient, this type of analysis fails to utilize a large amount of collected information. Alternatively, the mixed-effects model is commonly used for repeated measurement data. It models all available data jointly and allows explicit assessment of the overall treatment effects across the entire time spectrum. In this paper, we propose an analytic strategy for longitudinal clinical trial data where the mixed-effects model is coupled with a model selection scheme. The proposed test statistics not only make full use of all available data but also utilize the information from the optimal model deemed for the data. The performance of the proposed method under various setups, including different data missing mechanisms, is evaluated via extensive Monte Carlo simulations. Our numerical results demonstrate that the proposed analytic procedure is more powerful than the t-test when the primary interest is to test for the treatment effect at the last time point. Simulations also reveal that the proposed method outperforms the usual mixed-effects model for testing the overall treatment effects across time. In addition, the proposed framework is more robust and flexible in dealing with missing data compared with several competing methods. The utility of the proposed method is demonstrated by analyzing a clinical trial on the cognitive effect of testosterone in geriatric men with low baseline testosterone levels. PMID:25645442

  19. Additional Language Teaching within the International Baccalaureate Primary Years Programme: A Comparative Study

    ERIC Educational Resources Information Center

    Lebreton, Marlène

    2014-01-01

    The International Baccalaureate Primary Years Programme supports the learning of languages and cultures, but the role of the additional language within this programme is often unclear. There remains a great variability in schools regarding the frequency of lessons and the way that the additional language is taught within the Primary Years…

  20. Beyond the Call of Duty: A Qualitative Study of Teachers' Additional Responsibilities Related to Sexuality Education

    ERIC Educational Resources Information Center

    Eisenberg, Marla E.; Madsen, Nikki; Oliphant, Jennifer A.; Resnick, Michael

    2011-01-01

    Seven focus groups were conducted with sexuality educators in Minnesota to explore ways that teaching sexuality education differs from teaching other health education content and to determine if additional supports or resources are needed for sexuality educators. Teachers described many specific additional responsibilities or concerns related to…

  1. Clinical study of endemic cretinism in south Sikkim.

    PubMed

    Sankar, R; Pulger, T; Rai, B; Sankar, G; Gyatso, T R; Rai, B M

    1993-06-01

    One hundred individuals suffering from Endemic Cretinism were studied. There were 55 males and 45 females. 62% of the cretins had visible goitre. Thirty nine (62.9%) goitrous cretins had grade II goitre. Neurological cretinism was the predominant type encountered (99%) and Myxoedematous cretinism was seen in only one patient. The most salient neurological feature was deaf-mutism seen in 74%. Findings in the motor system were, apart from deaf-mutism, the most characteristic feature of the condition on clinical examination. 58% had exaggerated deep tendon reflexes and 31% had extensor plantar response. Squint was noticed in 29%. Familial aggregation was noticed and was striking. Endemic cretinism is a distinctive and easily identifiable clinical entity and is an important indicator of the severity of iodine deficiency in a community. PMID:8005966

  2. Diode laser contact transscleral retinal photocoagulation: a clinical study.

    PubMed Central

    McHugh, D A; Schwartz, S; Dowler, J G; Ulbig, M; Blach, R K; Hamilton, P A

    1995-01-01

    AIM--To examine the clinical efficacy of contact transscleral retinal photocoagulation with a diode laser. METHODS--Transscleral retinal photocoagulation was performed on 36 eyes. The conditions treated included peripheral retinal breaks associated with retinal detachments (30 eyes) and giant retinal tears (six eyes). Of the 30 eyes with retinal detachments, 28 underwent transscleral photocoagulation to the site of drainage of subretinal fluid in an attempt to reduce the risk of hemorrhage. RESULTS--Threshold lesions were obtained with irradiances of between 95.4 W/cm2 and 191 W/cm2. Satisfactory chorioretinal adhesion was achieved in all eyes with retinal breaks and giant retinal tears. The only significant complications of treatment encountered were punctate choroidal haemorrhages (three eyes). Drainage related choroidal haemorrhage following earlier photocoagulation occurred in two of 28 eyes. CONCLUSIONS--This study confirms the clinical potential of transscleral diode laser photocoagulation in the therapy of surgical retinal conditions. Images PMID:8562540

  3. [Clinical manifestations, complications and treatment of brucellosis: 45-patient study].

    PubMed

    Zribi, M; Ammari, L; Masmoudi, A; Tiouiri, H; Fendri, C

    2009-07-01

    The aim of this study was to evaluate the clinical, laboratory findings and therapeutic features of patients with brucellosis. The diagnosis was made by clinical findings, automated blood culture, serology (Rose Bengal plate agglutination test, standard tube agglutination (Wright) and immunofluorerescence). The susceptibility of 13 strains was tested in vitro. The base sequence was determined for four strains. Forty-five cases were collected (31 acute and 14 sub-acute). Contamination was digestive in 62%. Symptoms of patients were fever (93%), sweating (82%), arthralgia (78%) and splenomegaly (51%). Elevated erythrocyte sedimentation rate was determined in 80%, leukopenia in 49% and anaemia in 37% of cases. Blood cultures were positives in 39% of cases. The four sequenced strains were identified as Brucella melitensis biovar abortus. Six strains were resistant to sufomethoxazol-trimetoprim (54%). In 93% of cases, the treatment was associated rifampicin and doxycyclin. One patient died. No relapse was reported. PMID:18387752

  4. Experimental study of combustion characteristics of nanoscale metal and metal oxide additives in biofuel (ethanol)

    PubMed Central

    2011-01-01

    An experimental investigation of the combustion behavior of nano-aluminum (n-Al) and nano-aluminum oxide (n-Al2O3) particles stably suspended in biofuel (ethanol) as a secondary energy carrier was conducted. The heat of combustion (HoC) was studied using a modified static bomb calorimeter system. Combustion element composition and surface morphology were evaluated using a SEM/EDS system. N-Al and n-Al2O3 particles of 50- and 36-nm diameters, respectively, were utilized in this investigation. Combustion experiments were performed with volume fractions of 1, 3, 5, 7, and 10% for n-Al, and 0.5, 1, 3, and 5% for n-Al2O3. The results indicate that the amount of heat released from ethanol combustion increases almost linearly with n-Al concentration. N-Al volume fractions of 1 and 3% did not show enhancement in the average volumetric HoC, but higher volume fractions of 5, 7, and 10% increased the volumetric HoC by 5.82, 8.65, and 15.31%, respectively. N-Al2O3 and heavily passivated n-Al additives did not participate in combustion reactively, and there was no contribution from Al2O3 to the HoC in the tests. A combustion model that utilized Chemical Equilibrium with Applications was conducted as well and was shown to be in good agreement with the experimental results. PMID:21711760

  5. A theoretical study of wave dispersion and thermal conduction for HMX/additive interfaces

    NASA Astrophysics Data System (ADS)

    Long, Yao; Chen, Jun

    2014-04-01

    The wave dispersion rule for non-uniform material is useful for ultrasonic inspection and engine life prediction, and also is key in achieving an understanding of the energy dissipation and thermal conduction properties of solid material. On the basis of linear response theory and molecular dynamics, we derive a set of formulas for calculating the wave dispersion rate of interface systems, and study four kinds of interfaces inside plastic bonded explosives: HMX/{HMX, TATB, F2312, F2313}. (HMX: octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine; TATB: 1,3,5-triamino-2,4,6-trinitrobenzene; F2312, F2313: fluoropolymers). The wave dispersion rate is obtained over a wide frequency range from kHz to PHz. We find that at low frequency, the rate is proportional to the square of the frequency, and at high frequency, the rate couples with the molecular vibration modes at the interface. By using the results, the thermal conductivities of HMX/additive interfaces are derived, and a physical model is built for describing the total thermal conductivity of mixture explosives, including HMX multi-particle systems and {TATB, F2312, F2313}-coated HMX.

  6. Addition reaction of alkyl radical to C60 fullerene: Density functional theory study

    NASA Astrophysics Data System (ADS)

    Tachikawa, Hiroto; Kawabata, Hiroshi

    2016-02-01

    Functionalized fullerenes are known as a high-performance molecules. In this study, the alkyl-functionalized fullerenes (denoted by R-C60) have been investigated by means of the density functional theory (DFT) method to elucidate the effects of functionalization on the electronic states of fullerene. Also, the reaction mechanism of alkyl radicals with C60 was investigated. The methyl, ethyl, propyl, and butyl radicals (denoted by n = 1-4, where n means the number of carbon atoms in the alkyl radical) were examined as alkyl radicals. The DFT calculation showed that the alkyl radical binds to the carbon atom of C60 at the on-top site, and a strong C-C single bond is formed. The binding energies of alkyl radicals to C60 were distributed in the range of 31.8-35.1 kcal mol-1 at the CAM-B3LYP/6-311G(d,p) level. It was found that the activation barrier exists before alkyl addition, the barrier heights were calculated to be 2.1-2.8 kcal mol-1. The electronic states of R-C60 complexes were discussed on the basis of the theoretical results.

  7. Ecological Optimization and Parametric Study of an Irreversible Regenerative Modified Brayton Cycle with Isothermal Heat Addition

    NASA Astrophysics Data System (ADS)

    Tyagi, Sudhir K.; Kaushik, Subhash C.; Tiwari, Vivek

    2003-12-01

    An ecological optimization along with a detailed parametric study of an irreversible regenerative Brayton heat engine with isothermal heat addition have been carried out with external as well as internal irreversibilities. The ecological function is defined as the power output minus the power loss (irreversibility) which is ambient temperature times the entropy generation rate. The external irreversibility is due to finite temperature difference between the heat engine and the external reservoirs while the internal irreversibilities are due to nonisentropic compression and expansion processes in the compressor and the turbine respectively and the regenerative heat loss. The ecological function is found to be an increasing function of the isothermal-, sink- and regenerative-side effectiveness, isothermal-side inlet temperature, component efficiencies and sink-side temperature while it is found to be a decreasing function of the isobaric-side temperature and effectiveness and the working fluid heat capacitance rate. The effects of the isobaric-side effectiveness are found to be more than those of the other parameters and the effects of turbine efficiency are found to be more than those of the compressor efficiency on all the performance parameters of the cycle.

  8. Theoretical study of addition reactions of carbene, silylene, and germylene to carbon nanotubes

    NASA Astrophysics Data System (ADS)

    Chu, Ying-Ying; Su, Ming-Der

    2004-08-01

    A theoretical study of the mechanism of the reaction of a single-walled carbon nanotube (SWCNT) with carbene (H 2C), silylene (H 2Si), and germylene (H 2Ge) has been carried out using a two-layered ONIOM(B3LYP/6-311G ∗:PM3) approach. The main findings are as follows: (1) The computational results based on the method used in this work are in good agreement with recent theoretical findings [Angew. Chem. Int. Ed. 41 (2002) 1853]. That is, SWCNTs with H 2C, H 2Si, and H 2Ge addends favor opened structures rather than three-membered rings. (2) The greater the atomic number of the carbene center, the larger the activation energy and the less exothermic (or the more endothermic) the cycloaddition reaction becomes. Therefore, addition to the C dbnd C bond of a SWCNT is more difficult the heavier the carbene center. (3) The theoretical observations suggest that the singlet-triplet splitting of a carbene can be used as a guide to its reactivity during the SWCNT cycloaddition process.

  9. Gender effect on clinical features of achalasia: a prospective study

    PubMed Central

    Mikaeli, Javad; Farrokhi, Farnoosh; Bishehsari, Faraz; Mahdavinia, Mahboobeh; Malekzadeh, Reza

    2006-01-01

    Background Achalasia is a well-characterized esophageal motor disorder but the rarity of the disease limits performing large studies on its demographic and clinical features. Methods Prospectively, 213 achalasia patients (110 men and 103 women) were enrolled in the study. The diagnosis established by clinical, radiographic, and endoscopic as well as manometry criteria. All patients underwent a pre-designed clinical evaluation before and within 6 months after the treatment. Results Solid dysphagia was the most common clinical symptom in men and women. Chest pain was the only symptom which was significantly different between two groups and was more complained by women than men (70.9% vs. 54.5% P value= 0.03). Although the occurrence of chest pain significantly reduced after treatment in both groups (P < 0.001), it was still higher among women (32% vs. 20.9% P value= 0.04). In both sexes, chest pain did not relate to the symptom duration, LES pressure and type of treatment patients received. Also no significant relation was found between chest pain and other symptoms expressed by men and women before and after treatment. Chest pain was less frequently reported by patients over 56 yrs of age in comparison to those less than 56 yrs (p < 0.05). Conclusion It seems that chest pain is the distinct symptom of achalasia which is affected by sex as well as age and does not relate to the duration of illness, LESP and the type of treatment achalasia patients receive. PMID:16579859

  10. Food additives.

    PubMed

    Berglund, F

    1978-01-01

    The use of additives to food fulfils many purposes, as shown by the index issued by the Codex Committee on Food Additives: Acids, bases and salts; Preservatives, Antioxidants and antioxidant synergists; Anticaking agents; Colours; Emulfifiers; Thickening agents; Flour-treatment agents; Extraction solvents; Carrier solvents; Flavours (synthetic); Flavour enhancers; Non-nutritive sweeteners; Processing aids; Enzyme preparations. Many additives occur naturally in foods, but this does not exclude toxicity at higher levels. Some food additives are nutrients, or even essential nutritents, e.g. NaCl. Examples are known of food additives causing toxicity in man even when used according to regulations, e.g. cobalt in beer. In other instances, poisoning has been due to carry-over, e.g. by nitrate in cheese whey - when used for artificial feed for infants. Poisonings also occur as the result of the permitted substance being added at too high levels, by accident or carelessness, e.g. nitrite in fish. Finally, there are examples of hypersensitivity to food additives, e.g. to tartrazine and other food colours. The toxicological evaluation, based on animal feeding studies, may be complicated by impurities, e.g. orthotoluene-sulfonamide in saccharin; by transformation or disappearance of the additive in food processing in storage, e.g. bisulfite in raisins; by reaction products with food constituents, e.g. formation of ethylurethane from diethyl pyrocarbonate; by metabolic transformation products, e.g. formation in the gut of cyclohexylamine from cyclamate. Metabolic end products may differ in experimental animals and in man: guanylic acid and inosinic acid are metabolized to allantoin in the rat but to uric acid in man. The magnitude of the safety margin in man of the Acceptable Daily Intake (ADI) is not identical to the "safety factor" used when calculating the ADI. The symptoms of Chinese Restaurant Syndrome, although not hazardous, furthermore illustrate that the whole ADI

  11. Did the addition of concomitant chemotherapy to radiotherapy improve outcomes in hypopharyngeal cancer? A population-based study

    PubMed Central

    Hall, S.F.; Griffiths, R.

    2016-01-01

    Background For oncologists and for patients, no site-specific clinical trial evidence has emerged for the use of concurrent chemotherapy with radiotherapy (ccrt) over radiotherapy (rt) alone for cancer of the hypopharynx (hpc) or for other human papilloma virus–negative head-and-neck cancers. Methods This retrospective population-based cohort study using administrative data compared treatments over time (1990–2000 vs. 2000–2010), treatment outcomes, and outcomes over time in 1333 cases of hpc diagnosed in Ontario between January 1990 and December 2010. Results The incidence of hpc is declining; the use of ccrt that began in 2001 is increasing; and the 3-year overall survival for all patients remains poor at 34.6%. No difference in overall survival was observed in a comparison of patients treated in the decade before ccrt and of patients treated in the decade during the uptake of ccrt. Conclusions The addition of ccrt to the armamentarium of treatment options for oncologists treating head-and-neck patients did not improve outcomes for hpc at the population level. PMID:27536177

  12. Importance of population-based studies in clinical practice

    PubMed Central

    Ronnie, George; Ve, Ramesh Sathyamangalam; Velumuri, Lokapavani; Asokan, Rashima; Vijaya, Lingam

    2011-01-01

    In the last decade, there have been reports on the prevalence of glaucoma from the Vellore Eye Survey, Andhra Pradesh Eye Diseases Survey, Aravind Comprehensive Eye Survey, Chennai Glaucoma Study and West Bengal Glaucoma Study. Population-based studies provide important information regarding the prevalence and risk factors for glaucoma. They also highlight regional differences in the prevalence of various types of glaucoma. It is possible to gather important insights regarding the number of persons affected with glaucoma and the proportion with undiagnosed disease. We reviewed the different population-based studies from India and compare their findings. The lacunae in ophthalmic care that can be inferred from these studies are identified and possible reasons and solutions are discussed. We also discuss the clinical relevance of the various findings, and how it reflects on clinical practice in the country. Since India has a significantly high disease burden, we examine the possibility of population-based screening for disease in the Indian context. PMID:21150021

  13. How do chiropractors manage clinical risk? A questionnaire study

    PubMed Central

    2013-01-01

    Background The literature on chiropractic safety tends to focus on adverse events and little is known about how chiropractors ensure safety and manage risk in the course of their daily practice. The purpose of this study was to investigate how chiropractors manage potentially risky clinical scenarios. We also sought to establish how chiropractors perceive the safety climate in their workplace and thus whether there is an observable culture of safety within the profession. Methods An online questionnaire was designed to determine which of nine management options would be chosen by the respondent in response to four defined clinical case scenarios. Safety climate within the respondent’s practice setting was measured by seeking the level of agreement with 23 statements relating to six different safety dimensions. 260 licensed chiropractors in Switzerland and 1258 UK members of The Royal College of Chiropractors were invited to complete the questionnaire. Questionnaire responses were analysed quantitatively in respect of the four clinical scenarios and the nine management options to determine the likelihood of each option being undertaken, with results recorded in terms of % likelihood. Gender differences in response to the management options for each scenario were evaluated using the Mann–Whitney U (MWU) test. Positive agreement with elements comprising each of the six safety dimensions contributed to a composite ‘% positive agreement’ score calculated for each dimension. Results Questionnaire responses were received from 76% (200/260) of Swiss participants and 31% (393/1258) of UK members of The Royal College of Chiropractors. There was a general trend for Swiss and UK chiropractors to manage clinical scenarios where treatment appears not to be successful, not indicated, possibly harmful or where a patient is apparently getting worse, by re-evaluating their care. Stopping treatment and/or incident reporting to a safety incident reporting and learning system

  14. IMPACT - Integrative Medicine PrimAry Care Trial: protocol for a comparative effectiveness study of the clinical and cost outcomes of an integrative primary care clinic model

    PubMed Central

    2014-01-01

    Background Integrative medicine (IM) is a patient-centered, healing-oriented clinical paradigm that explicitly includes all appropriate therapeutic approaches whether they originate in conventional or complementary medicine (CM). While there is some evidence for the clinical and cost-effectiveness of IM practice models, the existing evidence base for IM depends largely on studies of individual CM therapies. This may in part be due to the methodological challenges inherent in evaluating a complex intervention (i.e., many interacting components applied flexibly and with tailoring) such as IM. Methods/Design This study will use a combination of observational quantitative and qualitative methods to rigorously measure the health and healthcare utilization outcomes of the University of Arizona Integrative Health Center (UAIHC), an IM adult primary care clinic in Phoenix, Arizona. There are four groups of study participants. The primary group consists of clinic patients for whom clinical and cost outcomes will be tracked indicating the impact of the UAIHC clinic (n = 500). In addition to comparing outcomes pre/post clinic enrollment, where possible, these outcomes will be compared to those of two matched control groups, and for some self-report measures, to regional and national data. The second and third study groups consist of clinic patients (n = 180) and clinic personnel (n = 15-20) from whom fidelity data (i.e., data indicating the extent to which the IM practice model was implemented as planned) will be collected. These data will be analyzed to determine the exact nature of the intervention as implemented and to provide covariates to the outcomes analyses as the clinic evolves. The fourth group is made up of patients (n = 8) whose path through the clinic will be studied in detail using qualitative (periodic semi-structured interviews) methods. These data will be used to develop hypotheses regarding how the clinic works. Discussion The US health care

  15. [Quality of the clinical reports: observational study in Sassari].

    PubMed

    Virdis, A; Licheri, N; Ruiu, A

    2009-01-01

    Within the program of clinical risk management, and in particular in the phase of the "knowledge" of company reality, the work deals with the topic of the case history in Sassari' local health authority. A study is treated where, on a sample of about 400 cases history, four definite aspects are considered, in particular those that are regarded as the most important in the risk management and about medical responsability: 1) formal consent; 2) daily clinical allowance; 3) therapeutic card; 4) operating card. The results we got show the presence of a formal consent filled in correctly in 36 cases (9%), completed a daily allowance in 36 cases (9%), therapeutic card in 14 (3.5%) cases, operation card in 21 cases (19% su 116 surgical cases). These data, that have permitted to estimate the specific company reality as from pointed out critical states, show the necessity of working, with involvement of professional doctors, to build a history case model with clear and shared rules where you can clearly find the clinical path of a patient, where everything made is quoted and easily readable when necessary. PMID:20169826

  16. Gender Differences in the Clinical Characteristics of Psychotic Depression: Results from the CRESCEND Study

    PubMed Central

    Park, Seon-Cheol; Østergaard, Søren Dinesen; Kim, Jae-Min; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jung-Bum; Yim, Hyeon-Woo; Park, Yong Chon

    2015-01-01

    Objective To test whether there are gender differences in the clinical characteristics of patients with psychotic depression (PD). Methods Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, we tested for potential gender differences in clinical characteristics among 53 patients with PD. The Psychotic Depression Assessment Scale (PDAS) and other psychometric scales were used to evaluate various clinical features of the study subjects. Independent t-tests were performed for normally distributed variables, Mann-Whitney U-tests for non-normally distributed variables, and χ2 tests for discrete variables. In addition, to exclude the effects of confounding variables, we carried out an analysis of covariance (ANCOVA) for the normally distributed variables and binary logistic regression analyses for discrete variables, after adjusting the effects of marital status. Results We identified more prevalent suicidal ideation (adjusted odds ratio [aOR]=10.316, p=0.036) and hallucinatory behavior (aOR=8.332, p=0.016), as well as more severe anxiety symptoms (degrees of freedom [df]=1, F=6.123, p=0.017), and poorer social and occupational functioning (df=1, F=6.265, p=0.016) in the male patients compared to the female patients. Conclusion Our findings suggest that in South Korean patients with PD, suicidal ideation, hallucinatory behavior, and anxiety is more pronounced among males than females. This should be taken into consideration in clinical practice. PMID:26598583

  17. Fortification of yogurts with different antioxidant preservatives: A comparative study between natural and synthetic additives.

    PubMed

    Caleja, Cristina; Barros, Lillian; Antonio, Amilcar L; Carocho, Márcio; Oliveira, M Beatriz P P; Ferreira, Isabel C F R

    2016-11-01

    Consumers demand more and more so-called "natural" products and, therefore, the aim of this work was to compare the effects of natural versus synthetic antioxidant preservatives in yogurts. Matricaria recutita L. (chamomile) and Foeniculum vulgare Mill. (fennel) decoctions were tested as natural additives, while potassium sorbate (E202) was used as a synthetic additive. The fortification of yogurts with natural and synthetic antioxidants did not cause significant changes in the yoghurt pH and nutritional value, in comparison with control samples (yogurt without any additive). However, the fortified yogurts showed higher antioxidant activity, mainly the yogurts with natural additives (and among these, the ones with chamomile decoction). Overall, it can be concluded that plant decoctions can be used to develop novel yogurts, by replacing synthetic preservatives and improving the antioxidant properties of the final product, without changing the nutritional profile. PMID:27211646

  18. A Comprehensive Prospective Clinical Study of Hydatid Disease

    PubMed Central

    Kayal, Ankit; Hussain, Akhlak

    2014-01-01

    The actual prevalence of hydatid disease in northern part of India is found more than usually interpreted. The present study has been done on 25 patients suffering from hydatid disease of various sites and treated during June 2009 to November 2011 at JLN Medical College and Hospital, Ajmer, with the aim of studying the clinical manifestations of hydatid disease of different sites and/or organ system and of analysing the morbidity and mortality of hydatid disease. The age, sex, h/o dog contact, duration of hospital stay, clinical presentation, treatment advised, findings and difficulties encountered during operation, and postoperative management of patients as well as morbidity and mortality were recorded and analysed. We observed that the mean age was 40 years. The sex incidence revealed female preponderance in the study (M : F: 1 : 2). Duration of illness in the present study varied from 1 month to 6 years in case of liver hydatid disease. Majority of patients were from rural areas (21) and the remaining (4) from urban areas. Swelling was the most common presenting feature. Incidence of hydatid disease at unusual sites in India is higher than in other parts of the world. PMID:24734188

  19. 3D ultrasound computer tomography: update from a clinical study

    NASA Astrophysics Data System (ADS)

    Hopp, T.; Zapf, M.; Kretzek, E.; Henrich, J.; Tukalo, A.; Gemmeke, H.; Kaiser, C.; Knaudt, J.; Ruiter, N. V.

    2016-04-01

    Ultrasound Computer Tomography (USCT) is a promising new imaging method for breast cancer diagnosis. We developed a 3D USCT system and tested it in a pilot study with encouraging results: 3D USCT was able to depict two carcinomas, which were present in contrast enhanced MRI volumes serving as ground truth. To overcome severe differences in the breast shape, an image registration was applied. We analyzed the correlation between average sound speed in the breast and the breast density estimated from segmented MRIs and found a positive correlation with R=0.70. Based on the results of the pilot study we now carry out a successive clinical study with 200 patients. For this we integrated our reconstruction methods and image post-processing into a comprehensive workflow. It includes a dedicated DICOM viewer for interactive assessment of fused USCT images. A new preview mode now allows intuitive and faster patient positioning. We updated the USCT system to decrease the data acquisition time by approximately factor two and to increase the penetration depth of the breast into the USCT aperture by 1 cm. Furthermore the compute-intensive reflectivity reconstruction was considerably accelerated, now allowing a sub-millimeter volume reconstruction in approximately 16 minutes. The updates made it possible to successfully image first patients in our ongoing clinical study.

  20. Cannabis and Schizophrenia Spectrum Disorders: A Review of Clinical Studies

    PubMed Central

    Rodrigo, Chaturaka; Rajapakse, Senaka

    2009-01-01

    Cannabis is the most widely used illegitimate substance in the world, and the number of users has increased by 10% over the last decade worldwide. Therefore, it is important to review the evidence on psychoactive properties of cannabis and its possible association with schizophrenia spectrum disorders (SSD). We searched MEDLINE with the key words cannabis and schizophrenia. The search was limited to articles published in English over the last 10 years (1999-2009). Bibliographies of cited literature were also searched. Data sources included reviews published in core clinical journals, cohort studies, interventional studies, case-control studies, cross-sectional analyses and epidemiological data. Results are discussed under 2 topics. Firstly, evidence related to biochemical functioning of cannabinoids and their relationship to endocannabinoid system is discussed briefly. Secondly, the evidence from clinical studies on cannabis, psychosis proneness and SSD are discussed in detail. The discussion is structured to fit in the evidence from results section to 3 plausible hypotheses on cannabis use and SSD. The evidence for and against each hypothesis is discussed. Despite new evidence, the exact relationship between cannabis and SSD is unclear. There is no firm evidence that cannabis causes SSD. The evidence for the argument that schizophrenic patients are attracted to cannabis is also not strong. The most plausible explanation is that cannabis use and psychosis proneness may have synergistic effects in a vulnerable minority. PMID:21938097

  1. ALUM ADDITION AND STEP-FEED STUDIES IN OXYGEN-ACTIVATED SLUDGE

    EPA Science Inventory

    A plug flow, O2-activated sludge process was operated with alum addition to remove phosphorus and with lime addition to prevent the process pH from decreasing below 6.4. The O2 reactor was operated at F/M ratios between 0.18 to 0.24 gm of BOD5/gm of MLVSS/day in a typical co-curr...

  2. 75 FR 28686 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-21

    ... AFFAIRS Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation... (Federal Advisory Committee Act) that a meeting of the Clinical Science Research and Development Service... Committee advises the Chief Research and Development Officer through the Director of the Clinical...

  3. 77 FR 31072 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-24

    ... AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... (Federal Advisory Committee Act) that a meeting of the Clinical Science Research and Development Service... the Clinical Science Research and Development Service on the relevance and feasibility of...

  4. 76 FR 65781 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-24

    ... AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... (Federal Advisory Committee Act) that a meeting of the Clinical Science Research and Development Service... Research and Development Officer through the Director of the Clinical Science Research and...

  5. 76 FR 73781 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-29

    ... AFFAIRS Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation... (Federal Advisory Committee Act) that a meeting of the Clinical Science Research and Development Service... Clinical Science Research and Development Service on the relevance and feasibility of proposed projects...

  6. 75 FR 79446 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... AFFAIRS Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation... (Federal Advisory Committee Act) that a meeting of the Clinical Science Research and Development Service... Clinical Science Research and Development Service on the relevance and feasibility of proposed projects...

  7. Chemostat Studies of TCE-Dehalogenating Anaerobic Consortia under Excess and Limited Electron Donor Addition

    NASA Astrophysics Data System (ADS)

    Semprini, L.; Azizian, M.; Green, J.; Mayer-Blackwell, K.; Spormann, A. M.

    2015-12-01

    Two cultures - the Victoria Strain (VS) and the Evanite Strain (EV), enriched with the organohalide respiring bacteria Dehalococcoides mccartyi - were grown in chemostats for more than 4 years at a mean cell residence time of 50 days. The slow doubling rate represents growth likely experienced in the subsurface. The chemostats were fed formate as an electron donor and trichloroethene (TCE) as the terminal electron acceptor. Under excess formate conditions, stable operation was observed with respect to TCE transformation, steady-state hydrogen (H2) concentrations (40 nM), and the structure of the dehalogenating community. Both cultures completely transformed TCE to ethene, with minor amounts of vinyl chloride (VC) observed, along with acetate formation. When formate was limited, TCE was transformed incompletely to ethene (40-60%) and VC (60- 40%), and H2 concentrations ranged from 1 to 3 nM. The acetate concentration dropped below detection. Batch kinetic studies of TCE transformation with chemostat harvested cells found transformation rates of c-DCE and VC were greatly reduced when the cells were grown with limited formate. Upon increasing formate addition to the chemostats, from limited to excess, essentially complete transformation of TCE to ethene was achieved. The increase in formate was associated with an increase in H2 concentration and the production of acetate. Results of batch kinetic tests showed increases in transformation rates for TCE and c-DCE by factors of 3.5 and 2.5, respectively, while VC rates increased by factors of 33 to 500, over a six month period. Molecular analysis of chemostat samples is being performed to quantify the changes in copy numbers of reductase genes and to determine whether shifts in the strains of Dehalococcoides mccartyi where responsible for the observed rate increases. The results demonstrate the importance of electron donor supply for successful in-situ remediation.

  8. A study of the electrochemistry of nickel hydroxide electrodes with various additives

    NASA Astrophysics Data System (ADS)

    Zhu, Wen-Hua; Ke, Jia-Jun; Yu, Hong-Mei; Zhang, Deng-Jun

    Nickel composite electrodes (NCE) with various additives are prepared by a chemical impregnation method from nitrate solutions on sintered porous plaques. The electrochemical properties, such as utilization of active material, swelling and the discharge potential of the nickel oxide electrode (NOE) are determined mainly through the composition of the active material and the characteristics of nickel plaques. Most additives (Mg, Ca, Sr, Ba, Zn, Cd, Co, Li and Al hydroxide) exert effects on the discharge potential and swelling of the NOE. Chemical co-precipitation with the addition of calcium, zinc, magnesium and barium hydroxide increases the discharge potential by more than 20 mV, but that with zinc hydroxide results in an obvious decrease of active-material utilization and that with calcium and magnesium hydroxide produces a larger increase of electrode thickness. The effects of anion additives are also examined. Less than 1% mol of NiS in the active material increases the discharge potential. Cadmium, cobalt and zinc hydroxide are excellent additives for preventing swelling of the NCE. Slow voltammetry (0.2 mV s -1) in 6 M KOH is applied to characterize the oxygen-evolving potential of the NCE. The difference between the oxygen-evolution potential and the potential of the oxidation peak for the NCE with additives of calcium, lithium, barium and aluminium hydroxide is at least + 60 mV.

  9. Etiology of Cellulitis and Clinical Prediction of Streptococcal Disease: A Prospective Study

    PubMed Central

    Bruun, Trond; Oppegaard, Oddvar; Kittang, Bård R.; Mylvaganam, Haima; Langeland, Nina; Skrede, Steinar

    2016-01-01

    Background. The importance of bacteria other than group A streptococci (GAS) in different clinical presentations of cellulitis is unclear, commonly leading to treatment with broad-spectrum antibiotics. The aim of this study was to describe the etiological and clinical spectrum of cellulitis and identify clinical features predicting streptococcal etiology. Methods. We prospectively enrolled 216 patients hospitalized with cellulitis. Clinical details were registered. Bacterial culture was performed from blood, cutaneous or subcutaneous tissue, and/or swabs from skin lesions. Paired serum samples were analyzed for anti-streptolysin O and anti-deoxyribonuclease B antibodies. Results. Serology or blood or tissue culture confirmed β-hemolytic streptococcal (BHS) etiology in 72% (146 of 203) of cases. An additional 13% (27 of 203) of cases had probable BHS infection, indicated by penicillin response or BHS cultured from skin swabs. β-hemolytic streptococcal etiology was predominant in all clinical subgroups, including patients without sharply demarcated erythema. β-hemolytic group C or G streptococci (GCS/GGS) were more commonly isolated than GAS (36 vs 22 cases). This predominance was found in the lower extremity infections. Group C or G streptococci in swabs were associated with seropositivity just as often as GAS. Staphylococcus aureus was cultured from swabs as a single pathogen in 24 cases, 14 (64%) of which had confirmed BHS etiology. Individual BHS-associated clinical characteristics increased the likelihood of confirmed BHS disease only slightly; positive likelihood ratios did not exceed 2.1. Conclusions. β-hemolytic streptococci were the dominating cause of cellulitis in all clinical subgroups and among cases with S aureus in cutaneous swabs. Group C or G streptococci were more frequently detected than GAS. No single clinical feature substantially increased the probability of confirmed BHS etiology. PMID:26734653

  10. 78 FR 68461 - Guidance for Industry: Studies To Evaluate the Utility of Anti-Salmonella Chemical Food Additives...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-14

    ... Guidance for Industry: Studies to Evaluate the Utility of Anti-Salmonella Chemical Food Additives in Feeds... HUMAN SERVICES Food and Drug Administration Guidance for Industry: Studies To Evaluate the Utility of Anti- Salmonella Chemical Food Additives in Feeds; Request for Comments AGENCY: Food and...

  11. Breast cancer resistance protein (ABCG2) in clinical pharmacokinetics and drug interactions: practical recommendations for clinical victim and perpetrator drug-drug interaction study design.

    PubMed

    Lee, Caroline A; O'Connor, Meeghan A; Ritchie, Tasha K; Galetin, Aleksandra; Cook, Jack A; Ragueneau-Majlessi, Isabelle; Ellens, Harma; Feng, Bo; Taub, Mitchell E; Paine, Mary F; Polli, Joseph W; Ware, Joseph A; Zamek-Gliszczynski, Maciej J

    2015-04-01

    Breast cancer resistance protein (BCRP; ABCG2) limits intestinal absorption of low-permeability substrate drugs and mediates biliary excretion of drugs and metabolites. Based on clinical evidence of BCRP-mediated drug-drug interactions (DDIs) and the c.421C>A functional polymorphism affecting drug efficacy and safety, both the US Food and Drug Administration and European Medicines Agency recommend preclinical evaluation and, when appropriate, clinical assessment of BCRP-mediated DDIs. Although many BCRP substrates and inhibitors have been identified in vitro, clinical translation has been confounded by overlap with other transporters and metabolic enzymes. Regulatory recommendations for BCRP-mediated clinical DDI studies are challenging, as consensus is lacking on the choice of the most robust and specific human BCRP substrates and inhibitors and optimal study design. This review proposes a path forward based on a comprehensive analysis of available data. Oral sulfasalazine (1000 mg, immediate-release tablet) is the best available clinical substrate for intestinal BCRP, oral rosuvastatin (20 mg) for both intestinal and hepatic BCRP, and intravenous rosuvastatin (4 mg) for hepatic BCRP. Oral curcumin (2000 mg) and lapatinib (250 mg) are the best available clinical BCRP inhibitors. To interrogate the worst-case clinical BCRP DDI scenario, study subjects harboring the BCRP c.421C/C reference genotype are recommended. In addition, if sulfasalazine is selected as the substrate, subjects having the rapid acetylator phenotype are recommended. In the case of rosuvastatin, subjects with the organic anion-transporting polypeptide 1B1 c.521T/T genotype are recommended, together with monitoring of rosuvastatin's cholesterol-lowering effect at baseline and DDI phase. A proof-of-concept clinical study is being planned by a collaborative consortium to evaluate the proposed BCRP DDI study design. PMID:25587128

  12. Developing Medicare Competitive Bidding: A Study of Clinical Laboratories

    PubMed Central

    Hoerger, Thomas J.; Meadow, Ann

    1997-01-01

    Competitive bidding to derive Medicare fees promises several advantages over administered fee systems. The authors show how incentives for cost savings, quality, and access can be incorporated into bidding schemes, and they report on a study of the clinical laboratory industry conducted in preparation for a bidding demonstration. The laboratory industry is marked by variable concentration across geographic markets and, among firms themselves, by social and economic heterogeneity. The authors conclude that these conditions can be accommodated by available bidding design options and by careful selection of bidding markets. PMID:10180003

  13. Early clinical studies of novel therapies for thyroid cancers.

    PubMed

    Sherman, Steven I

    2008-06-01

    Historically, systemic therapies for advanced, metastatic thyroid carcinomas have been poorly effective. However, as a result of a confluence of increasing knowledge of the biologic basis for thyroid cancer development and progression, identification of therapeutic agents that could target these biologic abnormalities, and enthusiasm for research by both funding agencies as well as patients, multiple clinical trials have been initiated and successfully completed during the past several years. This article focuses on findings from key studies that reflect the new paradigms for treatment. PMID:18502340

  14. Lowe syndrome: clinical and neuropathological studies of an adult case.

    PubMed

    Giannakopoulos, P; Bouras, C; Vallet, P; Constantinidis, J

    1990-12-01

    A 23-year-old male with clinically diagnosed Lowe syndrome had bilateral cataracts, glaucoma, pendulous nystagmus, severe mental and growth retardation, hypotonia, areflexia, joints hyperextensibility, proteinuria, aminoaciduria, and metabolic acidosis. There was also severe epileptic activity (Lennox-Gastaut syndrome). The neuropathological examination revealed a marked cerebellar atrophy and central chromatolysis in the cerebral cortex. These observations do not confirm the hypothesis of dysmyelination as formulated in previous studies. The reported case rather suggests the existence of a dynamic process starting as a still-undefined metabolic abnormality that, in turn, causes various and inconsistent lesions at the microscopic level. PMID:2077136

  15. Local cause of gingival overgrowth. Clinical and histological study.

    PubMed

    Drăghici, Emma Cristina; CrăiŢoiu, Ştefania; MercuŢ, Veronica; Scrieciu, Monica; Popescu, Sanda Mihaela; Diaconu, Oana Andreea; Oprea, Bogdan; Pascu, Roxana Maria; CrăiŢoiu, Monica Mihaela

    2016-01-01

    The overgrowth, depending on its extension, has multiple effects on the stomatognathic apparatus: functional disorders (impaired speech), difficulty in chewing and aesthetic problems but can cause significant psychological problems. We proposed this study, motivated by the relative increased frequency of the gum outgrowth, its multifactorial etiopathogeny, but especially from the point of view of the specialist practitioner, by the problems that this pathology raises not only for the functionality of the stomatognathic apparatus but also for the facial esthetics, and especially for future therapeutic attitudes needed to solve the existing pathology at this level. We conducted a clinical study and a histological one. For the clinical study, we selected 74 patients who experienced different degrees of gingival outgrowing associated with fillings, dental caries, fixed prostheses, mobile prostheses, orthodontic apparatus. Thirty gingival fragments from patients with gingival outgrowing were processed by paraffin-embedding histological technique and stained with Hematoxylin-Eosin. The morphological results obtained provide the necessary support for understanding the possibility of developing a therapeutic strategy to prevent or minimize the gum outgrowth by administering antibiotic and anti-inflammatory medications associated with medications, which shall cause the apoptosis of the fibroblasts. PMID:27516015

  16. Maltreated children's representations of mother and an additional caregiver: a longitudinal study.

    PubMed

    Manashko, Shany; Besser, Avi; Priel, Beatriz

    2009-04-01

    In the current longitudinal investigation, we explored the continuity of and changes in the mental representations of the mother and an additional caregiver among forty-five 9- to 11-year-old children who had been severely maltreated and subsequently placed in long-term residential care as well as the relationships between the content and structure of these representations and teacher's assessments of the child's externalizing and internalizing symptoms. At Time 1, a nonmaltreated comparison group was assessed concomitantly. Compared to nonmaltreated children, maltreated children scored higher for externalizing and internalizing symptoms, and their maternal representations were found to be significantly less benevolent and integrated and more punitive. In addition, among the maltreated children, the additional caregiver representations were found to be more benevolent and integrated, and less punitive, than the maternal representations. After 30 months, the maltreated children's levels of externalizing and internalizing symptoms diminished, their maternal representations become more benevolent and less punitive, and the additional caregiver representations became less benevolent. Moreover, the Benevolence of the additional caregiver representation was found to predict these children's changes in externalizing symptoms beyond the effects of their symptomatology and its associations with the Benevolence of these representations at Time 1. PMID:19220720

  17. [Pantethine, diabetes mellitus and atherosclerosis. Clinical study of 1045 patients].

    PubMed

    Donati, C; Bertieri, R S; Barbi, G

    1989-03-31

    After a review of the clinical studies on the treatment of diabetic patients with pantethine, the authors discuss the results obtained in a postmarketing surveillance (PMS) study on 1045 hyperlipidemic patients receiving pantethine (900 mg/day on average). Of these patients, 57 were insulin-dependent (Type I) and 241 were non insulin-dependent (Type II) diabetics. Beyond the epidemiological considerations made possible by a PMS study, the authors show that pantethine brought about a statistically significant and comparable improvement of lipid metabolism in the three groups of patients, with very good tolerability. Pantethine should therefore be considered for the treatment of lipid abnormalities also in patients at risk such as those with diabetes mellitus. PMID:2524328

  18. Cauda equina arachnoiditis. A correlative clinical and roentgenologic study.

    PubMed

    Brodsky, A E

    1978-03-01

    A series of 93 consecutive patients whose myelograms were reported as showing arachnoiditis were studied, and correlations between the radiographic appearance and the clinical and surgical findings were tabulated. All but 1 patient had had either lumbar disc surgery and/or Pantopaque myelography. The study led to a classification of such roentgenogram changes which revealed that the majority of patients studied did not have the usual adhesive arachnoiditis, but the picture they projected was more commonly due to spinal stenosis, extraarachnoid dye injection, extradural scar, etc. Only 1 patient of the 93 presented the classic severely disabling paraparesis, intractable pain, and loss of bowel and bladder functions commonly ascribed to adhesive arachnoiditis. The presence of such myelographic changes need not deter necessary surgery for coexisting disc pathology, nerve root entrapment, or spinal stenosis. In only a small percentage of these patients could the symptoms be attributed to the arachnoiditis changes seen in the myelogram. PMID:644393

  19. [French Guiana "papillonite" (lepidopterism). Clinical and epidemiological study].

    PubMed

    Ducombs, G; Lamy, M; Michel, M; Pradinaud, R; Jamet, P; Vincendeau, P; Maleville, J; Texier, L

    1983-01-01

    Clinical studies by Dr R. Pradinaud (Cayenne) has given prominence to the symptoms of "papillonite": its primary and secondary cutaneous lesions, their localisation and evolution as well as its accompanying symptoms such as respiratory pathology. Epidemiologic survey shows a parallelism between the occurrence of papillonite and the presence of the moth Hylesia urticans. The urticant apparatus of this moth was studied with the scanning electron microscope. "Arrow" (fléchettes) were found and they more or less resemble the urticant apparatus of Thaumetopoea pityocampa Schiff caterpillar. The mechanism of action has been studied in the animal and in humans. Extracts prepared from the "arrows" have been rested in vivo guinea-pigs (bleu Evans, Liacopoulos et al.). The findings seem to incriminate an histamino-liberation. PMID:6666924

  20. Serial study of clinical and CT changes in tuberculous meningitis.

    PubMed

    Ranjan, P; Kalita, J; Misra, U K

    2003-05-01

    Clinical and radiological changes in tuberculous meningitis (TBM) have been reported but there is paucity of comprehensive serial clinicoradiological follow-up. In this prospective hospital based study, we investigated serial changes in the clinical and radiological findings and their relationships over 6 months in 31 consecutive patients with TBM, diagnosed on the basis of clinical, radiological and spinal fluid criteria. We graded the severity of the TBM as I-III. Detailed clinical examination, contrast-enhanced CT and activities of daily living (ADL) assessments were made on admission, and 3 and 6 months after therapy. Further CT was carried out as required. Patients received four-drug antituberculous therapy (RHZE) and underwent a ventriculoperitoneal shunt if necessary. Outcome was defined as poor, partial or complete recovery using the Barthel index score at 6 months. The age of the patients was 6-80 years, mean 35.2 years; four were children and 13 female. Meningitis was stage I in 5, stage II in six and stage III in 20 patients. Focal weakness was present in nine, papilloedema in six and ophthalmoplegia in ten. There were ten patients who deteriorated within first 6 weeks of therapy. Mean Glasgow coma score (GCS) deteriorated from 12.5 to 11.4; the grade of meningitis increased by two stages in one patient, one stage in another, and motor deficits appeared in four and optic atrophy in four; four patients required shunt surgery. By 3 months most patients were stable. At 6 months 17 patients had complete, four partial and nine poor recovery. Initial CT was abnormal in 28 patients, revealing hydrocephalus and exudates in 15 each, infarcts in ten and tuberculomas in 13. It was repeated in ten patients who deteriorated, showing new abnormalities such as hydrocephalus in two, infarcts in four, exudates in four and granulomas in two, with worsening of the previous findings. CT at 3 and 6 months was still abnormal in most patients. At 6 months hydrocephalus had

  1. Invited review: study design considerations for clinical research in veterinary radiology and radiation oncology.

    PubMed

    Scrivani, Peter V; Erb, Hollis N

    2013-01-01

    High quality clinical research is essential for advancing knowledge in the areas of veterinary radiology and radiation oncology. Types of clinical research studies may include experimental studies, method-comparison studies, and patient-based studies. Experimental studies explore issues relative to pathophysiology, patient safety, and treatment efficacy. Method-comparison studies evaluate agreement between techniques or between observers. Patient-based studies investigate naturally acquired disease and focus on questions asked in clinical practice that relate to individuals or populations (e.g., risk, accuracy, or prognosis). Careful preplanning and study design are essential in order to achieve valid results. A key point to planning studies is ensuring that the design is tailored to the study objectives. Good design includes a comprehensive literature review, asking suitable questions, selecting the proper sample population, collecting the appropriate data, performing the correct statistical analyses, and drawing conclusions supported by the available evidence. Most study designs are classified by whether they are experimental or observational, longitudinal or cross-sectional, and prospective or retrospective. Additional features (e.g., controlled, randomized, or blinded) may be described that address bias. Two related challenging aspects of study design are defining an important research question and selecting an appropriate sample population. The sample population should represent the target population as much as possible. Furthermore, when comparing groups, it is important that the groups are as alike to each other as possible except for the variables of interest. Medical images are well suited for clinical research because imaging signs are categorical or numerical variables that might be predictors or outcomes of diseases or treatments. PMID:23578318

  2. Clinical study of cutaneous leishmaniasis in the Kashmir Valley

    PubMed Central

    Wani, Gh Mohiuddin; Ahmad, Sheikh Manzoor; Khursheed, Bilques

    2015-01-01

    Background: Cutaneous leishmaniasis (CL) is an infectious disease of tropical and semitropical areas of the world. The cold and harsh winter conditions of the Kashmir Valley do not favor the survival and growth of the Leishmania parasite or its vector, the sand fly, and the disease was until now practically unheard of in the Kashmir Valley. Aims: There has been a recent rise in the number of cases of CL in the Kashmir Valley. Against this background, the present study was taken up to describe the epidemiology, clinical features, and management outcomes of CL in the Kashmir Valley, where it represents a new phenomenon. Materials and Methods: Patients with direct smear-confirmed CL were evaluated. For each patient, we noted age, gender, geographical origin, stays in endemic areas, clinical aspects, number, site and size of lesions, treatment, and outcome. All the infected patients were treated with sodium stibogluconate. The dose, route of administration, adverse effects, and the clinical response in each patient was noted down. Results: Eighteen patients, 11 males (61.12%) and 7 females (38.88%) were studied. The age of the patients ranged from 3 to 60 years (mean age 29.8). The majority of our patients (16, 88.9%) belonged to two hilly areas, Uri and Karnah. Duration of the disease ranged from a minimum of 1 month to a maximum of 18 months (mean duration 4.6 months). Lesions in most of our patients (16, 88.9%) were located on the face including the lip and nose. The size of lesions varied from 4 to about 50 mm (average 2-3 cm). Most of our patients (13, 73.3%) had only a single lesion and a few (5, 26.7%) had two or three lesions. The clinical type of lesion in most of our patients (16, 88.9%) was noduloulcerative, only two (11.1%) had nodular (nonulcerative) lesions. Sixteen patients; all with facial lesions were treated with intravenous sodium stibogluconate. A complete response was seen in 14 (87%), without any major adverse effect. Two adult patients with

  3. A clinical study of canine collagen type III glomerulopathy

    PubMed Central

    2013-01-01

    Background Collagen type III glomerulopathy (Col3GP), also known as collagenofibrotic glomerulonephropathy, is a rare renal disease with unknown pathogenesis that occurs in animals and humans. We recently described a naturally occurring canine autosomal recessive model of Col3GP, and the aim of the present work was to study the clinical features of canine Col3GP and compare with the human phenotype. In humans two different clinical syndromes with different age at onset (child- or adulthood) have been observed. In children a more aggressive course with familial occurrence is described, characterized by progressively increasing proteinuria, nephrotic syndrome, hypertension and chronic renal failure. A markedly increased serum level of the aminoterminal propeptide of type III procollagen (PIIINP) is considered a useful marker for the disease. Since Col3GP and concurrent hypocomplementemia have been observed in humans, we also aimed to investigate if hypocomplementemia was present in Col3GP affected dogs. A litter consisting of seven puppies, four Col3GP affected and three healthy unaffected, was observed from the day of birth until the affected puppies developed a mild or moderate renal azotemia. Results During the period of observation growth retardation, increasing blood pressure, progressive proteinuria, azotemia, hypoalbuminemia, hypercholesterolemia and increased serum PIIINP were observed in all the affected dogs. Hypocomplementemia was not detected. Affected dogs were euthanized between 109 and 144 days of age, and pathological examinations revealed ascites and massive glomerular accumulations of collagen type III, consistent with Col3GP. Conclusions Dogs with Col3GP develop juvenile chronic renal failure, preceded by nephrotic syndrome, elevated serum PIIINP and hypertension, thus have similar clinical features as the juvenile Col3GP in humans. Further studies of this naturally occurring canine phenotype may provide more information on the pathogenesis and

  4. A clinical and microbiological study on the enantiomers of delmopinol.

    PubMed

    Sjödin, Torgny; Nilner, Krister; Sparre, Birgitta; Bernet, Catarina; Åström, Mikael

    2016-07-01

    Objective The clinical part of this study aimed to investigate whether the racemate of delmopinol [(±)-delmopinol] is equivalent to its two enantiomers [(+)-delmopinol and (-)-delmopinol] with respect to efficiency and to determine and compare their pharmacokinetic properties. The purpose of the pre-clinical part was to elucidate possible differences in antimicrobial efficiency. Materials and methods The compounds were tested clinically in a double-blind, randomized, cross-over study comprising three treatment periods of 4 days each. The antimicrobial efficacy of the enantiomers was compared in vitro with respect to planktonic and biofilm bacteria of different species. Results No statistically significant differences in prevention of plaque formation were observed. Except for a somewhat higher systemic exposure in terms of AUC and Cmax indicated for (-)-delmopinol compared to (+)-delmopinol, the pharmacokinetic properties were similar. The most common adverse event was a transient anaesthetic feeling in the mouth. This event was reported with the same frequency for all three test solutions. The enantiomers showed similar antimicrobial effects on planktonic bacteria and their biofilms. Conclusions The enantiomers were found to be equally effective with respect to inhibition of plaque development and only minor differences were observed with respect to their pharmacokinetic properties. No differences could be observed in the adverse events reports. There is, therefore, no reason to use one of the enantiomers of delmopinol instead of the racemate. This was further supported by the antimicrobial tests. It is suggested that the combined action of cationic and neutral delmopinol is important for its effect on biofilms. PMID:26940371

  5. Central odontogenic fibroma: Retrospective study of 8 clinical cases

    PubMed Central

    Hrichi, Radia; Gargallo-Albiol, Jordi; Berini-Aytés, Leonardo

    2012-01-01

    Introduction and Objectives: The central odontogenic fibroma (COF) is a benign odontogenic tumour derived from the dental mesenchymal tissues. It is a rare tumour and only 70 cases of it have been published. Bearing in mind the rareness of the tumour, 8 new cases of central odontogenic fibroma have been found by analyzing the clinical, radiological and histopathological characteristics of COF. Patients and Method: A retrospective study was carried out on 3011 biopsies in the Service of Oral and Maxillofacial Surgery of the Dental Clinic of Barcelona University between January 1995 and March 2008. 85 odontogenic tumours were diagnosed of which 8 were central odontogenic fibroma. The radiological study was based on orthopantomographs, periapical and occlusal radiographies and computerised tomographics. The variables collected were: sex, age, clinical characteristics of the lesion, treatment received and possible reappearances of the tumour. Results: The central odontogenic fibroma represents 9.4% of all odontogenic tumours. Of the 8 cases, 5 were diagnosed in men and 3 in women. The average age was 19.9 years with an age range of 11 to 38 years. The most common location of the tumour was in the mandible. All cases were associated with unerupted teeth. Of the 8 tumours, 3 provoked rhizolysis of the adjacent teeth and 4 cases caused cortical bone expansion. 50% of the patients complained of pain associated to the lesion. No case of recurrence was recorded up to 2 years after the treatment. Conclusions: Central odontogenic fibromas usually evolve asymptomatically although they can manifest very aggressively provoking dental displacement and rhizolysis. Radiologically, COF manifest as a uni or multilocular radiotransparent image although they can be indistinguishable from other radiotransparent lesions making diagnosis more difficult. COF treatment involves conservative surgery as well as follow-up patient checks. Key words: Odontogenic tumour, central odontogenic

  6. Mechanical characterization of filler sandcretes with rice husk ash additions. Study applied to Senegal

    SciTech Connect

    Cisse, I.K.; Laquerbe, M.

    2000-01-01

    To capitalize on the local materials of Senegal (agricultural and industrial wastes, residual fines from crushing process, sands from dunes, etc.), rise husk ash and residues of industrial and agricultural wastes have been used as additions in sandcretes. The mechanical resistance of sandcrete blocks obtained when unground ash (and notably the ground ash) is added reveals that there is an increase in performance over the classic mortar blocks. In addition, the use of unground rice husk ash enables production of a lightweight sandcrete with insulating properties, at a reduced cost. The ash pozzolanic reactivity explains the high strengths obtained.

  7. Computational study of the rate constants and free energies of intramolecular radical addition to substituted anilines

    PubMed Central

    Seddiqzai, Meriam; Dahmen, Tobias; Sure, Rebecca

    2013-01-01

    Summary The intramolecular radical addition to aniline derivatives was investigated by DFT calculations. The computational methods were benchmarked by comparing the calculated values of the rate constant for the 5-exo cyclization of the hexenyl radical with the experimental values. The dispersion-corrected PW6B95-D3 functional provided very good results with deviations for the free activation barrier compared to the experimental values of only about 0.5 kcal mol−1 and was therefore employed in further calculations. Corrections for intramolecular London dispersion and solvation effects in the quantum chemical treatment are essential to obtain consistent and accurate theoretical data. For the investigated radical addition reaction it turned out that the polarity of the molecules is important and that a combination of electrophilic radicals with preferably nucleophilic arenes results in the highest rate constants. This is opposite to the Minisci reaction where the radical acts as nucleophile and the arene as electrophile. The substitution at the N-atom of the aniline is crucial. Methyl substitution leads to slower addition than phenyl substitution. Carbamates as substituents are suitable only when the radical center is not too electrophilic. No correlations between free reaction barriers and energies (ΔG ‡ and ΔG R) are found. Addition reactions leading to indanes or dihydrobenzofurans are too slow to be useful synthetically. PMID:24062821

  8. Study on automatic optical element addition or deletion in lens optimization

    NASA Astrophysics Data System (ADS)

    Cheng, Xuemin; Wang, Yongtian; Hao, Qun

    2002-09-01

    Two lens form parameters, quantifying the symmetry of the optical system and the optical power distribution among the individual lens elements, are used as the criteria for automatic element addition or deletion in lens optimization. The scheme based on the criteria is described in this paper. Design examples are provided, which demonstrate that the scheme is practicable.

  9. Teaching Young Children Decomposition Strategies to Solve Addition Problems: An Experimental Study

    ERIC Educational Resources Information Center

    Cheng, Zi-Juan

    2012-01-01

    The ability to count has traditionally been considered an important milestone in children's development of number sense. However, using counting (e.g., counting on, counting all) strategies to solve addition problems is not the best way for children to achieve their full mathematical potential and to prepare them to develop more complex and…

  10. Computational study of the rate constants and free energies of intramolecular radical addition to substituted anilines.

    PubMed

    Gansäuer, Andreas; Seddiqzai, Meriam; Dahmen, Tobias; Sure, Rebecca; Grimme, Stefan

    2013-01-01

    The intramolecular radical addition to aniline derivatives was investigated by DFT calculations. The computational methods were benchmarked by comparing the calculated values of the rate constant for the 5-exo cyclization of the hexenyl radical with the experimental values. The dispersion-corrected PW6B95-D3 functional provided very good results with deviations for the free activation barrier compared to the experimental values of only about 0.5 kcal mol(-1) and was therefore employed in further calculations. Corrections for intramolecular London dispersion and solvation effects in the quantum chemical treatment are essential to obtain consistent and accurate theoretical data. For the investigated radical addition reaction it turned out that the polarity of the molecules is important and that a combination of electrophilic radicals with preferably nucleophilic arenes results in the highest rate constants. This is opposite to the Minisci reaction where the radical acts as nucleophile and the arene as electrophile. The substitution at the N-atom of the aniline is crucial. Methyl substitution leads to slower addition than phenyl substitution. Carbamates as substituents are suitable only when the radical center is not too electrophilic. No correlations between free reaction barriers and energies (ΔG (‡) and ΔG R) are found. Addition reactions leading to indanes or dihydrobenzofurans are too slow to be useful synthetically. PMID:24062821

  11. Vector generalized additive models for extreme rainfall data analysis (study case rainfall data in Indramayu)

    NASA Astrophysics Data System (ADS)

    Utami, Eka Putri Nur; Wigena, Aji Hamim; Djuraidah, Anik

    2016-02-01

    Rainfall pattern are good indicators for potential disasters. Global Circulation Model (GCM) contains global scale information that can be used to predict the rainfall data. Statistical downscaling (SD) utilizes the global scale information to make inferences in the local scale. Essentially, SD can be used to predict local scale variables based on global scale variables. SD requires a method to accommodate non linear effects and extreme values. Extreme value Theory (EVT) can be used to analyze the extreme value. One of methods to identify the extreme events is peak over threshold that follows Generalized Pareto Distribution (GPD). The vector generalized additive model (VGAM) is an extension of the generalized additive model. It is able to accommodate linear or nonlinear effects by involving more than one additive predictors. The advantage of VGAM is to handle multi response models. The key idea of VGAM are iteratively reweighted least square for maximum likelihood estimation, penalized smoothing, fisher scoring and additive models. This works aims to analyze extreme rainfall data in Indramayu using VGAM. The results show that the VGAM with GPD is able to predict extreme rainfall data accurately. The prediction in February is very close to the actual value at quantile 75.

  12. Studies on the Food Additive Propyl Gallate: Synthesis, Structural Characterization, and Evaluation of the Antioxidant Activity

    ERIC Educational Resources Information Center

    Garrido, Jorge; Garrido, E. Manuela; Borges, Fernanda

    2012-01-01

    Antioxidants are additives largely used in industry for delaying, retarding, or preventing the development of oxidative deterioration. Propyl gallate (E310) is a phenolic antioxidant extensively used in the food, cosmetics, and pharmaceutical industries. A series of lab experiments have been developed to teach students about the importance and…

  13. Posterior shoulder pain and anterior instability: a preliminary clinical study.

    PubMed

    Castagna, Alessandro; Conti, Marco; Borroni, Mario; Massazza, Giuseppe; Vinci, Enzo; Franceschi, Giorgio; Garofalo, Raffaele

    2008-02-01

    Different clinical tests have been suggested in the literature as significant indicators of anterior shoulder instability. Sometimes patients with recurrent anterior shoulder instability may show some muscular guarding thus making the evaluation of specific clinical tests very difficult. These patients may also report a medical history with posterior shoulder pain that can be also elicited during some clinical manoeuvres. From September 2005 to September 2006 we prospectively studied patients who underwent an arthroscopic anterior capsuloplasty. Shoulder clinical examination was performed including anterior shoulder instability tests (drawer, apprehension and relocation tests). Furthermore the exam was focused on the presence of scapular dyskinesia and posterior shoulder pain. The patients were also evaluated with ASES, Rowe, SST (Simple Shoulder Test), Constant and UCLA (University of California at Los Angeles) scoring system preoperatively and at the latest follow-up time. In the period of this study we observed 16 patients treated for anterior gleno-humeral arthroscopic stabilisation, who preoperatively complained also of a posterior scapular pain. The pain was referred at the level of lower trapezium and upper rhomboids tendon insertion on the medial border of the scapula. It was also reproducible upon local palpation by the examiner. Four of these patients also referred pain in the region of the insertion of the infraspinatus and teres minor. After arthroscopic stabilisation the shoulder was immobilised in a sling with the arm in the neutral rotation for a period of 4 weeks. A single physician supervised shoulder rehabilitation. After a mean time of 6.8 months of follow-up, all the shoulder scores were significantly improved and, moreover, at the same time the patients referred the disappearance of the posterior pain. Posterior scapular shoulder pain seems to be another complaint and sign that can be found in patients affected by anterior shoulder instability

  14. Lessons Learned from an ICD-10-CM Clinical Documentation Pilot Study

    PubMed Central

    Moczygemba, Jackie; Fenton, Susan H

    2012-01-01

    On October 1, 2013, the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) will be mandated for use in the United States in place of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). This new classification system will used throughout the nation's healthcare system for recording diagnoses or the reasons for treatment or care. A pilot study was conducted to determine whether current levels of inpatient clinical documentation provide the detail necessary to fully utilize the ICD-10-CM classification system for heart disease, pneumonia, and diabetes cases. The design of this pilot study was cross-sectional. Four hundred ninety-one de-identified records from two sources were coded using ICD-10-CM guidelines and codebooks. The findings of this study indicate that healthcare organizations need to assess clinical documentation and identify gaps. In addition, coder proficiency should be assessed prior to ICD-10-CM implementation to determine the need for further education and training in the biomedical sciences, along with training in the new classification system. PMID:22548021

  15. Ataxia telangiectasia in Chinese children. A clinical and electrophysiological study.

    PubMed

    Wong, V; Yu, Y L; Chan-Lui, W Y; Woo, E; Yeung, C Y

    1987-01-01

    The clinical manifestations, immunological, chromosomal, and multimodal electrophysiological studies of five Chinese patients with ataxia telangiectasia are described. One died of hepatocellular carcinoma not associated with Hepatitis B-antigenaemia. Another died of respiratory failure. Two siblings are free of sinopulmonary infections although they are wheelchair bound. Computed tomography of the brain showed cerebellar atrophy in four cases. Nerve conduction studies showed evidence of axonal neuropathy in all cases with the earliest detection at six years. Electromyography showed mild denervation changes in two cases. Two patients had abnormal somatosensory evoked potentials and one had abnormal visual and brain stem auditory evoked potentials. The level of alpha foetal protein was elevated whereas the serum carcino-embryonic antigen was normal in all patients. PMID:3665286

  16. Fundamental and clinical studies on tumor control by TBI

    SciTech Connect

    Sakamoto, Kiyohiko; Myojin, Miyako

    1996-12-31

    Total body irradiation (TBI) has been considered to bring about immunosuppressive effects on organisms. The conclusion is derived from data obtained by sublethal doses of TBI, but there are no data on how low doses of TBI act on organisms. On the other hand, it is known that low doses of TBI are effective on some malignant lymphoma or chronic myelogenous leukemia. However, the effect of low doses of TBI is rarely investigated radiobiologically. For 15 yr, the authors have studied the effects of low doses of TBI on normal or tumor-bearing mice and its immunological background. In this paper, they show the results of fundamental and clinical studies on tumor control by low doses of TBI.

  17. Clinical studies of a vegetarian food diet mixture.

    PubMed

    Carter, J P; Bonney, G; Molnar, I G; Garces, N; Lulseged, S; Habte, D; Ryan, J; Allen, D

    1989-05-01

    A vegetarian food mixture when incorporated into a commercially prepared diet can be used as a supplement or in a vegetarian protein-sparing modified fast. A modification of this diet was given to protein-energy deficient malnourished children in Ethiopia, and it reversed their biochemical defects. The soluble or gel-forming fiber in the mixture also gives the product a favorable glycemic index and reduces glycemic excursion as well as fasting blood glucose and insulin levels. This accounts for the improvements seen in glucose tolerance in type II diabetic patients. These results, however, were preceded by a study of the effects of the mixture in improving glucose tolerance in diabetic rats. A clinical study among New Orleans police officers also suggests that this mixture helps people, without much self-motivation, to lose weight. PMID:2746679

  18. Clinical studies of a vegetarian food diet mixture.

    PubMed Central

    Carter, J. P.; Bonney, G.; Molnar, I. G.; Garces, N.; Lulseged, S.; Habte, D.; Ryan, J.; Allen, D.

    1989-01-01

    A vegetarian food mixture when incorporated into a commercially prepared diet can be used as a supplement or in a vegetarian protein-sparing modified fast. A modification of this diet was given to protein-energy deficient malnourished children in Ethiopia, and it reversed their biochemical defects. The soluble or gel-forming fiber in the mixture also gives the product a favorable glycemic index and reduces glycemic excursion as well as fasting blood glucose and insulin levels. This accounts for the improvements seen in glucose tolerance in type II diabetic patients. These results, however, were preceded by a study of the effects of the mixture in improving glucose tolerance in diabetic rats. A clinical study among New Orleans police officers also suggests that this mixture helps people, without much self-motivation, to lose weight. PMID:2746679

  19. Clinical Study of Ursodeoxycholic Acid in Barrett's Esophagus Patients.

    PubMed

    Banerjee, Bhaskar; Shaheen, Nicholas J; Martinez, Jessica A; Hsu, Chiu-Hsieh; Trowers, Eugene; Gibson, Blake A; Della'Zanna, Gary; Richmond, Ellen; Chow, H-H Sherry

    2016-07-01

    Prior research strongly implicates gastric acid and bile acids, two major components of the gastroesophageal refluxate, in the development of Barrett's esophagus and its pathogenesis. Ursodeoxycholic acid (UDCA), a hydrophilic bile acid, has been shown to protect esophageal cells against oxidative stress induced by cytotoxic bile acids. We conducted a pilot clinical study to evaluate the clinical activity of UDCA in patients with Barrett's esophagus. Twenty-nine patients with Barrett's esophagus received UDCA treatment at a daily dose of 13 to 15 mg/kg/day for 6 months. The clinical activity of UDCA was assessed by evaluating changes in gastric bile acid composition and markers of oxidative DNA damage (8-hydroxydeoxyguanosine), cell proliferation (Ki67), and apoptosis (cleaved caspase-3) in Barrett's esophagus epithelium. The bile acid concentrations in gastric fluid were measured by liquid chromatography/mass spectrometry. At baseline, UDCA (sum of unchanged and glycine/taurine conjugates) accounted for 18.2% of total gastric bile acids. After UDCA intervention, UDCA increased significantly to account for 93.4% of total gastric bile acids (P < 0.0001). The expression of markers of oxidative DNA damage, cell proliferation, and apoptosis was assessed in the Barrett's esophagus biopsies by IHC. The selected tissue biomarkers were unchanged after 6 months of UDCA intervention. We conclude that high-dose UDCA supplementation for 6 months resulted in favorable changes in gastric bile acid composition but did not modulate selected markers of oxidative DNA damage, cell proliferation, and apoptosis in the Barrett's esophagus epithelium. Cancer Prev Res; 9(7); 528-33. ©2016 AACRSee related article by Brian J. Reid, p. 512. PMID:26908564

  20. Neuronal involvement in cisplatin neuropathy: prospective clinical and neurophysiological studies.

    PubMed

    Krarup-Hansen, A; Helweg-Larsen, S; Schmalbruch, H; Rørth, M; Krarup, C

    2007-04-01

    Although it is well known that cisplatin causes a sensory neuropathy, the primary site of involvement is not established. The clinical symptoms localized in a stocking-glove distribution may be explained by a length dependent neuronopathy or by a distal axonopathy. To study whether the whole neuron or the distal axon was primarily affected, we have carried out serial clinical and electrophysiological studies in 16 males with testicular cancer before or early and late during and after treatment with cisplatin, etoposide and bleomycin at limited (<400 mg/m2 cisplatin), conventional (approximately 400 mg/m2 cisplatin) or high (>400 mg/m2 cisplatin) doses. At cumulative doses of cisplatin higher than 300 mg/m2 the patients lost distal tendon and H-reflexes and displayed reduced vibration sense in the feet and the fingers. The amplitudes of sensory nerve action potentials (SNAP) from the fingers innervated by the median nerve and the dorsolateral side of the foot innervated by the sural nerve were 50-60% reduced, whereas no definite changes occurred at lower doses. The SNAP conduction velocities were reduced by 10-15% at cumulative doses of 400-700 mg/m2 consistent with loss of large myelinated fibres. SNAPs from primarily Pacinian corpuscles in digit 3 and the dorsolateral side of the foot evoked by a tactile probe showed similar changes to those observed in SNAPs evoked by electrical stimulation. At these doses, somatosensory evoked potentials (SEPs) from the tibial nerve had increased latencies of peripheral, spinal and central responses suggesting loss of central processes of large dorsal root ganglion cells. Motor conduction studies, autonomic function and warm and cold temperature sensation remained unchanged at all doses of cisplatin treatment. The results of these studies are consistent with degeneration of large sensory neurons whereas there was no evidence of distal axonal degeneration even at the lowest toxic doses of cisplatin. PMID:17301082

  1. Issues and promise in clinical studies of botanicals with anticonvulsant potential.

    PubMed

    Ekstein, Dana

    2015-11-01

    Botanicals are increasingly used by people with epilepsy worldwide. However, despite abundant preclinical data on the anticonvulsant properties of many herbal remedies, there are very few human studies assessing safety and efficacy of these products in epilepsy. Additionally, the methodology of most of these studies only marginally meets the requirements of evidence-based medicine. Although the currently available evidence for the use of cannabinoids in epilepsy is similarly lacking, several carefully designed and well controlled industry-sponsored clinical trials of cannabis derivatives are planned to be completed in the next couple of years, providing the needed reliable data for the use of these products. The choice of the best botanical candidates with anticonvulsant properties and their assessment in well-designed clinical trials may significantly improve our ability to effectively and safely treat patients with epilepsy. This article is part of a Special Issue entitled "Botanicals for Epilepsy". PMID:26341963

  2. The efficacy of pressure relief maneuvers in spinal cord injury patients, a clinical study

    NASA Astrophysics Data System (ADS)

    Ho, Thuan; Nguyen, Ahn Thu; Lichy, Alison; Groah, Suzanne; Ramella-Roman, Jessica C.

    2014-02-01

    Pressure reliefs are recommended to wheelchair bound individuals to control and minimize skin damage. To this date recommendation on duration and intervals between pressure reliefs is not clear. Recent studies have shown a relationship between reduction in tissue perfusion and oxygenation due to pressure and skin pathophysiologic changes. We have developed a fiber-optics probe that allows measurement of oxygenation in addition to perfusion in real time; this low profile probe can be utilized while sitting and during pressure reliefs. We have conducted a clinical trial at the National Rehabilitation Hospital on individual with spinal cord injury. The overriding goal of this project was to develop the evidence base for clinical recommendations on pressure reliefs. Results of the study will be presented.

  3. A laboratory study of the perceived benefit of additional noise attenuation by houses

    NASA Technical Reports Server (NTRS)

    Flindell, I. H.

    1983-01-01

    Two Experiments were conducted to investigate the perceived benefit of additional house attenuation against aircraft flyover noise. First, subjects made annoyance judgments in a simulated living room while an operative window with real and dummy storm windows was manipulated in full view of those subjects. Second, subjects made annoyance judgments in an anechoic audiometric test chamber of frequency shaped noise signals having spectra closely matched to those of the aircraft flyover noises reproduced in the first experiment. These stimuli represented the aircraft flyover noises in levels and spectra but without the situational and visual cues present in the simulated living room. Perceptual constancy theory implies that annoyance tends to remain constant despite reductions in noise level caused by additional attenuation of which the subjects are fully aware. This theory was supported when account was taken for a reported annoyance overestimation for certain spectra and for a simulated condition cue overreaction.

  4. Enhanced flux pinning in MOCVD-YBCO films through Zr-additions:Systematic feasibility studies

    SciTech Connect

    Aytug, Tolga; Paranthaman, Mariappan Parans; Specht, Eliot D; Kim, Kyunghoon; Zhang, Yifei; Cantoni, Claudia; Zuev, Yuri L; Goyal, Amit; Christen, David K; Maroni, Victor A.

    2009-01-01

    Systematic effects of Zr additions on the structural and flux pinning properties of YBa{sub 2}Cu{sub 3}O{sub 7-{delta}} (YBCO) films deposited by metal-organic chemical vapor deposition (MOCVD) have been investigated. Detailed characterization, conducted by coordinated transport, x-ray diffraction, scanning and transmission electron microscopy analyses, and imaging Raman microscopy have revealed trends in the resulting property/performance correlations of these films with respect to varying mole percentages (mol%) of added Zr. For compositions {le} 7.5 mol%, Zr additions lead to improved in-field critical current density, as well as extra correlated pinning along the c-axis direction of the YBCO films via the formation of columnar, self-assembled stacks of BaZrO{sub 3} nanodots.

  5. Enhanced flux pinning in MOCVD-YBCO films through Zr additions : systematic feasibility studies.

    SciTech Connect

    Aytug, T.; Paranthaman, M.; Specht, E. D.; Zhang, Y.; Kim, K.; Zuev, Y. L.; Cantoni, C.; Goyal, A.; Christen, D. K.; Maroni, V. A.; Chen, Y.; Selvamanickam, V.; ORNL; SuperPower, Inc.

    2010-01-01

    Systematic effects of Zr additions on the structural and flux pinning properties of YBa{sub 2}Cu{sub 3}O{sub 7-{delta}} (YBCO) films deposited by metal-organic chemical vapor deposition (MOCVD) have been investigated. Detailed characterization, conducted by coordinated transport, x-ray diffraction, scanning and transmission electron microscopy analyses, and imaging Raman microscopy have revealed trends in the resulting property/performance correlations of these films with respect to varying mole percentages (mol%) of added Zr. For compositions {le} 7.5 mol%, Zr additions lead to improved in-field critical current density, as well as extra correlated pinning along the c-axis direction of the YBCO films via the formation of columnar, self-assembled stacks of BaZrO{sub 3} nanodots.

  6. Indolyne Experimental and Computational Studies: Synthetic Applications and Origins of Selectivities of Nucleophilic Additions

    PubMed Central

    Im, G-Yoon J.; Bronner, Sarah M.; Goetz, Adam E.; Paton, Robert S.; Cheong, Paul H.-Y.; Houk, K. N.; Garg, Neil K.

    2010-01-01

    Efficient syntheses of 4,5-, 5,6-, and 6,7-indolyne precursors beginning from commercially available hydroxyindole derivatives are reported. The synthetic routes are versatile and allow access to indolyne precursors that remain unsubstituted on the pyrrole ring. Indolynes can be generated under mild fluoride-mediated conditions, trapped by a variety of nucleophilic reagents, and used to access a number of novel substituted indoles. Nucleophilic addition reactions to indolynes proceed with varying degrees of regioselectivity; distortion energies control regioselectivity and provide a simple model to predict the regioselectivity in the nucleophilic additions to indolynes and other unsymmetrical arynes. This model has led to the design of a substituted 4,5-indolyne that exhibits enhanced nucleophilic regioselectivity. PMID:21114321

  7. The quality and characteristics of clinical drug study notifications reviewed by the regulatory agency in Finland.

    PubMed

    Keinonen, Tuija; Nieminen, Sakari; Saareks, Virpi; Miettinen, Pirkko; Saano, Veijo; Ylitalo, Pauli

    2002-02-01

    The aim of our study was to investigate the validity of clinical drug study notifications reviewed by the regulatory agency in Finland during the 1990s. (In practice, the notification is equivalent to tacit authorization, which the agency has full powers to revoke before it takes effect.) All clinical drug studies reviewed by the agency during the years 1992, 1994, 1996, and 1998 were studied retrospectively. The main measurements used were the number of studies with no objection to start; the number and type of questions raised; the profile, phase, and type of study; and the study design. Additionally, the studies approved by two ethics committees of university hospitals during the same years were cross-checked to see whether the agency was notified of them in accordance with the national regulations. In total, 1174 study notifications were reviewed. Most studies were international (52%), phase III (46%), placebo-controlled with/without active control (35%) investigations of new chemical entities (38%) and were carried out in university hospitals (63%). The regulatory agency had no objections or questions regarding 55% of the notifications; 37% of the studies were permitted to begin after a clarification; 5% had to be clarified a second time; and 3% were rejected. Most questions dealt with subject information. Out of the 1140 permitted studies, 8% were later canceled or prematurely terminated as reported by the applicant. Altogether 71% of the studies that had been reviewed and approved by the ethics committees were reported to the authorities before commencement. Study completions were rarely reported. Most of the clinical drug studies planned in Finland are large international studies to investigate new chemical entities. More than half of the notifications are valid according to the regulatory authorities. Not all studies, nor the majority of study completions, are reported to the authority, though according to the regulations they should be so reported. The

  8. Structural changes in gluten protein structure after addition of emulsifier. A Raman spectroscopy study

    NASA Astrophysics Data System (ADS)

    Ferrer, Evelina G.; Gómez, Analía V.; Añón, María C.; Puppo, María C.

    2011-06-01

    Food protein product, gluten protein, was chemically modified by varying levels of sodium stearoyl lactylate (SSL); and the extent of modifications (secondary and tertiary structures) of this protein was analyzed by using Raman spectroscopy. Analysis of the Amide I band showed an increase in its intensity mainly after the addition of the 0.25% of SSL to wheat flour to produced modified gluten protein, pointing the formation of a more ordered structure. Side chain vibrations also confirmed the observed changes.

  9. A design study for the addition of higher order parametric discrete elements to NASTRAN

    NASA Technical Reports Server (NTRS)

    Stanton, E. L.

    1972-01-01

    The addition of discrete elements to NASTRAN poses significant interface problems with the level 15.1 assembly modules and geometry modules. Potential problems in designing new modules for higher-order parametric discrete elements are reviewed in both areas. An assembly procedure is suggested that separates grid point degrees of freedom on the basis of admissibility. New geometric input data are described that facilitate the definition of surfaces in parametric space.

  10. Psychometric Study of the Clinical Treatment Planning Simulations (CTPS) for Assessing Clinical Judgment.

    ERIC Educational Resources Information Center

    Falvey, Janet Elizabeth; Hebert, David J.

    1992-01-01

    Examined psychometric properties of four clinical treatment planning simulations (CTPS) developed by interdisciplinary mental health experts to examine clinical judgment in treatment planning processes of practitioners. Found that scoring reliability was high and simulations demonstrated adequate content, discriminant, and predictive validity.…

  11. Load bearing and stiffness tailored NiTi implants produced by additive manufacturing: a simulation study

    NASA Astrophysics Data System (ADS)

    Rahmanian, Rasool; Shayesteh Moghaddam, Narges; Haberland, Christoph; Dean, David; Miller, Michael; Elahinia, Mohammad

    2014-03-01

    Common metals for stable long-term implants (e.g. stainless steel, Titanium and Titanium alloys) are much stiffer than spongy cancellous and even stiffer than cortical bone. When bone and implant are loaded this stiffness mismatch results in stress shielding and as a consequence, degradation of surrounding bony structure can lead to disassociation of the implant. Due to its lower stiffness and high reversible deformability, which is associated with the superelastic behavior, NiTi is an attractive biomaterial for load bearing implants. However, the stiffness of austenitic Nitinol is closer to that of bone but still too high. Additive manufacturing provides, in addition to the fabrication of patient specific implants, the ability to solve the stiffness mismatch by adding engineered porosity to the implant. This in turn allows for the design of different stiffness profiles in one implant tailored to the physiological load conditions. This work covers a fundamental approach to bring this vision to reality. At first modeling of the mechanical behavior of different scaffold designs are presented as a proof of concept of stiffness tailoring. Based on these results different Nitinol scaffolds can be produced by additive manufacturing.

  12. Magnetic Force Microscopy Study of Zr2Co11 -Based Nanocrystalline Materials: Effect of Mo Addition

    DOE PAGESBeta

    Yue, Lanping; Jin, Yunlong; Zhang, Wenyong; Sellmyer, David J.

    2015-01-01

    Tmore » he addition of Molybdenum was used to modify the nanostructure and enhance coercivity of rare-earth-free Zr2Co11-based nanocrystalline permanent magnets. he effect of Mo addition on magnetic domain structures of melt spun nanocrystalline Zr16Co84-xMox(x=0, 0.5, 1, 1.5, and 2.0) ribbons has been investigated. It was found that magnetic properties and local domain structures are strongly influenced by Mo doping. he coercivity of the samples increases with the increase in Mo content (x≤1.5). he maximum energy product(BH)maxincreases with increasingxfrom 0.5 MGOe forx=0to a maximum value of 4.2 MGOe forx=1.5. he smallest domain size with a relatively short magnetic correlation length of 128 nm and largest root-mean-square phase shiftΦrmsvalue of 0.66° are observed for thex=1.5. he optimal Mo addition promotes magnetic domain structure refinement and thus leads to a significant increase in coercivity and energy product in this sample.« less

  13. Parameters and pitfalls to consider in the conduct of food additive research, Carrageenan as a case study.

    PubMed

    Weiner, Myra L

    2016-01-01

    This paper provides guidance on the conduct of new in vivo and in vitro studies on high molecular weight food additives, with carrageenan, the widely used food additive, as a case study. It is important to understand the physical/chemical properties and to verify the identity/purity, molecular weight and homogeneity/stability of the additive in the vehicle for oral delivery. The strong binding of CGN to protein in rodent chow or infant formula results in no gastrointestinal tract exposure to free CGN. It is recommended that doses of high Mw non-caloric, non-nutritive additives not exceed 5% by weight of total solid diet to avoid potential nutritional effects. Addition of some high Mw additives at high concentrations to liquid nutritional supplements increases viscosity and may affect palatability, caloric intake and body weight gain. In in vitro studies, the use of well-characterized, relevant cell types and the appropriate composition of the culture media are necessary for proper conduct and interpretation. CGN is bound to media protein and not freely accessible to cells in vitro. Interpretation of new studies on food additives should consider the interaction of food additives with the vehicle components and the appropriateness of the animal or cell model and dose-response. PMID:26615870

  14. Clinical evaluation study of the German network of disorders of sex development (DSD)/intersexuality: study design, description of the study population, and data quality

    PubMed Central

    Lux, Anke; Kropf, Siegfried; Kleinemeier, Eva; Jürgensen, Martina; Thyen, Ute

    2009-01-01

    Background The German Network of Disorders of Sex Development (DSD)/Intersexuality carried out a large scale clinical evaluation study on quality of life, gender identity, treatment satisfaction, coping, and problems associated with diagnoses and therapies in individuals with disorders of sex development (DSD). DSD are a heterogeneous group of various genetic disorders of sex determination or sex differentiation, all of which are rare conditions. In about half of all cases the molecular genetic diagnosis is unknown and diagnosis rests on clinical features. Methods and design The multi-centre clinical evaluation study includes short-term follow-up in some and cross-sectional assessments in all age and diagnostic groups fitting the criteria of DSD. Recruitment was from January 2005 until December 2007 in whole Germany and, additionally, in 2007 in Austria and German-speaking Switzerland. The study consists of a psychosocial inquiry for children, adolescents and their parents, and adults with standardized instruments and the collection of DSD-specific medical data by the attending physician. The main goal was the description of clinical outcomes and the health-care situation of individuals with DSD using a broad generic definition of DSD including all conditions with a mismatch of chromosomal, gonadal and phenotypical sex. 439 children and adolescents, their parents and adults with DSD participated. Discussion The clinical evaluation study represents the most comprehensive study in this clinical field. The paper discusses the study protocol, the data management and data quality as well as the classification used, and it describes the study population. Given the lack of large datasets in rare conditions such as DSD and often biased results from small scale clinical case series, the study aims to generate concrete hypotheses for evidence-based guidelines, which should be tested in further studies. PMID:19383134

  15. [Clinical study of BRON-L syrup (cough suppressant) abuse].

    PubMed

    Miyatake, Ryosuke; Doi, Tomoko; Date, Kenji; Naitoh, Tomomichi; Suwaki, Hiroshi

    2002-02-01

    In 1980s, abuse and dependence of BRON-W syrup (cough suppressant), which contains methylephedrine, dihydrocodeine, chlorpheniramine and caffeine, were prevalent in Japan. Pharmacological and clinical studies suggest that methylephedrine and dihydrocodeine cause dependence. Although BRON-L syrup, newly modified cough suppressant contains only chlorpheniramine and caffeine, there still are abuse and dependence of this drug. In this report, three cases of BRON-L syrup abuse are demonstrated. All cases started using BRON-L syrup in the late teens in their peer groups, and dropped out from school. Case 1 misused only BRON-L syrup, but case 2 and 3 were multi-drug abusers (case 2: amphetamine, cocaine, and marijuana, case 3: solvent, alcohol, bromovalerylurea), and had kept in tough with the peer groups. Case 2 and 3 hospitalized more than 2 times. Withdrawal symptoms, such as headache, insomnia, and irritability were mild and improved in a few weeks after drug use was stopped. These findings suggest that 1) psychosocial backgrounds of these cases are in common with those of BRON-W syrup abusers, but 2) the clinical course and prognosis of multi-drug abusers are different from the BRON single abuser, 3) chlorpheniramine and caffeine possibly cause dependence, 4) abusers are likely to choose BRON brand although two main dependence-producing constituents are removed from it now. Therefore, prevention and care of BRON-L abusers requires both psychosocial and pharmacological aspects. PMID:11915306

  16. Clinical and parasitological study on scabies in Sirte, Libya.

    PubMed

    Fathy, Fouad M; El-Kasah, Fathi; El-Ahwal, Abdulla M

    2010-12-01

    The present work aimed to determine the risk factors, clinical and parasitological skin lesion features and effective drug regimens. Study was carried out on 200 patients referred to dermatology outpatient clinics in Sirte-Libya. Each was subjected to detailed questionnaire, dermatological skin examination, parasitological skin scraping test (SST), burrow ink test (BIT), drug administration and follow up. Results revealed that females 59%, children 37.5% and military personnel 18% of immigrant families were particularly prone to scabies infestation. Effective risk factors included overcrowding, bed sharing, low hygienic and education levels. Commonest skin lesions included erythematous papules 93%, excoriated papules 77.5%, burrows 66%, pustulation 31%, vesicles 21.5 and nodules 3%. Predilection lesion sites were hand 86%, wrist 82%, abdomen 56%, male external genitalia 64.5% and female breast 28%. Specific SST was positive in 67.3% of cases, particularly sensitive in early cases with short itching duration. BIT was positive in 62%. Topical permethrin proved more effective than precipitated sulpher with cure rates of of 100% and 85.3% in 21% and 75% of cases, respectively. Ivermectin was 100% effective in 4% of cases. PMID:21268539

  17. [A clinical and epidemiological study of Tori mandibularis].

    PubMed

    Karaiskos, S; Dimitriou, P; Tsironis, G; Spyropoulos, N D

    1989-10-01

    This is a study aiming at: a) reviewing the information found in the relevant literature as regards the etiology, incidence, distribution, implication and management of the tori mandibularis, b) evaluating the incidence, location and morphology of this bony mass in a sample of Greek population and c) comparing the findings with those of other investigators. The material consisted of 357 patients, from 20 years old and onwards, who had consecutively visited the Clinic of Removable Prosthodontics for some problem. After clinical examination and tabulation of the findings, the following conclusions were drawn: a) the etiology of appearance of tori mandibularis remains unknown; b) in our sample, 12.8% had this condition; c) the incidence was higher in men (60.4%) than in women (39.5%); d) in our sample, the higher percentage of individuals showing the condition originated from Thraci (Northern Greece) while the lower came from Hepiros; e) No indication of a heredity factor was found; f) this condition is more often bilateral than unilateral and g) the torus mandibularis was extending from the canine to the area of the first premolar in 54.4% of the cases. PMID:2518071

  18. Dysphagia in psychiatric patients: clinical and videofluoroscopic study.

    PubMed

    Bazemore, P H; Tonkonogy, J; Ananth, R

    1991-01-01

    Deaths due to airway obstruction are more common in psychiatric inpatients than in the normal population. A dysphagia program was started in a 400 bed Massachusetts psychiatric hospital after 4 patients in 1 year died from asphyxia. In the year after the program was started, there were no deaths; however, 28 patients experienced 32 choking incidents. The 28 patients received clinical evaluations by speech pathologists, neurologists, psychiatrists, and internists. Of the incidents, 55% required use of the Heimlich maneuver to open the airway. Choking incidents could be classified into five types based on results of clinical examination: bradykinetic, dyskinetic, fast eating syndrome, paralytic, and medical. Twenty-one of the 28 patients were studied by videofluoroscopy and 86% of the videos were abnormal, showing aspiration in eight, webs in five, and delay in the oral phase in five. Patients with bradykinetic dysphagia (secondary to neuroleptic-induced extra-pyramidal syndrome [EPS]) and paralytic dysphagia appeared to experience a more severe form of choking. PMID:1884635

  19. Clinical study of Manjishthadi Ghrita in vrana ropana

    PubMed Central

    Baria, Jyoti; Gupta, S. K.; Bhuyan, C.

    2011-01-01

    Healing of vrana (wound) is either primary or secondary by nature. Secondary healing requires more attention than primary healing. Basically, two things, shodhana (making free from undesirable healing factors) and ropana (closure of wound), are desirable for proper healing. Many drugs have been described in classics for healing, but none of them is capable of healing the wound individually. Hence, to fulfill the aim, manjishthadi ghrita was prepared with the help of 7 drugs having vrana ropana effects and was evaluated clinically for its healing properties in this study. It was used topically in postoperative wounds, mostly of ano-rectal cases, twice a day, for 21 days. The follow-up period was 1 month to observe the healing as well as vaikritapaham (reduced deformity) properties and any untoward effects of the drug. A randomized control clinical trial was done. Out of 45 patients, 24 patients in group A were treated with “Manjishthadi Ghrita” (treated group), while 21 patients in group B (standard group) treated with povidine iodine ointment. Better result was observed in the treated group in comparison to the standard group. No adverse effect was observed in any patient. Manjishthadi ghrita can be prescribed as a local healing agent for common wound. PMID:22131765

  20. Holt-Oram syndrome: a clinical genetic study.

    PubMed Central

    Newbury-Ecob, R A; Leanage, R; Raeburn, J A; Young, I D

    1996-01-01

    A clinical and genetic study of the Holt-Oram syndrome (HOS) has been carried out in the United Kingdom involving 55 cases designated Holt-Oram syndrome, together with their parents and sibs. Data from the clinical assessment of both familial and isolated cases were used to define the HOS phenotype and to outline the spectrum of abnormalities, especially factors affecting severity. Skeletal defects affected the upper limbs exclusively and were bilateral and asymmetrical. They ranged from minor signs such as clinodactyly, limited supination, and sloping shoulders to severe reduction deformities of the upper arm (4.5%). The radial ray was predominantly affected than the right. All affected cases showed evidence of upper limb involvement. Cardiac defects were seen in 95% of familial cases and included both atrial septal defect (ASD, 34%) and ventricular septal defect (VSD, 25%); 39% had only ECG changes. Cardiac involvement ranged from asymptomatic conduction disturbances to multiple structural defects requiring surgery in infancy. Sudden death could be caused by heart block. Inheritance was autosomal dominant with 100% penetrance and no evidence of reduced fitness. Increasing severity occurred in succeeding generations consistent with anticipation. Images PMID:8730285

  1. Clinical TVA-based studies: a general review

    PubMed Central

    Habekost, Thomas

    2015-01-01

    In combination with whole report and partial report tasks, the theory of visual attention (TVA) can be used to estimate individual differences in five basic attentional parameters: the visual processing speed, the storage capacity of visual short-term memory, the perceptual threshold, the efficiency of top–down selectivity, and the spatial bias of attentional weighting. TVA-based assessment has been used in about 30 studies to investigate attentional deficits in a range of neurological and psychiatric conditions: (a) neglect and simultanagnosia, (b) reading disturbances, (c) aging and neurodegenerative diseases, and most recently (d) neurodevelopmental disorders. The article introduces TVA based assessment, discusses its methodology and psychometric properties, and reviews the progress made in each of the four research fields. The empirical results demonstrate the general usefulness of TVA-based assessment for many types of clinical neuropsychological research. The method’s most important qualities are cognitive specificity and theoretical grounding, but it is also characterized by good reliability and sensitivity to minor deficits. The review concludes by pointing to promising new areas for clinical TVA-based research. PMID:25852607

  2. Choosing the Correct AED: From Animal Studies to the Clinic

    PubMed Central

    Holmes, Gregory L.; Zhao, Qian

    2009-01-01

    Epilepsy is a chronic condition caused by an imbalance of normal excitatory and inhibitory forces in the brain. Antiepileptic drug therapy has been directed primarily toward reducing excitability through blockage of voltage-gated Na+ or Ca2+ channels, or increasing inhibition through enhancement of γ-aminobutyric acid currents. Prior to clinical studies, putative antiepileptic drugs are screened in animals, usually rodents. Maximal electrical shock, pentylenetetrazol, and kindling are typically used as non-mechanistic screens for antiseizure properties and the rotorod test for assessing acute toxicity. While antiseizure drug screening has been successful in bringing drugs to the market and improving our understanding of the pathophysiology of seizures, it should be emphasized that the vast majority of drug screening occurs in mature male rodents and involves models of seizures, not epilepsy. Effective drugs in acute seizures may not be effective in chronic models of epilepsy. Seizure type, clinical and electroencephalographic phenotype, syndrome, and etiology are often quite different in children with epilepsy than adults. Despite these age-related unique features, drugs used in children are generally the same as used in adults. As awareness of the unique features of seizures during development increases, it is anticipated that more drug screening in the immature animal will occur. PMID:18279749

  3. Pemetrexed clinical studies in performance status 2 patients with non-small cell lung cancer (Review)

    PubMed Central

    ZINNER, RALPH; GRUL, CARLA VISSEREN; SPIGEL, DAVID R.; OBASAJU, COLEMAN

    2016-01-01

    Because poor performance status (PS) is an independent prognostic factor in non-small cell lung cancer (NSCLC), PS scores are widely used by oncologists to make treatment decisions. Advanced NSCLC patients with an Eastern Cooperative Oncology Group PS of 2 have poor prognoses and are frequently excluded from clinical trials. This article reviews the efficacy and safety of pemetrexed in this patient group. We identified English-language literature (through March 2015) involving completed and ongoing studies through searches of PubMed, meeting abstracts, ClinicalTrials.gov and the European Clinical Trials Register; search terms included ‘pemetrexed,’ ‘NSCLC’ and ‘PS2’. Only studies reporting ≥1 subset analysis of PS2 patients receiving pemetrexed were chosen. Our search identified a total of ten pemetrexed studies in PS2 patients. Eight studies included only chemonaive patients, one study included both chemonaive patients and patients with one prior chemotherapy regimen and one study included only patients with one prior regimen. In subset analyses in these studies, PS2 patients had worse outcomes than PS0-1 patients regardless of treatment. In a phase 3 study, chemonaive advanced NSCLC patients with PS2 receiving pemetrexed-carboplatin versus pemetrexed experienced improved overall survival [hazard ratio (HR)=0.62; P=0.001], progression-free survival (HR=0.46; P<0.001) and response (P=0.032). This review confirms the poorer outcomes in PS2 vs. PS0-1 patients. Although it is not an approved combination therapy, in clinical studies, PS2 patients treated with pemetrexed plus carboplatin as first-line therapy had improved response rates and survival. Additional research on PS2 patients is needed. PMID:26530033

  4. Clinical and Dermoscopic Study of Pseudofolliculitis of the Beard Area

    PubMed Central

    Kaliyadan, Feroze; Kuruvilla, Joel; Al Ojail, Heba Yousef; Quadri, Sayed A

    2016-01-01

    Background: Pseudofolliculitis of the beard area is a very common dermatological problem in our geographical region. This could be partly because of the racial predilection as a large percentage of the population has curly hair and also may be due to local cultural customs, unlike the west do not encourage daily shaving of facial hair. Objectives: We aimed to mainly study the dermoscopic features of cases presenting with pseudofolliculitis. Secondary objectives included evaluating clinical patterns and possible etiological factors. Methods: Twenty-four consecutive male patients presenting to a University Health Center with a clinical diagnosis of pseudofolliculitis involving beard area were included in the study. Patient history with regards to shaving habits, patient hair type, morphological patterns of the skin lesions, and dermoscopic findings were recorded. Results: Majority of the patients had “curly” hair. Most of the patients had a usual shaving frequency of 2 or less per week. All the patients who were using razors mentioned that they tended to stretch the skin while shaving. The most common dermoscopic findings included - “Handle bar” sign showing curved hair attached to the skin on both ends, white areas indicate fibrosis and scaling, underlying linear bluish pigmentation (indicating the buried hair shaft), and linear vessels with occasional areas of hemorrhage. Conclusion: Dermoscopy can be a useful adjunct for diagnosis and patient counseling in pseudofolliculitis. Stretching the skin while using razors and growing the facial hair to a point where it has the length to curve might be important risk factors in the development of pseudofolliculitis. Limitations: The lack of histopathological correlation is the main limitation in our study. PMID:27127378

  5. The relevance of clinical and radiographic features of jaw lesions: A prospective study.

    PubMed

    Araujo, Juliane Piragine; Lemos, Celso Augusto; Miniello, Thais Gimenez; Alves, Fabio Abreu

    2016-01-01

    The study was carried out in a Brazilian population and the aim was to describe the prevalence and the clinic-radiographical features of jaw lesions. In addition, a comparison between the main diagnosis hypothesis and final diagnosis was accessed. A prospective study which evaluated all patients with jaw lesions diagnosed in an Oral Diagnosis Center, between August 2013 and October 2014. A total of 450 patients were observed for the first time, and 130 had some type of jaw lesion. The mean age of the patients was 35.2 years ± 17.86. Among these, 71 were women (54.62%) and 87 were Caucasian (66.92%). The mandible was affected more frequently (71.43%) than the maxilla (28.57%). Swelling and pain were the most frequent clinical signs and symptoms and were observed in 60 (42.85%) and 38 (27.14%) cases, respectively. The panoramic x-ray was the main radiographic exam utilized (88.57%). Radiolucent lesions accounted for 89 cases (63.57%) and the unilocular form was present in 114 cases (81.43%). A total of 93 cases had histopathological analyses and the periapical cyst was the most frequent lesion. In the other 47 lesions, the diagnosis was conducted by clinical and radiographic management. Bone lesions were frequent, being noted on first visit in approximately 30% of patients; in 1/3 of the cases, the diagnoses were completed with a combination of clinical and radiographic exams. PMID:27556683

  6. Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study

    PubMed Central

    2012-01-01

    Background The purpose of this study was to identify recommended practices for computerized clinical decision support (CDS) development and implementation and for knowledge management (KM) processes in ambulatory clinics and community hospitals using commercial or locally developed systems in the U.S. Methods Guided by the Multiple Perspectives Framework, the authors conducted ethnographic field studies at two community hospitals and five ambulatory clinic organizations across the U.S. Using a Rapid Assessment Process, a multidisciplinary research team: gathered preliminary assessment data; conducted on-site interviews, observations, and field surveys; analyzed data using both template and grounded methods; and developed universal themes. A panel of experts produced recommended practices. Results The team identified ten themes related to CDS and KM. These include: 1) workflow; 2) knowledge management; 3) data as a foundation for CDS; 4) user computer interaction; 5) measurement and metrics; 6) governance; 7) translation for collaboration; 8) the meaning of CDS; 9) roles of special, essential people; and 10) communication, training, and support. Experts developed recommendations about each theme. The original Multiple Perspectives framework was modified to make explicit a new theoretical construct, that of Translational Interaction. Conclusions These ten themes represent areas that need attention if a clinic or community hospital plans to implement and successfully utilize CDS. In addition, they have implications for workforce education, research, and national-level policy development. The Translational Interaction construct could guide future applied informatics research endeavors. PMID:22333210

  7. Strategic Petroleum Reserve (SPR) additional geologic site characterization studies, Bryan Mound Salt Dome, Texas

    SciTech Connect

    Neal, J.T.; Magorian, T.R.; Ahmad, S.

    1994-11-01

    This report revises the original report that was published in 1980. Some of the topics covered in the earlier report were provisional and it is now practicable to reexamine them using new or revised geotechnical data and that obtained from SPR cavern operations, which involves 16 new caverns. Revised structure maps and sections show interpretative differences as compared with the 1980 report and more definition in the dome shape and caprock structural contours, especially a major southeast-northwest trending anomalous zone. The original interpretation was of westward tilt of the dome, this revision shows a tilt to the southeast, consistent with other gravity and seismic data. This interpretation refines the evaluation of additional cavern space, by adding more salt buffer and allowing several more caverns. Additional storage space is constrained on this nearly full dome because of low-lying peripheral wetlands, but 60 MMBBL or more of additional volume could be gained in six or more new caverns. Subsidence values at Bryan Mound are among the lowest in the SPR system, averaging about 11 mm/yr (0.4 in/yr), but measurement and interpretation issues persist, as observed values are about the same as survey measurement accuracy. Periodic flooding is a continuing threat because of the coastal proximity and because peripheral portions of the site are at elevations less than 15 ft. This threat may increase slightly as future subsidence lowers the surface, but the amount is apt to be small. Caprock integrity may be affected by structural features, especially the faulting associated with anomalous zones. Injection wells have not been used extensively at Bryan Mound, but could be a practicable solution to future brine disposal needs. Environmental issues center on the areas of low elevation that are below 15 feet above mean sea level: the coastal proximity and lowland environment combined with the potential for flooding create conditions that require continuing surveillance.

  8. A near-infrared spectroscopic study of young field ultracool dwarfs: additional analysis

    NASA Astrophysics Data System (ADS)

    Allers, K. N.; Liu, M. C.

    We present additional analysis of the classification system presented in \\citet{allers13}. We refer the reader to \\citet{allers13} for a detailed discussion of our near-IR spectral type and gravity classification system. Here, we address questions and comments from participants of the Brown Dwarfs Come of Age meeting. In particular, we examine the effects of binarity and metallicity on our classification system. We also present our classification of Pleiades brown dwarfs using published spectra. Lastly, we determine SpTs and calculate gravity-sensitive indices for the BT-Settl atmospheric models and compare them to observations.

  9. The influence of bioaugmentation and biosurfactant addition on bioremediation efficiency of diesel-oil contaminated soil: feasibility during field studies.

    PubMed

    Szulc, Alicja; Ambrożewicz, Damian; Sydow, Mateusz; Ławniczak, Łukasz; Piotrowska-Cyplik, Agnieszka; Marecik, Roman; Chrzanowski, Łukasz

    2014-01-01

    The study focused on assessing the influence of bioaugmentation and addition of rhamnolipids on diesel oil biodegradation efficiency during field studies. Initial laboratory studies (measurement of emitted CO2 and dehydrogenase activity) were carried out in order to select the consortium for bioaugmentation as well as to evaluate the most appropriate concentration of rhamnolipids. The selected consortium consisted of following bacterial taxa: Aeromonas hydrophila, Alcaligenes xylosoxidans, Gordonia sp., Pseudomonas fluorescens, Pseudomonas putida, Rhodococcus equi, Stenotrophomonas maltophilia, Xanthomonas sp. It was established that the application of rhamnolipids at 150 mg/kg of soil was most appropriate in terms of dehydrogenase activity. Based on the obtained results, four treatment methods were designed and tested during 365 days of field studies: I) natural attenuation; II) addition of rhamnolipids; III) bioaugmentation; IV) bioaugmentation and addition of rhamnolipids. It was observed that bioaugmentation contributed to the highest diesel oil biodegradation efficiency, whereas the addition of rhamnolipids did not notably influence the treatment process. PMID:24291585

  10. Completeness of Reporting of Patient-Relevant Clinical Trial Outcomes: Comparison of Unpublished Clinical Study Reports with Publicly Available Data

    PubMed Central

    Wieseler, Beate; Wolfram, Natalia; McGauran, Natalie; Kerekes, Michaela F.; Vervölgyi, Volker; Kohlepp, Petra; Kamphuis, Marloes; Grouven, Ulrich

    2013-01-01

    significant for all types of outcomes. The main limitation of our study is that our sample is not representative because only CSRs provided voluntarily by pharmaceutical companies upon request could be assessed. In addition, the sample covered only a limited number of therapeutic areas and was restricted to randomized controlled trials investigating drugs. Conclusions In contrast to CSRs, publicly available sources provide insufficient information on patient-relevant outcomes of clinical trials. CSRs should therefore be made publicly available. Please see later in the article for the Editors' Summary PMID:24115912

  11. A clinical study of oral mucous membrane pemphigoid.

    PubMed

    Alkan, A; Günhan, O; Alkan, A; Otan, F

    2003-01-01

    We present 13 cases of oral mucous membrane pemphigoid (MMP) and review the literature. The cases were retrieved from the archives of Ondokuz Mayis University and Gülhane Military Medical Academy, Turkey, between 1997 and 2002. Inclusion criteria were clinical findings of oral MMP verified by histological and immunofluorescent examination. Thirteen patients (two males and 11 females), aged 16-72 years, were identified. Involvement was confined to the mouth in all cases except one, in which the conjunctiva was also affected. Two individuals in the study were < 20 years old, an age group rarely affected. The oral mucosa is often the initial site of MMP lesions, so it is important that dentists as well as physicians are aware of the symptoms and signs. A swift diagnosis, made in consultation with other specialists such as ophthalmologists and dermatologists, is needed in order to prevent a delay in treatment. PMID:12964512

  12. RTL THERAPY FOR MULTIPLE SCLEROSIS: A Phase I Clinical Study

    PubMed Central

    Offner, Halina; Burrows, Gregory G.; Ferro, Adolph J.; Vandenbark, Arthur A.

    2010-01-01

    A human Recombinant T-cell receptor Ligand (RTL1000) consisting of DR2 α1 and β1 domains linked covalently to MOG-35-55 peptide can reverse clinical and histological signs of experimental autoimmune encephalomyelitis (EAE), and was evaluated for safety in a Phase 1 randomized, placebo-controlled, escalating dose study in 34 subjects with multiple sclerosis (MS). RTL1000 was safe and well tolerated at a dose of ≤60mg that is well within the effective dose range for EAE and did not cause worsening of MS disease at doses ≤200mg. RTL1000 represents a novel approach for the treatment of MS that promises potent immunoregulation and CNS repair without global immunosuppression. PMID:20965577

  13. Studies in the radiobiology of osteoradionecrosis and their clinical significance

    SciTech Connect

    Marx, R.E.; Johnson, R.P.

    1987-10-01

    The radiobiology of osteoradionecrosis is a complex of cellular death and cellular functional impairments from radiation energy transfers. Four studies of irradiated patients and a data base from 536 patients with osteoradionecrosis revealed separate pathophysiologic conditions for osteoradionecrosis induced by early trauma, osteoradionecrosis induced by late trauma, and spontaneous osteoradionecrosis. A large body of data suggested useful clinical guidelines for the management of irradiated patients. The guidelines, in part, include a recommendation for deferring radiation treatment for 21 days after tissue wounding, if possible; a relative contraindication to wounding tissue during a radiation course; a recommendation for the use of hyperbaric oxygen before wounding; and a strong recommendation to provide comprehensive dental care to the irradiated patient.

  14. Progress of drug-loaded polymeric micelles into clinical studies.

    PubMed

    Cabral, Horacio; Kataoka, Kazunori

    2014-09-28

    Targeting tumors with long-circulating nano-scaled carriers is a promising strategy for systemic cancer treatment. Compared with free small therapeutic agents, nanocarriers can selectively accumulate in solid tumors through the enhanced permeability and retention (EPR) effect, which is characterized by leaky blood vessels and impaired lymphatic drainage in tumor tissues, and achieve superior therapeutic efficacy, while reducing side effects. In this way, drug-loaded polymeric micelles, i.e. self-assemblies of amphiphilic block copolymers consisting of a hydrophobic core as a drug reservoir and a poly(ethylene glycol) (PEG) hydrophilic shell, have demonstrated outstanding features as tumor-targeted nanocarriers with high translational potential, and several micelle formulations are currently under clinical evaluation. This review summarizes recent efforts in the development of these polymeric micelles and their performance in human studies, as well as our recent progress in polymeric micelles for the delivery of nucleic acids and imaging. PMID:24993430

  15. Anaerobic orbital cellulitis: a clinical and experimental study.

    PubMed Central

    Jedrzynski, M S; Bullock, J D; McGuire, T W; Elder, B L; Bullock, J D

    1991-01-01

    In this article we have reviewed the clinical and bacteriologic aspects of anaerobic orbital cellulitis and have presented six patients to illustrate these points. Physicians who treat patients with orbital cellulitis should have a high index of suspicion for possible instances involving anaerobes, so that appropriate management can be started early. To investigate this problem further, we created an animal model of anaerobic orbital cellulitis. This model may be useful in future studies of the pathogenesis and treatment of this serious and often devastating disease. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 8 FIGURE 9 FIGURE 10 FIGURE 11 FIGURE 12 FIGURE 13 FIGURE 14 FIGURE 15 FIGURE 16 FIGURE 17 FIGURE 18 FIGURE 19 PMID:1808813

  16. Kaolinite flocculation induced by smectite addition - a transmission X-ray microscopic study.

    PubMed

    Zbik, Marek S; Song, Yen-Fang; Frost, Ray L

    2010-09-01

    The influence of smectite addition on kaolinite suspensions in water was investigated by transmission X-ray microscopy (TXM) and Scanning Electron Microscopy (SEM). Sedimentation test screening was also conducted. Micrographs were processed by the STatistic IMage Analysing (STIMAN) program and structural parameters were calculated. From the results of the sedimentation tests important influences of small smectite additions to about 3wt.% on kaolinite suspension flocculation has been found. In order to determine the reason for this smectite impact on kaolinite suspension, macroscopic behaviour micro-structural examination using Transmission X-ray Microscope (TXM) and SEM has been undertaken. TXM & SEM micrographs of freeze-dried kaolinite-smectite suspensions with up to 20% smectite showed a high degree of orientation of the fabric made of highly oriented particles and greatest density when 3wt.% of smectite was added to the 10wt.% dense kaolinite suspension. In contrast, suspensions containing pure kaolinite do not show such platelet mutual orientation but homogenous network of randomly oriented kaolinite platelets. This suggests that in kaolinite-smectite suspensions, smectite forms highly oriented basic framework into which kaolinite platelets may bond in face to face preferential contacts strengthening structure and allowing them to show plastic behaviour which is cause of platelets orientation. PMID:20621806

  17. Clinical Study on 136 Children with Sudden Sensorineural Hearing Loss

    PubMed Central

    Li, Feng-Jiao; Wang, Da-Yong; Wang, Hong-Yang; Wang, Li; Yang, Feng-Bo; Lan, Lan; Guan, Jing; Yin, Zi-Fang; Rosenhall, Ulf; Yu, Lan; Hellstrom, Sten; Xue, Xi-Jun; Duan, Mao-Li; Wang, Qiu-Ju

    2016-01-01

    Background: The prevalence of sudden sensorineural hearing loss in children (CSSNHL) is consistently increasing. However, the pathology and prognosis of CSSNHL are still poorly understood. This retrospective study evaluated clinical characteristics and possible associated factors of CSSNHL. Methods: One hundred and thirty-six CSSNHL patients treated in Department of Otolaryngology-Head and Neck Surgery and Institute of Otolaryngology at Chinese PLA General Hospital between July 2008 and August 2015 were included in this study. These patients were analyzed for clinical characteristics, audiological characteristics, laboratory examinations, and prognostic factors. Results: Among the 136 patients (151 ears), 121 patients (121 ears, 80.1%) were diagnosed with unilaterally CSSNHL, and 15 patients (30 ears, 19.9%) with bilateral CSSNHL. The complete recovery rate of CSSNHL was 9.3%, and the overall recovery rate was 37.7%. We found that initial degree of hearing loss, onset of treatment, tinnitus, the ascending type audiogram, gender, side of hearing loss, the recorded auditory brainstem response (ABR), and distortion product otoacoustic emissions (DPOAEs) had prognostic significance. Age, ear fullness, and vertigo had no significant correlation with recovery. Furthermore, the relevant blood tests showed 30.8% of the children had abnormal white blood cell (WBC) counts, 22.1% had elevated homocysteine levels, 65.8% had high alkaline phosphatase (ALP), 33.8% had high IgE antibody levels, and 86.1% had positive cytomegalovirus (CMV) IgG antibodies. Conclusions: CSSNHL commonly occurs unilaterally and results in severe hearing loss. Initial severe hearing loss and bilateral hearing loss are negative prognostic factors for hearing recovery, while positive prognostic factors include tinnitus, gender, the ascending type audiogram, early treatment, identifiable ABR waves, and DPOAEs. Age, vertigo, and ear fullness are not correlated with the recovery. Some serologic indicators

  18. Neurofeedback and biofeedback with 37 migraineurs: a clinical outcome study

    PubMed Central

    2010-01-01

    Background Traditional peripheral biofeedback has grade A evidence for effectively treating migraines. Two newer forms of neurobiofeedback, EEG biofeedback and hemoencephalography biofeedback were combined with thermal handwarming biofeedback to treat 37 migraineurs in a clinical outpatient setting. Methods 37 migraine patients underwent an average of 40 neurofeedback sessions combined with thermal biofeedback in an outpatient biofeedback clinic. All patients were on at least one type of medication for migraine; preventive, abortive or rescue. Patients kept daily headache diaries a minimum of two weeks prior to treatment and throughout treatment showing symptom frequency, severity, duration and medications used. Treatments were conducted an average of three times weekly over an average span of 6 months. Headache diaries were examined after treatment and a formal interview was conducted. After an average of 14.5 months following treatment, a formal interview was conducted in order to ascertain duration of treatment effects. Results Of the 37 migraine patients treated, 26 patients or 70% experienced at least a 50% reduction in the frequency of their headaches which was sustained on average 14.5 months after treatments were discontinued. Conclusions All combined neuro and biofeedback interventions were effective in reducing the frequency of migraines with clients using medication resulting in a more favorable outcome (70% experiencing at least a 50% reduction in headaches) than just medications alone (50% experience a 50% reduction) and that the effect size of our study involving three different types of biofeedback for migraine (1.09) was more robust than effect size of combined studies on thermal biofeedback alone for migraine (.5). These non-invasive interventions may show promise for treating treatment-refractory migraine and for preventing the progression from episodic to chronic migraine. PMID:20205867

  19. Cystathionine γ-lyase: clinical, metabolic, genetic, and structural studies

    PubMed Central

    Kraus, Jan P.; Hašek, Jindrich; Kožich, Viktor; Collard, Renata; Venezia, Sarah; Janošíková, Bohumila; Wang, Jian; Stabler, Sally P.; Allen, Robert H.; Jakobs, Cornelis; Finn, Christine T.; Chien, Yin-Hsiu; Hwu, Wuh-Liang; Hegele, Robert A.; Mudd, S. Harvey

    2009-01-01

    We report studies of six individuals with marked elevations of cystathionine in plasma and/or urine. Studies of CTH, the gene that encodes cystathionine γ-lyase, revealed the presence among these individuals of either homozygous or compound heterozygous forms of a novel large deletion, p.Gly57_Gln196del, two novel missense mutations, c.589C>T (p.Arg197Cys) and c.932C>T (p.Thr311Ile), and one previously reported alteration, c.200C>T (p.Thr67Ile). Another novel missense mutation, c.185G>T (p.Arg62His), was found in heterozygous form in three mildly hypercystathioninemic members of a Taiwanese family. In one severely hypercystathioninemic individual no CTH mutation was found. Brief clinical histories of the cystathioninemic/cystathioninuric patients are presented. Most of the novel mutations were expressed and the CTH activities of the mutant proteins determined. The crystal structure of the human enzyme, hCTH, and the evidence available as to the effects of the mutations in question, as well as those of the previously reported p.Gln240Glu, on protein structure, enzymatic activity, and responsiveness to vitamin B6 administration are discussed. Among healthy Czech controls, 9.3% were homozygous for CTH c.1208G>T (p.Ser403Ile), previously found homozygously in 7.5% of Canadians for whom plasma total homocysteine (tHcy) had been measured. Compared to wild-type homozygotes, among the 55 Czech c.1208G>T (p.Ser403Ile) homozygotes a greater level of plasma cystathionine was found only after methionine loading. Three of the four individuals homozygous or compound heterozygous for inactivating CTH mutations had mild plasma tHcy elevations, perhaps indicating a cause-and-effect relationship. The experience with the present patients provides no evidence that severe loss of CTH activity is accompanied by adverse clinical effects. PMID:19428278

  20. [Economic assessment, a field between clinical research and observational studies].

    PubMed

    Launois, Robert

    2003-01-01

    Health technology assessments propose to study the differential impact of health interventions in a complex care system which is characterised by the multitude of individual behaviours and the diverse nature of the institutions involved. Current systems for data collection lend themselves poorly to this rigorous analysis of efficacy of treatments in the actual situations where they are used. Randomised trials endeavour to neutralise any parasitic interference which could compromise testing for a causal relationship between the treatment administered and the result obtained. Their methodology which establishes the term ceteris paribus in the principle of good practice lends itself poorly to an analysis of individual behaviour. Observational studies are start from actual treatment situations to describe them as reliably as possible. By definition, however, these assume that the natural course of events is not deviated by any intervention. The absence of an experimental plan increases the likelihood of bias and makes it more difficult to test for causal relationships. They lend themselves poorly to testing for incremental efficacy. The two instruments to be preferred are decisional analysis and quasi-experimental studies. Decisional analysis help to avoid the problems of external validity associated with randomised clinical trials by associating parameters which are extracted from data obtained from everyday practice. Quasi-experimental studies or pragmatic trials are based on the reality of behaviour of the prescriber and his/her patients; their impact on efficacy, quality of life social costs of the disease and of treatments may be identified under normal conditions of use. PMID:12609811

  1. 21 CFR 312.120 - Foreign clinical studies not conducted under an IND.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 5 2013-04-01 2013-04-01 false Foreign clinical studies not conducted under an....120 Foreign clinical studies not conducted under an IND. (a) Acceptance of studies. (1) FDA will... and well-conducted foreign clinical study not conducted under an IND, if the following conditions...

  2. 21 CFR 312.120 - Foreign clinical studies not conducted under an IND.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 5 2014-04-01 2014-04-01 false Foreign clinical studies not conducted under an....120 Foreign clinical studies not conducted under an IND. (a) Acceptance of studies. (1) FDA will... and well-conducted foreign clinical study not conducted under an IND, if the following conditions...

  3. 21 CFR 312.120 - Foreign clinical studies not conducted under an IND.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 5 2012-04-01 2012-04-01 false Foreign clinical studies not conducted under an....120 Foreign clinical studies not conducted under an IND. (a) Acceptance of studies. (1) FDA will... and well-conducted foreign clinical study not conducted under an IND, if the following conditions...

  4. 21 CFR 312.120 - Foreign clinical studies not conducted under an IND.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Foreign clinical studies not conducted under an....120 Foreign clinical studies not conducted under an IND. (a) Acceptance of studies. (1) FDA will... and well-conducted foreign clinical study not conducted under an IND, if the following conditions...

  5. Plaque removal efficacy of Colgate 360 toothbrush: A clinical study

    PubMed Central

    Iyer, Nageshwar; Chandna, Shalu; Dhindsa, Abhishek; Damle, Dhanashree; Loomba, Ashish

    2016-01-01

    Aim: The aim of this clinical study was to confirm the plaque removal efficacy of the Colgate 360 Whole Mouth Clean Toothbrush. Study Design: This was a single-center, monadic, case–controlled study with the 7 days duration. Materials and Methods: A total of eighty participants (56 male and 24 female) aged between 18 and 45 years with a minimum of 20 permanent teeth (excluding the third molars) without any prosthetic crowns and an initial plaque score of minimum 1.5 as determined by Modified Quigley-Hein Plaque Index (1970) participated in the study. There were two dropouts during the study duration, one male and one female. The participants were instructed to brush for 1 min, after which plaque index was recorded again. They were then instructed to brush their teeth twice a day for 1 min with the assigned toothbrush (Colgate 360 Whole Mouth Clean Toothbrush) and a commercially available fluoride toothpaste for the next 7 days. On the 7th day, all the participants were recalled for follow-up and plaque examination. The plaque index scores (pre- and post-brushing) were recorded, tabulated, and analyzed statistically. Results: The mean plaque indices reduced after brushing both on day 1 and day 7. There was also a reduction in mean plaque indices from day 1 to day 7. All these reductions were statistically significant (P < 0.001). The reduction in plaque scores was independent of the gender of the participants however female participants showed lower scores as compared to male participants (P < 0.001). Conclusion: The present study demonstrated a significant reduction in plaque scores with the use of Colgate 360 Whole Mouth Clean Soft Toothbrush throughout the study period. Continued use resulted in a further significant reduction in plaque scores irrespective of the gender of participants.

  6. Professional Competence Development of the Social Work Specialists in the Period of Study in the System of Additional Education

    ERIC Educational Resources Information Center

    Davletkaliev, Denis Kuanyshevich; Zueva, Natalia Konstantinovna; Lebedeva, Natalya Vasilevna; Mkrtumova, Irina Vladimirovna; Timofeeva, Olga

    2015-01-01

    The goal of this work is the study of psychological-pedagogical approaches to the understanding of the idea of professional competence of social work specialists as well as the role of study in the system of additional educations in professional-personal development of the listeners. In the process of study of this problem we define main…

  7. Preliminary study of neutron absorption by concrete with boron carbide addition

    SciTech Connect

    Abdullah, Yusof Yusof, Mohd Reusmaazran; Zali, Nurazila Mat; Ahmad, Megat Harun Al Rashid Megat; Yazid, Hafizal; Ariffin, Fatin Nabilah Tajul; Ahmad, Sahrim; Hamid, Roszilah; Mohamed, Abdul Aziz

    2014-02-12

    Concrete has become a conventional material in construction of nuclear reactor due to its properties like safety and low cost. Boron carbide was added as additives in the concrete construction as it has a good neutron absorption property. The sample preparation for concrete was produced with different weight percent of boron carbide powder content. The neutron absorption rate of these samples was determined by using a fast neutron source of Americium-241/Be (Am-Be 241) and detection with a portable backscattering neutron detector. Concrete with 20 wt % of boron carbide shows the lowest count of neutron transmitted and this indicates the most neutrons have been absorbed by the concrete. Higher boron carbide content may affect the concrete strength and other properties.

  8. A study of the effects of an additional sound source on RASS performance

    SciTech Connect

    Coulter, R.L.

    1998-12-31

    The Southern Great Plains (SGP) Cloud and Radiation Testbed (CART) site of the Atmospheric Radiation Measurements (ARM) Program continuously operates a nine panel 915 MHz wind profiler with Radio Acoustic Sounding System (RASS), measuring wind profiles for 50 minutes and virtual temperature profiles for the remaining 10 minutes during each hour. It is well recognized that one of the principal limits on RASS performance is high horizontal wind speed that moves the acoustic wave front sufficiently to prevent the microwave energy produced by the radar and scattered from the acoustic wave from being reflected back t the radar antenna. With this limitation in mind, the ARM program purchased an additional, portable acoustic source that could be mounted on a small trailer and placed in strategic locations to enhance the RASS performance (when it was not being used for spare parts). A test of the resulting improvement in RASS performance was performed during the period 1995--1997.

  9. Additive Manufacturing of a Microbial Fuel Cell—A detailed study

    PubMed Central

    Calignano, Flaviana; Tommasi, Tonia; Manfredi, Diego; Chiolerio, Alessandro

    2015-01-01

    In contemporary society we observe an everlasting permeation of electron devices, smartphones, portable computing tools. The tiniest living organisms on Earth could become the key to address this challenge: energy generation by bacterial processes from renewable stocks/waste through devices such as microbial fuel cells (MFCs). However, the application of this solution was limited by a moderately low efficiency. We explored the limits, if any, of additive manufacturing (AM) technology to fabricate a fully AM-based powering device, exploiting low density, open porosities able to host the microbes, systems easy to fuel continuously and to run safely. We obtained an optimal energy recovery close to 3 kWh m−3 per day that can power sensors and low-power appliances, allowing data processing and transmission from remote/harsh environments. PMID:26611142

  10. THERMODYNAMIC STUDY OF THE NICKEL ADDITION IN ZINC HOT-DIP GALVANIZING BATHS

    SciTech Connect

    Pistofidis, N.; Vourlias, G.

    2010-01-21

    A usual practice during zinc hot-dip galvanizing is the addition of nickel in the liquid zinc which is used to inhibit the Sandelin effect. Its action is due to the fact that the zeta(zeta) phase of the Fe-Zn system is replaced by the TAU(tau) phase of the Fe-Zn-Ni system. In the present work an attempt is made to explain the formation of the TAU phase with thermodynamics. For this reason the Gibbs free energy changes for TAU and zeta phases were calculated. The excess free energy for the system was calculated with the Redlich-Kister polyonyme. From this calculation it was deduced that the Gibbs energy change for the tau phase is negative. As a result its formation is spontaneous.

  11. Preliminary study of neutron absorption by concrete with boron carbide addition

    NASA Astrophysics Data System (ADS)

    Abdullah, Yusof; Ariffin, Fatin Nabilah Tajul; Hamid, Roszilah; Yusof, Mohd Reusmaazran; Zali, Nurazila Mat; Ahmad, Megat Harun Al Rashid Megat; Yazid, Hafizal; Ahmad, Sahrim; Mohamed, Abdul Aziz

    2014-02-01

    Concrete has become a conventional material in construction of nuclear reactor due to its properties like safety and low cost. Boron carbide was added as additives in the concrete construction as it has a good neutron absorption property. The sample preparation for concrete was produced with different weight percent of boron carbide powder content. The neutron absorption rate of these samples was determined by using a fast neutron source of Americium-241/Be (Am-Be 241) and detection with a portable backscattering neutron detector. Concrete with 20 wt % of boron carbide shows the lowest count of neutron transmitted and this indicates the most neutrons have been absorbed by the concrete. Higher boron carbide content may affect the concrete strength and other properties.

  12. Sulphur diffusion in β-NiAl and effect of Pt additive: an ab initio study

    NASA Astrophysics Data System (ADS)

    Chen, Kuiying

    2016-02-01

    Diffusivities of detrimental impurity sulfur (S) in stoichiometric and Pt doped β-NiAl were evaluated using density functional theory calculations. The apparent activation energy and the pre-exponential factor of diffusivity via the next nearest neighbour (NNN) and interstitial jumps were evaluated to identify possible preferred diffusion mechanism(s). By calculating the electron localization function (ELF), the bonding characteristics of S with its surrounding atoms were assessed for the diffusion process. By comparison with the experimental results, the S diffusion through the NNN vacancy-mediated mechanism is found to be favoured. Addition of Pt in β-NiAl was found to significantly reduce the S diffusivity, and an associated electronic effect was explored. The elucidation of the above mechanisms may shed light on the development of new Pt-modified doped β-NiAl bond coats that can extend the life of oxidation resistant and thermal barrier coatings.

  13. Additive Manufacturing of a Microbial Fuel Cell--A detailed study.

    PubMed

    Calignano, Flaviana; Tommasi, Tonia; Manfredi, Diego; Chiolerio, Alessandro

    2015-01-01

    In contemporary society we observe an everlasting permeation of electron devices, smartphones, portable computing tools. The tiniest living organisms on Earth could become the key to address this challenge: energy generation by bacterial processes from renewable stocks/waste through devices such as microbial fuel cells (MFCs). However, the application of this solution was limited by a moderately low efficiency. We explored the limits, if any, of additive manufacturing (AM) technology to fabricate a fully AM-based powering device, exploiting low density, open porosities able to host the microbes, systems easy to fuel continuously and to run safely. We obtained an optimal energy recovery close to 3 kWh m(-3) per day that can power sensors and low-power appliances, allowing data processing and transmission from remote/harsh environments. PMID:26611142

  14. Additive Manufacturing of a Microbial Fuel Cell—A detailed study

    NASA Astrophysics Data System (ADS)

    Calignano, Flaviana; Tommasi, Tonia; Manfredi, Diego; Chiolerio, Alessandro

    2015-11-01

    In contemporary society we observe an everlasting permeation of electron devices, smartphones, portable computing tools. The tiniest living organisms on Earth could become the key to address this challenge: energy generation by bacterial processes from renewable stocks/waste through devices such as microbial fuel cells (MFCs). However, the application of this solution was limited by a moderately low efficiency. We explored the limits, if any, of additive manufacturing (AM) technology to fabricate a fully AM-based powering device, exploiting low density, open porosities able to host the microbes, systems easy to fuel continuously and to run safely. We obtained an optimal energy recovery close to 3 kWh m-3 per day that can power sensors and low-power appliances, allowing data processing and transmission from remote/harsh environments.

  15. Analysis of antigen specific T cells in diabetes - Lessons from pre-clinical studies and early clinical trials.

    PubMed

    Krishnamurthy, Balasubramanian; Selck, Claudia; Chee, Jonathan; Jhala, Guarang; Kay, Thomas W H

    2016-07-01

    Antigen-specific immune tolerance promises to provide safe and effective therapies to prevent type 1 diabetes (T1D). Antigen-specific therapy requires two components: well-defined, clinically relevant autoantigens; and safe approaches to inducing tolerance in T cells specific for these antigens. Proinsulin is a critical autoantigen in both NOD mice, based on knockout mouse studies and induction of immune tolerance to proinsulin preventing disease whereas most antigens cannot, and also in human T1D based on proinsulin-specific T cells being found in the islets of affected individuals and the early appearance of insulin autoantibodies. Effective antigen-specific therapies that prevent T1D in humans have not yet been developed although doubt remains about the best molecular form of the antigen, the dose and the route of administration. Preclinical studies suggest that antigen specific therapy is most useful when administered before onset of autoimmunity but this time-window has not been tested in humans until the recent "pre-point" study. There may be a 'window of opportunity' during the neonatal period when 'vaccine' like administration of proinsulin for a short period may be sufficient to prevent diabetes. After the onset of autoimmunity, naive antigen-specific T cells have differentiated into antigen-experienced memory cells and the immune responses have spread to multiple antigens. Induction of tolerance at this stage becomes more difficult although recent studies have suggested generation of antigen-specific TR1 cells can inhibit memory T cells. Preclinical studies are required to identify additional 'help' that is required to induce tolerance to memory T cells and develop protocols for effective therapy in individuals with established autoimmunity. PMID:27083395

  16. Production of clinical-grade plasmid DNA for human Phase I clinical trials and large animal clinical studies.

    PubMed

    Przybylowski, Mark; Bartido, Shirley; Borquez-Ojeda, Oriana; Sadelain, Michel; Rivière, Isabelle

    2007-06-28

    The use of plasmid DNA as vaccines for the treatment of cancer and infectious diseases is on the rise. In order to facilitate the manufacture of clinical-grade plasmid DNA for Phase I clinical trials, we developed a process whereby >200 mg plasmid could be produced in a single production run under Good Manufacturing Practices. A dedicated cleanroom (Class 10,000 with Class 100 biosafety cabinet) is utilized for production of the bacterial cell bank, fermentation, harvest/lysis of the biomass, and downstream purification. Fermentation requires three 16-18 h runs (approximately 12 L each) in shaker-flasks, yielding approximately 60 g bacterial paste following batch centrifugation. The biomass is alkaline-lysed, pooled, and the resulting flocculent precipitate is separated by a novel vacuum step, followed by depth-filtration. Downstream processing includes anion-exchange chromatography, utilizing Qiagen silica-based resin, and precipitation with isopropanol. Following precipitation, the DNA is harvested by centrifugation, dried, formulated, and sterile-filtered using a Sartorius Sartobran 150 filter prior to Final-Filling. All processing steps utilize sterilized, single-use components. This process results in a product manufactured according to regulatory guidelines. The plasmid DNA is sterile with >or=95% supercoiled DNA, an A260/A280 ratio>or=1.9, undetectable or extremely low residual endotoxin, RNA, genomic DNA, protein, and antibiotic. Residual solvent levels are negligible. The product yields the predicted profile upon restriction-enzyme digestion, is biologically active upon transfection and remains stable for several years at -20 degrees C. We have therefore developed a reproducible and cost effective process to manufacture clinical-grade plasmid DNA. This process can be adapted by other academic centers for human or large animal clinical trials. PMID:17537555

  17. Urticarial vasculitis in northern Spain: clinical study of 21 cases.

    PubMed

    Loricera, Javier; Calvo-Río, Vanesa; Mata, Cristina; Ortiz-Sanjuán, Francisco; González-López, Marcos A; Alvarez, Lino; González-Vela, M Carmen; Armesto, Susana; Fernández-Llaca, Héctor; Rueda-Gotor, Javier; González-Gay, Miguel A; Blanco, Ricardo

    2014-01-01

    Urticarial vasculitis (UV) is a subset of cutaneous vasculitis (CV), characterized clinically by urticarial skin lesions of more than 24 hours' duration and histologically by leukocytoclastic vasculitis. We assessed the frequency, clinical features, treatment, and outcome of a series of patients with UV. We conducted a retrospective study of patients with UV included in a large series of unselected patients with CV from a university hospital. Of 766 patients with CV, UV was diagnosed in 21 (2.7%; 9 male and 12 female patients; median age, 35 yr; range, 1-78 yr; interquartile range, 5-54 yr). Eight of the 21 cases were aged younger than 20 years old. Potential precipitating factors were upper respiratory tract infections and drugs (penicillin) (n = 4; in all cases in patients aged <20 yr), human immunodeficiency virus (HIV) infection (n = 1), and malignancy (n = 1). Besides urticarial lesions, other features such as palpable purpura (n = 7), arthralgia and/or arthritis (n = 13), abdominal pain (n = 2), nephropathy (n = 2), and peripheral neuropathy (n = 1) were observed. Hypocomplementemia (low C4) with low C1q was disclosed in 2 patients. Other abnormal laboratory findings were leukocytosis (n = 7), increased erythrocyte sedimentation rate (n = 6), anemia (n = 4), and antinuclear antibody positivity (n = 2). Treatment included corticosteroids (n = 12), antihistaminic drugs (n = 6), chloroquine (n = 4), nonsteroidal antiinflammatory drugs (n = 3), colchicine (n = 2), and azathioprine (n = 1). After a median follow-up of 10 months (interquartile range, 2-38 mo) recurrences were observed in 4 patients. Apart from 1 patient who died because of an underlying malignancy, the outcome was good with full recovery in the remaining patients. In conclusion, our results indicate that UV is rare but not exceptional. In children UV is often preceded by an upper respiratory tract infection. Urticarial lesions and joint manifestations are the most frequent clinical manifestation

  18. Rapid maxillary canine retraction by dental distraction: A clinical study

    PubMed Central

    Koteswara Prasad, N. K.; Chitharanjan, Arun; Kailasam, Vignesh

    2014-01-01

    Aim: The aim of this clinical study was to perform rapid maxillary canine retraction through distraction of the periodontal ligament and investigate the rate and amount of canine retraction, amount of anchor loss, the nature of tooth movement achieved, and radiographic changes in the periodontal ligament region during and after canine distraction. Materials and Methods: This study was conducted on 10 distractions ranging in age from 14 years to 25 years who needed canine retraction and first premolar extraction in the maxillary arch. Ten canine distractions were carried out with custom-made, tooth-borne intra-oral distraction device. Results: The results indicate that the periodontal ligament can be distracted just like the mid-palatal suture in rapid palatal expansion and the maxillary canines are retracted rapidly into the first premolar extraction space at the rate of about 2.53 mm/week. Conclusion: Though this study indicates that the periodontal ligament can be distracted to elicit rapid tooth movement, the long-term effects of canine distraction are not well known and need close monitoring. PMID:25298710

  19. Leptospirosis in Vellore: A Clinical and Serological Study

    PubMed Central

    Vimala, G.; Rani, A. Mary Josephine; Gopal, V. Raja

    2014-01-01

    Leptospirosis is a severe spirochetal zoonosis in the world. It is considered an occupational disease of persons engaged in agriculture, sewage works, forestry, and animal slaughtering. A study was conducted with an objective of assessing the seroprevalence of leptospirosis in and around Vellore district, Tamil Nadu. The study was based on the signs and symptoms of the patients reporting fever in Vellore Municipal Clinic (Urban Malarial Scheme). Blood samples were collected from 129 patients. Animal studies were conducted from 24 rodents captured form the market place of the Vellore municipality. In the ZET (Zonal Entomological Team, Vellore) Laboratory the sera were examined by macroscopic slide agglutination test (MSAT). In the MAST, totally 10 positive leptospiral cases from human beings and 10 positive leptospiral cases from rats (Rattus rattus and Rattus norvegicus) were found out. Then both positive cases of leptospiral vials were labeled, sealed, and sent to the Leptospirosis Research Laboratory, Madhavaram, Chennai, for further serovars examination. Among the various serovars identified autumnalis was more prevalent. Our findings showed that the age groups between 15 and 55 years showed more susceptibility. Particularly the adults were more infected. The majority of seropositive individuals in the cases had only subclinical infection. Rodents were abundant and contributed to enzootic and endemic prevalence of leptospirosis. PMID:25050124

  20. Clinical trial participants’ experiences of completing questionnaires: a qualitative study

    PubMed Central

    Holmberg, Christine; Karner, Julia J; Rappenecker, Julia; Witt, Claudia M

    2014-01-01

    Objectives To improve clinical study developments for elderly populations, we aim to understand how they transfer their experiences into validated, standardised self-completed study measurement instruments. We analysed how women (mean 78±8 years of age) participating in a randomised controlled trial (RCT) cognised study instruments used to evaluate outcomes of the intervention. Setting The interview study was nested in an RCT on chronic neck pain using common measurement instruments situated in an elderly community in Berlin, Germany, which comprised of units for independent and assisted-living options. Participants The sample (n=20 women) was selected from the RCT sample (n=117, 95% women, mean age 76 (SD±8) years). Interview participants were selected using a purposive sampling list based on the RCT outcomes. Outcomes We asked participants about their experiences completing the RCT questionnaires. Interviews were analysed thematically, then compared with the questionnaires. Results Interviewees had difficulties in translating complex experiences into a single value on a scale and understanding the relationship of the questionnaires to study aims. Interviewees considered important for the trial that their actual experiences were understood by trial organisers. This information was not transferrable by means of the questionnaires. To rectify these difficulties, interviewees used strategies such as adding notes, adding response categories or skipping an item. Conclusions Elderly interview participants understood the importance of completing questionnaires for trial success. This led to strategies of completing the questionnaires that resulted in ‘missing’ or ambiguous data. To improve data collection in elderly populations, educational materials addressing the differential logics should be developed and tested. Pilot testing validated instruments using cognitive interviews may be particularly important in such populations. Finally, when the target of an

  1. Sensitization to Food Additives in Patients with Allergy: A Study Based on Skin Test and Open Oral Challenge.

    PubMed

    Moghtaderi, Mozhgan; Hejrati, Zinatosadat; Dehghani, Zahra; Dehghani, Faranak; Kolahi, Niloofar

    2016-06-01

    There has been a great increase in the consumption of various food additives in recent years. The purpose of this study was to identify the incidence of sensitization to food additives by using skin prick test in patients with allergy and to determine the concordance rate between positive skin tests and oral challenge in hypersensitivity to additives. This cross-sectional study included 125 (female 71, male 54) patients aged 2-76 years with allergy and 100 healthy individuals. Skin tests were performed in both patient and control groups with 25 fresh food additives. Among patients with allergy, 22.4% showed positive skin test at least to one of the applied materials. Skin test was negative to all tested food additives in control group. Oral food challenge was done in 28 patients with positive skin test, in whom 9 patients showed reaction to culprit (Concordance rate=32.1%). The present study suggested that about one-third of allergic patients with positive reaction to food additives showed positive oral challenge; it may be considered the potential utility of skin test to identify the role of food additives in patients with allergy. PMID:27424134

  2. Presentation and clinical investigation of mitochondrial respiratory chain disease. A study of 51 patients.

    PubMed

    Jackson, M J; Schaefer, J A; Johnson, M A; Morris, A A; Turnbull, D M; Bindoff, L A

    1995-04-01

    Defects of the mitochondrial respiratory chain are associated with a great variety of clinical disorders. Whilst recognition of these conditions is increasing, the need for sophisticated biochemical and molecular studies has tended to limit both their investigation and diagnosis to a few specialist centres. Using a group of 51 patients with histochemically, biochemically and/or genetically defined respiratory chain defects, we have examined both the clinical heterogeneity of these disorders and how they may be investigated most effectively in non-specialist centres. We evaluated the use of the following routinely available clinical investigations--fasting intermediary metabolites (lactate, pyruvate, ketone bodies, etc.) in blood and cerebrospinal fluid, serum creatine kinase estimation, EMG, EEG, CT, MRI and histological/histochemical muscle biopsy analysis. Our studies show that, in addition to well-recognized syndromes (e.g. chronic progressive external ophthalmoplegia, mitochondrial encephalopathy lactic acidosis and stroke like episodes, and myoclonus epilepsy with ragged red-fibres, a significant number of patients present with non-specific encephalopathic disorders. Furthermore, even within those categories of respiratory chain disease which have been genetically defined, a wide variation of presenting symptoms and signs were found. Where there was initial doubt concerning the diagnosis, the following clinical features were helpful in suggesting respiratory chain disease: ophthalmoplegia; a maternal pattern of inheritance; the presence of myopathy or deafness in association with encephalopathy. Of the clinical investigations we assessed, elevated lactate in blood or cerebrospinal fluid and low density lesions in the basal ganglia were helpful in identifying patients with respiratory chain dysfunction. Histochemical analysis of muscle was, however, the single most useful investigation being diagnostic in patients with chronic progressive external

  3. Spectroscopic Evidence for Covalent Binding of Sulfadiazine to Natural Soils via 1,4-nucleophilic addition (Michael Type Addition) studied by Spin Labeling ESR

    NASA Astrophysics Data System (ADS)

    Aleksandrova, Olga

    2015-04-01

    Among different classes of veterinary pharmaceuticals, Sulfadiazine (SDZ) is widely used in animal husbandry. Its residues were detected in different environmental compartments. However, soil is a hot spot for SDZ as it receives a large portion of excreted compounds through the application of manure during soil fertilization. Ample studies on the fate of SDZ in soils showed that a large portion forms nonextractable residues (NER) along with transformation products and a low mineralization (Mueller et al., 2013). A common observation was an initially fast formation of NER up to 10% of the applied amount promptly after the application of SDZ to soil, and this portion increased up to 50% within a few days (Mueller et al., 2013; Nowak et al., 2011). A common finding for SDZ, as for other sulfonamides, was biphasic kinetics of the formation of NER, which was attributed to the occurrence of two reaction processes: a rapid, often reversible process and a slower, irreversible process (Weber et al., 1996). A single-phase reaction process was also established under anaerobic treatment (Gulkowska et al., 2014). A major focus of this work is to elucidate a reaction mechanism of covalent binding of SDZ to soil that is currently required to estimate a risk of NER formed by SDZ in soils for human health. Taking into account a key role of the amine functional groups of SDZ on its reactivity in soil, nitroxide radicals with the sewed aromatic or aliphatic amines labeled soil samples and then, were investigated by means of ESR spectroscopy. 2,5,5-Trimethyl-2-(3-aminophenyl)pyrrolidin-1-yloxy and 4-amino-2,2,6,6-Tetramethylpiperidin-1-oxyl modeled decomposition products of SDZ with the aromatic and aliphatic amines, respectively. The application of the defined combination of both spin labels (SL) to different soils well simulated a change of a paramagnetic signal of soil organic radicals interacted with SDZ. After their application to soil, SL were found in soil sites characterized

  4. Spectroscopic Evidence for Covalent Binding of Sulfadiazine to Natural Soils via 1,4-nucleophilic addition (Michael Type Addition) studied by Spin Labeling ESR

    NASA Astrophysics Data System (ADS)

    Aleksandrova, Olga

    2015-04-01

    Among different classes of veterinary pharmaceuticals, Sulfadiazine (SDZ) is widely used in animal husbandry. Its residues were detected in different environmental compartments. However, soil is a hot spot for SDZ as it receives a large portion of excreted compounds through the application of manure during soil fertilization. Ample studies on the fate of SDZ in soils showed that a large portion forms nonextractable residues (NER) along with transformation products and a low mineralization (Mueller et al., 2013). A common observation was an initially fast formation of NER up to 10% of the applied amount promptly after the application of SDZ to soil, and this portion increased up to 50% within a few days (Mueller et al., 2013; Nowak et al., 2011). A common finding for SDZ, as for other sulfonamides, was biphasic kinetics of the formation of NER, which was attributed to the occurrence of two reaction processes: a rapid, often reversible process and a slower, irreversible process (Weber et al., 1996). A single-phase reaction process was also established under anaerobic treatment (Gulkowska et al., 2014). A major focus of this work is to elucidate a reaction mechanism of covalent binding of SDZ to soil that is currently required to estimate a risk of NER formed by SDZ in soils for human health. Taking into account a key role of the amine functional groups of SDZ on its reactivity in soil, nitroxide radicals with the sewed aromatic or aliphatic amines labeled soil samples and then, were investigated by means of ESR spectroscopy. 2,5,5-Trimethyl-2-(3-aminophenyl)pyrrolidin-1-yloxy and 4-amino-2,2,6,6-Tetramethylpiperidin-1-oxyl modeled decomposition products of SDZ with the aromatic and aliphatic amines, respectively. The application of the defined combination of both spin labels (SL) to different soils well simulated a change of a paramagnetic signal of soil organic radicals interacted with SDZ. After their application to soil, SL were found in soil sites characterized

  5. Te Rita Papesch: Case Study of an Exemplary Learner of Maori as an Additional Language

    ERIC Educational Resources Information Center

    Ratima, Matiu Tai; Papesch, Te Rita

    2014-01-01

    This paper presents a case study of the life experiences of one exemplar adult second language Maori learner--Te Rita Papesch. Te Rita was one of 17 participants who were interviewed as a part of the first author's PhD study which sought to answer the question: what factors lead to the development of proficiency in te reo Maori amongst adult…

  6. Translational insight into statin-induced muscle toxicity: from cell culture to clinical studies.

    PubMed

    Taha, Dhiaa A; De Moor, Cornelia H; Barrett, David A; Gershkovich, Pavel

    2014-08-01

    Statins are lipid-lowering drugs used widely to prevent and treat cardiovascular and coronary heart diseases. These drugs are among the most commonly prescribed medicines intended for long-term use. In general, statins are well tolerated. However, muscular adverse effects appear to be the most common obstacle that limits their use, resulting in poor patient compliance or even drug discontinuation. In addition, rare but potentially fatal cases of rhabdomyolysis have been reported with the use of these drugs, especially in the presence of certain risk factors. Previous reports have investigated statin-induced myotoxicity in vivo and in vitro using a number of cell lines, muscle tissues, and laboratory animals, in addition to randomized clinical trials, observational studies, and case reports. None of them have compared directly results from laboratory investigations with clinical observations of statin-related muscular adverse effects. To the best of our knowledge this is the first review article that combines laboratory investigation with clinical aspects of statin-induced myotoxicity. By reviewing published literature of in vivo, in vitro, and clinically relevant studies of statin myotoxicity, we aim to translate this important drug-related problem to establish a clear picture of proposed mechanisms that explain the risk factors and describe the diagnostic approaches currently used for evaluating the degree of muscle damage induced by these agents. This review provides baseline novel translational insight that can be used to enhance the safety profile, to minimize the chance of progression of these adverse effects to more severe and potentially fatal rhabdomyolysis, and to improve the overall patient compliance and adherence to long-term statin therapy. PMID:24530275

  7. Study of NiO cathode modified by ZnO additive for MCFC

    NASA Astrophysics Data System (ADS)

    Huang, Bo; Li, Fei; Yu, Qing-chun; Chen, Gang; Zhao, Bin-yuan; Hu, Ke-ao

    The preparation and subsequent oxidation of nickel cathodes modified by impregnation with zinc oxide (ZnO) were evaluated by surface and bulk analysis. The electrochemical behaviors of ZnO impregnated NiO cathodes was also evaluated in a molten 62 mol% Li 2CO 3 + 38 mol% K 2CO 3 eutectic at 650 °C by electrochemical impedance spectroscopy (EIS) as a function of ZnO content and immersion time. The ZnO impregnated nickel cathodes showed the similar porosity, pore size distribution and morphology to the reference nickel cathode. The stability tests of ZnO impregnated NiO cathodes showed that the ZnO additive could dramatically reduce the solubility of NiO in a eutectic carbonate mixture under the standard cathode gas condition. The impedance spectra for cathode materials show important variations during the 100 h of immersion. The incorporation of lithium in its structure and the low dissolution of nickel oxide and zinc oxide are responsible of these changes. After that, the structure reaches a stable state. The cathode material having 2 mol% of ZnO showed a very low dissolution and a good catalytic efficiency close to the NiO value. We thought that 2 mol% ZnO/NiO materials would be able to adapt as alternative cathode materials for MCFCs.

  8. Generalized linear and generalized additive models in studies of species distributions: Setting the scene

    USGS Publications Warehouse

    Guisan, A.; Edwards, T.C., Jr.; Hastie, T.

    2002-01-01

    An important statistical development of the last 30 years has been the advance in regression analysis provided by generalized linear models (GLMs) and generalized additive models (GAMs). Here we introduce a series of papers prepared within the framework of an international workshop entitled: Advances in GLMs/GAMs modeling: from species distribution to environmental management, held in Riederalp, Switzerland, 6-11 August 2001. We first discuss some general uses of statistical models in ecology, as well as provide a short review of several key examples of the use of GLMs and GAMs in ecological modeling efforts. We next present an overview of GLMs and GAMs, and discuss some of their related statistics used for predictor selection, model diagnostics, and evaluation. Included is a discussion of several new approaches applicable to GLMs and GAMs, such as ridge regression, an alternative to stepwise selection of predictors, and methods for the identification of interactions by a combined use of regression trees and several other approaches. We close with an overview of the papers and how we feel they advance our understanding of their application to ecological modeling. ?? 2002 Elsevier Science B.V. All rights reserved.

  9. Numerical study of the effect of water addition on gas explosion.

    PubMed

    Liang, Yuntao; Zeng, Wen

    2010-02-15

    Through amending the SENKIN code of CHEMKIN III chemical kinetics package, a computational model of gas explosion in a constant volume bomb was built, and the detailed reaction mechanism (GRI-Mech 3.0) was adopted. The mole fraction profiles of reactants, some selected free radicals and catastrophic gases in the process of gas explosion were analyzed by this model. Furthermore, through the sensitivity analysis of the reaction mechanism of gas explosion, the dominant reactions that affect gas explosion and the formation of catastrophic gases were found out. At the same time, the inhibition mechanisms of water on gas explosion and the formation of catastrophic gases were analyzed. The results show that the induced explosion time is prolonged, and the mole fractions of reactant species such as CH(4), O(2) and catastrophic gases such as CO, CO(2) and NO are decreased as water is added to the mixed gas. With the water fraction in the mixed gas increasing, the sensitivities of the dominant reactions contributing to CH(4), CO(2) are decreased and the sensitivity coefficients of CH(4), CO and NO mole fractions are also decreased. The inhibition of gas explosion with water addition can be ascribed to the significant decrease of H, O and OH in the process of gas explosion due to the water presence. PMID:19811873

  10. Chromosome studies in the aquatic monocots of Myanmar: A brief review with additional records

    PubMed Central

    2014-01-01

    Abstract Myanmar (Burma) constitutes a significant component of the Indo-Myanmar biodiversity hotspot, with elements of the Indian, the Indochina, and the Sino-Japanese floristic regions, yet thus far only a few reliable sources of the country's flora have been available. As a part of a contribution for the floristic inventory of Myanmar, since it is important in a floristic survey to obtain as much information as possible, in addition to previous two reports, here we present three more chromosome counts in the aquatic monocots of Myanmar: Limnocharis flava with 2n = 20, Sagittaria trifolia with 2n = 22 (Alismataceae), and Potamogeton distinctus × Potamogeton nodosus with 2n = 52 (Potamogetonaceae); the third one is new to science. A brief review of cytological researches in the floristic regions' 45 non-hybrid aquatic monocots plus well investigated two inter-specific hybrids that are recorded in Myanmar is given, indicating that the further works with a focus on species in Myanmar that has infra-specific chromosome variation in the floristic regions will address the precise evolutionary history of the aquatic flora of Myanmar. PMID:24891826

  11. Exploratory studies of extended storage of apheresis platelets in a platelet additive solution (PAS).

    PubMed

    Slichter, Sherrill J; Corson, Jill; Jones, Mary Kay; Christoffel, Todd; Pellham, Esther; Bailey, S Lawrence; Bolgiano, Doug

    2014-01-01

    To evaluate the poststorage viability of apheresis platelets stored for up to 18 days in 80% platelet additive solution (PAS)/20% plasma, 117 healthy subjects donated platelets using the Haemonetics MCS+, COBE Spectra (Spectra), or Trima Accel (Trima) systems. Control platelets from the same subjects were compared with their stored test PAS platelets by radiolabeling their stored and control platelets with either (51)chromium or (111)indium. Trima platelets met Food and Drug Administration poststorage platelet viability criteria for only 7 days vs almost 13 days for Haemonetics platelets; ie, platelet recoveries after these storage times averaged 44 ± 3% vs 49 ± 3% and survivals were 5.4 ± 0.3 vs 4.6 ± 0.3 days, respectively. The differences in storage duration are likely related to both the collection system and the storage bag. The Spectra and Trima platelets were hyperconcentrated during collection, and PAS was added, whereas the Haemonetics platelets were elutriated with PAS, which may have resulted in less collection injury. When Spectra and Trima platelets were stored in Haemonetics' bags, poststorage viability was significantly improved. Platelet viability is better maintained in vitro than in vivo, allowing substantial increases in platelet storage times. However, implementation will require resolution of potential bacterial overgrowth during storage. PMID:24258816

  12. The Relationship between Nerve Conduction Study and Clinical Grading of Carpal Tunnel Syndrome

    PubMed Central

    Cheluvaiah, Janardhan D.; Agadi, Jagadish B.; Nagaraj, Karthik

    2016-01-01

    mild CTS, 25 (50%) had moderate CTS and 9 (18%) had severe CTS clinically. Prolongation of motor latency, latency difference between median and ulnar amplitudes, motor and sensory nerve conduction velocities, sensory latency between median and ulnar nerves, sensory nerve conduction velocities showed significant changes in comparison with controls. Among them sensory latency difference between median and ulnar nerves and sensory nerve conduction velocities are the most sensitive and specific for diagnosing CTS. Conclusion In this study, there was a graded deterioration of electrophysiological parameters along with the clinical severity grades, thus reiterating the fact that NCS provide additional, independent objective evidence in the diagnosis and severity assessment of CTS. The sensory conductions were more sensitive than motor conductions in assessing CTS.

  13. Food additives

    MedlinePlus

    Food additives are substances that become part of a food product when they are added during the processing or making of that food. "Direct" food additives are often added during processing to: Add nutrients ...

  14. Quality assurance study of caries risk assessment performance by clinical faculty members in a school of dentistry.

    PubMed

    Rechmann, Peter; Featherstone, John D B

    2014-09-01

    The goal of this quality assurance study was to explore the decision making of clinical faculty members at the University of California, San Francisco School of Dentistry predoctoral dental clinic in terms of caries risk level assignment using the caries risk assessment (CRA) as part of the Caries Management by Risk Assessment (CAMBRA) concept. This research was done in part to determine if additional training and calibration were needed for these faculty members. The study tested the reliability and reproducibility of the caries risk levels assigned by different clinical teachers who completed CRA forms for simulated patients. In the first step, five clinical teachers assigned caries risk levels for thirteen simulated patients. Six months later, the same five plus an additional nine faculty members assigned caries risk levels to the same thirteen simulated and nine additional cases. While the intra-examiner reliability with weighted kappa strength of agreement was very high, the inter-examiner agreements with a gold standard were on average only moderate. In total, 20 percent of the presented high caries risk cases were underestimated at caries levels too low, even when obvious caries disease indicators were present. This study suggests that more consistent training and calibration of clinical faculty members as well as students are needed. PMID:25179930

  15. Longitudinal Study of Left Ventricular Mass Growth: Comparative Study of Clinic and Ambulatory Systolic Blood Pressure in Chronic Kidney Disease.

    PubMed

    Agarwal, Rajiv

    2016-04-01

    Left ventricular (LV) hypertrophy is an established cardiovascular risk factor, yet little is known about its trajectory in people with chronic kidney disease. The goal of this prospective research study was to describe the trajectory of LV mass index, its relationship with blood pressure (BP), and specifically to compare the relationship of BP measured in the clinic and 24-hour ambulatory BP monitoring with LV mass index. Among 274 veterans with chronic kidney disease followed for over ≤ 4 years, the rate of growth of log LV mass index was inversely related to baseline LV mass index; it was rapid in the first 2 years, and plateaued subsequently. Systolic BP also significantly increased, but linearly, 1.7 mm Hg/y by clinic measurements and 1.8 mm Hg/y by 24-hour ambulatory BP. Cross-sectional and longitudinal associations of both clinic BP and 24-hour ambulatory BP with LV mass index were similar; both BP recording methods were associated with LV mass index and its growth over time. Controlled hypertension, masked uncontrolled hypertension, and uncontrolled hypertension categories had increasing LV mass index when diagnosed by 24-hour ambulatory and awake BP (P<0.05 for linear trend) but not sleep BP. After accounting for clinic BP both at baseline and longitudinally, LV mass index among individuals was additionally predicted by the difference in sleep systolic BP and clinic systolic BP (P=0.032). In conclusion, among people with chronic kidney disease, the growth of LV mass index is rapid. Research-grade clinic BP is useful to assess LV mass index and its growth over time. PMID:26831191

  16. Voice measures of workload in the advanced flight deck: Additional studies

    NASA Technical Reports Server (NTRS)

    Schneider, Sid J.; Alpert, Murray

    1989-01-01

    These studies investigated acoustical analysis of the voice as a measure of workload in individual operators. In the first study, voice samples were recorded from a single operator during high, medium, and low workload conditions. Mean amplitude, frequency, syllable duration, and emphasis all tended to increase as workload increased. In the second study, NASA test pilots performed a laboratory task, and used a flight simulator under differing work conditions. For two of the pilots, high workload in the simulator brought about greater amplitude, peak duration, and stress. In both the laboratory and simulator tasks, high workload tended to be associated with more statistically significant drop-offs in the acoustical measures than were lower workload levels. There was a great deal of intra-subject variability in the acoustical measures. The results suggested that in individual operators, increased workload might be revealed by high initial amplitude and frequency, followed by rapid drop-offs over time.

  17. Additional Study of Water Droplet Median Volume Diameter (MVD) Effects on Ice Shapes

    NASA Technical Reports Server (NTRS)

    Tsao, Jen-Ching; Anderson, David N.

    2005-01-01

    This paper reports the result of an experimental study in the NASA Glenn Icing Research Tunnel (IRT) to evaluate how well the MVD-independent effect identified previously might apply to SLD conditions in rime icing situations. Models were NACA 0012 wing sections with chords of 53.3 and 91.4 cm. Tests were conducted with a nominal airspeed of 77 m/s (150 kt) and a number of MVD's ranging from 15 to 100 m with LWC of 0.5 to 1 g/cu m. In the present study, ice shapes recorded from past studies and recent results at SLD and Appendix-C conditions are reviewed to show that droplet diameter is not important to rime ice shape for MVD of 30 microns or larger, but for less than 30 m drop sizes a rime ice shape transition from convex to wedge to spearhead type ice shape is observed.

  18. Study on Type C Coal Fly ash as an Additive to Molding Sand for Steel Casting

    NASA Astrophysics Data System (ADS)

    Palaniappan, Jayanthi

    2016-05-01

    Study of physio-chemical properties studies such as granulometric analysis, moisture, X ray fluorescence etc. were performed with Type C coal—combustion fly ash to investigate their potential as a distinct option for molding sand in foundry, thereby reducing the dependency on latter. Technological properties study such as compressive strength, tensile strength, permeability and compaction of various compositions of fly ash molding sand (10, 20 and 30 % fly ash substitute to chemically bonded sand) were performed and compared with silica molding sand. Steel casting production using this fly ash molding sand was done and the casting surface finish and typical casting parameters were assessed. It was noted that a good quality steel casting could be produced using type C fly ash molding sand, which effectively replaced 20 % of traditional molding sand and binders thereby providing greater financial profits to the foundry and an effective way of fly ash utilization (waste management).

  19. In situ vitrification and the effects of soil additives; A mixture experiment case study

    SciTech Connect

    Piepel, G.F.; Shade, J.W. )

    1992-01-01

    This paper presents a case study involving in situ vitrification (ISV), a process for immobilizing chemical or nuclear wastes in soil by melting-dissolving the contaminated soil into a glass block. One goal of the study was to investigate how viscosity and electrical conductivity were affected by mixing CaO and Na{sub 2}O with soil. A three-component constrained-region mixture experiment design was generated and the viscosity and electrical conductivity data collected. Several second-order mixture models were considered, and the Box-Cox transformation technique was applied to select property transformations. The fitted models were used to produce contour and component effects plots.

  20. Thermographic diagnostics to discriminate skin lesions: a clinical study

    NASA Astrophysics Data System (ADS)

    Stringasci, Mirian Denise; Moriyama, Lilian Tan; Salvio, Ana Gabriela; Bagnato, Vanderlei Salvador; Kurachi, Cristina

    2015-06-01

    Cancer is responsible for about 13% of all causes of death in the world. Over 7 million people die annually of this disease. In most cases, the survival rates are greater when diagnosed in early stages. It is known that tumor lesions present a different temperature compared with the normal tissues. Some studies have been performed in an attempt to establish new diagnosis methods, targeting this temperature difference. In this study, we aim to investigate the use of a handheld thermographic camera to discriminate skin lesions. The patients presenting Basal Cell Carcinoma, Squamous Cell Carcinoma, Actinic Keratosis, Pigmented Seborrheic Keratosis, Melanoma or Intradermal Nevus lesions have been investigated at the Skin Departament of Amaral Carvalho Hospital. Patients are selected by a dermatologist, and the lesion images are recorded using an infrared camera. The images are evaluated taken into account the temperature level, and differences into lesion areas, borders, and between altered and normal skin. The present results show that thermography may be an important tool for aiding in the clinical diagnostics of superficial skin lesions.

  1. Preclinical and Clinical Studies for Sodium Tungstate: Application in Humans

    PubMed Central

    Bertinat, Romina; Nualart, Francisco; Li, Xuhang; Yáñez, Alejandro J.; Gomis, Ramón

    2015-01-01

    Diabetes is a complex metabolic disorder triggered by the deficient secretion of insulin by the pancreatic β-cell or the resistance of peripheral tissues to the action of the hormone. Chronic hyperglycemia is the major consequence of this failure, and also the main cause of diabetic problems. Indeed, several clinical trials have agreed in that tight glycemic control is the best way to stop progression of the disease. Many anti-diabetic drugs for treatment of type 2 diabetes are commercially available, but no ideal normoglycemic agent has been developed yet. Moreover, weight gain is the most common side effect of many oral anti-diabetic agents and insulin, and increased weight has been shown to worsen glycemic control and increase the risk of diabetes progression. In this sense, the inorganic salt sodium tungstate (NaW) has been studied in different animal models of metabolic syndrome and diabetes, proving to have a potent effect on normalizing blood glucose levels and reducing body weight, without any hypoglycemic action. Although the liver has been studied as the main site of NaW action, positive effects have been also addressed in muscle, pancreas, brain, adipose tissue and intestine, explaining the effective anti-diabetic action of this salt. Here, we review NaW research to date in these different target organs. We believe that NaW deserves more attention, since all available anti-diabetic treatments remain suboptimal and new therapeutics are urgently needed. PMID:25995968

  2. [Chemoprevention of oral cancer--clinical and experimental studies].

    PubMed

    Szumiło, Justyna; Podlodowska, Justyna; Podlodowski, Wiktor; Starosławska, Elzbieta; Burdan, Franciszek

    2012-02-01

    Chemoprevention is one of the cancer prevention methods, applied for the oral squamous cell carcinoma and its main precursor lesions--leukoplakia and erythroplakia. Presently, the most extensive clinically studied group used in such cases are retinoids: vitamin A (retinol), 13-cis-retinic acid (isotretinoin), N-(4-hydroxyphenyl)retinamide (fenretinide) and precursor of vitamin A--beta-carotene. However, despite good short-time effectiveness, retinoids do not prevent recurrences of the lesions and insignificantly increase cancer-free survival. Moreover, they are also characterized by relatively high toxicity. Vitamin E, Bowman-Birkprotease inhibitor, Spirulina fusiformis and green tee extracts as well as traditional Chinese herbs known as ZengShengPing were also found as effective agents. Lack of activity was reported for cyclooxygenase inhibitors--ketorolac and celecoxib. More promising data was collected from animal experimental studies with chemically induced oral squamous cell carcinoma. Chemopreventive activity was revealed for various agents including plant-derived compounds like resveratrol, green and black tee polyphenols, as well as protocatechuic, ellagic and caffeic acids. PMID:22590920

  3. A clinical study of febrile myoclonus in children.

    PubMed

    Onoe, Sachiko; Nishigaki, Toshinori

    2004-08-01

    Fever is sometimes associated with chill, myoclonus, delirium and convulsion. We previously reported EEG findings of febrile delirium, when we found that 18% of patients showed febrile myoclonus simultaneously with febrile delirium. The purpose of this study is to clarify the clinical features of febrile myoclonus and to investigate the relation to febrile convulsion. Myoclonic episodes were studied in 11 patients, aged 8 months to 11 years. EEG was recorded in eight patients. In the past history, febrile convulsion was noted in two patients and one of them also had febrile delirium. The age range of patients with febrile myoclonus was similar to those developing febrile convulsion except for one case. The duration of febrile myoclonus was usually from several to 30 min, but was longer than 2 h in four patients. Seventy-three percent of patients showed fear, surprise and shouting. EEG was abnormal in four patients and spike components were found in two patients. Myoclonic jerks were seen during the EEG recording in two patients and EEG findings were not concordant with epileptic myoclonic attack. Ten patients were followed for 1-2 years, and none had afebrile seizures. Febrile myoclonus is a benign symptom associated with fever. Mood change, fear or surprise and shouting with myoclonic jerks may suggest action of cytokine on the hypothalamus induced by infection. Febrile myoclonus, delirium and convulsion were seen in one patient in his first 3 years of life. These three symptoms seem to appear in children depending on their predisposition. PMID:15165673

  4. Non-compressive myelopathy: clinical and radiological study.

    PubMed

    Prabhakar, S; Syal, P; Singh, P; Lal, V; Khandelwal, N; Das, C P

    1999-12-01

    Fifty seven patients (42 males and 15 females) with non-compressive myelopathy were studied from 1997 to 1999. Acute transverse myelitis (ATM) was the commonest (31) followed by Vit B12 deficiency myelopathy (8), primary progressive multiple sclerosis (5), hereditary spastic paraplegia (3), tropical spastic paraplegia (2), subacute necrotising myelitis (1), radiation myelitis (1), syphilitic myelitis (1) and herpes zoster myelitis (1). 4 cases remained unclassified. In the ATM group, mean age was 30.35 years, antecedent event was observed in 41.9% case, 25 cases had symmetrical involvement and most of the cases had severe deficit at onset. CSF study carried out in 23 patients of ATM revealed rise in proteins (mean 147.95mg%, range 20-1200 mg/dL) and pleocytosis (mean 20.78/cumm, range 0-200 mm3). Oligoclonal band (OCB) was present in 28% of cases of ATM. The most common abnormality detected was a multisegment hyperintense lesion on T2W images, that occupied the central area on cross section. In 6 patients hyperintense signal was eccentric in location. MRI was normal in 4 cases of ATM. Thus ATM is the leading cause of non-compressive myelopathy. Clinical features combined with MRI findings are helpful in defining the cause of ATM. PMID:10625902

  5. Tretinoin-loaded liposomal formulations: from lab to comparative clinical study in acne patients.

    PubMed

    Rahman, Salwa Abdel; Abdelmalak, Nevine Shawky; Badawi, Alia; Elbayoumy, Tahany; Sabry, Nermeen; El Ramly, Amany

    2016-05-01

    Topical tretinoin is the most commonly used retinoid for acne. However, its irritative potential on the applied area and the barrier properties of the stratum corneum limit its use. The objective of the present study was to formulate tretinoin liposomal gel to obtain a formula with lower skin irritation potential and greater clinical effect. A statistical 2(4) factorial design was adopted. Sixteen formulae prepared and were properly evaluated. A candidate formula (F13G) prepared with 0.025% tretinoin, phospholipid- cholesterol-dicetylphosphate (9:1:0.01) and incorporated in 1% carbopol gel was selected for skin irritation test. Clinical study was conducted on acne patients and compared to marketed product. All liposomes formulations were spherical in shape. The addition of cholesterol in the film hydration method significantly decreased the vesicle size, and increased the percentage of incorporation efficiency at (p < 0.05). The presence of dicetylphosphate significantly increased drug release but did not affect the percentage of incorporation efficiency and vesicle size. The results of the clinical study in acne patients revealed that F13G showed significantly higher efficacy when compared to marketed product (p < 0.05). PMID:26004128

  6. Use of Fisiograft in Intrabony Defects- A Clinical and Radiological Study

    PubMed Central

    Pandey, Ruchi; Madhumala, R.; Saranyan, R.; Sreekanth, P.

    2013-01-01

    Aim: To evaluate the efficacy of Polylactic Acid/Polygycolic Acid (PLA/PGA -Fisiograft®) with Open Flap Debridement (OFD) and OFD alone in the treatment of intrabony defects over a period of 9 months. Material and Methods: Twenty Nine systemically healthy subjects with total of 30 defects were included in the present, randomized, controlled and two arm parallel study. Tests were treated with OFD along with Fisiograft® and controls with OFD alone. Results: On intra-group comparison, clinical parameters at 6 and 9 months showed statistically significant results. On comparing between the two groups, the reduction in Defect Specific Bleeding Score (DSBS), Defect Specific Plaque Score (DSPS), Probing Depth (PD) and gain in Clinical Attachment Level (CAL) revealed no statistical significances other than Recession Depth (REC) which was more in controls. The mean radiographic parameters at 9 months post-operatively in both the groups were statistically significant. However, the inter-group comparison revealed no statistically significant values. Conclusions: The overall results at the end study proved that the adjunctive use of Fisiograft® was not beneficial when compared with OFD alone. Clinical Significance: Synthetic bone replacement graft materials are commonly used for periodontal regeneration. The present study was conducted by using PLA/PGA reveals no additional benefit over OFD alone in treatment of intrabony defects. PMID:24298530

  7. Untangling Uncertainty: A Study of the Discourses Shaping Clinical Ethics Consultation as a Professional Practice.

    PubMed

    Saxén, Salla

    2016-01-01

    This qualitative social scientific interview study delves into the ways in which professional vision is constructed in clinical ethics consultation (CEC). The data consist of 11 semi-structured interviews that were conducted with clinical ethics consultants currently working in hospitals in one major urban area in the U.S. The interviews were analyzed with the qualitative research method of critical discourse analysis, with a focus on identifying the cultural structures of knowledge that shape CEC as a professional practice. The discourses were first identified as belonging to two higher discourse categories, order and agency. Order was divided into three lower categories, emotional, managerial, and rational order, and discourses of agency into the lower categories of exploration, technique, deliberation, and distancing. An additional discourse of neutral interaction was identified as a bridging discourse, activated to level tensions emerging out of conflicting goals and agencies embedded in CEC practice. This analysis brings out as its main observation that clinical ethics consultants draw on and shift between potentially ideologically conflicting social positions that can create built-in tensions within the professional domain. The study calls attention to these tensions and suggests for the professional group to discuss the possibility of defining priorities between different kinds of order, identified in this study, that shape the CEC domain. PMID:27333060

  8. Reference values of clinical pathology parameters in cynomolgus monkeys (Macaca fascicularis) used in preclinical studies

    PubMed Central

    Park, Hyun-Kyu; Cho, Jae-Woo; Lee, Byoung-Seok; Park, Heejin; Han, Ji-Seok; Yang, Mi-Jin; Im, Wan-Jung; Park, Do-Yong; Kim, Woo-Jin; Han, Su-Cheol

    2016-01-01

    Nonhuman primates are increasingly used in biomedical research since they are highly homologous to humans compared to other rodent animals. However, there is limited reliable reference data of the clinical pathology parameters in cynomolgus monkeys, and in particular, only some coagulation and urinalysis parameters have been reported. Here, we reported the reference data of clinical chemical, hematological, blood coagulation, and urinalysis parameters in cynomolgus monkeys. The role of sex differences was analyzed and several parameters (including hematocrit, hemoglobin, red blood cell, blood urea nitrogen, total bilirubin, alkaline phosphatase, creatinine kinase, gamma-glutamyl tranferase, and lactate dehydrogenase) significantly differed between male and female subjects. In addition, compared to previous study results, lactate dehydrogenase, creatinine kinase, and aspartate aminotransferase showed significant variation. Interstudy differences could be affected by several factors, including age, sex, geographic origin, presence/absence of anesthetics, fasting state, and the analytical methods used. Therefore, it is important to deliberate with the overall reference indices. In conclusion, the current study provides a comprehensive and updated reference data of the clinical pathology parameters in cynomolgus monkeys and provides improved assessment criteria for evaluating preclinical studies or biomedical research. PMID:27382375

  9. Legitimating Clinical Research in the Study of Organizational Culture.

    ERIC Educational Resources Information Center

    Schein, Edgar H.

    1993-01-01

    Argues that traditional research model used in industrial-organizational psychology is not useful in understanding deeper dynamics of organizations, especially those phenomena labeled as "cultural." Contends that use of data obtained during clinical and consulting work should be legitimated as valid research data. Spells out clinical model and…

  10. Bowenoid papulosis: clinical and histological study of eight cases.

    PubMed Central

    Gimeno, E; Vilata, J J; Sanchez, J L; Lloret, A; Fortea, J M

    1987-01-01

    Eight cases of bowenoid papulosis are reported. The clinical diagnoses were confirmed by histology. In one case an immunoperoxidase method showed the presence of papillomavirus antigen in the nucleus of the most superficial epidermal cells. We consider bowenoid papulosis to be a condition with specific features that distinguish it clinically and histologically from carcinoma in situ and condylomata acuminata. Images PMID:3034760

  11. Reflection-in-Action: Case Study of a Clinical Supervisor.

    ERIC Educational Resources Information Center

    Turner-Muecke, Lee A.

    1986-01-01

    Applies Donald Schon's concept of the "reflective practitioner" to Robert Goldhammer's clinical supervision cycle (pre-observation conference, observation, analysis and strategy, supervision conference, and postconference analysis), stressing personal growth purposes for teacher and supervisor alike. Explores a clinical supervisor's reflection on…

  12. A review of approaches to the study of turbulence modification by means of non-Newtonian additives

    NASA Astrophysics Data System (ADS)

    Vlassopoulos, Dimitris; Schowalter, William R.

    1987-12-01

    The addition of small amounts of polymers to Newtonian liquids under conditions of turbulent flow results in substantial reduction of skin friction. This phenomenon has been observed experimentally. It can be attributed to the unusual behavior of dilute polymer solutions in turbulent flows. A condensed review of topics relevent to theoretical study of drag reduction by non-Newtonian additives is presented. In addition, the techniques and results of experimental investigations of this phenomenon are examined. It is proposed that dilute solutions of polymers or surfactants can be rheologically characterized by measuring the secondary flow characteristics that occur in the neighborhood of an oscillating cylinder. Plans for conducting these measurements are presented.

  13. A Study of the Effect of Additional Reading Assistance on Student Achievement

    ERIC Educational Resources Information Center

    Gillan-Sanderson, Nicole A.

    2012-01-01

    This study describes a procedure one school district used to increase students' reading abilities through reviewing data and adjusting the instruction to give students intensive services, as needed. This school worked in a problem-solving team approach to develop a comprehensive team that followed the progression of student achievement.…

  14. Genome-Wide Association Study of Intelligence: Additive Effects of Novel Brain Expressed Genes

    ERIC Educational Resources Information Center

    Loo, Sandra K.; Shtir, Corina; Doyle, Alysa E.; Mick, Eric; McGough, James J.; McCracken, James; Biederman, Joseph; Smalley, Susan L.; Cantor, Rita M.; Faraone, Stephen V.; Nelson, Stanley F.

    2012-01-01

    Objective: The purpose of the present study was to identify common genetic variants that are associated with human intelligence or general cognitive ability. Method: We performed a genome-wide association analysis with a dense set of 1 million single-nucleotide polymorphisms (SNPs) and quantitative intelligence scores within an ancestrally…

  15. Nahuatl as a Classical, Foreign, and Additional Language: A Phenomenological Study

    ERIC Educational Resources Information Center

    De Felice, Dustin

    2012-01-01

    In this study, participants learning an endangered language variety shared their experiences, thoughts, and feelings about the often complex and diverse language-learning process. I used phenomenological interviews in order to learn more about these English or Spanish language speakers' journey with the Nahuatl language. From first encounter to…

  16. CNV-based genome wide association study reveals additional variants contributing to meat quality in swine

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pork quality is important both to the meat processing industry and consumers’ purchasing attitudes. Copy number variation (CNV) is a burgeoning kind of variant that may influence meat quality. Herein, a genome-wide association study (GWAS) was performed between CNVs and meat quality traits in swine....

  17. What Leads Indians to Participate in Clinical Trials? A Meta-Analysis of Qualitative Studies

    PubMed Central

    Shah, Jatin Y.; Phadtare, Amruta; Rajgor, Dimple; Vaghasia, Meenakshi; Pradhan, Shreyasee; Zelko, Hilary; Pietrobon, Ricardo

    2010-01-01

    Background With the globalization of clinical trials, large developing nations have substantially increased their participation in multi-site studies. This participation has raised ethical concerns, among them the fear that local customs, habits and culture are not respected while asking potential participants to take part in study. This knowledge gap is particularly noticeable among Indian subjects, since despite the large number of participants, little is known regarding what factors affect their willingness to participate in clinical trials. Methods We conducted a meta-analysis of all studies evaluating the factors and barriers, from the perspective of potential Indian participants, contributing to their participation in clinical trials. We searched both international as well as Indian-specific bibliographic databases, including Pubmed, Cochrane, Openjgate, MedInd, Scirus and Medknow, also performing hand searches and communicating with authors to obtain additional references. We enrolled studies dealing exclusively with the participation of Indians in clinical trials. Data extraction was conducted by three researchers, with disagreement being resolved by consensus. Results Six qualitative studies and one survey were found evaluating the main themes affecting the participation of Indian subjects. Themes included Personal health benefits, Altruism, Trust in physicians, Source of extra income, Detailed knowledge, Methods for motivating participants as factors favoring, while Mistrust on trial organizations, Concerns about efficacy and safety of trials, Psychological reasons, Trial burden, Loss of confidentiality, Dependency issues, Language as the barriers. Conclusion We identified factors that facilitated and barriers that have negative implications on trial participation decisions in Indian subjects. Due consideration and weightage should be assigned to these factors while planning future trials in India. PMID:20505754

  18. Tacrolimus for myasthenia gravis: a clinical study of 212 patients.

    PubMed

    Ponseti, José M; Gamez, Josep; Azem, Jamal; López-Cano, Manuel; Vilallonga, Ramón; Armengol, Manuel

    2008-01-01

    Tacrolimus is a macrolide T cell immunomodulator that is used in myasthenia gravis (MG) patients to affect muscle contraction (ryanodine receptor by modulating intracellular calcium-release channels and increasing muscular strength), glucocorticoid receptors (increasing intracellular concentration of steroids and blocking the steroid export mechanism), and an increase in T cell apoptosis. In this study, we report the results of low-dose tacrolimus (0.1 mg/kg/day) treatment in 212 MG patients. There were 110 thymectomized, cyclosporine- and prednisone-dependent patients; 68 thymectomized patients who started tacrolimus early postoperatively (24 h after operation); and 34 patients over 60 years old with nonthymomatous generalized MG or in whom thymectomy was contraindicated. The mean follow-up time was 49.3 +/- 18.1 months. Muscular strength showed an increase of 23% after 1 month of treatment and 29% at the end of the study. The acetylcholine receptor antibodies decreased significantly from a mean of 33.5 nmol/L at base line to 7.8 nmol/L at the final visit. In the thymectomy group with combined prednisone and tacrolimus stratified by histology of the thymus, the mean probability to attain complete stable remission at 5 years was 80.8% in patients with hyperplasia, 48.1% in thymic involution, and 9.3% in patients with thymoma. In 4.9% of patients, tacrolimus was withdrawn because of major adverse effects. Our results suggest that a low dose of tacrolimus is effective for MG and could be included to the armamentarium for this autoimmune disease. The present results should be interpreted considering the limitations of a retrospective clinical study. Confirmation of these results in randomized studies is desirable. PMID:18096852

  19. First clinical pilot study with intravascular polarization sensitive optical coherence tomography (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Villiger, Martin; Karanasos, Antonios; Ren, Jian; Lippok, Norman; Shishkov, Milen; Daemen, Joost; Van Mieghem, Nicolas; Diletti, Roberto; Valgimigli, Marco; van Geuns, Robert-Jan; de Jaegere, Peter; Zijlstra, Felix; van Soest, Gijs; Nadkarni, Seemantini; Regar, Evelyn; Bouma, Brett E.

    2016-02-01

    Polarization sensitive (PS) OCT measures the polarization states of the light backscattered by tissue and provides measures of tissue birefringence and depolarization in addition to the structural OCT signal. Ex vivo studies have demonstrated that birefringence is increased in tissue rich in collagen and with elevated smooth muscle cell content. Preliminary data further suggests that depolarization can identify regions of macrophage infiltration, lipid, and irregularly arranged collagen fibers. These are important aspects of the mechanical integrity and vulnerability of atherosclerotic plaques. To evaluate the potential of PS-OCT in the clinical setting, we combined our custom PS-OCT system with commercially available OCT catheters (Fastview, Terumo Corporation) and performed a pilot study in 30 patients, scheduled to undergo percutaneous coronary intervention (PCI) on the grounds of stable or unstable angina. A total of 82 pullbacks in 39 vessels were performed, either in the native coronary arteries or post procedure. Comparing consecutive pullbacks of the same coronary artery, we found excellent agreement between the polarization features in the repeat pullbacks, validating the repeatability and robustness of PS-OCT in the clinical in vivo setting. In addition we observed that the birefringence and depolarization features vary significantly across lesions with identical structural OCT appearance, suggesting morphological subtypes. This first human pilot study proved the feasibility and robustness of intravascular PS-OCT. PS-OCT achieves improved tissue characterization and may help in identifying high-risk plaques, with the potential to ultimately improve risk stratification and help guiding PCI.

  20. Clinical prediction models for bronchopulmonary dysplasia: a systematic review and external validation study

    PubMed Central

    2013-01-01

    Background Bronchopulmonary dysplasia (BPD) is a common complication of preterm birth. Very different models using clinical parameters at an early postnatal age to predict BPD have been developed with little extensive quantitative validation. The objective of this study is to review and validate clinical prediction models for BPD. Methods We searched the main electronic databases and abstracts from annual meetings. The STROBE instrument was used to assess the methodological quality. External validation of the retrieved models was performed using an individual patient dataset of 3229 patients at risk for BPD. Receiver operating characteristic curves were used to assess discrimination for each model by calculating the area under the curve (AUC). Calibration was assessed for the best discriminating models by visually comparing predicted and observed BPD probabilities. Results We identified 26 clinical prediction models for BPD. Although the STROBE instrument judged the quality from moderate to excellent, only four models utilised external validation and none presented calibration of the predictive value. For 19 prediction models with variables matched to our dataset, the AUCs ranged from 0.50 to 0.76 for the outcome BPD. Only two of the five best discriminating models showed good calibration. Conclusions External validation demonstrates that, except for two promising models, most existing clinical prediction models are poor to moderate predictors for BPD. To improve the predictive accuracy and identify preterm infants for future intervention studies aiming to reduce the risk of BPD, additional variables are required. Subsequently, that model should be externally validated using a proper impact analysis before its clinical implementation. PMID:24345305

  1. StudySearch: a web-based application for posting and searching clinical research studies.

    PubMed

    Gonsenhauser, Blair; Hallarn, Rose; Carpenter, Daniel; Para, Michael F; Reider, Carson R

    2016-03-01

    Participant accrual into research studies is critical to advancing clinical and translational research to clinical care. Without sufficient recruitment, the purpose of any research study cannot be realized; yet, low recruitment and enrollment of participants persist. StudySearch is a web-based application designed to provide an easily readable, publicly accessible, and searchable listing of IRB-approved protocols that are accruing study participants. The Regulatory, Recruitment and Biomedical Informatics Cores of the Center for Clinical and Translational Science (CCTS) at The Ohio State University developed this research study posting platform. Postings include basic descriptive information: study title, purpose of the study, eligibility criteria and study personnel contact information. Language concerning benefits and/or inducements is not included; therefore, while IRB approval for a study to be listed on StudySearch is required, IRB approval of the posted language is not. Studies are listed by one of two methods; one automated and one manual: (1). Studies registered on ClinicalTrials.gov are automatically downloaded once a month; or (2). Studies are submitted directly by researchers to the CCTS Regulatory Core staff. In either case, final language is a result of an iterative process between researchers and CCTS staff. Deployed in January 2011 at OSU, this application has grown to approximately 200 studies currently posted and 1500 unique visitors per month. Locally, StudySearch is part of the CCTS recruitment toolkit. Features continue to be modified to better accommodate user behaviors. Nationally, this open source application is available for use. PMID:26912012

  2. StudySearch: a web-based application for posting and searching clinical research studies

    PubMed Central

    Gonsenhauser, Blair; Hallarn, Rose; Carpenter, Daniel; Para, Michael F; Reider, Carson R

    2016-01-01

    Participant accrual into research studies is critical to advancing clinical and translational research to clinical care. Without sufficient recruitment, the purpose of any research study cannot be realized; yet, low recruitment and enrollment of participants persist. StudySearch is a web-based application designed to provide an easily readable, publicly accessible, and searchable listing of IRB-approved protocols that are accruing study participants. The Regulatory, Recruitment and Biomedical Informatics Cores of the Center for Clinical and Translational Science (CCTS) at The Ohio State University developed this research study posting platform. Postings include basic descriptive information: study title, purpose of the study, eligibility criteria and study personnel contact information. Language concerning benefits and/or inducements is not included; therefore, while IRB approval for a study to be listed on StudySearch is required, IRB approval of the posted language is not. Studies are listed by one of two methods; one automated and one manual: (1). Studies registered on ClinicalTrials.gov are automatically downloaded once a month; or (2). Studies are submitted directly by researchers to the CCTS Regulatory Core staff. In either case, final language is a result of an iterative process between researchers and CCTS staff. Deployed in January 2011 at OSU, this application has grown to approximately 200 studies currently posted and 1500 unique visitors per month. Locally, StudySearch is part of the CCTS recruitment toolkit. Features continue to be modified to better accommodate user behaviors. Nationally, this open source application is available for use. PMID:26912012

  3. The human studies database project: federating human studies design data using the ontology of clinical research.

    PubMed

    Sim, Ida; Carini, Simona; Tu, Samson; Wynden, Rob; Pollock, Brad H; Mollah, Shamim A; Gabriel, Davera; Hagler, Herbert K; Scheuermann, Richard H; Lehmann, Harold P; Wittkowski, Knut M; Nahm, Meredith; Bakken, Suzanne

    2010-01-01

    Human studies, encompassing interventional and observational studies, are the most important source of evidence for advancing our understanding of health, disease, and treatment options. To promote discovery, the design and results of these studies should be made machine-readable for large-scale data mining, synthesis, and re-analysis. The Human Studies Database Project aims to define and implement an informatics infrastructure for institutions to share the design of their human studies. We have developed the Ontology of Clinical Research (OCRe) to model study features such as design type, interventions, and outcomes to support scientific query and analysis. We are using OCRe as the reference semantics for federated data sharing of human studies over caGrid, and are piloting this implementation with several Clinical and Translational Science Award (CTSA) institutions. PMID:21347149

  4. Food additives

    PubMed Central

    Spencer, Michael

    1974-01-01

    Food additives are discussed from the food technology point of view. The reasons for their use are summarized: (1) to protect food from chemical and microbiological attack; (2) to even out seasonal supplies; (3) to improve their eating quality; (4) to improve their nutritional value. The various types of food additives are considered, e.g. colours, flavours, emulsifiers, bread and flour additives, preservatives, and nutritional additives. The paper concludes with consideration of those circumstances in which the use of additives is (a) justified and (b) unjustified. PMID:4467857

  5. Thermal analysis studies of Ge additive of Se-Te glasses

    NASA Astrophysics Data System (ADS)

    Mohamed, M.; Abdel-Rahim, M. A.

    2016-04-01

    Ge x Se50Te50- x ( x = 5, 15, 20, 35 at.%) bulk glasses were synthesized by the melt quenching method. The amorphous nature of the investigated glasses was determined by X-ray diffraction. Results of differential scanning calorimetry (DSC) of the studied compositions under non-isothermal conditions were reported and discussed. The glass transition temperature ( T g), onset crystallization temperature ( T c), and crystallization peak temperature ( T p) were determined from DSC traces at different heating rates. It was found that the values of T g, T c, and T p rely on both composition and heating rate. A double crystallization stages were observed in the DSC results. Various kinetics parameters such as the glass transition energy ( E g), crystallization activation energy ( E c), and rate constant ( K p) were calculated. The glass-forming ability of the studied compositions was discussed as function of the determined kinetics parameters.

  6. Comparative study of glycine single crystals with additive of potassium nitrate in different concentration ratios

    NASA Astrophysics Data System (ADS)

    Gujarati, Vivek P.; Deshpande, M. P.; Patel, Kamakshi R.; Chaki, S. H.

    2016-05-01

    Semi-organic crystals of Glycine Potassium Nitrate (GPN) with potential applications in Non linear optics (NLO) were grown using slow evaporation technique. Glycine and Potassium Nitrate were taken in three different concentration ratios of 3:1, 2:1 and 1:1 respectively. We checked the solubility of the material in distilled water at different temperatures and could observe the growth of crystals in 7 weeks time. Purity of the grown crystals was confirmed by Energy Dispersive X-ray Analysis (EDAX) and CHN analysis. GSN Powder X-ray diffraction pattern was recorded to confirm the crystalline nature. To confirm the applications of grown crystals in opto-electronics field, UV-Vis-NIR study was carried out. Dielectric properties of the samples were studied in between the frequency range 1Hz to 100 KHz.

  7. Brief reconnaissance study for the addition of hydropower for Riegel Dam, Trion, Georgia

    SciTech Connect

    Gebhard, T.G. Jr.

    1982-05-10

    The feasibility of retrofitting the Riegel Dam near Trion, Georgia for power generation was examined. This dam has a developable head of 17 ft., was built in 1900 for supplying hydroelectric power for a textile mill, and currently provides cooling water to the mill. The study of environmental, institutional, safety and economic factors showed that hydroelectric power development at this site would require new generating equipment and that such retrofitting appears to be economically feasible. (LCL)

  8. Brief reconnaissance study for the addition of hydropower for Carr Fork Dam, Sassafras, Kentucky

    SciTech Connect

    Gebhard, T.G. Jr.

    1982-05-24

    The feasibility of retrofitting the Carr Fork Dam near Hazard, KY for power generation was examined. This dam has a developable head of 80 ft and was built in 1975 to provide flood protection. The study of environmental, institutional, safety, and economic factors showed that the total investment cost would be $909,600 and that hydroelectric power development at this site is not feasible unless a higher price could be obtained for the power sold. (LCL)

  9. Enterococcal urinary tract infections in a university hospital: clinical studies.

    PubMed

    Barros, Milton; Martinelli, Reinaldo; Rocha, Heonir

    2009-08-01

    Although urinary tract infections (UTI) represent the most common infection caused by enterococci, some aspects remain to be fully clarified. The aim of this study was to determine the clinical characteristics present in UTI caused by Enterococcus spp. in patients followed up at the Prof. Edgard Santos Teaching Hospital of the Federal University of Bahia. All patients consecutively examined between 1997 and 2005, who received a diagnosis of UTI caused by Enterococcus spp. were included in the study. UTI was defined as the presence of > or = 10(5) colony-forming units per mL of urine. Standard microbiological techniques were used. During the study period, 6.2% of the urine cultures were positive for Enterococcus spp. The mean age of the patients was 48.9 years and 57% were male. At initial evaluation, 13% of the patients had complaints suggestive of UTI. Nineteen patients had a history consistent with obstructive uropathy and 26 with neurogenic bladder. At final evaluation, UTI was the diagnosis in 48 patients. In 36 patients (29%), the primary diagnosis was related to urogenital diseases, consisting of obstructive uropathy in 23 of these cases, while in 32 patients (25.8%) primary diagnosis was related to neurologic diseases, frequently neurogenic bladder. UTI caused by Enterococcus spp. is not infrequent, is usually associated with few or no symptoms and occurs in sick patients who have anatomical or functional obstructive uropathy associated or not with urinary tract catheterization or instrumentation. The diagnosis of enterococcal UTI may indicate a urinary tract abnormality yet to be diagnosed. PMID:20231994

  10. An outpatient clinical study of dissociative disorder not otherwise specified.

    PubMed

    Yanartaş, Ömer; Özmen, Hülya Akar; Citak, Serhat; Zincir, Selma Bozkurt; Sünbül, Esra Aydin

    2014-05-01

    The relatively high prevalence of the diagnosis of dissociative disorder not otherwise specified is frequently considered to be disproportionate. The disproportionate rate of this diagnosis is thought to be related to nosologic and/or diagnostic issues in dissociative identity disorder. We sought to investigate and compare the symptom patterns of these two clinical entities. We conducted a cross-sectional study involving 1314 participants who were screened with the Dissociative Experience Scale (DES) and the Somatoform Dissociation Questionnaire (SDQ). Of the participants, 272 who scored above the cut-off points for the screening questionnaires (DES score>30 and/or SDQ score>40 points) were invited to complete a structured interview using the Dissociative Disorders Interview Schedule (DDIS); of this subsample, only 190 participants agreed to participate in the second phase of the study. The mean score for the DES was 18.55±17.23, and the mean score for the SDQ was 30.19±13.32. Of the 190 participants, 167 patients were diagnosed as having a dissociative disorder (87.8%). We found that DD-NOS was the most prevalent category of dissociative disorder. There was a significantly larger percentage of patients in the DID group than in the DD-NOS group according to secondary features of DID and Schneiderian symptoms. The secondary features of DID and Schneiderian symptoms appeared to be more specific for DID, while no differences were detected between DID and DD-NOS based on most of the items on the SCL 90R. Further longitudinal studies are needed to determine the features that are similar and dissimilar between DD-NOS and DID. PMID:24461163

  11. Nursing Students' Opinion on the Use of Smartphone Applications (Apps) in Clinical Education and Training: A Study Protocol.

    PubMed

    O'Connor, Siobhan; Andrews, Tom

    2016-01-01

    Nurse educators are exploring different mobile technologies to provide additional support to nursing students in clinical practice. However, the view of nursing students on the use of smartphone applications (apps) to enhance clinical education has not been explored. This proposed study will use a self-reported questionnaire to examine the opinions of nursing students on the current and potential use of smartphone apps when training in clinical settings. Descriptive and inferential statistics will be performed on the quantitative data. Qualitative data from open ended questions will be thematically analysed using the framework approach. This will be the first study to examine the use of smartphone apps as a support in clinical teaching from a students' perspective. Their opinion is vital if the right mobile technology is to be designed and implemented. PMID:27332464

  12. [Chewing gum as an additional agent in maintaining oral hygiene versus smoking status--preliminary study].

    PubMed

    Nakonieczna-Rudnicka, Marta; Strycharz-Dudziak, Małgorzata; Bachanek, Teresa

    2012-01-01

    Nowadays chewing gum is widely used in different age groups, so complying with proper duration and frequency of chewing is an important factor influencing the state of masticatory system. The study involved 112 dental students of the Medical University of Lublin. Everyday use of chewing gum declared 47,32% of cases. Chewing time up to 10 minutes was stated in 23,08% of respondents, 11-20 minutes in 40,38% of interviewees. Among the examined students 17,3% smoked cigarettes. In smokers group 83,33% of questioned chewed the gum every day, while among non-smokers - 43,37%. Chewing time shorter than 10 minutes declared 22,22% of smokers and 23,26% of non-smokers, while chewing time between 11-20 minutes - 27,78% i 44,35% of smokers and non-smokers respectively. Obtained results indicate the need of carrying out further studies aimed at the nicotine influence on saliva parameters with respect to development of diseases of hard tooth tissues. PMID:23421028

  13. Study on the interaction of the toxic food additive carmoisine with serum albumins: a microcalorimetric investigation.

    PubMed

    Basu, Anirban; Kumar, Gopinatha Suresh

    2014-05-30

    The interaction of the synthetic azo dye and food colorant carmoisine with human and bovine serum albumins was studied by microcalorimetric techniques. A complete thermodynamic profile of the interaction was obtained from isothermal titration calorimetry studies. The equilibrium constant of the complexation process was of the order of 10(6)M(-1) and the binding stoichiometry was found to be 1:1 with both the serum albumins. The binding was driven by negative standard molar enthalpy and positive standard molar entropy contributions. The binding affinity was lower at higher salt concentrations in both cases but the same was dominated by mostly non-electrostatic forces at all salt concentrations. The polyelectrolytic forces contributed only 5-8% of the total standard molar Gibbs energy change. The standard molar enthalpy change enhanced whereas the standard molar entropic contribution decreased with rise in temperature but they compensated each other to keep the standard molar Gibbs energy change almost invariant. The negative standard molar heat capacity values suggested the involvement of a significant hydrophobic contribution in the complexation process. Besides, enthalpy-entropy compensation phenomenon was also observed in both the systems. The thermal stability of the serum proteins was found to be remarkably enhanced on binding to carmoisine. PMID:24742664

  14. Combined ab initio molecular dynamics and experimental studies of carbon atom addition to benzene.

    PubMed

    McKee, Michael L; Reisenauer, Hans Peter; Schreiner, Peter R

    2014-04-17

    Car-Parrinello molecular dynamics was used to explore the reactions between triplet and singlet carbon atoms with benzene. The computations reveal that, in the singlet C atom reaction, products are very exothermic where nearly every collision yields a product that is determined by the initial encounter geometry. The singlet C atom reaction does not follow the minimum energy path because the bimolecular reaction is controlled by dynamics (i.e., initial orientation of encounter). On the other hand, in a 10 K solid Ar matrix, ground state C((3)P) atoms do tend to follow RRKM kinetics. Thus, ab initio molecular dynamics (AIMD) results indicate that a significant fraction of C-H insertion occurs to form phenylcarbene whereas, in marked contrast to previous theoretical and experimental conclusions, the Ar matrix isolation studies indicate a large fraction of direct cycloheptatetraene formation, without the intermediacy of phenylcarbene. The AIMD calculations are more consistent with vaporized carbon atom experiments where labeling studies indicate the initial formation of phenylcarbene. This underlines that the availability of thermodynamic sinks can completely alter the observed reaction dynamics. PMID:24661002

  15. [Importance of Post-Marketing Studies in Gathering of Clinical Evidences for Proper Usage of Anti-Cancer Drugs, and the StudyRequirements for Their Credibility].

    PubMed

    Inagaki, Osamu

    2016-04-01

    Pharmaceutical companies recognize the importance of post-marketing studies because they are crucial in the generation of clinical evidences for the usage of new medicines. To generate clinical evidences, quality of post-marketing studies should be well controlled from view point of "ethical conduction" and "reliability of results". In addition, control of conflict of interest (COI) between researchers and industries is also indispensable and is requested for the transparency of the studies. Japan Pharmaceutical Manufacturers Association(JPMA)stresses its commitment to the progressof transparency in post-marketing studies. PMID:27220799

  16. BASF studies: epidemiological and clinical investigations on dioxin-exposed chemical workers.

    PubMed

    Zober, A; Messerer, P; Ott, M G

    First in 1953 and again later in 1988, BASF Aktiengesellschaft, Ludwigshafen, Germany, faced production-related dioxin contamination problems. In both situations, the immediate actions were efforts to limit the potential for employee exposure. In 1953, after a reactor accident, the production of trichlorophenol was stopped and extensive clean-up and demolition work was undertaken. In 1988, major technical improvements were made to an extrusion blending process and the flame retardants were changed to substances that chemically should not be dioxin precursors. The health experience of the potentially exposed populations has been followed extensively in both situations. Five recent epidemiological investigations: a long-term mortality follow-up, a morbidity study, a clinical laboratory study, and a chromosome study of persons from the 1953 accident cohort, as well as immunological studies of employees assigned to the extrusion operations, are discussed. In addition, considerable dioxin biomonitoring data from blood lipids for both populations are summarized. PMID:9508734

  17. The Application of Pulsed Field Gel Electrophoresis in Clinical Studies

    PubMed Central

    Parizad, Eskandar Gholami; Valizadeh, Azar

    2016-01-01

    Pulsed-field gel electrophoresis is a method applied in separating large segments of deoxyribonucleotide using an alternating and cross field. In a uniform magnetic field, components larger than 50kb pass a route through the gel and since the movement of DNA (Deoxyribonucleic acid) molecules are in a Zigzag form, separation of DNAs as bands carried out better via gel. PFGE in microbiology is a standard method which is used for typing of bacteria. It is also a very useful tool in epidemiological studies and gene mapping in microbes and mammalian cell, also motivated development of large-insert cloning system such as bacterial and yeast artifical chromosomes. In this method, close and similar species in terms of genetic patterns show alike profiles regarding DNA separation, and those ones which don’t have similarity or are less similar, reveal different separation profiles. So this feature can be used to determine the common species as the prevalence agent of a disease. PFGE can be utilized for monitoring and evaluating different micro-organisms in clinical samples and existing ones in soil and water. This method can also be a reliable and standard method in vaccine preparation. In recent decades, PFGE is highly regarded as a powerful tool in control, prevention and monitoring diseases in different populations. PMID:26894068

  18. Assessing monoclonal antibody product quality attribute criticality through clinical studies.

    PubMed

    Goetze, Andrew M; Schenauer, Matthew R; Flynn, Gregory C

    2010-01-01

    Recombinant therapeutic proteins, including antibodies, contain a variety of chemical and physical modifications. Great effort is expended during process and formulation development in controlling and minimizing this heterogeneity, which may not affect safety or efficacy, and, therefore, may not need to be controlled. Many of the chemical conversions also occur in vivo, and knowledge about the alterations can be applied to assessment of the potential impact on characteristics and the biological activity of therapeutic proteins. Other attributes may affect the drug clearance and thereby alter drug efficacy. In this review article, we describe attribute studies conducted using clinical samples and how information gleaned from them is applied to attribute criticality assessment. In general, how fast attributes change in vivo compared to the rate of mAb elimination is the key parameter used in these evaluations. An attribute with more rapidly changing levels may have greater potential to affect safety or efficacy and thereby reach the status of a Critical Quality Attribute (CQA) that should be controlled during production and storage, but the effect will depend on whether compositional changes are due to chemical conversion or differential clearance. PMID:20671426

  19. Adeno-associated viral vectors for clinical gene transfer studies.

    PubMed

    Snyder, Richard O; Francis, Joyce

    2005-06-01

    Recombinant adeno-associated viral (rAAV) vectors can mediate the safe and long-term correction of genetic diseases in animal models following a single administration. These pre-clinical studies are the basis of human trials that have shown rAAV vector persistence and safety in humans following delivery to lung, sinus, skeletal muscle, brain and liver. Transient disease correction has also been demonstrated in humans treated for hemophilia B and cystic fibrosis using AAV2 vectors. The physiochemical properties of rAAV vector virions are amenable to industry accepted manufacturing methodologies, long-term storage and direct in vivo administration. Recombinant adeno-associated virus vectors are manufactured in compliance with current Good Manufacturing Practices (cGMPs) as outlined in the Code of Federal Regulations (21CFR). To meet these requirements, manufacturing controls and quality systems are established, including 1) adequate facilities and equipment, 2) personnel who have relevant education or experience and are trained for specific assigned duties, 3) raw materials that are qualified for use and 4) a process (including production, purification, formulation, filling, storage and shipping) that is controlled, aseptic, reliable and consistent. Quality systems including Quality Control (QC) and Quality Assurance (QA) are also implemented. These manufacturing procedures and quality systems are designed so the product meets its release specifications to ensure that patients receive a safe, pure, potent and stable investigational drug. PMID:15975008

  20. Experimental and clinical studies on transmyocardial laser revascularzation (TMLR)

    NASA Astrophysics Data System (ADS)

    Okada, Masayoshi

    2005-07-01

    The number of patients with coronary artery disease has been increasing in Japan and several kinds of treatments have been performed to reduce their cardiovascular diseases. In patients with small branches, or diffuse stenotic lesions of the coronary arteries, on whom coronary artery bypass grafting(CABG) and percutaneous coronary intervention (PCI) cannot be carried out, it has been hemodynamically demonstrated possible to supply arterial blood from the left ventricular cavity to the ischemic myocardium through laser channels. On the basis of excellent experimental studies using mongrel dogs, newly created laser channels 0.2 mm in diameter have been confirmed to be histologically patent even 3 years after transmyocardial revascularization(TMLR). Thus, this method could be applied as an alternative procedure of transmyocardial revascularization. First clinical procedure of TMLR alone was performed on 55 year-old male patient with severe angina pectoris who had undergone pericardiectomy 7 years ago. He had no candidate for percutaneous coronary intervention, or coronary artery bypass grafting, because his left venticle had severe adhesion to the left lung. Therefore, this method was finally carried out. He is getting well after this surgical intervention. This procedure should be recommended for the patient with end-stage coronary artery disease.

  1. Shelf Life and Quality Study of Minced Tilapia with Nori and Hijiki Seaweeds as Natural Additives

    PubMed Central

    Ribeiro, Ingridy Simone; Shirahigue, Ligianne Din; Ferraz de Arruda Sucasas, Lia; Anbe, Lika; da Cruz, Pedro Gomes; Gallo, Cláudio Rosa; Carpes, Solange Teresinha; Marques, Marcos José; Oetterer, Marília

    2014-01-01

    The extraction of mechanically separated meat has emerged as an attractive process. However, it increases the incorporation of oxygen and, consequently, of flavors due to rancidity. Thus, preservatives must be added. The objective of this study was to evaluate the shelf life of minced tilapia to replace synthetic preservatives with Hijiki and Nori seaweeds extracts. The application of the extracts had no effect on the chemical composition of the minced tilapia. The seaweed extracts had inhibitory effect on total volatile base nitrogen. The minced tilapia complied with the microbiological standard set by Brazilin law. The panelists detected no differences in the rancid aroma and only minor differences were detected in the color of the products. It can be concluded that the minced tilapia with added seaweed extracts were within quality standards during frozen storage. PMID:25478593

  2. Shelf life and quality study of minced tilapia with Nori and Hijiki seaweeds as natural additives.

    PubMed

    Ribeiro, Ingridy Simone; Shirahigue, Ligianne Din; Ferraz de Arruda Sucasas, Lia; Anbe, Lika; da Cruz, Pedro Gomes; Gallo, Cláudio Rosa; Carpes, Solange Teresinha; Marques, Marcos José; Oetterer, Marília

    2014-01-01

    The extraction of mechanically separated meat has emerged as an attractive process. However, it increases the incorporation of oxygen and, consequently, of flavors due to rancidity. Thus, preservatives must be added. The objective of this study was to evaluate the shelf life of minced tilapia to replace synthetic preservatives with Hijiki and Nori seaweeds extracts. The application of the extracts had no effect on the chemical composition of the minced tilapia. The seaweed extracts had inhibitory effect on total volatile base nitrogen. The minced tilapia complied with the microbiological standard set by Brazilin law. The panelists detected no differences in the rancid aroma and only minor differences were detected in the color of the products. It can be concluded that the minced tilapia with added seaweed extracts were within quality standards during frozen storage. PMID:25478593

  3. Cervical spondylosis and hypertension: a clinical study of 2 cases.

    PubMed

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-03-01

    Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis. PMID:25761188

  4. l-carnitine as a Potential Additive in Blood Storage Solutions: A Study on Erythrocytes.

    PubMed

    Soumya, R; Carl, H; Vani, R

    2016-09-01

    Erythrocytes undergo various changes during storage (storage lesion) that in turn reduces their functioning and survival. Oxidative stress plays a major role in the storage lesion and antioxidants can be used to combat this stress. This study elucidates the effects of l-carnitine (LC) on erythrocytes of stored blood. Blood was obtained from male Wistar rats and stored (4 °C) for 20 days in CPDA-1 (citrate phosphate dextrose adenine) solution. Samples were divided into-(i) controls (ii) LC 10 (l-carnitine at a concentration of 10 mM) (iii) LC 30 (l-carnitine at a concentration of 30 mM) and (iv) LC 60 (l-carnitine at a concentration of 60 mM). Every fifth day, the biomarkers (haemoglobin, hemolysis, antioxidant enzymes, lipid peroxidation and protein oxidation products) were analysed in erythrocytes. Hemoglobin and protein sulfhydryls were insignificant during storage indicative of the maintenance of hemoglobin and sulfhydryls in all groups. Superoxide dismutase and malondialdehyde levels increased initially and decreased towards the end of storage. The levels of catalase and glutathione peroxidase were lower in experimentals than controls during storage. l-carnitine assisted the enzymes by scavenging the reactive oxygen species produced. Hemolysis increased in all groups with storage, elucidating that l-carnitine could not completely protect lipids and proteins from oxidative stress. Hence, this study opens up new avenues of using l-carnitine as a component of storage solutions with combinations of antioxidants in order to maintain efficacy of erythrocytes. PMID:27429526

  5. Biological effect of food additive titanium dioxide nanoparticles on intestine: an in vitro study.

    PubMed

    Song, Zheng-Mei; Chen, Ni; Liu, Jia-Hui; Tang, Huan; Deng, Xiaoyong; Xi, Wen-Song; Han, Kai; Cao, Aoneng; Liu, Yuanfang; Wang, Haifang

    2015-10-01

    Titanium dioxide nanoparticles (TiO2 NPs) are widely found in food-related consumer products. Understanding the effect of TiO2 NPs on the intestinal barrier and absorption is essential and vital for the safety assessment of orally administrated TiO2 NPs. In this study, the cytotoxicity and translocation of two native TiO2 NPs, and these two TiO2 NPs pretreated with the digestion simulation fluid or bovine serum albumin were investigated in undifferentiated Caco-2 cells, differentiated Caco-2 cells and Caco-2 monolayer. TiO2 NPs with a concentration less than 200 µg ml(-1) did not induce any toxicity in differentiated cells and Caco-2 monolayer after 24 h exposure. However, TiO2 NPs pretreated with digestion simulation fluids at 200 µg ml(-1) inhibited the growth of undifferentiated Caco-2 cells. Undifferentiated Caco-2 cells swallowed native TiO2 NPs easily, but not pretreated NPs, implying the protein coating on NPs impeded the cellular uptake. Compared with undifferentiated cells, differentiated ones possessed much lower uptake ability of these TiO2 NPs. Similarly, the traverse of TiO2 NPs through the Caco-2 monolayer was also negligible. Therefore, we infer the possibility of TiO2 NPs traversing through the intestine of animal or human after oral intake is quite low. This study provides valuable information for the risk assessment of TiO2 NPs in food. PMID:26106068

  6. Mechanistic study of secondary organic aerosol components formed from nucleophilic addition reactions of methacrylic acid epoxide

    NASA Astrophysics Data System (ADS)

    Birdsall, A. W.; Miner, C. R.; Mael, L. E.; Elrod, M. J.

    2014-08-01

    Recently, methacrylic acid epoxide (MAE) has been proposed as a precursor to an important class of isoprene-derived compounds found in secondary organic aerosol (SOA): 2-methylglyceric acid (2-MG) and a set of oligomers, nitric acid esters and sulfuric acid esters related to 2-MG. However, the specific chemical mechanisms by which MAE could form these compounds have not been previously studied. In order to determine the relevance of these processes to atmospheric aerosol, MAE and 2-MG have been synthesized and a series of bulk solution-phase experiments aimed at studying the reactivity of MAE using nuclear magnetic resonance (NMR) spectroscopy have been performed. The present results indicate that the acid-catalyzed MAE reaction is more than 600 times slower than a similar reaction of an important isoprene-derived epoxide, but is still expected to be kinetically feasible in the atmosphere on more acidic SOA. The specific mechanism by which MAE leads to oligomers was identified, and the reactions of MAE with a number of atmospherically relevant nucleophiles were also investigated. Because the nucleophilic strengths of water, sulfate, alcohols (including 2-MG), and acids (including MAE and 2-MG) in their reactions with MAE were found to be of a similar magnitude, it is expected that a diverse variety of MAE + nucleophile product species may be formed on ambient SOA. Thus, the results indicate that epoxide chain reaction oligomerization will be limited by the presence of high concentrations of non-epoxide nucleophiles (such as water); this finding is consistent with previous environmental chamber investigations of the relative humidity-dependence of 2-MG-derived oligomerization processes and suggests that extensive oligomerization may not be likely on ambient SOA because of other competitive MAE reaction mechanisms.

  7. Mechanistic study of secondary organic aerosol components formed from nucleophilic addition reactions of methacrylic acid epoxide

    NASA Astrophysics Data System (ADS)

    Birdsall, A. W.; Miner, C. R.; Mael, L. E.; Elrod, M. J.

    2014-12-01

    Recently, methacrylic acid epoxide (MAE) has been proposed as a precursor to an important class of isoprene-derived compounds found in secondary organic aerosol (SOA): 2-methylglyceric acid (2-MG) and a set of oligomers, nitric acid esters, and sulfuric acid esters related to 2-MG. However, the specific chemical mechanisms by which MAE could form these compounds have not been previously studied with experimental methods. In order to determine the relevance of these processes to atmospheric aerosol, MAE and 2-MG have been synthesized and a series of bulk solution-phase experiments aimed at studying the reactivity of MAE using nuclear magnetic resonance (NMR) spectroscopy have been performed. The present results indicate that the acid-catalyzed MAE reaction is more than 600 times slower than a similar reaction of an important isoprene-derived epoxide, but is still expected to be kinetically feasible in the atmosphere on more acidic SOA. The specific mechanism by which MAE leads to oligomers was identified, and the reactions of MAE with a number of atmospherically relevant nucleophiles were also investigated. Because the nucleophilic strengths of water, sulfate, alcohols (including 2-MG), and acids (including MAE and 2-MG) in their reactions with MAE were found to be of similar magnitudes, it is expected that a diverse variety of MAE + nucleophile product species may be formed on ambient SOA. Thus, the results indicate that epoxide chain reaction oligomerization will be limited by the presence of high concentrations of non-epoxide nucleophiles (such as water); this finding is consistent with previous environmental chamber investigations of the relative humidity dependence of 2-MG-derived oligomerization processes and suggests that extensive oligomerization may not be likely on ambient SOA because of other competitive MAE reaction mechanisms.

  8. Value addition of Palmyra palm and studies on the storage life.

    PubMed

    Chaurasiya, A K; Chakraborty, I; Saha, J

    2014-04-01

    Palmyra palm (Borassus flabellifer L.) belonging to the family Palmae is referred to as tree of life with several uses including food, beverage, fibre, medicinal and timber. Unfortunately, the nutritionally enriched pulp of ripened palm has limited commercial use. Extraction of pulp has been accomplished by using water and heat to ensure maximum pulp recovery. Different recipes were tried for the preparation of two uncommon value added products like palm spread and palm toffee. On the basis of biochemical composition, organoleptic scores, microbial estimation and storage study both under ambient and refrigerated conditions; the suitable recipe was selected with the maximum acceptability. Gradual increase in total soluble solid (TSS), total sugar and reducing sugar while decrease in ascorbic acid, pH, β-carotene and protein content of processed products have been observed irrespective of storage condition. The results obtained from sensory evaluation and microbial status revealed that palm spread and toffee remained acceptable up to 9 months and 8 months, respectively at ambient temperature. The income per rupee investment for these two products was found to be remunerative. PMID:24741173

  9. Mass analysis addition to the Differential Ion Flux Probe (DIFP) study

    NASA Technical Reports Server (NTRS)

    Wright, K. H., Jr.; Jolley, Richard

    1994-01-01

    The objective of this study is to develop a technique to measure the characteristics of space plasmas under highly disturbed conditions; e.g., non-Maxwellian plasmas with strong drifting populations and plasmas contaminated by spacecraft outgassing. The approach, conducted in conjunction with current MSFC activities, is to extend the capabilities of the Differential Ion Flux Probe (DIFP) to include a high throughput mass measurement that does not require either high voltage or contamination sensitive devices such as channeltron electron multipliers or microchannel plates. This will significantly reduce the complexity and expense of instrument fabrication, testing, and integration of flight hardware compared to classical mass analyzers. The feasibility of the enhanced DIFP has been verified by using breadboard test models in a controlled plasma environment. The ability to manipulate particles through the instrument regardless of incident angle, energy, or ionic component has been amply demonstrated. The energy analysis mode is differential and leads directly to a time-of-flight mass measurement. With the new design, the DIFP will separate multiple ion streams and analyze each stream independently for ion flux intensity, velocity (including direction of motion), mass, and temperature (or energy distribution). In particular, such an instrument will be invaluable on follow-on electrodynamic TSS missions and, possibly, for environmental monitoring on the space station.

  10. The California Clinical Data Project: a case study in the adoption of clinical data standards for quality improvement.

    PubMed

    Sujansky, Walter; Chang, Sophia

    2006-01-01

    The California Clinical Data Project is a statewide initiative to remove barriers to the widespread and effective use of information technology to improve chronic disease care. The project is a case study in the development and widespread adoption of clinical data standards by varied and often competing stakeholders. As an initial step, the project defined precise data standards for the batch reporting of pharmacy claims data and laboratory results data. These uniform standards facilitate the flow of existing electronic clinical information into disease registries and electronic health record systems. Pharmacy and lab results data now are being exchanged electronically with this standard among the largest health plans, medical groups, and clinical laboratories participating in California's pay-for-performance programs. Lessons from this project may apply to the development and adoption of data standards for other states and locales and for the emerging national health information infrastructure. PMID:16903664

  11. The Making of a Thriving University-Based Reading Clinic: A Case Study

    ERIC Educational Resources Information Center

    Moreland, Meagan L.

    2013-01-01

    In this case study, the researcher closely examined an active, university-based reading clinic. In particular, this study explored the experiences and perspectives of the stakeholders regarding the reading clinic. It also sought to identify major factors contributing to the sustainability and growth of the reading clinic. The first research…

  12. 76 FR 19189 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-06

    ... AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... (Federal Advisory Committee Act) that a meeting of the Clinical Science Research and Development Service... Science Research and Development Service on the relevance and feasibility of proposed projects and...

  13. Neurobehavioral deficits in Persian Gulf veterans: additional evidence from a population-based study.

    PubMed

    Storzbach, D; Rohlman, D S; Anger, W K; Binder, L M; Campbell, K A

    2001-01-01

    Reports of low-concentration nerve gas exposures during the Gulf War (GW) have spurred concern about possible health consequences and symptoms reported by many returning veterans. The Portland Environmental Hazards Research Center is studying veterans from the northwest United States who report persistent, unexplained "Gulf War" symptoms (cases) and those who do not report those symptoms (controls). An epidemiological survey focused on exposures and symptoms was mailed to a random sample of GW veterans from Oregon and southwestern Washington. Volunteers recruited from survey respondents agreed to undergo a thorough medical examination and psychological and neurobehavioral assessment. Persistent symptoms with no medical explanation associated with Persian Gulf service (e.g., fatigue, muscle pain, memory deficits) beginning during or after the war qualified respondents as cases. The 239 cases with unexplained symptoms and the 112 controls without symptoms were administered a computerized assessment battery of 12 psychosocial and 6 neurobehavioral tests. Replicating and extending previous interim findings, a subgroup of veterans emerged from the initial analysis in the form of extreme outliers which produced a visually and quantitatively obvious bimodal distribution. This led, as it had previously, to analyses of the outliers as a separate group (labeled "slow ODTP"), which confirmed the initial findings of neurobehavioral differences between the outliers and the other cases and controls and provided more convincing evidence that the majority of cases who report neurobehavioral symptoms have no objective evidence of neurobehavioral deficits. However, the larger group of symptomatic veterans do have highly significant and compelling evidence of psychological distress based on scores from 11 separate psychological tests. Whereas the cases differed from the controls by poorer neurobehavioral test performance, extraction of the slow ODTP participants (almost all cases

  14. Pre-clinical and Clinical Safety Studies of CMX-2043: A Cytoprotective Lipoic Acid Analogue for Ischaemia–Reperfusion Injury

    PubMed Central

    Kates, Steven A; Lader, Alan S; Casale, Ralph; Beeuwkes, Reinier

    2014-01-01

    CMX-2043 is an α-lipoic acid analogue targeted to reduction of cellular injury and organ damage due to ischaemia–reperfusion injury (IRI). It has been shown to be effective in a rat model of cardiac IRI. The studies here reported evaluate its safety and pharmacokinetic profile in preparation for human clinical studies in procedures associated with IRI. Safety and tolerability were tested in standard pre-clinical in vitro and animal models and in a Phase 1 human clinical trial. CMX-2043 did not bind to a wide range of receptors and specific targets at approximately 4 μg/mL (10 μM). It was not mutagenic by Ames assay, did not produce chromosome aberrations in Chinese hamster ovary (CHO) cells, and was negative for clastogenic potential. Toxicological studies in rats including both single and 14-day repeat intravenous doses and in dogs (single intravenous dose) with a 2-week recovery period were conducted. The NOAEL in rats and dogs was 30 and >10 mg/kg, respectively. No serious adverse events were reported in a placebo-controlled, sequential dose escalation Phase 1 clinical trial. The low toxicity in the pre-clinical studies and the absence of adverse events in the Phase 1 trial have supported investigation of CMX-2043 in a human efficacy trial. PMID:24751172

  15. [Clinical study on development of nontuberculous mycobacterial lung disease].

    PubMed

    Kurashima, Atsuyuki

    2004-12-01

    problem, most are still unidentified. STUDY OF MAC LUNG DISEASE TREATMENT: It was known that Mycobacterium kansasii lung disease is healed with a chemotherapy like analog of anti-tuberculosis chemotherapy, already in those days. However, the results of MAC lung disease chemotherapy were extremely poor. We tried to express a physicians experience quantitatively as follows, in 1987. The results of 8 weeks sputum culture on Ogawa egg medium were converted semi-quantitatively to CFU numbers based on "Japanese standard guideline of Mycobacterium tuberculosis inspection". We exhibit the ratio of post-treatment consecutive 6 months culture yield to pre-treatment culture yield as response rate, about 110 pulmonary MAC cases. Through this study, we clarify the followings. The results of chemotherapy do not correlate susceptibility test for Mycobacterium tuberculosis. Multidrug regimen is more useful. Small extent of lesion is more responsive. Combination with aminoglycoside chemotherapy is more effective. These conclusions were almost same as the ATS guideline of 1990. New drugs such as, new macrolides and new quinolones appeared for pulmonary MAC treatment through the feedback from systemic MAC complicated AIDS treatments from the latter half of 90's. We measured the sensitive strain ratio at 2 mcg/ml of OFLX, CPFX, LVFX about 990 clinical isolates and could expect availability for M. kansasii or M. fortuitum, but these new quinolones are not enough effective for MAC. Also we examined MIC for various antimycobacterial agent by 50 MAC clinical isolates, and we could expect a certain availability of SPFX, GFLX, CPFX, CAM for MAC. The availability of clarithromycin (CAM) has been established through many randomized clinical trials for disseminated MAC complicated AIDS, but for pulmonary MAC, complete cure is still difficult if we use CAM including regimen. We performed surgical treatment for relatively young patients with localized lesions. We carry out the adaptation reference such

  16. Donepezil Treatment of Older Adults with Cognitive Impairment and Depression (DOTCODE study): clinical rationale and design

    PubMed Central

    Pelton, Gregory H.; Andrews, Howard; Roose, Steven P.; Marcus, Sue M.; D’Antonio, Kristina; Husn, Hala; Petrella, Jeffrey R.; Zannas, Anthony S.; Doraiswamy, P. Murali; Devanand, D. P.

    2014-01-01

    Treatment strategies for patients with depression and cognitive impairment (DEP-CI), who are at high risk to develop a clinical diagnosis of dementia, are not established. This issue is addressed in the donepezil treatment of cognitive impairment and depression (DOTCODE) pilot clinical trial. The DOTCODE study is the first long-term treatment trial that assesses differences in conversion to dementia and cognitive change in DEP-CI patients using a study design of open antidepressant medication plus add-on randomized, double-blind, placebo-controlled treatment with the acetylcholinesterase inhibitor donepezil. In Phase 1, DEP-CI patients receive optimized antidepressant treatment for 16 weeks. In Phase 2, antidepressant treatment is continued with the addition of randomized, double-blind treatment with donepezil or placebo. The total study duration for each patient is 78 weeks (18 months). Eighty DEP-CI outpatients (age 55 to 95 years) are recruited: 40 at New York State Psychiatric Institute/Columbia University and 40 at Duke University Medical Center. The primary outcome is conversion to a clinical diagnosis of dementia. The secondary outcomes are cognitive change scores in Selective Reminding Test (SRT) total recall and the modified Alzheimer’s Disease Assessment Scale (ADAS-cog). Other key assessments include the 24-item Hamilton Depression Rating Scale and antidepressant response; Clinical Global Impression (CGI) for depression, cognition, and global status; neuropsychological test battery for diagnosis; informant report of functional abilities (Pfeffer FAQ); Treatment Emergent Symptom Scale (TESS) for somatic side effects. Apolipoprotein E ε4 status, odor identification deficits, and MRI entorhinal/hippocampal cortex atrophy at baseline are evaluated as neurobiological moderators of donepezil treatment effects. PMID:24315979

  17. Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study

    PubMed Central

    Hickson, Lucas S.; Daltro, Carla; Castro, Simone; Kornfeld, Hardy; Netto, Eduardo M.; Andrade, Bruno B.

    2016-01-01

    Background The rising prevalence of diabetes mellitus (DM) worldwide, especially in developing countries, and the persistence of tuberculosis (TB) as a major public health issue in these same regions, emphasize the importance of investigating this association. Here, we compared the clinical profile and disease outcomes of TB patients with or without coincident DM in a TB reference center in Brazil. Methods We performed a retrospective analysis of a TB patient cohort (treatment naïve) of 408 individuals recruited at a TB primary care center in Brazil between 2004 and 2010. Data on diagnosis of TB and DM were used to define the groups. The study groups were compared with regard to TB disease presentation at diagnosis as well as to clinical outcomes such as cure and mortality rates upon anti-tuberculosis therapy (ATT) initiation. A composite score utilizing clinical, radiological and microbiological parameters was used to compare TB severity between the groups. Results DM patients were older than non-diabetic TB patients. In addition, diabetic individuals more frequently presented with cough, night sweats, hemoptysis and malaise than those without DM. The overall pattern of lung lesions assessed by chest radiographic examination was similar between the groups. Compared to non-diabetic patients, those with TB-diabetes exhibited positive acid-fast bacilli in sputum samples more frequently at diagnosis and at 30 days after ATT initiation. Notably, higher values of the TB severity score were significantly associated with TB-diabetes comorbidity after adjustment for confounding factors. Moreover, during ATT, diabetic patients required more frequent transfers to TB reference hospitals for complex clinical management. Nevertheless, overall mortality and cure rates were indistinguishable between the study groups. Conclusions These findings reinforce the idea that diabetes negatively impacts pulmonary TB severity. Our study argues for the systematic screening for DM in TB

  18. The Effect of Emphasizing Mathematical Structure in the Acquisition of Whole Number Computation Skills (Addition and Subtraction) By Seven- and Eight-Year Olds: A Clinical Investigation.

    ERIC Educational Resources Information Center

    Uprichard, A. Edward; Collura, Carolyn

    This investigation sought to determine the effect of emphasizing mathematical structure in the acquisition of computational skills by seven- and eight-year-olds. The meaningful development-of-structure approach emphasized closure, commutativity, associativity, and the identity element of addition; the inverse relationship between addition and…

  19. A 5-year retrospective clinical study of the Dentium implants

    PubMed Central

    Lee, Jeong-Yol; Park, Hyo-Jin; Kim, Jong-Eun; Choi, Yong-Geun; Kim, Young-Soo; Huh, Jung-Bo

    2011-01-01

    PURPOSE The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION The 5-year CSR of Implantium implants was 97.37%. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated

  20. Urachal carcinoma: a pathologic and clinical study of 46 cases.

    PubMed

    Dhillon, Jasreman; Liang, Yu; Kamat, Ashish M; Siefker-Radtke, Arlene; Dinney, Colin P; Czerniak, Bogdan; Guo, Charles C

    2015-12-01

    Urachal carcinoma is a rare tumor that has not been well studied. To determine the pathologic and clinical features of this disease, we retrospectively evaluated 46 cases from our surgical pathology files. The patients included 16 women and 30 men, with a mean age of 53.4 years (range, 28-82 years). Forty patients had undergone cystectomy, and the remaining 6 had undergone transurethral bladder biopsy. Most tumors were located at the dome (n = 44); only 2 were located at both the dome and anterior wall. All tumors consisted of adenocarcinoma, including mucinous (n = 36), enteric (n = 7), not otherwise specified (n = 2), and signet ring cell (n = 1) types. Focal areas of signet ring cell features were present in 23 cases, but urothelial carcinoma in situ was not identified in any cases. The tumors invaded the muscularis propria (n = 8), perivesical adipose tissue (n = 27), and abdominal wall (n = 3). Twenty-five patients had died of cancer at a mean of 32 months (range, 12-74 months), and 21 patients were alive at a mean of 65 months (range, 7-230 months). The median cancer-specific survival time of urachal adenocarcinoma patients was 45 months, which was significantly longer than that of bladder urothelial carcinoma patients with similar-stage disease (P = .047). Patients' cancer-specific survival was associated with tumor stage according to the Sheldon, Mayo, and TNM staging systems. In conclusion, urachal carcinomas are predominantly composed of invasive adenocarcinomas, which commonly demonstrate mucinous features. Most tumors present at advanced stages but are still associated with a better survival rate than bladder urothelial carcinomas. PMID:26364859

  1. Diabetic neuropathy: a clinical, laboratory and electrodiagnostic study.

    PubMed

    Halar, E M; Graf, R J; Halter, J B; Brozovich, F V; Soine, T L

    1982-07-01

    The objective of this study was to determine the relationship between nerve conduction velocity (NCV) and hyperglycemia and to assess the extent of NCV changes in adult-onset diabetic patients before and after diabetic treatment. Twenty-five diabetic males (mean age = 50.9 years) were tested twice prior to beginning diabetic treatment. Eighteen of these 25 were also tested at 1, 3, 6, and 12 months after initiation of therapy. Both groups were compared to 23 age-matched controls. Each test session consisted of NCV and clinical sensory and blood chemistry testing. The findings revealed that, before treatment average NCVs of the median, peroneal sural, and tibial nerves and H-reflex latency results were all significantly impaired in diabetic subjects (p less than 0.025). No difference was found between right and left NCVs of the same nerve (p less than 0.05) and NCVs in the lower as well as the upper extremities were significantly reduced (p less than 0.05). Thus, it appears that the neuropathy in these patients was symmetrical and diffuse. Peroneal and median motor nerves showed the greatest amount of NCV slowing when compared to normal values. Furthermore, median, peroneal, and tibial motor NCVs and H-reflex latencies correlated significantly with the degree of hyperglycemia in diabetic subjects before treatment. After initiation of diabetic treatment, median motor NCVs after 1, 3, 6 and 12 months showed significantly improvement when compared to baseline NCV values (all p less than 0.05). Also, the improvement in median NCVs after 3 and 13 months and peroneal NCV after 3 months directly correlated to decreased fasting plasma glucose levels (p less than 0.05). PMID:7092528

  2. Steroid-responsive and nephrotic syndrome and allergy: clinical studies.

    PubMed Central

    Meadow, S R; Sarsfield, J K

    1981-01-01

    Eighty-four children with steroid-responsive nephrotic syndrome who had been shown to have, or were believed to have, minimal change histology were investigated to study the relationship between steroid-responsive nephrotic syndrome and allergy. They were found to have a greater incidence of the standard atopic disorders--asthma, eczema, recurrent urticaria, and hay fever. Their 1st-degree relatives had an increased incidence of these atopic disorders too. A nasal discharge was a frequent precursor or an accompaniment of nephrotic syndrome, but an overt atrophic disorder at the same time was rare. Such disorders, related to relapse, occurred in only 5 children; in none was it a consistent or recurrent happening at the time of each relapse. No example of pollen hypersensitivity nephrotic syndrome was found, and no particular allergen could be identified with certainty as responsible for a child's nephrotic syndrome. No association was found between the time of relapse and the season of the year, or the season in which the child was born. Children with nephrotic syndrome had a greater incidence of positive skin tests to common antigens, the comparative frequency of positive reactions to different antigens being similar to that found in children with asthma, although the total frequency was about half that of children with asthma. Despite the increased incidence of clinical features of atopy, measures to reduce the frequency of relapse of nephrotic syndrome by allergen avoidance, the use of sodium cromoglycate, and the use of a new oral antiallergic drug were unsuccessful. PMID:6791592

  3. Steroid-responsive and nephrotic syndrome and allergy: clinical studies.

    PubMed

    Meadow, S R; Sarsfield, J K

    1981-07-01

    Eighty-four children with steroid-responsive nephrotic syndrome who had been shown to have, or were believed to have, minimal change histology were investigated to study the relationship between steroid-responsive nephrotic syndrome and allergy. They were found to have a greater incidence of the standard atopic disorders--asthma, eczema, recurrent urticaria, and hay fever. Their 1st-degree relatives had an increased incidence of these atopic disorders too. A nasal discharge was a frequent precursor or an accompaniment of nephrotic syndrome, but an overt atrophic disorder at the same time was rare. Such disorders, related to relapse, occurred in only 5 children; in none was it a consistent or recurrent happening at the time of each relapse. No example of pollen hypersensitivity nephrotic syndrome was found, and no particular allergen could be identified with certainty as responsible for a child's nephrotic syndrome. No association was found between the time of relapse and the season of the year, or the season in which the child was born. Children with nephrotic syndrome had a greater incidence of positive skin tests to common antigens, the comparative frequency of positive reactions to different antigens being similar to that found in children with asthma, although the total frequency was about half that of children with asthma. Despite the increased incidence of clinical features of atopy, measures to reduce the frequency of relapse of nephrotic syndrome by allergen avoidance, the use of sodium cromoglycate, and the use of a new oral antiallergic drug were unsuccessful. PMID:6791592

  4. The Distally Based Dorsal Metatarsal Artery Perforator Flap: Vascular Study and Clinical Implications.

    PubMed

    van Alphen, Nick A; Laungani, Alexis T; Christner, Jodie A; Lachman, Nirusha; Carlsen, Brian T; Saint-Cyr, Michel

    2016-05-01

    Background Intrinsic flaps based on the dorsal metacarpal arteries are useful for coverage of dorsal hand, finger, and thumb defects. The purpose of this study was to explore the anatomy of the dorsal metatarsal arteries (DMtAs) in the foot to help define their clinical utility. We observed the size and numbers of distal perforators from the DMtAs and quantified the vascular perfusion pattern of the DMtA perforator across the skin. Methods Ten fresh cadaver feet were injected with latex and dissected to assess the size and number of distal perforators from the DMtAs. Five DMtA perforator flaps were injected with methylene blue to visualize and quantify the vascular territory of the skin flap to understand the clinical possibilities. In addition, a clinical case is described and shown. Results Ten fresh cadaver feet were dissected. The first DMtA was absent in two specimens and the second, third, or fourth DMtA was absent in one specimen each. The available DMtAs had between two and five cutaneous perforators supplying the skin (average, 3.7 perforators per DMtA). The largest perforators to the skin were always seen in the distal half of the DMtA and ranged from 0.4 to 0.8 mm (average, 0.5 mm). Methylene blue injections showed an average flap surface of 21.6 × 47.6 mm. Conclusion This cadaveric study demonstrates the usefulness of the DMtA perforator flap. The flap is a valuable addition to the arsenal of flaps to cover the dorsum of the toe, webspace, or defects exposing tendons on the distal dorsum of the foot. PMID:26165886

  5. A Pilot Study to Examine the Effect of Additional Structured Outdoor Playtime on Preschoolers' Physical Activity Levels

    ERIC Educational Resources Information Center

    Alhassan, Sofiya; Nwaokelemeh, Ogechi; Lyden, Kate; Goldsby, TaShauna; Mendoza, Albert

    2013-01-01

    The impact of additional structured outdoor playtime on preschoolers'; physical activity (PA) level is unclear. The purpose of this pilot study was to explore the effects of increasing structured outdoor playtime on preschoolers'; PA levels. Eight full-day classrooms (n = 134 children) from two preschool programmes were randomised into a treatment…

  6. STUDY OF THE EFFECT OF CHLORINE ADDITION ON MERCURY OXIDATION BY SCR CATALYST UNDER SIMULATED SUBBITUMINOUS COAL FLUE GAS

    EPA Science Inventory

    An entrained flow reactor is used to study the effect of addition of chlorine-containing species on the oxidation of elemental mercury (Hgo)by a selective catalytic reduction (SCR) catalyst in simulated subbituminous coal combustion flue gas. The combustion flue gas was doped wit...

  7. Clinical Needs Finding: Developing the Virtual Experience, A Case Study

    PubMed Central

    Mittal, Vaishali; Thompson, Megan; Altman, Stuart M; Taylor, Peter; Summers, Alexander; Goodwin, Kelsey; Louie, Angelique Y

    2013-01-01

    We describe an innovative program at the University of California, Davis for students to engage in clinical needs finding. Using a team-based approach, students participated in clinical rotations to observe firsthand the needs of clinicians at the university affiliated medical center. The teams were asked to develop documentary-style videos to capture key experiences that would allow future viewers to use the videos as “virtual” clinical rotations. This was conceived as a strategy to allow students in prohibitively large classes, or students in programs at institutions without associated medical or veterinary school programs, to experience clinical rotations and perform needs assessments. The students' perspectives on the experience as well as instructor analysis of best practices for this type of activity are presented and discussed. We found that the internship experience was valuable to the students participating, by not only introducing the practice of needs finding but for increasing the students' confidence in the practice of engineering design and their ability to work independently. The videos produced were of such high quality that instructors from other institutions have requested copies for instructional use. Virtual clinical rotations through video experiences may provide a reasonable substitute for students who do not have the ability to participate in rotations in person. PMID:23483373

  8. Impact of tofacitinib on patient outcomes in rheumatoid arthritis – review of clinical studies

    PubMed Central

    Boyce, Eric G; Vyas, Deepti; Rogan, Edward L; Valle-Oseguera, Cynthia S; O’Dell, Kate M

    2016-01-01

    Rheumatoid arthritis is a chronic, progressive autoimmune disease associated with inflammation and destruction of joints and systemic effects, which result in significant impact on patient’s quality of life and function. Tofacitinib was approved for the treatment of rheumatoid arthritis in the USA in 2012 and subsequently in other countries, but not by the European Medicines Agency. The goal of this review was to evaluate the impact of tofacitinib on patient-reported and patient-specific outcomes from prior clinical studies, focusing on quality of life, functionality, pain, global disease assessment, major adverse consequences, and withdrawals. A total of 13 reports representing 11 clinical studies on tofacitinib in rheumatoid arthritis were identified through PubMed and reference lists in meta-analyses and other reviews. Data on improvements in patient-driven composite tools to measure disease activity in rheumatoid arthritis, such as the Health Assessment Questionnaire, served as a major outcome evaluated in this review and were extracted from each study. Additional data extracted from those clinical studies included patient assessment of pain (using a 0–100 mm visual analog scale), patient global assessment of disease (using a 0–100 mm visual analog scale), patient withdrawals, withdrawals due to adverse effects or lack of effect, and risk of serious adverse effects, serious infections, and deaths. Tofacitinib 5 mg bid appears to have a favorable impact on patient outcomes related to efficacy and safety when compared with baseline values and with comparator disease-modifying antirheumatic drugs and placebo. Improvements were seen in the composite and individual measures of disease activity. Serious adverse effects, other adverse consequences, overall withdrawals, and withdrawals due to adverse effects and lack of efficacy are similar or more favorable for tofacitinib versus comparator disease-modifying antirheumatic drugs and placebo. At this point

  9. A study of the effectiveness of family planning clinics in the Philippines.

    PubMed Central

    MacCorquodale, D W

    1975-01-01

    A study of 190 Philippine family planning clinics revealed that certain clinic and physician characteristics were significantly and positively associated with clinic effectiveness, defined in terms of the mean number of monthly acceptors of family planning and the efficacy of the methods selected. Clinics with a high degree of effectiveness were more likely to be staffed by physicians who wanted three or fewer children, who relied more extensively on the IUD (intrauterine device) than physicians in less effective clinics, and who derived more satisfaction from working in family planning than physicians in less effective clinics. Autonomous clinics were more effective than integrated clinics, and clinics staffed by physicians trained by institutions with more experience in family planning were more effective than those staffed by physicians trained by institutions with less experience in this field. The findings regarding the following hypotheses were in the predicted direction: Clinic effectiveness will be greater in clinics staffed by female rather than by male physicians, in urban rather than in rural clinics, in clinics staffed by physicians with a low rather than a high degree of religiosity, and in clinics staffed by physicians with a high rather than a low degree of concern about population growth. The differences in clinic effectiveness, however, in these instances, were not significant. PMID:813258

  10. Is abeta a sufficient biomarker for monitoring anti-abeta clinical studies? A critical review.

    PubMed

    Moreth, Jens; Mavoungou, Chrystelle; Schindowski, Katharina

    2013-01-01

    Amyloid-beta (Aβ) in Alzheimer's disease (AD) appeared to be a promising target for disease-modifying therapeutic strategies like passive immunotherapy with anti-Aβ monoclonal antibodies (mAbs). Biochemical markers in cerebrospinal fluid (CSF) include alterations of Aβ that allow the diagnosis of AD. Biomarker strategies, such as the levels of Aβ in CSF and plasma, currently play an important role in early clinical trials for AD. Indeed, these strategies have a relevant impact on the outcome of such studies, since the biomarkers are used to monitor the bioactivity of anti-Aβ mAbs. The clinical trials of Solanezumab were mainly based on the readout of Aβ levels in CSF and plasma, whereas those of Bapineuzumab were based on cognition; however, little is known about the mechanisms altering these biomarker levels, and no biomarker has yet been proven to be a successful predictor for AD therapy. In addition, the Aβ biomarkers allow for the determination of free and bound anti-Aβ mAb in order to monitor the available amount of bioactive drug and could give hints to the mechanism of action. In this review, we discuss clinical Aβ biomarker data and the latest regulatory strategies. PMID:23847530

  11. Studies on nursing risks and measures of clinical medication.

    PubMed

    Li, Min; Bai, Jie; Huang, Jie

    2015-09-01

    To investigate the cause analysis of clinical medication nursing risks and propose relevant nursing measures, so as to control and reduce the clinical nursing risks and reach the physical and mental safety of patients and nurses. Clinical nursing risk events with 30 cases in TCM Hospital of Zhengzhou City from June 2010 to April 2012 were underwent statistical analyses. The risk of medication error ranked the first in the direct reasons of nursing risks, accounting for a higher ratio. Moreover, the reasons of nursing risks were also involved in nonstandard operation, disease observation and other relative factors. Nurses must fully understand the relative factors of medication nursing risks, regarding the patients as their own family and always permeating the consciousness of nursing risks into the working process. PMID:26525028

  12. Hamartomatous polyps - a clinical and molecular genetic study.

    PubMed

    Jelsig, Anne Marie

    2016-08-01

    Hamartomatous polyps (HPs) in the gastrointestinal (GI) tract are rare compared to other types of GI polyps, yet they are the most common type of polyp in children. The symptoms are usually rectal bleeding, abdominal pain, obstipation, anaemia, and/or small bowel obstruction. The polyps are typically removed concurrently with endoscopy when located in the colon, rectum, or stomach, whereas polyps in the small bowel are removed during push-enteroscopy, device-assisted enteroscopy, or by surgery. HPs can be classified as juvenile polyps or Peutz-Jeghers polyps based on their histopathological appearance. Patients with one or a few juvenile polyps are usually not offered clinical follow-up as the polyp(s) are considered not to harbour any malignant potential. Nevertheless, it is important to note that juvenile polyps and HPs are also found in patients with hereditary hamartomatous polyposis syndromes (HPS). Patients with HPS have an increased risk of cancer, recurrences of polyps, and extraintestinal complications. The syndromes are important to diagnose, as patients should be offered surveillance from childhood or early adolescence. The syndromes include juvenile polyposis syndrome, Peutz-Jeghers syndrome, and the PTEN hamartoma tumour syndrome. Currently, the HPS diagnoses are based on clinical criteria and are often assisted with genetic testing as candidate genes have been described for each syndrome. This thesis is based on six scientific papers. The overall aim of the studies was to expand the knowledge on clinical course and molecular genetics in patients with HPs and HPS, and to investigate research participants' attitude towards the results of extensive genetic testing.   Paper I: In the first paper we investigated the occurrence, anatomic distribution, and other demographics of juvenile polyps in the colon and rectum in Denmark in 1995-2014. Based on the Danish Pathology Data Bank we found that 1772 patients had 2108 JPs examined in the period, and we

  13. Perceptions of postgraduate trainees on the impact of objective structured clinical examinations on their study behavior and clinical practice

    PubMed Central

    Opoka, Robert O; Kiguli, Sarah; Ssemata, Andrew S; Govaerts, Marjan; Driessen, Erik W

    2015-01-01

    Background The objective structured clinical examination (OSCE) is a commonly used method of assessing clinical competence at various levels, including at the postgraduate level. How the OSCE impacts on learning in higher education is poorly described. In this study, we evaluated the perceptions of postgraduate trainees regarding the impact of the OSCE on their study and clinical behavior. Methods We employed an explorative qualitative research design by conducting focus group discussions with 41 pediatric postgraduate trainees at the College of Health Science, Makerere University. A semi-structured tool was used to obtain the views and experiences of the trainees. Transcripts from the discussion were analyzed in an iterative manner using thematic content analysis. Results The trainees reported the OSCEs as a fair and appropriate tool for assessing clinical competency at the postgraduate level. However, they noted that whereas OSCEs assess a broad range of skills and competencies relevant to their training, there were areas that they did not adequately assess. In particular, OSCEs did not adequately assess in-depth clinical knowledge or detailed history-taking skills. Overall, the majority of the trainees reported that the OSCEs inspired them to study widely and improve their procedural and communication skills. Conclusion OSCEs are a useful tool for assessing clinical competencies in postgraduate education. However, the perceived limitations in their ability to assess complex skills raises concerns about their use as a standalone mode of assessment at the postgraduate level. Future studies should evaluate how use of OSCEs in combination with other assessment tools impacts on learning. PMID:26082673

  14. SCISSOR—Spinal Cord Injury Study on Small molecule-derived Rho inhibition: a clinical study protocol

    PubMed Central

    Kopp, Marcel A; Liebscher, Thomas; Watzlawick, Ralf; Martus, Peter; Laufer, Stefan; Blex, Christian; Schindler, Ralf; Jungehulsing, Gerhard J; Knüppel, Sven; Kreutzträger, Martin; Ekkernkamp, Axel; Dirnagl, Ulrich; Strittmatter, Stephen M; Niedeggen, Andreas; Schwab, Jan M

    2016-01-01

    Introduction The approved analgesic and anti-inflammatory drugs ibuprofen and indometacin block the small GTPase RhoA, a key enzyme that impedes axonal sprouting after axonal damage. Inhibition of the Rho pathway in a central nervous system-effective manner requires higher dosages compared with orthodox cyclooxygenase-blocking effects. Preclinical studies on spinal cord injury (SCI) imply improved motor recovery after ibuprofen/indometacin-mediated Rho inhibition. This has been reassessed by a meta-analysis of the underlying experimental evidence, which indicates an overall effect size of 20.2% regarding motor outcome achieved after ibuprofen/indometacin treatment compared with vehicle controls. In addition, ibuprofen/indometacin may also limit sickness behaviour, non-neurogenic systemic inflammatory response syndrome (SIRS), neuropathic pain and heterotopic ossifications after SCI. Consequently, ‘small molecule’-mediated Rho inhibition after acute SCI warrants clinical investigation. Methods and analysis Protocol of an investigator-initiated clinical open-label pilot trial on high-dose ibuprofen treatment after acute traumatic, motor-complete SCI. A sample of n=12 patients will be enrolled in two cohorts treated with 2400 mg/day ibuprofen for 4 or 12 weeks, respectively. The primary safety end point is an occurrence of serious adverse events, primarily gastroduodenal bleedings. Secondary end points are pharmacokinetics, feasibility and preliminary effects on neurological recovery, neuropathic pain and heterotopic ossifications. The primary safety analysis is based on the incidence of severe gastrointestinal bleedings. Additional analyses will be mainly descriptive and casuistic. Ethics and dissemination The clinical trial protocol was approved by the responsible German state Ethics Board, and the Federal Institute for Drugs and Medical Devices. The study complies with the Declaration of Helsinki, the principles of Good Clinical Practice and all further

  15. A Qualitative Study of Resident Learning in Ambulatory Clinic

    ERIC Educational Resources Information Center

    Smith, C. Scott; Morris, Magdalena; Francovich, Chris; Hill, William; Gieselman, Janet

    2004-01-01

    Qualitative analysis of a large ethnographic database from observations of a resident teaching clinic revealed three important findings. The first finding was that breakdown, a situation where an "actor" (such as a person or the group) is not achieving expected effectiveness, was the most important category because of its frequency and explanatory…

  16. Clinical Electroencephalography and the Study of Suicide Behavior.

    ERIC Educational Resources Information Center

    Struve, Frederick A.

    1986-01-01

    Shows that EEGs (electroencephalography) can be used to help screen for the presence of covert disease that may produce psychiatric depressive symptomatology, as well as to denote cerebral dysrhythmias that may directly influence suicidal behavior. The clinical EEG cannot effectively predict suicide attempt risk, nor can it reasonably guide…

  17. Adult clinical neuropsychology: lessons from studies of the frontal lobes.

    PubMed

    Stuss, Donald T; Levine, Brian

    2002-01-01

    Clinical neuropsychologists have adopted numerous (and sometimes conflicting) approaches to the assessment of brain-behavior relationships. We review the historical development of these approaches and we advocate an approach to clinical neuropsychology that is informed by recent findings from cognitive neuroscience. Clinical assessment of executive and emotional processes associated with the frontal lobes of the human brain has yet to incorporate the numerous experimental neuroscience findings on this topic. We review both standard and newer techniques for assessment of frontal lobe functions, including control operations involved in language, memory, attention, emotions, self-regulation, and social functioning. Clinical and experimental research has converged to indicate the fractionation of frontal subprocesses and the initial mapping of these subprocesses to discrete frontal regions. One anatomical distinction consistent in the literature is that between dorsal and ventral functions, which can be considered cognitive and affective, respectively. The frontal lobes, in particular the frontal poles, are involved in uniquely human capacities, including self-awareness and mental time travel. PMID:11752491

  18. A clinical study of a family with Cockayne's syndrome

    PubMed Central

    Proops, Rosalyn; Taylor, A M R; Insley, J

    1981-01-01

    Two sibs with Cockayne's syndrome are described. The recognised cellular sensitivity to ultraviolet light is confirmed. The clinical features in the two children are described and comparisons are made with some forms of xeroderma pigmentosum, a condition in which there is progressive neurological degeneration and cellular sensitivity to ultraviolet irradiation. Images PMID:7277423

  19. 77 FR 72438 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-05

    ... AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and Development Service Cooperative... Clinical Science Research and Development Service on the relevance and feasibility of proposed projects...

  20. 78 FR 70102 - Clinical Science Research and Development Service Cooperative Studies; Scientific Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-22

    ... AFFAIRS Clinical Science Research and Development Service Cooperative Studies; Scientific Evaluation... Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and Development Service Cooperative... the Director of the Clinical Science Research and Development Service on the relevance and...