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Sample records for complex tfcc treatment

  1. Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation

    PubMed Central

    Hirschfeld, Ulrich; Strunz, Hendrik; Werner, Michael; Wolfskämpf, Thomas; Löffler, Sabine

    2017-01-01

    Introduction. The triangular fibrocartilage complex (TFCC) provides both mobility and stability of the radiocarpal joint. TFCC lesions are difficult to diagnose due to the complex anatomy. The standard treatment for TFCC lesions is arthroscopy, posing surgery-related risks onto the patients. This feasibility study aimed at developing a workup for soft-tissue reconstruction using clinical imaging, to verify these results in retrospective patient data. Methods. Microcomputed tomography (μ-CT), 3 T magnetic resonance imaging (MRI), and plastination were used to visualize the TFCC in cadaveric specimens applying segmentation-based 3D reconstruction. This approach further trialed the MRI dataset of a patient with minor radiological TFCC alterations but persistent pain. Results. TFCC reconstruction was impossible using μ-CT only but feasible using MRI, resulting in an appreciation of its substructures, as seen in the plastinates. Applying this approach allowed for visualizing a Palmer 2C lesion in a patient, confirming ex postum the arthroscopy findings, being markedly different from MRI (Palmer 1B). Discussion. This preliminary study showed that image-based TFCC reconstruction may help to identify pathologies invisible in standard MRI. The combined approach of μ-CT, MRI, and plastination allowed for a three-dimensional appreciation of the TFCC. Image quality and time expenditure limit the approach's usefulness as a diagnostic tool. PMID:28246600

  2. Arthroscopic foveal repair of the triangular fibrocartilage complex.

    PubMed

    Atzei, Andrea; Luchetti, Riccardo; Braidotti, Federica

    2015-02-01

    Background Foveal disruption of the triangular fibrocartilage complex (TFCC) is associated with distal radioulnar joint (DRUJ) instability. TFCC fixation onto the fovea is the suitable treatment, which is not achieved by conventional arthroscopic techniques. We describe an all-inside arthroscopic technique that uses a suture anchor through distal DRUJ arthroscopy for foveal repair of the TFCC. Materials and Methods Forty-eight patients with TFCC foveal tear and DRUJ instability were selected according to the Atzei-European Wrist Arthroscopy Society (EWAS) algorithm of treatment. Retrospective evaluation included pain, DRUJ instability, range of motion (ROM), grip strength, Modified Mayo Wrist Score (MMWS), and the Disabilities of the Arm, Shoulder, and Hand (DASH) Score. Description of Technique DRUJ arthroscopy was performed to débride the TFCC and the foveal area. Under arthroscopic guidance, a suture anchor was inserted via the distal foveal portal to repair the TFCC onto the fovea. Sutures were tied on the radiocarpal surface of the TFCC. Postoperative immobilization of forearm rotation was maintained for 4 weeks. Heavy tasks were allowed after 3 months. Results After a mean follow-up of 33 months, pain improved significantly but remained moderate in four patients, severe in one. DRUJ instability resolved in 44 patients. Wrist ROM increased. Grip strength, MMWS, and DASH score improved significantly. Excellent and good MMWS equaled 83.3%. Forty-one patients (85.5%) resumed previous work and sport activities. As a postoperative complication, five patients experienced neuroapraxia of the dorsal sensory branch of the ulnar nerve (DSBUN) with full spontaneous recovery. Conclusions With appropriate indications and patient selection, arthroscopic foveal repair of the TFCC may restore DRUJ stability and provide satisfactory results without significant complications.

  3. Arthroscopic Foveal Repair of the Triangular Fibrocartilage Complex

    PubMed Central

    Atzei, Andrea; Luchetti, Riccardo; Braidotti, Federica

    2015-01-01

    Background Foveal disruption of the triangular fibrocartilage complex (TFCC) is associated with distal radioulnar joint (DRUJ) instability. TFCC fixation onto the fovea is the suitable treatment, which is not achieved by conventional arthroscopic techniques. We describe an all-inside arthroscopic technique that uses a suture anchor through distal DRUJ arthroscopy for foveal repair of the TFCC. Materials and Methods Forty-eight patients with TFCC foveal tear and DRUJ instability were selected according to the Atzei–European Wrist Arthroscopy Society (EWAS) algorithm of treatment. Retrospective evaluation included pain, DRUJ instability, range of motion (ROM), grip strength, Modified Mayo Wrist Score (MMWS), and the Disabilities of the Arm, Shoulder, and Hand (DASH) Score. Description of Technique DRUJ arthroscopy was performed to débride the TFCC and the foveal area. Under arthroscopic guidance, a suture anchor was inserted via the distal foveal portal to repair the TFCC onto the fovea. Sutures were tied on the radiocarpal surface of the TFCC. Postoperative immobilization of forearm rotation was maintained for 4 weeks. Heavy tasks were allowed after 3 months. Results After a mean follow-up of 33 months, pain improved significantly but remained moderate in four patients, severe in one. DRUJ instability resolved in 44 patients. Wrist ROM increased. Grip strength, MMWS, and DASH score improved significantly. Excellent and good MMWS equaled 83.3%. Forty-one patients (85.5%) resumed previous work and sport activities. As a postoperative complication, five patients experienced neuroapraxia of the dorsal sensory branch of the ulnar nerve (DSBUN) with full spontaneous recovery. Conclusions With appropriate indications and patient selection, arthroscopic foveal repair of the TFCC may restore DRUJ stability and provide satisfactory results without significant complications. PMID:25709875

  4. Triangular fibrocartilage complex injuries in the elite athlete.

    PubMed

    Ko, Jason H; Wiedrich, Thomas A

    2012-08-01

    Injuries to the triangular fibrocartilage complex (TFCC) in athletes can be caused by acute trauma, chronic repetitive loading, or a combination of both. Regardless of cause, the management of TFCC injuries in the high-performance athlete is often different from the basic tenets applied to the general population. The diagnosis, treatment, and rehabilitation regimen should be individualized and sport-specific in athletes, taking into consideration the priorities and needs of the athlete while striking a balance between healing, return to play, and long-term well-being.

  5. Dorsal Tear of Triangular Fibrocartilage Complex: Clinical Features and Treatment

    PubMed Central

    Abe, Yukio; Moriya, Atsushi; Tominaga, Yasuhiro; Yoshida, Koji

    2016-01-01

    Background Several different triangular fibrocartilage complex (TFCC) tear patterns have been classified through the use of wrist arthroscopy. A tear of the dorsal aspect of the TFCC has been previously reported, but it is not included in Palmer original classification. Our purpose was to describe this type of tear pattern along with the clinical presentation. Methods An isolated dorsal TFCC tear was encountered in seven wrists of six patients (three men and three women; average age was 31 years). All patients were evaluated by physical exam, X-ray, plain axial computed tomography with pronation, neutral and supination position, magnetic resonance imaging (MRI) with coronal, sagittal, and axial section and arthroscopy. Results The clinical findings varied and included the following: tenderness at the dorsoulnar aspect of the wrist was positive in all wrists, fovea sign was positive in five wrists, and tenderness at the dorsal aspect of the distal radioulnar joint was present in one wrist. Pain with forearm rotation was positive in all wrists. The ulnar head ballottement test induced pain in all wrists, whereas dorsal instability of the ulnar head was present in one wrist with this test. The ulnocarpal stress test was positive in five wrists. Axial and sagittal images on MRI revealed the dorsal tear in five wrists. All wrists were treated with an arthroscopic capsular repair. The final functional outcome at an average follow-up of 16.1 months was four excellent and one good wrist according to the modified Mayo wrist score. Conclusions The aim of this article is to describe our experiences with tears involving the dorsal aspect of the TFCC, which may be misdiagnosed if the surgeon is not cognizant of this injury. Type of study/level of evidence Diagnostic/level IV PMID:26855835

  6. Ulnar-sided wrist pain due to isolated disk tear of triangular fibrocartilage complex within the distal radioulnar joint: two case reports.

    PubMed

    Abe, Yukio; Tominaga, Yasuhiro

    2011-01-01

    Wrist arthroscopy has been successfully used with many modifications and improvements. However, distal radioulnar joint (DRUJ) arthroscopy is still uncommon. We experienced 2 cases of ulnar-sided wrist pain due to isolated triangular fibrocartilage complex (TFCC) disk tear within the DRUJ. DRUJ arthroscopy in these cases showed horizontal tear and fibrillation of TFCC disk without TFCC tear at the radiocarpal joint. Foveal attachment was intact in both cases. These were treated with debridement, which relieved pain after surgery and achieved good functional recovery. Although DRUJ arthroscopy is technically difficult, it is mandatory for making a diagnosis and treating ulnar-sided wrist pain.

  7. Arthroscopic-assisted repair of triangular fibrocartilage complex foveal avulsion in distal radioulnar joint injury

    PubMed Central

    Woo, Sung Jong; Jegal, Midum; Park, Min Jong

    2016-01-01

    Background: Disruption of the triangular fibrocartilage complex (TFCC) foveal insertion can lead to distal radioulnar joint (DRUJ) instability accompanied by ulnar-sided pain, weakness, snapping, and limited forearm rotation. We investigated the clinical outcomes of patients with TFCC foveal tears treated with arthroscopic-assisted repair. Materials and Methods: Twelve patients underwent foveal repair of avulsed TFCC with the assistance of arthroscopy between 2011 and 2013. These patients were followed up for an average of 19 months (range 14–25 months). The avulsed TFCC were reattached to the fovea using a transosseous pull-out suture or a knotless suture anchor. At the final followup, the range of motion, grip strength and DRUJ stability were measured as objective outcomes. Subjective outcomes were assessed using the Visual Analog Scale (VAS) for pain, patient rated wrist evaluation (PRWE), Disabilities of the Arm, Shoulder and Hand questionnaire (DASH score) and return to work. Results: Based on the DRUJ stress test, 5 patients had normal stability and 7 patients showed mild laxity as compared with the contralateral side. Postoperatively, the mean range of pronation supination increased from 141° to 166°, and the mean VAS score for pain decreased from 5.3 to 1.7 significantly. The PRWE and DASH questionnaires also showed significant functional improvement. All patients were able to return to their jobs. However, two patients complained of persistent pain. Conclusions: Arthroscopically assisted repair of TFCC foveal injury can provide significant pain relief, functional improvement and restoration of DRUJ stability. PMID:27293286

  8. Ulnar-sided wrist pain. II. Clinical imaging and treatment

    PubMed Central

    Watanabe, Atsuya; Souza, Felipe; Vezeridis, Peter S.; Blazar, Philip

    2009-01-01

    Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed. PMID:20012039

  9. An index of orthodontic treatment complexity.

    PubMed

    Llewellyn, Stuart K; Hamdan, Ahmad M; Rock, William P

    2007-04-01

    The aim of the present study was to develop an index specifically for the measurement of treatment complexity. Input factors were directly related to complexity, and the output was a score measuring the degree of treatment complexity. The sample comprised 120 sets of dental casts, 30 for each of the four main malocclusion classes. Sixteen orthodontists graded the study casts for perceived treatment complexity on a six-point scale and then listed, in order of importance, up to three occlusal features which they felt contributed to complexity from a pre-determined list. Multiple regression analysis was used to derive weightings for each occlusal feature, which would reflect the relevant treatment complexity. In order to obtain an overall treatment complexity score for each case, weightings were then multiplied by the corresponding occlusal feature scores and summed. The relationship between treatment complexity scores and perceived complexity was examined using Spearman's ranked correlation coefficient. The regression equation explained 49.5 per cent of the variance in treatment complexity of the whole sample. Regression analysis on the basis of malocclusion produced R (2) values of 90.7 per cent for Class I, 42.6 per cent for Class II division 1, 62.3 per cent for Class II division 2, and 79.5 per cent for Class III malocclusions. The index of orthodontic treatment complexity (IOTC) scores showed a moderate but highly significant association with the orthodontists' perceived complexity assessments (rho = 0.42, P = 0.000). The proposed IOTC shows sufficient promise to warrant further development.

  10. Complexity in Language Learning and Treatment

    ERIC Educational Resources Information Center

    Thompson, Cynthia K.

    2007-01-01

    Purpose: To introduce a Clinical Forum focused on the Complexity Account of Treatment Efficacy (C. K. Thompson, L. P. Shapiro, S. Kiran, & J. Sobecks, 2003), a counterintuitive but effective approach for treating language disorders. This approach espouses training "complex" structures to promote generalized improvement of simpler, linguistically…

  11. Complexity in the Treatment of Naming Deficits

    PubMed Central

    Kiran, Swathi

    2009-01-01

    Purpose This paper discusses a novel approach for treatment of lexical retrieval deficits in aphasia in which treatment begins with complex, rather than simple, lexical stimuli. This treatment considers the semantic complexity of items within semantic categories, with a focus on their featural detail. Methods and Results Previous work on training items within animate categories (Kiran & Thompson, 2003a) and preliminary work aimed at items within inanimate categories are discussed in this paper. Both these studies indicate that training atypical category items that entail features inherent in the category prototype as well as distinctive features that are not characteristic of the category prototype results in generalization to untrained typical examples which entail only features consistent with the category prototype. Conversely, training typical examples does not result in generalization to untrained atypical examples. In this paper, it is argued that atypical items are more complex than typical items within a category and a theoretical framework for this dimension of semantic complexity is discussed. Then, evidence from treatment studies that support this complexity hierarchy is presented. Potential patient- and stimulus- specific factors that may influence the success of this treatment approach are also discussed. Conclusions The applications of semantic complexity to treatment of additional semantic categories and functional applications of this approach are proposed. PMID:17329672

  12. Multifunctional carbon nanohorn complexes for cancer treatment.

    PubMed

    Chechetka, Svetlana A; Pichon, Benoit; Zhang, Minfang; Yudasaka, Masako; Bégin-Colin, Sylvie; Bianco, Alberto; Miyako, Eijiro

    2015-01-01

    Multifunctional carbon nanohorn (CNH) complexes were synthesized using oxidized CNH, magnetite (MAG) nanoparticles, and polyethyleneimine (PEI). The ferromagnetic MAG nanoparticles were loaded onto CNH (MAG-CNH) using iron(II) acetate and subsequent heat treatment. Chemical functionalization of the MAG-CNH complexes with PEI improved their water-dispersibility and allowed further conjugation with a fluorophore. The application of an external magnetic field significantly intensified the targeted vectorization of CNH complexes into human cervical cancer (HeLa) cells. Following cell uptake, laser irradiation of the cells showed a significant enhancement in the photothermal effects of CNHs leading to cell death. We have confirmed that the photothermal properties and ferromagnetic characteristics of CNH complexes show efficient cell elimination. The present study is an essential step toward the development of an innovative cancer therapy and a highly sensitive detection of cancer cells at the single-cell level.

  13. Treatment of complex regional pain syndrome.

    PubMed

    Resmini, Giuseppina; Ratti, Chiara; Canton, Gianluca; Murena, Luigi; Moretti, Antimo; Iolascon, Giovanni

    2015-01-01

    Complex Regional Pain Syndrome (CRPS) is a multifactorial and disabling disorder with complex etiology and pathogenesis. Goals of therapy in CRPS should be pain relief, functional restoration, and psychological stabilization, but early interventions are needed in order to achieve these objectives. Several drugs have been used to reduce pain and to improve functional status in CRPS, despite the lack of scientific evidence supporting their use in this scenario. They include anti-inflammatory drugs, analgesics, anesthetics, anticonvulsants, antidepressants, oral muscle relaxants, corticosteroids, calcitonin, bisphosphonates, calcium channel blockers and topical agents. NSAIDs showed no value in treating CRPS. Glucocorticoids are the only anti-inflammatory drugs for which there is direct clinical trial evidence in early stage of CRPS. Opioids are a reasonable second or third-line treatment option, but tolerance and long term toxicity are unresolved issues. The use of anticonvulsants and tricyclic antidepressants has not been well investigated for pain management in CRPS. During the last years, bisphosphonates have been the mostly studied pharmacologic agents in CRPS treatment and there are good evidence to support their use in this condition. Recently, the efficacy of intravenous (IV) administration of neridronate has been reported in a randomized controlled trial. Significant improvements in VAS score and other indices of pain and quality of life in patients who received four 100 mg IV doses of neridronate versus placebo were reported. These findings were confirmed in the open-extension phase of the study, when patients formerly enrolled in the placebo group received neridronate at the same dosage, and these results were maintained at 1 year follow-up. The current literature concerning sympathetic blocks and sympathectomy techniques lacks evidence of efficacy. Low evidence was recorded for a free radical scavenger, dimethylsulphoxide (DMSO) cream (50%). The same level

  14. Complex PTSD and phased treatment in refugees: a debate piece

    PubMed Central

    ter Heide, F. Jackie June; Mooren, Trudy M.; Kleber, Rolf J.

    2016-01-01

    Background Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatment. This recommendation has contributed to a clinical practice of delaying or waiving trauma-focused treatment in refugees with PTSD. Objective The aim of this debate piece is to defend two theses: (1) that complex trauma leads to complex PTSD in a minority of refugees only and (2) that trauma-focused treatment should be offered to all refugees who seek treatment for PTSD. Methods The first thesis is defended by comparing data on the prevalence of complex PTSD in refugees to those in other trauma-exposed populations, using studies derived from a systematic review. The second thesis is defended using conclusions of systematic reviews and a meta-analysis of the efficacy of psychotherapeutic treatment in refugees. Results Research shows that refugees are more likely to meet a regular PTSD diagnosis or no diagnosis than a complex PTSD diagnosis and that prevalence of complex PTSD in refugees is relatively low compared to that in survivors of childhood trauma. Effect sizes for trauma-focused treatment in refugees, especially narrative exposure therapy (NET) and culturally adapted cognitive-behaviour therapy (CA-CBT), have consistently been found to be high. Conclusions Complex PTSD in refugees should not be assumed to be present on the basis of complex traumatic experiences but should be carefully diagnosed using a validated interview. In line with treatment guidelines for PTSD, a course of trauma-focused treatment should be offered to all refugees seeking treatment for PTSD, including asylum seekers. PMID:26886486

  15. [Optimization of complex treatment of patients with severe oral leukoplakia].

    PubMed

    Rabinovich, O F; Rabinovich, I M; Abramova, E S

    2015-01-01

    The aim of the study was to prove the rationale for antiviral therapy combined with surgical procedures for treatment of severe oral leukoplakia. Complex clinical and laboratory evaluation and treatment was performed in 56 patients divided in 2 groups. Control group was presented by 13 patients receiving dental treatment, local and systemic keratoplastic formulations. Main group involved 43 patients in which conventional treatment protocol was completed by antiviral therapy and surgical procedures. Leukoplakia diagnosis was based on clinical findings, histological and immunohistochemical studies as well as optic coherent tomography data. The obtained results evidently prove the necessity for including antiviral therapy and surgical procedures in treatment scheme of severe oral leukoplakia.

  16. Surgical treatment of complex axis fractures with adjacent segment instability.

    PubMed

    Wang, Lei; Xia, Tian; Dong, Shuanghai; Zhao, Qinghua; Tian, Jiwei

    2012-03-01

    This study investigates the clinical and radiographic characteristics of complex axis fractures with adjacent segment instability and describes the outcome of surgical treatment. Twenty-one patients (14 male, seven female; mean age=34 years) with complex axis fractures and adjacent segment instability who were treated between August 2003 and June 2009 were retrospectively reviewed. Treatment selection was based on fracture type and stability of the upper cervical segments. All patients were immobilized with a hard collar for three months after surgery. The mean follow-up period was 12 months (range=6-36 months). No intraoperative surgery-related complications were observed and fusion was achieved in all patients. The outcome was excellent for 17 patients, good for two patients, fair for one patient, and poor for one patient. The upper cervical segments that can become unstable due to complex axis fractures include the atlantoaxial and C2-3 joints. Recommended surgical treatments produce good results.

  17. Interventional modalities in the treatment of complex regional pain syndrome.

    PubMed

    Nambi-Joseph, Pushpa; Stanton-Hicks, Michael; Sferra, James J

    2004-06-01

    Complex regional pain syndrome (CRPS) applies to a variety of conditions in which symptoms such as allodynia and hyperalgesia predominate along with hyperpathia and vasomotor/sudomotor disturbances. The incidence of CRPS in the chronic pain population varies and is difficult to determine, though it appears to affect women more than men. Treatment is multidisciplinary, and recovery of function and the reduction of pain are the main goals of treatment;this article addresses some of the interventional modalities that are used.

  18. [Cell technologies in complex treatment of venous trophic ulcers].

    PubMed

    Gavrilenko, A V; Pavlova, O V; Ivanov, A A; Vakhrat'ian, P E; Dashinimaev, É B; Li, R A

    2011-01-01

    Live skin equivalent and fibroblasts in gel were used in complex treatment of venous trophic ulcers to evaluate efficacy of cell transplants. Their efficacy depended on extent of trophic ulcer and time of their existence. Cell culture method is minimally traumatic, can be used in elder patients and seniors and gives positive results in 85% of cases.

  19. [Staged complex treatment of paralytic lagophthalmos (case report)].

    PubMed

    Gushchina, M B; Mal'kov, S A; Kovshun, E V; Yuzhakova, N S

    2017-01-01

    Paralytic lagophthalmos, resulting from facial nerve palsy, is a difficult medical and social issue that requires cooperation of different specialists. Complications that arise in paralytic lagophthalmos may cause significant vision loss and even eye loss. Various techniques of paralytic lagophthalmos correction are used to protect the cornea and restore eyelid anatomy and functions. These comprise palliative (conservative), surgical, and alternative treatments (such as botulinum toxin type A therapy). Surgical treatment of paralytic lagophthalmos patients often has to be staged and complex. This article presents a clinical case of a female patient with paralytic lagophthalmos complicated by corneal perforation. Her staged complex treatment included lower eyelid surgery, chemodenervation of the upper eyelid levator and optical reconstructive surgery. The following positive results were achieved: the protective function of the eyelids was restored, residual visual functions - preserved, the risk of eye loss - eliminated, and the asymmetry between the two halves of the face - corrected.

  20. Clearing the complexity: immune complexes and their treatment in lupus nephritis

    PubMed Central

    Toong, Catherine; Adelstein, Stephen; Phan, Tri Giang

    2011-01-01

    Systemic lupus erythematosus (SLE) is a classic antibody-mediated systemic autoimmune disease characterised by the development of autoantibodies to ubiquitous self-antigens (such as antinuclear antibodies and antidouble-stranded DNA antibodies) and widespread deposition of immune complexes in affected tissues. Deposition of immune complexes in the kidney results in glomerular damage and occurs in all forms of lupus nephritis. The development of nephritis carries a poor prognosis and high risk of developing end-stage renal failure despite recent therapeutic advances. Here we review the role of DNA-anti-DNA immune complexes in the pathogenesis of lupus nephritis and possible new treatment strategies aimed at their control. PMID:21694945

  1. Work-Related Complex Regional Pain Syndrome: Diagnosis and Treatment.

    PubMed

    Friedman, Andrew

    2015-08-01

    Complex regional pain syndrome can be a debilitating disorder, which, in its earliest stages, can be prevented by aggressive rehabilitation based on reactivation. It is critical to follow international criteria on making the diagnosis; overdiagnosis can lead to inappropriate interventions and further disability. When present, early recognition with reactivation is the cornerstone of treatment. This article presents a phased approach to treatment that suggests movements of nonresponders quickly to more integrated levels of care. Some commonly used invasive interventions, such as sympathectomy and spinal cord stimulation, have not been proved effective; these unproven and potentially harmful therapies should be avoided.

  2. [Magnetic therapy for complex treatment of chronic periodontal disease].

    PubMed

    P'yanzina, A V

    2017-01-01

    The aim of the study was to elaborate the methodology of magnetic therapy for complex treatment of chronic periodontal disease (CPD). The study included 60 patients aged 35 to 65 years with moderate CPD divided in 2 groups. Patients in group 1 (controls) received impulse carbonate irrigation for 12 min №10, group 2 additionally received magnetic therapy for 5 min №10 in maxillary and mandibular areas.

  3. Successful treatment of disseminated coccidioidomycosis with amphotericin B lipid complex.

    PubMed

    Koehler, A P; Cheng, A F; Chu, K C; Chan, C H; Ho, A S; Lyon, D J

    1998-01-01

    Coccidioidomycosis is endemic in regions of the Americas, but this infection may be encountered in travellers who return from an endemic region. A case is reported of a disseminated infection in a Hong Kong Chinese man, who was successfully treated with amphotericin B lipid complex (ABLC) after intolerance and toxicity precluded the use of other antifungal agents. Lipid-based formulations of amphotericin B merit further evaluation in the treatment of coccidioidomycosis and other systemic mycoses.

  4. [Some aspects of the complex treatment of acute suppurative perionitis].

    PubMed

    Kovalev, M M; Roĭ, V P; Zaritskiĭ, I; Konovalenko, V V; Mellin, V M

    1976-10-01

    The authors present an analysis of the results of complex treatment in 4318 patients operated upon for acute peritonitis, caused by acute appendicitis, perforating gastric and duodenal ulcers, acute cholecystitis, ruptures and perforations of the intestine and other surgical and gynecological diseases. Patients with diffuse purulent peritonitis showed marked disorders in protein-aminoacid, nitrogen, and water electrolyte metabolism, acid-base balance, a reduced nonspecific immune responsiveness of the organism. Therpeutic tactics was delineated taking into account the revealed changes.

  5. Pediatric distal radius fractures and triangular fibrocartilage complex injuries.

    PubMed

    Bae, Donald S; Waters, Peter M

    2006-02-01

    Management of distal radius fractures is guided by the pattern and location of injury, degree of deformity, and expectations of bony remodeling based on the amount of remaining skeletal growth.Indications for surgical treatment include unstable or irreducible fractures, open fractures, floating elbow injuries, and neurovascular or soft-tissue compromise precluding cast immobilization. Patients and families should be counseled regarding the potential for post-traumatic distal radial growth arrest following physeal fractures. In these cases, epiphysiodeses, ulnar shortening osteotomies, or corrective radial osteotomies may be performed, depending on the pattern of arrest,degree of deformity, and remaining skeletal growth.TFCC tears may be the source of ulnar-sided wrist pain in children and adolescents, though symptoms and physical examination findings maybe subtle. Patients who have persistent pain and functional limitations despite activity modification and therapy are candidates for surgical treatment. Appropriate repair of peripheral TFCC tears with correction of concomitant wrist pathology restores normal wrist anatomy, alleviates pain, and allows for return to functional activities.

  6. 76 FR 39110 - Medicare Program; Section 3113: The Treatment of Certain Complex Diagnostic Laboratory Tests...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... HUMAN SERVICES Centers for Medicare & Medicaid Services Medicare Program; Section 3113: The Treatment of... participate in the Treatment of Certain Complex Diagnostic Laboratory Tests Demonstration. The Demonstration... Treatment of Certain Complex Diagnostic Laboratory Tests Demonstration. The authorizing legislation...

  7. Constructed wetland treatment system for upper blackfoot mining complex

    SciTech Connect

    Sanders, F.S.

    1996-12-31

    A combined passive oxidation/sedimentation (pre-treatment) and constructed wetland (polishing) system has been designed and installed to treat mine drainage at the inactive Upper Blackfoot River Mining Complex northeast of Lincoln, MT. The system is designed to treat up to 100 gpm flow with moderate heavy metal concentrations (25 to 95 mg/L Zn; lower concentrations of Pb, Cu, and As), moderate Fe concentrations (< 100 mg/L), and periodic high acidity (pH 2.6 to 3.5). The treatment scheme is flexible to accommodate a wide range of flows, metal concentrations, and acidity in order to gain cost-efficiencies and to meet restrictive discharge standards for the environmentally-sensitive Blackfoot River watershed. The wetland treatment system presently is undergoing start-up testing and initial tuning and will be operational during summer, 1996. Conceptual and engineering designs are presented along with preliminary data.

  8. Pellagra encephalopathy following B-complex vitamin treatment without niacin.

    PubMed

    Pitsavas, Stergios; Andreou, Christina; Bascialla, Franzesca; Bozikas, Vasilis P; Karavatos, Athanasios

    2004-01-01

    Pellagra is caused by nicotinic acid deficiency; it is rarely encountered in developed countries, and it is mainly related to poverty and malnutrition, as well as with chronic alcoholism. We report the case of an alcoholic patient who was diagnosed with pellagra and administered B-complex vitamin tablets that did not contain niacin. A few weeks later, the patient developed nervousness, irritability, insomnia and, consequently, delusional ideas and hallucinations, for which he had to be hospitalized. After his admission, the patient manifested loss of consciousness and myoclonus. All of his symptoms (cutaneous, neurological, and psychiatric) resolved fully with treatment with niacin in combination with other B-complex vitamins. All undiagnosed encephalopathies in alcoholic patients should be treated with multiple vitamin therapy, including nicotinic acid.

  9. [PREPARATIONS OF PAMIDRONOVIC ACID IN COMPLEX TREATMENT ON OSTEOGENESIS IMPERFECTA].

    PubMed

    Zyma, A M; Guk, Yu M; Magomedov, O M; Gayko, O G; Kincha-Polishchuk, T A

    2015-07-01

    Modern view of drug therapy in the complex treatment of orthopedic manifestations of osteogenesis imperfecta (OI) was submitted. Developed and tested system of drug correction of structural and functional state of bone tissue (BT) using drugs pamidronovic acid, depending on osteoporosis severity and type of disease. Such therapy is appropriate to apply both independently and in conjunction with surgery to correct deformations of long bones of the lower extremities. Effectiveness and feasibility of the proposed methods of drug therapy was proved, most patients resume features walking and support.

  10. [Some critical issues in the diagnosis and treatment of complex anal fistula].

    PubMed

    Ren, Donglin; Zhang, Heng

    2015-12-01

    In the past thirty years, colorectal surgeons have made great progress regarding the diagnosis and treatment of complex anal fistula, including the improvement of the accuracy of the preoperative evaluation of complex anal fistula, the improvement and standardization of the diagnosis and treatment of perianal fistulising Crohn's disease, the application of various "sphincter-sparing" procedures. However, complex anal fistula continues to prove a formidable challenge with a high recurrence rate and high incontinence rate. The variety of the surgical treatment also means that there is still no established "golden standard" with respect to that of the complex anal fistula. According to recent relevant literatures and personal experience, some critical issues in the diagnosis and treatment of complex anal fistula, including the approach to the accurate diagnosis, the value and significance of seton technique, the individual algorithm between the minimal invasive and extensive surgical treatments, the value of biopsy, are discussed in this article.

  11. Diagnosis and treatment of injuries to the posterolateral ligament complex.

    PubMed

    Rue, John-Paul; Kilcoyne, Kelly; Dickens, Jonathan; Kluk, Matthew

    2011-09-01

    Posterolateral corner (PLC) injuries are an often unrecognized and disabling injury that frequently accompanies other ligamentous disruptions. The spectrum of injury severity and heterogeneity of treatment options have made comparison of outcomes difficult. Several clinical studies and reviews have focused on the outcomes and treatment algorithms of knee dislocations or multiligamentous knee injuries. There is, however, a paucity of data in the literature analyzing the clinical outcomes and treatment recommendations of isolated PLC injuries or PLC injuries in combination with a single cruciate ligament tear. Furthermore, to our knowledge there is no review that analyzes the different repair or reconstructive techniques and assesses the clinical outcomes of these techniques.

  12. [CONSERVATIVE THERAPY IN THE COMPLEX TREATMENT OF ACUTE NECROTIZING PANCREATITIS].

    PubMed

    Khomyak, I V

    2015-07-01

    Developed and implemented a phased differentiated treatment tactics in acute necrotizing pancreatitis, based on the theory of phase course of acute pancreatitis. Treatment started with conservative measures. Applications developed set of measures allowed us to achieve recovery of 39.53% patients without any instrumental interventions performans, including diapevtycal. Laparotomy reduced frequency performance of 57.14%--in the control group to 33.07%--in the main. Mortality in the main group was 6.72%; complication rate decreased 2.26 times; postoperative mortality was 9.83%.

  13. Design and Evaluation of Complex Moving HIFU Treatment Protocols

    NASA Astrophysics Data System (ADS)

    Kargl, Steven G.; Andrew, Marilee A.; Kaczkowski, Peter J.; Brayman, Andrew A.; Crum, Lawrence A.

    2005-03-01

    The use of moving high-intensity focused ultrasound (HIFU) treatment protocols is of interest in achieving efficient formation of large-volume thermal lesions in tissue. Judicious protocol design is critical in order to avoid collateral damage to healthy tissues outside the treatment zone. A KZK-BHTE model, extended to simulate multiple, moving scans in tissue, is used to investigate protocol design considerations. Prediction and experimental observations are presented which 1) validate the model, 2) illustrate how to assess the effects of acoustic nonlinearity, and 3) demonstrate how to assess and control collateral damage such as prefocal lesion formation and lesion formation resulting from thermal conduction without direct HIFU exposure. Experimental data consist of linear and circular scan protocols delivered over a range of exposure regimes in ex vivo bovine liver.

  14. Modern Palliative Radiation Treatment: Do Complexity and Workload Contribute to Medical Errors?

    SciTech Connect

    D'Souza, Neil; Holden, Lori; Robson, Sheila; Mah, Kathy; Di Prospero, Lisa; Wong, C. Shun; Chow, Edward; Spayne, Jacqueline

    2012-09-01

    Purpose: To examine whether treatment workload and complexity associated with palliative radiation therapy contribute to medical errors. Methods and Materials: In the setting of a large academic health sciences center, patient scheduling and record and verification systems were used to identify patients starting radiation therapy. All records of radiation treatment courses delivered during a 3-month period were retrieved and divided into radical and palliative intent. 'Same day consultation, planning and treatment' was used as a proxy for workload and 'previous treatment' and 'multiple sites' as surrogates for complexity. In addition, all planning and treatment discrepancies (errors and 'near-misses') recorded during the same time frame were reviewed and analyzed. Results: There were 365 new patients treated with 485 courses of palliative radiation therapy. Of those patients, 128 (35%) were same-day consultation, simulation, and treatment patients; 166 (45%) patients had previous treatment; and 94 (26%) patients had treatment to multiple sites. Four near-misses and 4 errors occurred during the audit period, giving an error per course rate of 0.82%. In comparison, there were 10 near-misses and 5 errors associated with 1100 courses of radical treatment during the audit period. This translated into an error rate of 0.45% per course. An association was found between workload and complexity and increased palliative therapy error rates. Conclusions: Increased complexity and workload may have an impact on palliative radiation treatment discrepancies. This information may help guide the necessary recommendations for process improvement for patients who require palliative radiation therapy.

  15. [SELENIUM EFFICIENCY IN PROPHYLAXIS AND COMPLEX TREATMENT OF DIFFUSE GOITER].

    PubMed

    Osadtsiv, O I; Kravchenko, V I; Andrusyshyna, I M

    2014-01-01

    Efficiency of the combined prophylaxis and treatment of a diffuse goiter by preparations of sele- nium and iodine at 54 patients--men at the age of 41-50 years with the diagnosis of a diffuse goiter of 1st and 2nd degree was investigated. The diagnosis of a diffuse goiter was based on palpatory and ultrasonic research of the thyroid gland, which volume was compared with a body surface area. All surveyed have been divided into three groups. Patients of the first group accepted preparations of selenium and the iodine throughout three months, the second group--iodine preparations, in control group only dynamic supervision was spent. Thyroid gland volume at men who constantly used iodated salt and had no palpatory signs of a goiter was also measured for control. In the group which members accepted selenium and iodine preparations, at 11,8 % of patients was noted reduction of thyroid volume to normal and was revealed more expressed reduction of thyroid volume (for 2.15 sm3/M2 ± 0.07 sm3/M2), than at monotherapy by iodine preparations (for 0.92 sm3/M2 ± 0.17 sm3/M2). The conclusion was made that it is possible to recommend selenium preparations in a dose of 100 mkg a day together with preparations of iodine for prophylaxis and treatment of a diffuse goiter in conditions of the combined insufficiency in consumption of selenium and light deficiency of iodine.

  16. Comparison of Chemical Composition of Complex Disinfection Byproduct (DBP) Mixtures Produced by Different Treatment Methods

    EPA Science Inventory

    Analyses of the chemical composition of complex DBP mixtures, produced by different drinking water treatment processes, are essential to generate toxicity data required for assessing their risks to humans. For mixture risk assessments, whole mixture toxicology studies generally a...

  17. Comparison of Chemical Composition of Complex Disinfection Byproduct (DBP) Mixtures Produced by Different Treatment Methods - slides

    EPA Science Inventory

    Analyses of the chemical composition of complex DBP mixtures, produced by different drinking water treatment processes, are essential to generate toxicity data required for assessing their risks to humans. For mixture risk assessments, whole mixture toxicology studies generally a...

  18. Percutaneous treatment of complex biliary stone disease using endourological technique and literature review

    PubMed Central

    Korkes, Fernando; Carneiro, Ariê; Nasser, Felipe; Affonso, Breno Boueri; Galastri, Francisco Leonardo; de Oliveira, Marcos Belotto; Macedo, Antônio Luiz de Vasconcellos

    2015-01-01

    Most biliary stone diseases need to be treated surgically. However, in special cases that traditional biliary tract endoscopic access is not allowed, a multidisciplinary approach using hybrid technique with urologic instrumental constitute a treatment option. We report a case of a patient with complex intrahepatic stones who previously underwent unsuccessful conventional approaches, and who symptoms resolved after treatment with hybrid technique using an endourologic technology. We conducted an extensive literature review until October 2012 of manuscripts indexed in PubMed on the treatment of complex gallstones with hybrid technique. The multidisciplinary approach with hybrid technique using endourologic instrumental represents a safe and effective treatment option for patients with complex biliary stone who cannot conduct treatment with conventional methods. PMID:26061073

  19. Antiangiogenic cancer treatment: The great discovery and greater complexity (Review)

    PubMed Central

    Maj, Ewa; Papiernik, Diana; Wietrzyk, Joanna

    2016-01-01

    The discovery of tumor angiogenesis opened a new path in fighting cancer. The approval of different antiangiogenic agents, most targeting vascular endothelial growth factor (VEGF) signaling, has either increased the effectiveness of standard chemotherapy or even replaced it by offering better patient outcomes. However, an increasing number of preclinical and clinical observations have shown that the process of angiogenesis is far from clearly understood. Apart from targeting the VEGF pathway, novel strategies aim to influence other molecular factors that are involved in tumor angiogenesis. In addition, naturally occurring compounds seem to offer additional agents for influencing angiogenesis. The first concept of antiangiogenic therapy aimed to destroy tumor vessels, while it turned out that, paradoxically, antiangiogenic drugs normalized vasculature and as a result offered an improvement in chemotherapeutic delivery. In order to design an effective treatment schedule, methods for detecting the time window of normalization and biomarkers predicting patient response are needed. The initial idea that antiangiogenic therapy would be resistance-free failed to materialize and currently we still face the obstacle of resistance to antiangiogenic therapy. PMID:27826619

  20. Comorbidity, Case Complexity, and Effects of Evidence-Based Treatment for Children Referred for Disruptive Behavior

    ERIC Educational Resources Information Center

    Kazdin, Alan E.; Whitley, Moira K.

    2006-01-01

    Comorbidity and complexity of cases seen in clinical work form a basis for discounting the applicability and generality of evidence-based treatments (EBTs). The authors evaluated treatment outcomes in 2 samples of clinically referred children who met criteria for oppositional defiant disorder (n = 183; 42 girls, 141 boys; ages 3-14) or conduct…

  1. Classification of ulnar triangular fibrocartilage complex tears. A treatment algorithm for Palmer type IB tears.

    PubMed

    Atzei, A; Luchetti, R; Garagnani, L

    2017-01-01

    The classical definition of 'Palmer Type IB' triangular fibrocartilage complex tear, includes a spectrum of clinical conditions. This review highlights the clinical and arthroscopic criteria that enable us to categorize five classes on a treatment-oriented classification system of triangular fibrocartilage complex peripheral tears. Class 1 lesions represent isolated tears of the distal triangular fibrocartilage complex without distal radio-ulnar joint instability and are amenable to arthroscopic suture. Class 2 tears include rupture of both the distal triangular fibrocartilage complex and proximal attachments of the triangular fibrocartilage complex to the fovea. Class 3 tears constitute isolated ruptures of the proximal attachment of the triangular fibrocartilage complex to the fovea; they are not visible at radio-carpal arthroscopy. Both Class 2 and Class 3 tears are diagnosed with a positive hook test and are typically associated with distal radio-ulnar joint instability. If required, treatment is through reattachment of the distal radio-ulnar ligament insertions to the fovea. Class 4 lesions are irreparable tears due to the size of the defect or to poor tissue quality and, if required, treatment is through distal radio-ulnar ligament reconstruction with tendon graft. Class 5 tears are associated with distal radio-ulnar joint arthritis and can only be treated with salvage procedures. This subdivision of type IB triangular fibrocartilage complex tear provides more insights in the pathomechanics and treatment strategies.

  2. Improving the understanding and treatment of complex grief: an important issue for psychotraumatology

    PubMed Central

    Boelen, Paul A.

    2016-01-01

    In the Netherlands, every year 500,000 people are confronted with the death of a close relative. Many of these people experience little emotional distress. In some, bereavement precipitates severe grief, distress, and dysphoria. A small yet significant minority of bereaved individuals develops persistent and debilitating symptoms of persistent complex bereavement disorder (PCBD) (also termed prolonged grief disorder), posttraumatic stress disorder, and depression. Knowledge about early identification of, and preventive care for complex grief has increased. Moreover, in recent years there has been an increase in treatment options for people for whom loss leads to persistent psychological problems. That said, preventive and curative treatments are effective for some, but not all bereaved individuals experiencing distress and dysfunction following loss. This necessitates further research on the development, course, and treatment of various stages of complex grief, including PCBD. Highlights of the article “Complex grief” is an informal term referring to debilitating, non-normative grief. It will likely be named Prolonged Grief Disorder in the forthcoming ICD-11. It is named Persistent Complex Bereavement Disorder in DSM-5. Research on the development, course, and treatment of complex grief is needed. This research should address different stages and manifestations of complex grief. PMID:27667723

  3. Complex regional pain syndrome: observations on diagnosis, treatment and definition of a new subgroup.

    PubMed

    Żyluk, A; Puchalski, P

    2013-07-01

    Several definitions and sets of diagnostic criteria of complex regional pain syndrome have been proposed, but to date none has been accepted completely. This article presents a specific subtype of the disease, called 'chronic, refractory complex regional pain syndrome' which is extremely severe, disabling and resistant to treatment. It also emphasizes difficulties with diagnosing complex regional pain syndrome because of its variable clinical presentation and diagnostic criteria being insufficiently precise. The necessity to distinguish between criteria for clinical use and for scientific purposes is suggested with a proposal of practical guideline for diagnosing acute complex regional pain syndrome. A review of treatments for complex regional pain syndrome is presented, with opinion on their effectiveness: good in an early stage, less well in chronic and generally poor in the chronic, refractory subtype.

  4. Quantification of beam complexity in intensity-modulated radiation therapy treatment plans

    SciTech Connect

    Du, Weiliang Cho, Sang Hyun; Zhang, Xiaodong; Kudchadker, Rajat J.; Hoffman, Karen E.

    2014-02-15

    Purpose: Excessive complexity in intensity-modulated radiation therapy (IMRT) plans increases the dose uncertainty, prolongs the treatment time, and increases the susceptibility to changes in patient or target geometry. To date, the tools for quantitative assessment of IMRT beam complexity are still lacking. In this study, The authors have sought to develop metrics to characterize different aspects of beam complexity and investigate the beam complexity for IMRT plans of different disease sites. Methods: The authors evaluated the beam complexity scores for 65 step-and-shoot IMRT plans from three sites (prostate, head and neck, and spine) and 26 volumetric-modulated arc therapy (VMAT) plans for the prostate. On the basis of the beam apertures and monitor unit weights of all segments, the authors calculated the mean aperture area, extent of aperture shape irregularity, and degree of beam modulation for each beam. Then the beam complexity values were averaged to obtain the complexity metrics of the IMRT plans. The authors studied the correlation between the beam complexity metrics and the quality assurance (QA) results. Finally, the effects of treatment planning parameters on beam complexity were studied. Results: The beam complexity scores were not uniform among the prostate IMRT beams from different gantry angles. The lateral beams had larger monitor units and smaller shape irregularity, while the anterior-posterior beams had larger modulation values. On average, the prostate IMRT plans had the smallest aperture irregularity, beam modulation, and normalized monitor units; the head and neck IMRT plans had large beam irregularity and beam modulation; and the spine stereotactic radiation therapy plans often had small beam apertures, which may have been associated with the relatively large discrepancies between planned and QA measured doses. There were weak correlations between the beam complexity scores and the measured dose errors. The prostate VMAT beams showed

  5. Differentiating Types of Wide-Complex Tachycardia to Determine Appropriate Treatment in the Emergency Department.

    PubMed

    deSouza, Ian S; Peterson, Alanna C; Marill, Keith A

    2015-07-01

    Wide-complex tachycardia is a rare disease entity among patients presenting to the emergency department. However, due to its potential life-threatening nature, emergency clinicians must know how to assess and manage this condition. Wide-complex tachycardia encompasses a range of cardiac dysrhythmias, some of which can be difficult to distinguish and may require specific treatment approaches. This review summarizes the etiology and pathophysiology of wide-complex tachycardia, describes the differential diagnosis, and presents an evidence-based approach to identification of the different types of tachycardias through the use of a thorough history and physical examination, vagal maneuvers, electrocardiography, and adenosine. The treatment options and disposition for patients with various wide-complex tachycardias are also discussed, with attention to special circumstances and select controversial/contemporary topics.

  6. The use of imagery in phase 1 treatment of clients with complex dissociative disorders

    PubMed Central

    van der Hart, Onno

    2012-01-01

    The “standard of care” for clients with complex dissociative disorders and other complex trauma-related disorders is phase-oriented treatment. Within this frame, therapeutic progress can be enhanced by the use of imagery-based therapeutic techniques. In this article, the emphasis is on their application in phase 1 treatment, stabilization, symptom reduction, and skills training, but attention is also paid to applications in phase 2 and phase 3 treatment. Many of the existing imagery techniques are geared toward clients becoming more able to function in a more adaptive way in daily life, which, however, requires the involvement of various dissociative parts of the personality. Such collaborative involvement is also essential in the later treatment phases. Therefore, understanding the dissociative nature of these disorders is helpful in the judicious application of these techniques. PMID:22893843

  7. [Soy-based food in a complex treatment of patients with tuberculosis].

    PubMed

    Mel'nyk, V P; Anisimova, Iu M; Borovs'kyĭ, V R; Stadnyk, L V; Svitlychna, T H

    2006-12-01

    Results of clinical and laboratoty studies on efficiency and safety of upplied soya-based food during intensive antimicobacterial treatment of patients with tuberculosis are presented in the article. Obtained results showed the necessity of introduction soya-based food in a complex treatment of this infection as it enhances processes of detoxication, positevely influences on functional and structural state of the liver, reduces cytolysis, cholestasis symptomes, mesenchymal and inflamation reactions thus increases the tolerance of antimicobacterial agents.

  8. Treatment of Renal Angiomyolipoma and Other Hamartomas in Patients with Tuberous Sclerosis Complex.

    PubMed

    Samuels, Joshua A

    2017-03-16

    Tuberous sclerosis complex is an autosomal dominant genetic disease characterized by growth of benign tumors (hamartomas) in multiple organs, especially the kidneys, brain, heart, lungs, and skin. Tuberous sclerosis complex is usually caused by a mutation in either the tuberous sclerosis complex 1 or tuberous sclerosis complex 2 gene, resulting in constitutive activation of mammalian target of rapamycin signaling. Currently, mammalian target of rapamycin inhibitors are recommended in adult patients with tuberous sclerosis complex for the treatment of asymptomatic, growing renal angiomyolipoma that are >3 cm in diameter and pediatric or adult patients with brain lesions (subependymal giant cell astrocytoma) that either are growing or are not amenable to surgical resection. Clinical evidence suggests that systemic administration of a mammalian target of rapamycin inhibitor may provide concurrent improvements in multiple lesions and symptoms of tuberous sclerosis complex. With the major paradigm shift in consensus guidelines toward screening at diagnosis and ongoing monitoring and with the recent availability of an effective oral treatment, it is important that nephrologists have a thorough understanding of our role in the management of patients with tuberous sclerosis complex. Because the various manifestations of tuberous sclerosis complex typically emerge at different periods during patients' lifetimes, patients will need to be followed throughout their lives. Unlike brain and cardiac lesions, renal lesions are more likely to emerge as patients age and can grow at any time. Considerations regarding long-term medication administration for the potential control of multiple tuberous sclerosis complex manifestations will need to be addressed; these include the most appropriate starting dose, appropriate doses for tumor shrinkage versus prevention of regrowth, and management of adverse events. Best practices and potential obstacles for nephrologists treating patients

  9. B-complex vitamins in the prophylaxis and treatment of Wernicke-Korsakoff syndrome.

    PubMed

    Cook, C C; Thomson, A D

    Wernicke-Korsakoff syndrome, which is associated with high morbidity and mortality, is a more common neuropsychiatric sequela of alcohol misuse than is widely realized. It is easily prevented and treated with parenteral B-complex vitamins, although this treatment is widely under-utilized.

  10. Complex Psychiatric Comorbidity of Treatment-Seeking Youth with Autism Spectrum Disorder and Anxiety Symptoms

    ERIC Educational Resources Information Center

    Hepburn, Susan L.; Stern, Jessica A.; Blakeley-Smith, Audrey; Kimel, Lila K.; Reaven, Judith A.

    2014-01-01

    This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of youth with ASD and anxiety (ages 8-14) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). Youth…

  11. Complex treatment of trophic affections with vascular patients using monochromatic red light and hyperbaric oxygenation

    NASA Astrophysics Data System (ADS)

    Babkina, Zinaida M.; Vasilyev, Mikhail V.; Zakharov, Vyacheslav P.; Nikolayev, Viktor V.; Babkin, Vasily I.; Samoday, Valery G.; Zon, Boris A.; Pakhomov, Gennady V.; Naskidashvili, Vasily I.; Kumin, Anatoly A.

    1996-11-01

    Monochromatic red light irradiation therapy of trophic skin affections with vascular patients permits to receive positive results with small wounds. A combination of monochromatic red light and hyperbaric oxygenation is most perspective when conducting a complex therapy of trophic wounds not more than 40 mm2 and allows to diminish time of treatment almost two times.

  12. [Application of nootropic agents in complex treatment of patients with concussion of the brain].

    PubMed

    Tkachev, A V

    2007-01-01

    65 patients with a mild craniocereberal trauma have been observed. Medical examination included among general clinical methods the following methods: KT (MRT) of the brain, oculist examination including the observation of eye fundus. For objectification of a patient' complaints the authors used orientation and Galvestona's amnesia tests, feeling scale (psychological test), the table to determine the level of memory. Tests have been carried out on the first, tenth and thirty day of the treatment. Patients of the first group received in a complex treatment -pramistar, patients of the second group - piracetam. Patients of both groups noted considerable improvement during a complex treatment (disappearance of headache, dizziness and nausea) and at the same time patients receiving pramistar had better restoration of orientation and feeling. Pramistar was also more effective in patients with amnesia.

  13. The potential of sarcospan in adhesion complex replacement therapeutics for the treatment of muscular dystrophy.

    PubMed

    Marshall, Jamie L; Kwok, Yukwah; McMorran, Brian J; Baum, Linda G; Crosbie-Watson, Rachelle H

    2013-09-01

    Three adhesion complexes span the sarcolemma and facilitate critical connections between the extracellular matrix and the actin cytoskeleton: the dystrophin- and utrophin-glycoprotein complexes and α7β1 integrin. Loss of individual protein components results in a loss of the entire protein complex and muscular dystrophy. Muscular dystrophy is a progressive, lethal wasting disease characterized by repetitive cycles of myofiber degeneration and regeneration. Protein-replacement therapy offers a promising approach for the treatment of muscular dystrophy. Recently, we demonstrated that sarcospan facilitates protein-protein interactions amongst the adhesion complexes and is an important potential therapeutic target. Here, we review current protein-replacement strategies, discuss the potential benefits of sarcospan expression, and identify important experiments that must be addressed for sarcospan to move to the clinic.

  14. Complexity.

    PubMed

    Gómez-Hernández, J Jaime

    2006-01-01

    It is difficult to define complexity in modeling. Complexity is often associated with uncertainty since modeling uncertainty is an intrinsically difficult task. However, modeling uncertainty does not require, necessarily, complex models, in the sense of a model requiring an unmanageable number of degrees of freedom to characterize the aquifer. The relationship between complexity, uncertainty, heterogeneity, and stochastic modeling is not simple. Aquifer models should be able to quantify the uncertainty of their predictions, which can be done using stochastic models that produce heterogeneous realizations of aquifer parameters. This is the type of complexity addressed in this article.

  15. Variables related to surgical and nonsurgical treatment of zygomatic complex fracture.

    PubMed

    Olate, Sergio; Lima, Sergio Monteiro; Sawazaki, Renato; Moreira, Roger William Fernandez; de Moraes, Márcio

    2011-07-01

    The aim of this retrospective research was to establish the association between variables for the surgical treatment of zygomatic complex (ZC) fractures. In a 10-year period, 532 patients were examined for ZC fractures. The medical records of patients were analyzed to obtain information related to sociodemographic characteristics, trauma etiology, sign and symptoms of patients, and surgical or nonsurgical treatment. Statistical analysis was performed using χ test with statistical significance of P < 0.05. Most fractures were sustained by subjects between 21 and 40 years of age (55.8%), being principally men (80.1%), and 153 patients underwent surgery (28.8%). Surgical treatment of ZC fractures was statistically associated to the presence of other facial fractures (P = 0.004), alteration of occlusion (P = 0.0001; probably due to jaw fractures), presence of the comminuted fractures (P = 0.0002), and infraorbital nerve sensory disturbances (P = 0.003). A mixture of complex variables can be associated to surgical treatment; however, variables as comminuted fracture and alteration of occlusion were associated to surgical treatment indications.

  16. Plasma immersion ion implantation for surface treatment of complex branched structures

    NASA Astrophysics Data System (ADS)

    Kashin, Oleg A.; Lotkov, Alexander I.; Borisov, Dmitry P.; Slabodchikov, Vladimir A.; Kuznetsov, Vladimir M.; Kudryashov, Andrey N.; Krukovsky, Konstantin V.

    2016-11-01

    The paper presents experimental results demonstrating the capabilities of plasma immersion ion implantation of silicon (Si) for surface treatment of complex branched structures such are self-expanding intravascular nickel-titanium (NiTi) stents. Using NiTi stents of diameter 4 and 8 mm, it is shown that plasma immersion ion implantation can provide rather homogeneous doping of their outer and inner surfaces with Si atoms. Also presented are research data on the processes that determine the thickness, composition, and structure of surface layers subjected to this type of treatment.

  17. Everolimus Treatment for an Early Infantile Subependymal Giant Cell Astrocytoma With Tuberous Sclerosis Complex.

    PubMed

    Fukumura, Shinobu; Watanabe, Toshihide; Takayama, Rumiko; Minagawa, Kimio; Tsutsumi, Hiroyuki

    2015-08-01

    Subependymal giant cell astrocytomas are benign tumors often observed with tuberous sclerosis complex. These tumors are rarely diagnosed during fetal life or early infancy. Until recently, the only available treatment has been surgical resection. Current clinical research has demonstrated that everolimus can induce these tumors' regression. We report a 19-month-old boy with tuberous sclerosis complex. At 2 months of age, he presented with congenital subependymal giant cell astrocytoma that was complicated by refractory epilepsy and severe mental retardation. Treatment with everolimus was started when he was 10 months old. Three months after initiating everolimus, the tumor was significantly reduced in size, and the reduction was subsequently maintained. His seizures decreased and he showed cognitive and developmental improvement. No severe adverse events have been observed to date. Everolimus has promise as an effective alternative to surgery for subependymal giant cell astrocytomas during early infancy.

  18. [A new approach to postexposure treatment of rabies by complex of immuno- and chemotherapy in belarus].

    PubMed

    Mishaeva, N P; Votiakov, V I; Titov, L P; Naralenkov, V A; Nekhaĭ, M R; Sinkevich, V V; Kurlukov, A I; Gorbunov, V A

    2013-01-01

    A method for preventive treatment of rabies with a complex of immuno- and chemotherapeutics was developed. Rifampicin was used a an etiotropic drug. In the experiments on laboratory animals infected with fixed and street strains of rabies virus it was shown to prolong the incubation period and to increase the survival rate. The protective mechanisms of rifampicin against rabies should be associated with inhibition of RNA transcription, as well as immunomodulating function of macrophages, dendritic cells, B- and T-cells. Since 1992, after the approval of the Ministry of Health of Belarus rifampicin is used in complex with antirabic vaccine for postexposure treatment of rabies in people after severe bites by infected animals (wolves, foxes, dogs). For an 18-year period (1992-2009) of integrated application of chemo- and immunotherapy in Belarus there was not registered any case of hydrophobia in people even after the heaviest wolf bites, incompatible with life (penetrating injuries of the skull, scalping, multiple bites).

  19. Treatment of complex tibial fractures in children with the taylor spatial frame.

    PubMed

    Eidelman, Mark; Katzman, Alexander

    2008-10-01

    Most tibial shaft fractures in children can be treated with closed reduction and cast fixation, but some fractures need external or internal fixation. The Taylor spatial frame (Smith & Nephew, Memphis, Tennessee) is a relatively new external fixator that can correct 6-axis deformities with computer accuracy. This article reports our experience using the Taylor spatial frame as a rewarding treatment modality for complex tibial fractures in children and adolescents.

  20. Surgical treatment of extensive complex odontoma in the mandible by corticotomy. A case report.

    PubMed

    Nogueira, A S; Gonçales, E S; Gonçales, A G B; Thiegui-Neto, V; Nogueira, C B P; Nogueira, A; Medeiros, R

    2013-09-01

    Odontomas represent the most prevalent odontogenic tumors in the jaw. The treatment of choice is surgical removal, usually performed by conventional techniques involving ostectomies to expose the tumor. In this paper, the authors describe, through the report of a case of complex odontoma located in the mandibular angle, a more conservative surgical technique called corticotomy, in which the bone removed for access to the tumor (buccal cortical) is repositioned and fixed by titanium plates of 1.5 mm.

  1. Aperture width of the osteomeatal complex as a predictor of successful treatment of odontogenic maxillary sinusitis.

    PubMed

    Tomomatsu, N; Uzawa, N; Aragaki, T; Harada, K

    2014-11-01

    Odontogenic maxillary sinusitis (OMS) is an inflammatory disease caused by the spread of dental inflammation into the sinus. The long-term administration of antibiotic medicine and/or treatment of the causative tooth are the usual initial treatments. These initial treatments are not always effective, and the reason is not well understood. The purpose of this study was to identify factors of significance that may contribute to the results of the initial treatment of OMS. Thirty-nine patients were studied, divided into two groups according to the results of initial treatment: effective or non-effective. The effective group comprised 20 patients who were cured by initial treatment. The non-effective group comprised 19 patients who required an additional operation. The duration of symptoms, spread into the other sinuses, aperture width of the osteomeatal complex (OMC) on the side of the maxillary sinus, and anatomical variations in the sinuses were compared between the groups. The only significant difference found was in the aperture width of the OMC, which was significantly narrower in the non-effective group than in the effective group. The aperture width of the OMC may be a significant predictor of the effectiveness of initial treatment of OMS.

  2. Can data repositories help find effective treatments for complex diseases? Submitted to Progress in neurobiology.

    PubMed

    Farber, Gregory K

    2016-03-24

    There are many challenges to developing treatments for complex diseases. This review explores the question of whether it is possible to imagine a data repository that would increase the pace of understanding complex diseases sufficiently well to facilitate the development of effective treatments. First, consideration is given to the amount of data that might be needed for such a data repository and whether the existing data storage infrastructure is enough. Several successful data repositories are then examined to see if they have common characteristics. An area of science where unsuccessful attempts to develop a data infrastructure is then described to see what lessons could be learned for a data repository devoted to complex disease. Then, a variety of issues related to sharing data are discussed. In some of these areas, it is reasonably clear how to move forward. In other areas, there are significant open questions that need to be addressed by all data repositories. Using that baseline information, the question of whether data archives can be effective in understanding a complex disease is explored. The major goal of such a data archive is likely to be identifying biomarkers that define sub-populations of the disease.

  3. Successful Treatment of Lower Limb Complex Regional Pain Syndrome following Three Weeks of Hyperbaric Oxygen Therapy

    PubMed Central

    Katznelson, Rita; Segal, Shira C.; Clarke, Hance

    2016-01-01

    Hyperbaric oxygen therapy (HBOT) is a treatment that delivers 100% oxygen at increased atmospheric pressures. The efficacy of HBOT for treating pain has been described in various animal pain models and may have clinical efficacy in the treatment of human chronic pain syndromes. We present our experience with posttraumatic Complex Regional Pain Syndrome (CRPS) type 2 in a patient who underwent 15 sessions of HBOT. A 41-year-old male with one-year history of CRPS of left foot followed by left ankle fracture demonstrated less pain, decreased swelling, less allodynia, and improvement in skin color and range of motion of the lower limb after 3 weeks of HBOT. Patient was back to work for the first time in over a year. HBOT may be considered as a valuable therapeutic tool in the treatment of long-standing CRPS. PMID:27445607

  4. [Reflexotherapy combined with cortexin in the complex treatment of speech disorders in patients with cerebral palsy].

    PubMed

    Ukhanova, T A; Gorbunov, F E; Ivanova, V V

    2011-01-01

    Authors studied 78 outpatients with children cerebral palsy, aged from 2 to 7 years, in the children department of neurology and reflexotherapy. All children had speech disorders of different severity: from a severe mental-speech deficit to muscle asinergia of the speech apparatus. Combined microcurrent reflexotherapy (MCRT) in the author's technique and the neuroprotector cortexin were used for treatment. The main group included 40 patients who received the treatment of MCRT in the combination with cortexin, the comparison group consisted of 38 patients who received only MCRT. MCRT consisted of 15 sessions with one month interval after the first treatment and two months after the second one. The treatment with cortexin included sessions of 10 injections each after the end of the first and the third MCRT sessions. Patient state was measured at baseline and at the end of 6 month treatment program. An analysis of results of the complex treatment demonstrated its high efficacy in the recovery of speech functions in children with cerebral palsy compared to patients of the comparison group.

  5. [Experience of use of prolit septo in the complex treatment of patients with urolithiasis].

    PubMed

    Ianenko, Ė K; Konstantinova, O V; Poliakov, N V; Elagin, V O

    2012-01-01

    The efficacy of phytogenic drug prolit septo in the complex treatment of patients with urolithiasis complicated by infectious-inflammatory process was evaluated. The effects of prolit septo were assessed by a comparative evaluation of the results of microbiological analysis of urine in 14 patients of main group and 12 patients of control group. Patients in both groups were matched by sex, age, and results of raiological, clinical, biochemical and microbiological methods of examination. For the treatment of 11 patients of the main group, prolit septo was applied in combination with standard anti-bacterial treatment, 3 patients received monotherapy with prolit septo within 3-6 weeks. The drug was administered at a dose of 1200 mg (2 capsules) 3 times a day. Twelve patients of the control group received only standard treatment. The duration of treatment in both groups was 1-2 weeks. It was found that combined therapy with prolit septo is more effective than standard antibacterial treatment. Against the background of combined therapy the disappearance of bacteriuria was noted in 54.5% of patients of main group compared with 8.3% of patients of control group.

  6. Treatment for lexical retrieval using abstract and concrete words in persons with aphasia: Effect of complexity

    PubMed Central

    Kiran, Swathi; Sandberg, Chaleece; Abbott, Karen

    2009-01-01

    Background The significance of imageability and concreteness as factors for lexical tasks in aphasic individuals is under debate. No previous treatment studies have looked specifically at training abstract words compared to concrete for improved lexical retrieval in patients with chronic aphasia. Aim The goal of the present study was to determine the efficacy of a treatment for lexical retrieval that is based on models of lexical processing by utilizing abstractness as a mode of complexity. It was hypothesized that training abstract words in a category will result in improvement of those words and generalization to untrained target concrete words in the same category. Training concrete words in a category, however, will result in the retrieval of trained concrete words, but not generalization to target abstract words. Methods & Procedures A single subject experimental design across participants and behaviors was used to examine treatment and generalization. Generative naming for three categories (church, hospital, courthouse) was tested during baseline and treatment. Each treatment session was carried out in five steps: (1) category sorting, (2) feature selection, (3) yes/no feature questions, (4) word recall, and (5) free generative naming. Results Although participant 1 demonstrated neither significant learning nor generalization during abstract or concrete word training, participants 2, 3, and 4 showed significant learning during abstract word training and generalization to untrained concrete words. Participants 3 and 4 were also trained on concrete words which they improved on but did not show generalization to untrained abstract words. Conclusions The results of the present experiment support our hypothesis that training abstract words would result in greater learning and generalization to untrained concrete words. They also tentatively support the idea that generalization is facilitated by treatment focusing on more complex constructions (Kiran & Thompson

  7. Amelioration of lapine osteoarthritis by treatment with glycosaminoglycan-peptide association complex (Rumalon).

    PubMed

    Dean, D D; Muniz, O E; Rodriquez, I; Carreno, M R; Morales, S; Agundez, A; Madan, M E; Altman, R D; Annefeld, M; Howell, D S

    1991-03-01

    The chondroprotective potential of glycosaminoglycan-peptide association complex (GP-C) was examined in the medial meniscectomy model of lapine osteoarthritis (OA). Prophylactic treatment with increasing doses of intramuscular GP-C (0.05-0.5 ml/kg) caused a significant reduction in OA lesion area and histologic scores, and the effect on disease activity appeared to be dose related. The DNA and uronic acid contents of OA tissue were unaffected by prophylactic treatment with GP-C. However, levels of hydroxyproline in OA cartilage increased to near control levels with prophylactic treatment. Cartilage levels of active and total metalloproteinases that digest proteoglycans were elevated in rabbits with OA; prophylactic treatment with low-dose GP-C (0.05 ml/kg) produced a significant reduction in active, but not total, enzyme. Cartilage levels of tissue inhibitor of metalloproteinases in animals with OA were comparable with control levels, but rose with increasing doses of GP-C. We also investigated GP-C as a therapeutic treatment in animals that had already developed OA lesions. Carbon black retention and histologic score returned to near-normal after therapeutic treatment with GP-C. Uronic acid and hydroxyproline levels were decreased in OA cartilage. Therapeutic treatment with GP-C had no statistically significant effect on uronic acid levels, but was associated with increased hydroxyproline content in the cartilage. The changes in metalloproteinase and metalloproteinase inhibitor were similar to those found in the studies of prophylactic treatment. The findings in this animal model may help explain some of the beneficial effects of GP-C in human OA.

  8. 2-Nitroimidazole-ruthenium polypyridyl complex as a new conjugate for cancer treatment and visualization.

    PubMed

    Mazuryk, Olga; Maciuszek, Monika; Stochel, Grażyna; Suzenet, Franck; Brindell, Małgorzata

    2014-05-01

    A novel long-lifetime highly luminescent ruthenium polypyridyl complex containing 2-nitroimidazole moiety [Ru(dip)2(bpy-2-nitroIm)]Cl2 (dip=4,7-diphenyl-1,10-phenanthroline, bpy-2-nitroIm=4-[3-(2-nitro-1H-imidazol-1-yl)propyl]-2,2'-bipyridine) has been designed cancer treatment and imaging. The luminescence properties of the synthesized compound strongly depend on the oxygen concentration. Under oxygen-free conditions quantum yield of luminescence and the average lifetime of emission were found to be 0.034 and 1.9 μs, respectively, which is ca. three times higher in comparison to values obtained in air-equilibrated solution. The binding properties of the investigated ruthenium complex to human serum albumin have been studied and the apparent binding constant for the formation of the protein-ruthenium adduct was determined to be 1.1×10(5)M(-1). The quantum yield and the average lifetime of emission are greatly enhanced upon binding of ruthenium compound to the protein. The DNA binding studies revealed two distinguished binding modes which lead to a decrease in luminescence intensity of ruthenium complex up to 60% for [DNA]/[Ru]<2, and enhancement of emission for [DNA]/[Ru]>80. Preliminary biological studies confirmed fast and efficient accumulation of the ruthenium complex inside cells. Furthermore, the ruthenium complex was found to be relatively cytotoxic with LD50 of 12 and 13 μM for A549 and CT26 cell lines, respectively, under normoxic conditions. The retention and cellular uptake of ruthenium complex is enhanced under hypoxic conditions and its LD50 decreases to 8 μM for A549 cell line.

  9. [Expert assessment of operations' complexity and its interrelationship with lethal outcomes and duration of treatment].

    PubMed

    Bokeriia, L A; Samorodskaia, I V; Skopin, I I; Mironenko, V A; Kambarov, S Iu; Myrzakulov, E S

    2010-01-01

    The aim of the work was to carry out expert assessment of complexity of operations and to study interrelationship of the average score of complexity of the interventions with lethal outcome and duration of treatment in the Intensive Care Unit (exemplified by comparison with the outcomes of operations on cardiac valves performed in 2009 in the setting of artificial circulation in adult patients). Complexity was assessed by a total of 13 cardiovascular surgeons specialized in operations aimed at correcting valve defects (4 of them were from the A. N. Bakulev Scientific Centre for Cardiovascular Surgery), with none of the participants being aware of the therapeutic outcomes of each type of the operation performed. An average expert-defined score was assigned for each of the 33 names of the operations. The Kendall coefficient of concordance for all operations amounted to 0.29 (p<0.001); consensus in the complexity-score (from 69 to 85%) was achieved for 48.5% of the operations thus considered. The values of the mean scores of complexity of operations, defined by the specialists form the SCCS (2.02±0.54) were significantly lower (Wilcoxon's test; p<0.001) as compared with the average score assigned by specialists from other facilities (2.28±0.43). The duration of the stay at the ICU of the patients subdivided into groups depending on the expert score was found to differ significantly (p=0.007). The area under the ROC curve using the EuroSCORE (0.59) is suggestive of its lower accuracy in assessing the lethal outcome as compared to the expert score (0.68). The obtained findings strongly suggest advisability of using expert score of operations' complexity for solving complicated non-formalized tasks on allied problems of cardiovascular surgery and organization of public health care (accrediting of medical facilities, formation of the government order, and planning of the budget of medical facilities).

  10. A Day-Hospital Approach to Treatment of Pediatric Complex Regional Pain Syndrome: Initial Functional Outcomes

    PubMed Central

    Logan, Deirdre E.; Carpino, Elizabeth A.; Chiang, Gloria; Condon, Marianne; Firn, Emily; Gaughan, Veronica J.; Hogan, Melinda, P.T.; Leslie, David S.; Olson, Katie, P.T.; Sager, Susan; Sethna, Navil; Simons, Laura E.; Zurakowski, David; Berde, Charles B.

    2013-01-01

    Objectives To examine clinical outcomes of an interdisciplinary day hospital treatment program (comprised of physical, occupational, and cognitive-behavioral therapies with medical and nursing services) for pediatric complex regional pain syndrome (CRPS). Methods The study is a longitudinal case series of consecutive patients treated in a day hospital pediatric pain rehabilitation program. Participants were 56 children and adolescents ages 8–18 years (median = 14 years) with CRPS spectrum conditions who failed to progress sufficiently with a previous outpatient and/or inpatient treatments. Patients participated in daily physical therapy, occupational therapy and psychological treatment and received nursing and medical care as necessary. The model places equal emphasis on physical and cognitive-behavioral approaches to pain management. Median duration of stay was 3 weeks. Outcome measures included assessments of physical, occupational, and psychological functioning at program admission, discharge, and at post-treatment follow-up at a median of 10 months post-discharge. Scores at discharge and follow-up were compared with measures on admission by Wilcoxon tests, paired t tests, or ANOVA as appropriate, with corrections for multiple comparisons. Results Outcomes demonstrate clinically and statistically significant improvements from admission to discharge in pain intensity (p<0.001), functional disability (p<0.001), subjective report of limb function (p<0.001), timed running (p<0.001) occupational performance (p<0.001), medication use (p<0.01), use of assistive devices (p<0.001), and emotional functioning (anxiety, p<0.001; depression, p<0.01). Functional gains were maintained or further improved at follow-up. Discussion A day-hospital interdisciplinary rehabilitation approach appears effective in reducing disability and improving physical and emotional functioning and occupational performance among children and adolescents with complex regional pain syndromes that

  11. Ferrous sulfate versus iron polymaltose complex for treatment of iron deficiency anemia in children.

    PubMed

    Bopche, Ankur Vikas; Dwivedi, Rashmi; Mishra, Rakesh; Patel, G S

    2009-10-01

    We assessed the clinical response and side effects of Ferrous sulfate (FS) and Iron polymaltose complex (IPC) in 118 children with Iron deficiency anemia (IDA). Subjects were randomized to receive therapy with either oral IPC (Group A, n=59) or oral FS (Group B, n=59); all were given elemental iron in three divided doses of 6 mg/kg/day. One hundred and six children could be followed up; 53 in each group. Children who received ferrous sulfate were having higher hemoglobin level, and less residual complaints as compared to those who had received iron polymaltose complex. Our study suggests ferrous sulfate has a better clinical response and less significant adverse effects during treatment of IDA in children.

  12. The assessment and treatment of a complex geriatric patient by an interprofessional primary care team

    PubMed Central

    Bell, Stephanie H; Tracy, C Shawn; Upshur, Ross E G

    2011-01-01

    Mr K is an 89-year-old married man with a number of comorbid conditions and multiple recent falls. He was referred to the IMPACT clinic (Interprofessional Model of Practice for Aging and Complex Treatments) as his primary care physician was concerned about his declining health and the growing care giver burden on his wife. Mr K’s condition was deteriorating while the complexity of his case was increasing; therefore, an in-depth team assessment was sought to determine the best management plan and to assess his capacity to remain at home (his expressed preference). The IMPACT team met with Mr K and his wife for a 2 h interprofessional assessment. A comprehensive care plan was developed including specific recommendations for implementing change. After the visit to the IMPACT clinic, Mr K’s care was returned to his regular family physician. PMID:22698900

  13. Long-term bosentan treatment of complex congenital heart disease and Eisenmenger's syndrome.

    PubMed

    Díaz-Caraballo, Eva; González-García, Ana E; Reñones, Margarita; Sánchez-Recalde, Angel; García-Río, Francisco; Oliver-Ruiz, José M

    2009-09-01

    The BREATHE-5 study demonstrated that bosentan, an oral endothelin receptor antagonist, provides clinical benefits in patients with Eisenmenger's syndrome. As a result, the European Medicines Agency (EMEA) approved its use for this indication. However, follow-up in that study was limited to 16 weeks and patients with complex congenital heart disease were excluded. We assessed the effect of long-term bosentan treatment in 10 patients with complex congenital heart disease and Eisenmenger's syndrome. In the mean clinical follow-up period of 25 months, all patients reached the target dose without developing side effects and without experiencing a change in arterial oxygen consumption at either rest or maximal exercise. Moreover, there were significant changes in clinical parameters: NYHA functional class improved from 3.3+/-0.7 to 2.5+/-0.9 (P=.002) and the 6-minute walk distance increased from 266+/-161 m to 347+/-133 m (P=.015).

  14. [Complex conservative treatment of legg-calve-perthes disease with dona--glucosamine sulfate (sachet)].

    PubMed

    Maisuradze, T G

    2012-04-01

    The experience of 10 year application of the preparation dona - glucosamine sulphate (Sachet) Rottapharm, Italy among the children age group during the conservative treatment of thighbone head osteochondropathy (Pertes disease) at the Tbilisi, Children's Sanatorium "Gazapkhuli" orthopedic department is described in the article. In the article, it is mentioned the great importance of glicosaminglycans (GAG) in the matter of formation and existence of connective tissue, their greatest role in the metabolism of bone and cartilaginoid tissue, the considerable importance of preparation dona components (glucosamine, sulphate group) in biochemical processes that proceeds in cartilaginoid tissue - in the gialuroni acid and glicosaminglycans synthesis (the substances that the proteoglycans are composed of). The experience that the Department has in the application of polysulphate glicosaminglycan - preparation rumalon (Russia), during the conservative treatment of Pertes disease, is mentioned. Taking into account the afore-mentioned, the preparation dona was introduced into the scheme of conservative treatment of 300 child patients within 5-14 age group having different stages of Pertes disease. During 5-6 years after the treatment cessation, observation on children patients showed that during the lasting treatment period with the preparation, the hypersensitivity, negative circumstances and complications were not observed. The positive results of the treatments (90-92%), structural restoration processes both in bone and cartilaginoid tissue after the intake of roentgenologically approved preparation, gives the basis for the author of the article to express its opinion on the possibility of application of preparation dona - glucosamine sulphate (Sachet)-1500, as a structural-modified preparation, during the complex conservative treatment of Pertes disease among children within 5-14 age group.

  15. A dual wavelength-activatable gold nanorod complex for synergistic cancer treatment

    NASA Astrophysics Data System (ADS)

    Pacardo, Dennis B.; Neupane, Bhanu; Rikard, S. Michaela; Lu, Yue; Mo, Ran; Mishra, Sumeet R.; Tracy, Joseph B.; Wang, Gufeng; Ligler, Frances S.; Gu, Zhen

    2015-07-01

    A multifunctional gold nanorod (AuNR) complex is described with potential utility for theranostic anticancer treatment. The AuNR was functionalized with cyclodextrin for encapsulation of doxorubicin, with folic acid for targeting, and with a photo-responsive dextran-azo compound for intracellular controlled drug release. The interaction of a AuNR complex with HeLa cells was facilitated via a folic acid targeting ligand as displayed in the dark-field images of cells. Enhanced anticancer efficacy was demonstrated through the synergistic combination of promoted drug release upon ultraviolet (UV) light irradiation and photothermal therapy upon infrared (IR) irradiation. This multifunctional AuNR-based system represents a novel theranostic strategy for spatiotemporal delivery of anticancer therapeutics.A multifunctional gold nanorod (AuNR) complex is described with potential utility for theranostic anticancer treatment. The AuNR was functionalized with cyclodextrin for encapsulation of doxorubicin, with folic acid for targeting, and with a photo-responsive dextran-azo compound for intracellular controlled drug release. The interaction of a AuNR complex with HeLa cells was facilitated via a folic acid targeting ligand as displayed in the dark-field images of cells. Enhanced anticancer efficacy was demonstrated through the synergistic combination of promoted drug release upon ultraviolet (UV) light irradiation and photothermal therapy upon infrared (IR) irradiation. This multifunctional AuNR-based system represents a novel theranostic strategy for spatiotemporal delivery of anticancer therapeutics. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr01568e

  16. In-Stent Stenosis of Stent Assisted Endovascular Treatment on Intracranial Complex Aneurysms

    PubMed Central

    Yoon, Kyeong-Wook

    2010-01-01

    Objective To introduce the frequency and segment analysis of in-stent stenosis for intracranial stent assisted endovascular treatment on complex aneurysms. Methods A retrospective study was performed in 158 patients who had intracranial complex aneurysms and were treated by endovascular stent application with or without coil embolization. Of these, 102 patients were evaluated with catheter based angiography after 6, 12, and 18 months. Aneurysm location, using stent, time to stenosis, stenosis rate and narrowing segment were analyzed. Results Among follow-up cerebral angiography done in 102 patients, 8 patients (7.8%) were shown an in-stent stenosis. Two patients have unruptured aneurysm and six patients have ruptured one. Number of Neuroform stents were 7 cases (7.5%) and Enterprise stent in 1 case (11.1%). Six patients demonstrated in-stent stenosis at 6 months after stent application and remaining two patients were shown at 12 months, 18 months, respectively. Conclusion In-stent stenosis can be confronted after intracranial stent deployment. In our study, no patient showed symptomatic stenosis and there were no patients who required to further treatment except continuing antiplatets medication. In-stent stenosis has been known to be very few when they are placed into the non-pathologic parent artery during the complex aneurysm treatment, but the authors found that it was apt to happen on follow up angiography. Although the related symptom was not seen in our cases, the luminal narrowing at the stented area may result the untoward hemodynamic event in the specific condition. PMID:21430973

  17. Treatment of Complex Regional Pain Syndrome (CRPS) using low dose naltrexone (LDN).

    PubMed

    Chopra, Pradeep; Cooper, Mark S

    2013-06-01

    Complex Regional Pain Syndrome (CRPS) is a neuropathic pain syndrome, which involves glial activation and central sensitization in the central nervous system. Here, we describe positive outcomes of two CRPS patients, after they were treated with low-dose naltrexone (a glial attenuator), in combination with other CRPS therapies. Prominent CRPS symptoms remitted in these two patients, including dystonic spasms and fixed dystonia (respectively), following treatment with low-dose naltrexone (LDN). LDN, which is known to antagonize the Toll-like Receptor 4 pathway and attenuate activated microglia, was utilized in these patients after conventional CRPS pharmacotherapy failed to suppress their recalcitrant CRPS symptoms.

  18. Changes in rat epiphyseal cartilage after treatment with dexamethasone and glycosaminoglycan-peptide complex.

    PubMed

    Annefeld, M

    1992-06-01

    In 3-month-old rats, systemic administration of glucocorticosteroids induced regressive changes in the epiphyseal plate cartilage. Dexamethasone treatment resulted in inhibition of both chondrocyte proliferation and cartilage matrix production. The inhibition of chondrocyte proliferation was determined histologically from the thickness of the epiphyseal plate, the number of cell columns and the ratio of proliferating to hypertrophied chondrocytes. The decrease in cartilage matrix production was measured autoradiographically by incorporation of radioactive 35S-sulphate. Concomitant treatment with glycosaminoglycan-peptide complex (GP-C = RUMALON) overcame the negative effect of dexamethasone. The values in the dexamethasone + GP-C group approached those of the control group and differed significantly from the group given dexamethasone alone.

  19. [The enzyme therapy within a complex treatment of hemophthalmos in patients with diabetes mellitus].

    PubMed

    Polunin, G S; Andzhelova, D V; Kiseleva, T N

    2004-01-01

    The efficiency of the enzyme therapy was studied in patients with hemophthalmos concurrent with diabetes mellitus of different types. Sixty-eight patients received parabulbar injections of the hemase and collelizin enzymes and another 25 patients underwent the routine therapy comprising injections of dicynone, emoxipin and heparinum. The method of ultrasound B-scanning was used to determine the area of hemorrhage spread into the vitreous body. A high efficiency of the enzyme therapy, as used within the complex treatment of hemophthalmos in patients with diabetes mellitus, was demonstrated. Ultrasound B-scanning is a highly informative technique in evaluating the enzyme-therapy efficiency. The enzyme therapy can be recommended as the most effective method for the treatment of hemophthalmos in patients with diabetes mellitus.

  20. Treatment of complex intracranial aneurysm: Case report of the simultaneous use of endovascular and microsurgical techniques

    PubMed Central

    Fernandes, Sérgio T.; Alves, Raphael V.; Dória-Netto, Hugo L.; Puglia Júnior, Paulo; Rivau, Fabiano R.; Jory, Maurício

    2016-01-01

    Background: The surgical treatment of complex intracranial aneurysms (CIAs) represents a significant challenge to the skill and expertise of the neurosurgeon. The natural history of complex cerebrovascular lesions is especially unfavorable because of the pressure effect on adjacent areas, the risk of embolism in the presence of intraluminal thrombi, and the possibility of hemorrhage through leakage or rupture of the aneurysm. The surgical strategy must be customized for each case in order to maximize the treatment effectiveness and the safety of the patient. Case Description: A 68-year-old woman presented with a 10-month history of atypical headaches but no other neurological symptoms. Computed tomography scan and digital subtraction angiography revealed an unruptured saccular aneurysm on the M1 segment of the right middle cerebral artery. The lesion was 21 mm in length in its largest diameter and with an undefined neck (extensive involvement of the walls of the afferent vessel). Craniotomy was performed in order to expose the lesion and allow microsurgical dissection of the neck of the aneurysm and its adjacent structures. A balloon catheter was navigated via the internal carotid artery to a position alongside the aneurysm neck. With the balloon fully inflated, the aneurysm was punctured and drained, and a guide clip was located at the neck of the aneurysm. Additional clips were applied using a similar procedure to ensure the exclusion of the aneurysm. Conclusion: The patient recovered without complications and complete occlusion of the CIA was confirmed on follow-up angiography. A modified Rankin score of 0 was attributed to the patient 6 months after treatment. A multidisciplinary perspective is important in planning and executing the treatment of CIAs. PMID:28144484

  1. Melarsoprol cyclodextrin inclusion complexes as promising oral candidates for the treatment of human African trypanosomiasis.

    PubMed

    Rodgers, Jean; Jones, Amy; Gibaud, Stéphane; Bradley, Barbara; McCabe, Christopher; Barrett, Michael P; Gettinby, George; Kennedy, Peter G E

    2011-09-01

    Human African trypanosomiasis (HAT), or sleeping sickness, results from infection with the protozoan parasites Trypanosoma brucei (T. b.) gambiense or T. b. rhodesiense and is invariably fatal if untreated. There are 60 million people at risk from the disease throughout sub-Saharan Africa. The infection progresses from the haemolymphatic stage where parasites invade the blood, lymphatics and peripheral organs, to the late encephalitic stage where they enter the central nervous system (CNS) to cause serious neurological disease. The trivalent arsenical drug melarsoprol (Arsobal) is the only currently available treatment for CNS-stage T. b. rhodesiense infection. However, it must be administered intravenously due to the presence of propylene glycol solvent and is associated with numerous adverse reactions. A severe post-treatment reactive encephalopathy occurs in about 10% of treated patients, half of whom die. Thus melarsoprol kills 5% of all patients receiving it. Cyclodextrins have been used to improve the solubility and reduce the toxicity of a wide variety of drugs. We therefore investigated two melarsoprol cyclodextrin inclusion complexes; melarsoprol hydroxypropyl-β-cyclodextrin and melarsoprol randomly-methylated-β-cyclodextrin. We found that these compounds retain trypanocidal properties in vitro and cure CNS-stage murine infections when delivered orally, once per day for 7-days, at a dosage of 0.05 mmol/kg. No overt signs of toxicity were detected. Parasite load within the brain was rapidly reduced following treatment onset and magnetic resonance imaging showed restoration of normal blood-brain barrier integrity on completion of chemotherapy. These findings strongly suggest that complexed melarsoprol could be employed as an oral treatment for CNS-stage HAT, delivering considerable improvements over current parenteral chemotherapy.

  2. Esthetic orthodontic treatment using the invisalign appliance for moderate to complex malocclusions.

    PubMed

    Boyd, Robert L

    2008-08-01

    In this report, three patients were treated with a new treatment protocol for Invisalign to demonstrate that a variety of complex malocclusions can be successfully treated using this protocol, including correction of moderate crowding, correction of moderate Class II division 1, and deep overbite. Previous studies of Invisalign showed significant limitations for more complex orthodontic treatment, although a few recent case reports have shown successfully completed moderate to difficult orthodontic malocclusions. One reason for the discrepancy is that the earlier studies were done during the first four years of the appliance development (now ten years of clinical use), when significant problems existed with accomplishing bodily movement, torquing of roots, extrusions, and rotations of premolars and canines. The new protocol included new methods for anterior/posterior corrections, showing on the computer the effect of elastics for Class II treatment simulated as a one-stage anterior/posterior movement at the end of treatment. Staging for interproximal reduction (IPR) is now automatically staged when there is better access to interproximal contacts to avoid IPR where significant overlap between teeth is present to avoid performing IPR on surfaces that may be damaged by instruments such as burs, strips, and disks when cut on a sharp angle. Staging for tooth movements is now also done to enable combination movements to occur simultaneously for each tooth with the tooth that needs to move the most (the lead tooth) determining the minimum number of stages required. All other teeth move at a slower rate than the lead tooth throughout the duration of treatment. Attachments are now placed in the middle of the crown automatically for rotation and automatically sized in proportion to the clinical crown. Use of 1 mm thick (buccal-lingual dimension) horizontal beveled rectangular attachments is standard on premolars for retention of aligners during intrusive movements, such as

  3. [Comparative efficiency of nootropic drugs in complex treatment of patients with remote consequences of closed craniocereberal trauma].

    PubMed

    Hliebova, O S; Tkachenko, O V

    2008-01-01

    Main data of the research were data obtained after a complex treatment of 120 persons with late consequences of closed craniocereberal trauma (CCRCT). The treatment included administration of one of nootropic agents (noophen, aminolon or entropil), magnesium sulfate, group B vitamins. All patients have passed a complex examination: specially developed questionnaire, anamnesis gathering, neurologic status, neuropsychological status with the use of multiple-aspect scales and questionnaires, examination of fundus of eye, rheoencephalography, echoencephalography, brain MRT. Results of a complex examination proved positive effect of the use of nootropic agents, in particular noophen, entropil and aminolon in complex treatment of late consequences of closed craniocereberal trauma. For optimisation of the use of nootropic agents in the treatment of late consequences of closed craniocereberal trauma it is recommended to consider features of influence of nootropic agents on certain clinical aspects of the disease.

  4. Prolonged anti-bacterial activity of ion-complexed doxycycline for the treatment of osteomyelitis.

    PubMed

    Oh, Se Heang; Nam, Bo Ra; Lee, In Soo; Lee, Jin Ho

    2016-01-01

    The main purposes of the present study are the fabrication of an ion-complexed antibiotic which allows for the continuous release of the drug for sufficient periods of time without any additional matrix leading to unfavorable tissue responses, and the feasibility study of the ion-complexed antibiotic as a therapeutic system for osteomyelitis using an animal model. An ion-complexed doxycycline (icDX) as an antibiotic was prepared by simple mixing of positively charged doxycycline hyclate (DX) and negatively charged multivalent Na2HPO4 (2Na(+) HPO4(2-)) aqueous solutions. The icDX showed a controlled release of the DX up to 6 weeks. From the in vivo feasibility study using an osteomyelitis rat model, the icDX group showed a more effective therapeutic effect for the osteomyelitis, at 3 and 6 weeks, compared to the non-treated control and free DX groups. This was due to the sustained release of DX from the icDX in the osteomyelitis bone (medullary cavity) without migration. These findings suggest that the icDX may be a promising local delivery system in the clinical field for the treatment of the osteomyelitis.

  5. Enhancement of Auditory Fear Conditioning after Housing in a Complex Environment Is Attenuated by Prior Treatment with Amphetamine

    ERIC Educational Resources Information Center

    Briand, Lisa A.; Robinson, Terry E.; Maren, Stephen

    2005-01-01

    Prior exposure to drugs of abuse has been shown to occlude the structural plasticity associated with living in a complex environment. Amphetamine treatment may also occlude some cognitive advantages normally associated with living in a complex environment. To test this hypothesis we examined the influence of prior exposure to amphetamine on fear…

  6. Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review

    PubMed Central

    Dorrepaal, Ethy; Thomaes, Kathleen; Hoogendoorn, Adriaan W.; Veltman, Dick J.; Draijer, Nel; van Balkom, Anton J. L. M.

    2014-01-01

    Introduction Effective first-line treatments for posttraumatic stress disorder (PTSD) are well established, but their generalizability to child abuse (CA)-related Complex PTSD is largely unknown. Method A quantitative review of the literature was performed, identifying seven studies, with treatments specifically targeting CA-related PTSD or Complex PTSD, which were meta-analyzed, including variables such as effect size, drop-out, recovery, and improvement rates. Results Only six studies with one or more cognitive behavior therapy (CBT) treatment conditions and one with a present centered therapy condition could be meta-analyzed. Results indicate that CA-related PTSD patients profit with large effect sizes and modest recovery and improvement rates. Treatments which include exposure showed greater effect sizes especially in completers’ analyses, although no differential results were found in recovery and improvement rates. However, results in the subgroup of CA-related Complex PTSD studies were least favorable. Within the Complex PTSD subgroup, no superior effect size was found for exposure, and affect management resulted in more favorable recovery and improvement rates and less drop-out, as compared to exposure, especially in intention-to-treat analyses. Conclusion Limited evidence suggests that predominantly CBT treatments are effective, but do not suffice to achieve satisfactory end states, especially in Complex PTSD populations. Moreover, we propose that future research should focus on direct comparisons between types of treatment for Complex PTSD patients, thereby increasing generalizability of results. PMID:25563302

  7. [NEW OPPORTUNITIES OF IPL-THERAPY IN COMPLEX TREATMENT OF THE ROSACEA VASCULAR FORMS].

    PubMed

    Svyatenko, T; Starostina, O

    2015-06-01

    From the numerous reasons of emergence of an eritema, face skin teleangiektaziya, the particular interest in practice of dermatovenereologists, cosmetologists represents such widespread disease, as a rosacea. Despite well described clinical stages of a disease and the fulfilled protocols of treatment, early manifestations of this pathology very often remain not distinguished. It promotes progressing of a disease and transition to heavier clinical forms. Pathogenesis the rosacea is considered as angioneurosis vessels of the person with prevalence of venous insufficiency. Prevalence of a rosacea among patients who address to dermatologists, to cosmetologists, causes need for development of correct protocols of prevention and treatment of these states with use of modern knowledge and equipment. Data of own supervision of authors in the period of 2014-2015 for 26 patients at the age of 23-49 years with a vascular form of a rosacea whom complex therapy joined an IPL technique are provided in article. Considering the available own experience of use of IPL systems, authors came to a conclusion that the technique conforms to all safety requirements and increases efficiency of treatment of a vascular form of a rosacea.

  8. Effect of complex treatment using visual and auditory stimuli on the symptoms of attention deficit/hyperactivity disorder in children

    PubMed Central

    Park, Mi-Sook; Byun, Ki-Won; Park, Yong-Kyung; Kim, Mi-Han; Jung, Sung-Hwa; Kim, Hong

    2013-01-01

    We investigated the effects of complex treatment using visual and auditory stimuli on the symptoms of attention deficit/hyperactivity disorder (ADHD) in children. Forty-seven male children (7–13 yr old), who were clinically diagnosed with ADHD at the Balance Brain Center in Seoul, Korea, were included in this study. The complex treatment consisted of visual and auditory stimuli, core muscle exercise, targeting ball exercise, ocular motor exercise, and visual motor integration. All subjects completed the complex treatment for 60 min/day, 2–3 times/week for more than 12 weeks. Data regarding visual and auditory reaction time and cognitive function were obtained using the Neurosync program, Stroop Color-Word Test, and test of nonverbal intelligence (TONI) at pre- and post-treatment. The complex treatment significantly decreased the total reaction time, while it increased the number of combo actions on visual and auditory stimuli (P< 0.05). The Stroop color, word, and color-word scores were significantly increased at post-treatment compared to the scores at pretreatment (P< 0.05). There was no significant change in the TONI scores, although a tendency toward an increase in these scores was observed. In conclusion, complex treatment using visual and auditory stimuli alleviated the symptoms of ADHD and improved cognitive function in children. In addition, visual and auditory function might be possible indicators for demonstrating effective ADHD intervention. PMID:24278878

  9. Effect of complex treatment using visual and auditory stimuli on the symptoms of attention deficit/hyperactivity disorder in children.

    PubMed

    Park, Mi-Sook; Byun, Ki-Won; Park, Yong-Kyung; Kim, Mi-Han; Jung, Sung-Hwa; Kim, Hong

    2013-04-01

    We investigated the effects of complex treatment using visual and auditory stimuli on the symptoms of attention deficit/hyperactivity disorder (ADHD) in children. Forty-seven male children (7-13 yr old), who were clinically diagnosed with ADHD at the Balance Brain Center in Seoul, Korea, were included in this study. The complex treatment consisted of visual and auditory stimuli, core muscle exercise, targeting ball exercise, ocular motor exercise, and visual motor integration. All subjects completed the complex treatment for 60 min/day, 2-3 times/week for more than 12 weeks. Data regarding visual and auditory reaction time and cognitive function were obtained using the Neurosync program, Stroop Color-Word Test, and test of nonverbal intelligence (TONI) at pre- and post-treatment. The complex treatment significantly decreased the total reaction time, while it increased the number of combo actions on visual and auditory stimuli (P< 0.05). The Stroop color, word, and color-word scores were significantly increased at post-treatment compared to the scores at pretreatment (P< 0.05). There was no significant change in the TONI scores, although a tendency toward an increase in these scores was observed. In conclusion, complex treatment using visual and auditory stimuli alleviated the symptoms of ADHD and improved cognitive function in children. In addition, visual and auditory function might be possible indicators for demonstrating effective ADHD intervention.

  10. Stabilizing Group Treatment for Complex Posttraumatic Stress Disorder Related to Childhood Abuse Based on Psycho-Education and Cognitive Behavioral Therapy: A Pilot Study

    ERIC Educational Resources Information Center

    Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H.; van Balkom, Anton J. L. M.; van Dyck, Richard; Veltman, Dick J.; Draijer, Nel

    2010-01-01

    Objective: This study tests a Stabilizing Group Treatment protocol, designed for the management of the long-term sequelae of child abuse, that is, Complex Posttraumatic Stress Disorder (Complex PTSD). Evidence-based treatment for this subgroup of PTSD patients is largely lacking. This stabilizing treatment aims at improving Complex PTSD using…

  11. Narrative exposure therapy: an evidence-based treatment for multiple and complex trauma.

    PubMed

    Jongedijk, Ruud A

    2014-01-01

    Narrative exposure therapy (NET) is a recently developed, short-term treatment for patients with a posttraumatic stress disorder (PTSD) as a result of multiple trauma. NET can be applied very successfully in patients with complex trauma complaints (Jongedijk, 2014; Schauer, Neuner, & Elbert, 2011). An important feature of NET is that trauma processing is never an isolated event but is always embedded in the context of a traumatic event and in the life history as a whole. At the start, the lifeline is laid. The lifeline is made up of a rope, with flowers (happy events), stones (traumatic events), sometimes candles (grief), or recently also sticks for aggressive acts (NET for offenders; see Stenmark, Cuneyt Guzey, Elbert, & Holen, 2014). These symbols are laid down along the rope, in chronological order. Subsequently, in the subsequent therapy sessions the lifeline is processed in chronological order, giving attention to all the important events a person has experienced in his or her life, both the adverse as well as the pleasurable ones. The narration ends with a written testimony. To date, there is good evidence NET is effective in the treatment of PTSD patients, with support from 18 RCTs (N=950). For culturally diverse populations, NET is recommended as the most evidence-based trauma treatment, besides culturally adapted CBT. NET has been investigated in different populations in Africa, Europe, and Asia. In Asia, research has been carried out in Sri Lanka as well as in China. In China, NET was conducted and investigated with survivors of the Sichuan earthquake (Zang, Hunt, & Cox, 2013, 2014). NET is understandable, even appealing and also supportive for patients with multiple trauma. In this presentation, the treatment principles and the practice of NET will be explained.

  12. Complex Diagnostic and Treatment Issues in Psychotic Symptoms Associated with Narcolepsy

    PubMed Central

    Ivanenko, Anna

    2009-01-01

    Narcolepsy is an uncommon chronic, neurological disorder characterized by abnormal manifestations of rapid eye movement sleep and perturbations in the sleep-wake cycle. Accurate diagnosis of psychotic symptoms in a person with narcolepsy could be difficult due to side effects of stimulant treatment (e.g., hallucinations) as well as primary symptoms of narcolepsy (e.g., sleep paralysis and hypnagogic and/or hypnapompic hallucinations). Pertinent articles from peer-reviewed journals were identified to help understand the complex phenomenology of psychotic symptoms in patients with narcolepsy. In this ensuing review and discussion, we present an overview of narcolepsy and outline diagnostic and management approaches for psychotic symptoms in patients with narcolepsy. PMID:19724760

  13. Resolution of Crohn's disease and complex regional pain syndrome following treatment of paratuberculosis

    PubMed Central

    Kuenstner, J Todd; Chamberlin, William; Naser, Saleh A; Collins, Michael T; Dow, Coad Thomas; Aitken, John M; Weg, Stuart; Telega, Grzegorz; John, Kuruvilla; Haas, David; Eckstein, Torsten M; Kali, Maher; Welch, Christine; Petrie, Thomas

    2015-01-01

    A cohort of family members with various chronic diseases including Crohn’s disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis (MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP IgG in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans. PMID:25852293

  14. Resolution of Crohn's disease and complex regional pain syndrome following treatment of paratuberculosis.

    PubMed

    Kuenstner, J Todd; Chamberlin, William; Naser, Saleh A; Collins, Michael T; Dow, Coad Thomas; Aitken, John M; Weg, Stuart; Telega, Grzegorz; John, Kuruvilla; Haas, David; Eckstein, Torsten M; Kali, Maher; Welch, Christine; Petrie, Thomas

    2015-04-07

    A cohort of family members with various chronic diseases including Crohn's disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis (MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP IgG in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans.

  15. Sodium ferric gluconate complex in the treatment of iron deficiency for patients on dialysis.

    PubMed

    Fishbane, S; Wagner, J

    2001-05-01

    Intravenous iron has been found to be an important adjunctive therapy in the treatment of anemia for patients on dialysis. In the United States, iron dextran had been the only form available for parenteral use until 1999. This agent has been associated with a concerning number of severe adverse reactions, in some cases resulting in patients' deaths. Recently, a form of iron used for many years in Europe, sodium ferric gluconate complex in sucrose, was approved for intravenous use in the United STATES: Because this agent does not contain the immunogenic dextran component of iron dextran, it is expected that the safety profile of this drug should be superior to that of iron dextran. The purpose of this review is to critically appraise the relevant literature and to synthesize the information into a strategy for clinical use of this drug.

  16. Low-intensity laser radiation in complex treatment of inflammatory diseases of parodontium

    NASA Astrophysics Data System (ADS)

    Sokolova, Irina A.; Erina, Stanislava V.

    1995-04-01

    The problem of complex treatment of inflammatory disease of parodontium has become very acute and actual at the moment. The diseases of inflammatory nature are considered to be the most vital issues of the day. The state of the local immune system of oral cavity plays the most important role in the complicated mechanism of inflammatory process development in the tissues of parodontium. Recently physical factors have become predominant in the system of complex therapy of parodontitis. The application of low-intense laser radiation (LLR) is considered to be the most important and up-to-date method in the preventive dentistry. There were 60 patients of average damage rate suffering from chronic generalizing parodontitis at the age of 25 up to 55 under observation. The major goal of examination was to get the objective results of the following methods' application: parodontium index (Russel, 1956), hygiene index (Fyodorov, Volodkina, 1971), Bacterioscopy of dental-gingival pockets content, simple and broadened stomatoscopy (Kunin, 1970), SIgA level determination in mixed saliva (Manchini et all, 1965) and R-protein level in gingival blood (Kulberg, 1990). All the patients were split into 2 groups. The first group (30 patients) has undergone the laser therapy course while the second group of 30 patients couldn't get it (LLR). Despite the kind of therapy they have undergone, all the patients have got the local anti-inflammatory medicamental therapy. The results of clinical observations have proved the fact that laser therapy application makes it possible to shorten the course of treatment in 1.5 times. The shifts of oral cavity local resistance take place in case of chronic generalizing parodontitis. The direct immunostimulating effect could be observed as a result of LLR- therapy application. The close connection of both anti-inflammatory medicamental and LLR-therapy has proved the possibility of purposeful local immune status correction in case of parodontitis.

  17. Efficacy of a pectin-lecithin complex for treatment and prevention of gastric ulcers in horses.

    PubMed

    Sanz, M G; Viljoen, A; Saulez, M N; Olorunju, S; Andrews, F M

    2014-08-09

    The objective of this study was to evaluate the effect of a commercial feed supplement containing pectin-lecithin on squamous mucosa ulceration in horses exposed to an experimental ulceration model. Five mares were treated while five mares were controls for this crossover, blinded study. The mares were fed concentrates and hay and were stabled with a two-hour turn out per day for a period of four weeks. The pectin-lecithin complex was fed for the duration of the study on the treated group. At the end of a four-week period, all mares underwent a seven-day alternating feed deprivation (week 5). The study was repeated again after a four-week washout period. Gastroscopy was performed on days 1, 28 and 35 of the study and was digitally recorded. Independent evaluation of the recordings and scoring of the lesions using the Equine Gastric Ulcer Syndrome (EGUS), severity and number scores were performed by three experienced gastroscopists. The prevalence and severity of squamous ulcers significantly increased after intermittent feed deprivation (P<0.001). No significant effect of the treatment was observed (P>0.05). In this study, the addition of a commercially available pectin-lecithin complex to the feed of horses for five weeks did not prevent or minimise the risk for gastric ulceration of the squamous mucosa.

  18. Treatment of a Complex Distal Triceps Tendon Rupture With a New Technique: A Case Report

    PubMed Central

    Aunon-Martin, Ismael; Prada-Canizares, Alfonso; Jimenez-Diaz, Veronica; Vidal-Bujanda, Carlos; Leon-Baltasar, Jose Luis

    2016-01-01

    Introduction: The distal triceps tendon rupture is an uncommon injury. The acute treatment is well-defined, but when a delayed diagnosis is made or when a tendon retraction is present the alternatives or reconstruction are limited and sometimes complex. Case Presentation: In this case, we report on a 28-year-old man who presented with a chronic disruption of the distal triceps tendon with a gap of approximately 15 cm. The patient was diagnosed in another center with an inveterate breakage of the distal triceps tendon and was initially treated with an Achilles allograft that was complicated by a wound infection and required more than ten surgeries. Nearly 22 months after the initial trauma, and 12 months after the first surgery, we performed a reconstruction with an Achilles tendon allograft using the new technique of distal attachment. At the 12-month follow-up the patient presented a joint balance from -5º to 110º and presented with no pain. Conclusions: The use of an Achilles tendon allograft provides excellent results in complex distal triceps tendon ruptures. We report the use of a new technique to anchor a distal Achilles allograft. PMID:27148500

  19. Coupled variable selection for regression modeling of complex treatment patterns in a clinical cancer registry.

    PubMed

    Schmidtmann, I; Elsäßer, A; Weinmann, A; Binder, H

    2014-12-30

    For determining a manageable set of covariates potentially influential with respect to a time-to-event endpoint, Cox proportional hazards models can be combined with variable selection techniques, such as stepwise forward selection or backward elimination based on p-values, or regularized regression techniques such as component-wise boosting. Cox regression models have also been adapted for dealing with more complex event patterns, for example, for competing risks settings with separate, cause-specific hazard models for each event type, or for determining the prognostic effect pattern of a variable over different landmark times, with one conditional survival model for each landmark. Motivated by a clinical cancer registry application, where complex event patterns have to be dealt with and variable selection is needed at the same time, we propose a general approach for linking variable selection between several Cox models. Specifically, we combine score statistics for each covariate across models by Fisher's method as a basis for variable selection. This principle is implemented for a stepwise forward selection approach as well as for a regularized regression technique. In an application to data from hepatocellular carcinoma patients, the coupled stepwise approach is seen to facilitate joint interpretation of the different cause-specific Cox models. In conditional survival models at landmark times, which address updates of prediction as time progresses and both treatment and other potential explanatory variables may change, the coupled regularized regression approach identifies potentially important, stably selected covariates together with their effect time pattern, despite having only a small number of events. These results highlight the promise of the proposed approach for coupling variable selection between Cox models, which is particularly relevant for modeling for clinical cancer registries with their complex event patterns.

  20. Treatment with at Homeopathic Complex Medication Modulates Mononuclear Bone Marrow Cell Differentiation

    PubMed Central

    Cesar, Beatriz; Abud, Ana Paula R.; de Oliveira, Carolina C.; Cardoso, Francolino; Bernardi, Raffaello Popa Di; Guimarães, Fernando S. F.; Gabardo, Juarez; de Freitas Buchi, Dorly

    2011-01-01

    A homeopathic complex medication (HCM), with immunomodulatory properties, is recommended for patients with depressed immune systems. Previous studies demonstrated that the medication induces an increase in leukocyte number. The bone marrow microenvironment is composed of growth factors, stromal cells, an extracellular matrix and progenitor cells that differentiate into mature blood cells. Mice were our biological model used in this research. We now report in vivo immunophenotyping of total bone marrow cells and ex vivo effects of the medication on mononuclear cell differentiation at different times. Cells were examined by light microscopy and cytokine levels were measured in vitro. After in vivo treatment with HCM, a pool of cells from the new marrow microenvironment was analyzed by flow cytometry to detect any trend in cell alteration. The results showed decreases, mainly, in CD11b and TER-119 markers compared with controls. Mononuclear cells were used to analyze the effects of ex vivo HCM treatment and the number of cells showing ring nuclei, niche cells and activated macrophages increased in culture, even in the absence of macrophage colony-stimulating factor. Cytokines favoring stromal cell survival and differentiation in culture were induced in vitro. Thus, we observe that HCM is immunomodulatory, either alone or in association with other products. PMID:19736221

  1. Treatment of infantile spasms in tuberous sclerosis complex: dismal outcomes but future hope?

    PubMed

    Ess, Kevin C

    2009-02-01

    This commentary discusses a retrospective study by Muzykewicz et al. that details EEG results from children with infantile spasms in the setting of tuberous sclerosis complex (TSC). In this study, several factors were identified as being predictive of poor cognitive outcome, including worsening degree of hypsarrhythmia, abnormalities in EEG background activity, and incomplete response to vigabatrin. Notably, the majority of patients had a poor outcome, experiencing cognitive impairment and intractable epilepsy irrespective of whether they were treated with adrenocorticotropic hormone (corticotropin) or vigabatrin, despite the fact that vigabatrin has shown promise in previous studies. However, among the entire cohort a third of patients enjoyed greater than 1 year of seizure freedom and about a quarter had either mild or no cognitive impairment at follow-up. Overall, these findings underscore the great challenges that are faced in the treatment of infantile spasms in patients with TSC. I suggest that, while vigabatrin has been shown to have impressive short-term efficacy, the intractable seizures and cognitive impairment in many patients with TSC strongly indicate that new therapies and treatment strategies are urgently needed.

  2. Tailoring fly ash activated with bentonite as adsorbent for complex wastewater treatment

    NASA Astrophysics Data System (ADS)

    Visa, Maria

    2012-12-01

    Used as adsorbent, alkali fly ash represents a low cost solution for advanced wastewater treatment. The alkali treatment raises sustainability issues therefore, in this research we aim to replace alkali fly ash with washed fly ash (FAw). For improving the adsorption capacity of washed fly ash, bentonite powder (B) was added, as a natural adsorbent with a composition almost identical to the fly ash. The new adsorbent was characterized by AFM, XRD, FTIR, SEM, EDS and the surface energy was evaluated by contact angle measurements. For understanding the complex adsorption process on this mixed substrate, preliminary tests were developed on synthetic wastewaters containing a single pollutant system (heavy metal), binary (two-heavy metals) and ternary (dye and two heavy metals) systems. Experiments were done on synthetic wastewaters containing methylene blue, cadmium and copper, using FAw, B and their powder mixtures. The pseudo-second order kinetics could well model all the processes, indicating a good adsorbent material which can be used for the pollutants removal from wastewater. After adsorption the substrates loaded with pollutants, annealed at 500 °C can be reused for padding in stone blocks.

  3. Behavioural and EEG effects of chronic rapamycin treatment in a mouse model of tuberous sclerosis complex.

    PubMed

    Cambiaghi, Marco; Cursi, Marco; Magri, Laura; Castoldi, Valerio; Comi, Giancarlo; Minicucci, Fabio; Galli, Rossella; Leocani, Letizia

    2013-04-01

    Tuberous Sclerosis Complex (TSC) is a multisystem genetic disorder caused by mutation in either Tsc1 or Tsc2 genes that leads to the hyper activation of the mTOR pathway, a key signalling pathway for synaptic plasticity. TSC is characterized by benign tumors arising in different organs and severe neuropsychiatric symptoms, such as epilepsy, intellectual disability, autism, anxiety and depressive behaviour. Rapamycin is a potent inhibitor of mTOR and its efficacy in treating epilepsy and neurological symptoms remains elusive. In a mouse model in which Tsc1 has been deleted in embryonic telencephalic neural stem cells, we analyzed anxiety- and depression-like behaviour by elevated-plus maze (EPM), open-field test (OFT), forced-swim test (FST) and tail-suspension test (TST), after chronic administration of rapamycin. In addition, spectral analysis of background EEG was performed. Rapamycin-treated mutant mice displayed a reduction in anxiety- and depression-like phenotype, as shown by the EPM/OFT and FST, respectively. These results were inline with EEG power spectra outcomes. The same effects of rapamycin were observed in wild-type mice. Notably, in heterozygous animals we did not observe any EEG and/or behavioural variation after rapamycin treatment. Together these results suggest that both TSC1 deletion and chronic rapamycin treatment might have a role in modulating behaviour and brain activity, and point out to the potential usefulness of background EEG analysis in tracking brain dysfunction in parallel with behavioural testing.

  4. In vitro studies of lanthanide complexes for the treatment of osteoporosis.

    PubMed

    Mawani, Yasmin; Cawthray, Jacqueline F; Chang, Stanley; Sachs-Barrable, Kristina; Weekes, David M; Wasan, Kishor M; Orvig, Chris

    2013-05-07

    Lanthanide ions, Ln(III), are of interest in the treatment of bone density disorders because they are found to accumulate preferentially in bone (in vivo), have a stimulatory effect on bone formation, and exhibit an inhibitory effect on bone degradation (in vitro), altering the homeostasis of the bone cycle. In an effort to develop an orally active lanthanide drug, a series of 3-hydroxy-4-pyridinone ligands were synthesized and eight of these ligands (H1 = 3-hydroxy-2-methyl-1-(2-hydroxyethyl)-4-pyridinone, H2 = 3-hydroxy-2-methyl-1-(3-hydroxypropyl)-4-pyridinone, H3 = 3-hydroxy-2-methyl-1-(4-hydroxybutyl)-4-pyridinone, H4 = 3-hydroxy-2-methyl-1-(2-hydroxypropyl)-4-pyridinone, H5 = 3-hydroxy-2-methyl-1-(1-hydroxy-3-methylbutan-2-yl)-4-pyridinone, H6 = 3-hydroxy-2-methyl-1-(1-hydroxybutan-2-yl)-4-pyridinone, H7 = 1-carboxymethyl-3-hydroxy-2-methyl-4-pyridinone, H8 = 1-carboxyethyl-3-hydroxy-2-methyl-4-pyridinone) were coordinated to Ln(3+) (Ln = La, Eu, Gd, Lu) forming stable tris-ligand complexes (LnL(3), L = 1(-), 2(-), 3(-), 4(-), 5(-), 6(-), 7(-) and 8(-)). The dissociation (pK(an)) and metal ligand stability constants (log β(n)) of the 3-hydroxy-4-pyridinones with La(3+) and Gd(3+) were determined by potentiometric titrations, which demonstrated that the 3-hydroxy-4-pyridinones form stable tris-ligand complexes with the lanthanide ions. One phosphinate-EDTA derivative (H(5)XT = bis[[bis(carboxymethyl)amino]methyl]phosphinate) was also synthesized and coordinated to Ln(3+) (Ln = La, Eu, Lu), forming the potassium salt of [Ln(XT)](2-). Cytotoxicity assays were carried out in MG-63 cells; all the ligands and metal complexes tested were observed to be non-toxic to this cell line. Studies to investigate the toxicity, cellular uptake and apparent permeability (P(app)) of the lanthanide ions were conducted in Caco-2 cells where it was observed that [La(XT)](2-) had the greatest cell uptake. Binding affinities of free lanthanide ions (Ln = La, Gd and Lu), metal

  5. Sustained release of antibiotic complexed by multivalent ion: in vitro and in vivo study for the treatment of peritonitis.

    PubMed

    Na, Seung Yeon; Oh, Se Heang; Kim, Tae Ho; Yoon, Jin A; Lee, In Soo; Lee, Jin Ho

    2014-12-10

    The main aims of this study are (i) the development of an antibiotic complexed with multivalent ion, which can allow sustained release of the antibiotic without any additional matrix or difficult process and (ii) the feasibility study of the ion-complexed antibiotic as a therapeutic technique for peritonitis treatment. An ion-complexed antibiotic is prepared by simple mixing of two aqueous solutions containing an ionized (water-soluble) drug (tetracycline) and a multivalent counter ionic compound. The ion-complexed antibiotic shows a continuous release of the antibiotic up to 21 days, and thus prolonged anti-bacterial effect by gradual ionic exchange between the multivalent ions in the complex and same-charged monovalent ions in surrounding medium. From the in vivo animal study using a cecum perforated peritonitis mouse model, the ion-complexed antibiotic group shows sufficient anti-bacterial effect and thus effectively treat the peritonitis because of the extermination of the contaminated enteric bacteria in the peritoneum during wound healing of injury cecum (by the sustained release of antibiotic from the ion complex). These results suggest that the ion-complexed antibiotic system may be promising for the effective treatment of the peritonitis caused by frequent gastrointestinal defect in clinical fields.

  6. Peak Plasma Concentration of Azithromycin and Treatment Responses in Mycobacterium avium Complex Lung Disease.

    PubMed

    Jeong, Byeong-Ho; Jeon, Kyeongman; Park, Hye Yun; Moon, Seong Mi; Kim, Su-Young; Lee, Soo-Youn; Shin, Sung Jae; Daley, Charles L; Koh, Won-Jung

    2016-10-01

    Macrolides, such as azithromycin (AZM) and clarithromycin, are the cornerstones of treatment for Mycobacterium avium complex lung disease (MAC-LD). Current guidelines recommend daily therapy with AZM for cavitary MAC-LD and intermittent therapy for noncavitary MAC-LD, but the effectiveness of these regimens has not been thoroughly investigated. This study evaluated associations between microbiological response and estimated peak plasma concentrations (Cmax) of AZM. The AZM Cmax was measured in patients receiving daily therapy (250 mg of AZM daily, n = 77) or intermittent therapy (500 mg of AZM three times weekly, n = 89) for MAC-LD and daily therapy for Mycobacterium abscessus complex LD (MABC-LD) (250 mg of AZM daily, n = 55). The AZM Cmax was lower with the daily regimen for MAC-LD (median, 0.24 μg/ml) than with the intermittent regimen for MAC-LD (median, 0.65 μg/ml; P < 0.001) or daily therapy for MABC-LD (median, 0.53 μg/ml; P < 0.001). After adjusting for confounding factors, AZM Cmax was independently associated with favorable microbiological responses in MAC-LD patients receiving a daily regimen (adjusted odds ratio [aOR], 1.58; 95% confidence interval [CI], 1.01 to 2.48; P = 0.044) but not an intermittent regimen (aOR, 0.85; 95% CI, 0.58 to 1.23, P = 0.379). With the daily AZM-based multidrug regimen for MAC-LD, a low AZM Cmax was common, whereas a higher AZM Cmax was associated with favorable microbiologic responses. The results also suggested that the addition of rifampin may lower AZM Cmax When a daily AZM-based multidrug regimen is used for treating severe MAC-LD, such as cavitary disease, the currently recommended AZM dose might be suboptimal. (This study has been registered at ClinicalTrials.gov under identifier NCT00970801.).

  7. Amphotericin B Lipid Complex (Abelcet) in the treatment of invasive mycoses: the North American experience.

    PubMed

    Lister, J

    1996-01-01

    Abelcet, or Amphotericin B lipid Complex, is unique formulation, comprising an equimolar mixture of amphotericin B complexed with two lipids. In preclinical studies, Abelcet was clearly demonstrated to be less toxic than amphotericin B desoxycholate and to be effective in models where amphotericin B was ineffective at its maximum tolerated dose. Pharmacokinetic studies in animals also showed that the concentration of Abelcet in blood is similar or reduced compared to levels seen with conventional amphotericin B, with accumulation in the liver, lungs and spleen. Phase I clinical trials determined the optimum tolerated dose of Abelcet to be 5 mg/kg d-1. Data are now available for 228 cases (including 51 paediatric cases) of invasive fungal infection treated with Abelcet in an open-label emergency-release protocol. All patients had to have failed on previous amphotericin B or other conventional antifungals, or to have unacceptable toxicity on amphotericin B, or underlying renal disease, or nephrotoxicity due to other drugs. Abelcet was administered at a dose of 5 mg/kg d-1 for 4 wk. Approximately one-third of patients had candidiasis, one-third aspergillosis and one-third other infections, including fusariosis. Of 183 cases evaluable for response, 126 (69%) had a clinical response (cure or improvement) which was mycologically confirmed in 55% (61/110 tested). Results in paediatric cases were similar to or better than those seen in the group as a whole. When comparisons were made between cases with different types of infection, underlying disease/immunosuppressive disorder, and degree of neutropenia, the response rates were very consistent from group to group. Treatment with Abelcet was well tolerated and mean serum creatinine levels actually declined during therapy, particularly in patients with pre-existing renal dysfunction.

  8. [Application of bioregulating therapy in complex treatment of temporomandibular joint diseases in people of elderly and senile age].

    PubMed

    Iordanishvili, A K; Samsonov, V V; Soldatova, L N; Polens, A A; Ryzhak, G A

    2012-01-01

    The results of dynamic supervision over application a peptide bioregulator of "Sigumir" in complex treatment of 62 patients of the senior age groups with various diseases of a temporomandibular joint are presented. It is shown that application of a complex of treatment-and-prophylactic actions, including rational tooth prosthetics, functional and pharmacotherapy (including accompanying diseases), and also use a peptide bioregulator of cartilaginous and bone tissues "Sigumir" in complex therapy of patients with diseases of a temporomandibular joint of a various etiology, enables to stop in short-terms a painful syndrome in such patients, to increase amplitude of opening of a mouth, to improve chewing function, to reduce terms of treatment and to provide preventive maintenance of relapses of TMJ's pathology during all period of supervision.

  9. APINetworks: A general API for the treatment of complex networks in arbitrary computational environments

    NASA Astrophysics Data System (ADS)

    Niño, Alfonso; Muñoz-Caro, Camelia; Reyes, Sebastián

    2015-11-01

    The last decade witnessed a great development of the structural and dynamic study of complex systems described as a network of elements. Therefore, systems can be described as a set of, possibly, heterogeneous entities or agents (the network nodes) interacting in, possibly, different ways (defining the network edges). In this context, it is of practical interest to model and handle not only static and homogeneous networks but also dynamic, heterogeneous ones. Depending on the size and type of the problem, these networks may require different computational approaches involving sequential, parallel or distributed systems with or without the use of disk-based data structures. In this work, we develop an Application Programming Interface (APINetworks) for the modeling and treatment of general networks in arbitrary computational environments. To minimize dependency between components, we decouple the network structure from its function using different packages for grouping sets of related tasks. The structural package, the one in charge of building and handling the network structure, is the core element of the system. In this work, we focus in this API structural component. We apply an object-oriented approach that makes use of inheritance and polymorphism. In this way, we can model static and dynamic networks with heterogeneous elements in the nodes and heterogeneous interactions in the edges. In addition, this approach permits a unified treatment of different computational environments. Tests performed on a C++11 version of the structural package show that, on current standard computers, the system can handle, in main memory, directed and undirected linear networks formed by tens of millions of nodes and edges. Our results compare favorably to those of existing tools.

  10. [THE APPLICATION OF ANTIHOMOTOXIC DRUG PREPARATIONS IN THE COMPLEX TREATMENT IN PATIENTS WITH NEUROLOGICAL MANIFESTATIONS OF LUMBAR OSTEOCHONDROSIS].

    PubMed

    Nadkevich, A L; Babinets, L S

    2015-01-01

    The expediency of application homeosyniatry by preparations of Traumel S and Placenta Compositum after the offered chart in relation to a complex with classic acupuncture and in relation to the group of the generally accepted treatment has been proved in complex treatment patients with reflex syndromes of lumbar osteochondrosis. A similar conclusion was done after the statistically reliable (P < 0.05) dynamics of parameters of endogenous intoxication, liperoxydation and antioxydant systems of the protection (by the level of katalase, superoxyddismutase, SH-groups, ceruloplasmine).

  11. [Asthenic syndrome in clinical course of acute period of brain concussion during complex treatment using nootropic agents].

    PubMed

    Tkachov, A V

    2008-01-01

    The comparative analysis of a complex examination of 108 persons aged from 16 till 60 years in acute period of closed craniocerebral injury (CCCT) has been done. Every participants have been divided into 2 groups depending on a nootrop medication they receive in a complex treatment. A control group consisted of 30 practically healthy people. Objective examination by means of tests was done on the 1-st, 10-th that 30-th day of treatment. Patients of 1-st (37 persons) group received piracetam in complex treatment and patients of the 2-nd group (71 persons) pramistar. Patients of the first group received a base treatment (analgetics, tranquilizers, vitamins of group B, magnesium sulfate, diuretic preparations) as well as piracetam at dosage 0.2, two tablets three times per day. The Patients of the 2-nd group received a base treatment as well as pramistar at dosage 0.6, one tablet 2 times per day. Specially developed multiaspects scales and questionnaires, MRT of the brain and EEG have been used for objectification of patient, complaints. During a complex clinico-neuropsychological examination it was found that all cases of concussion of the brain are accompanied by those or other asthenic disorders.

  12. Giant and complex aneurysms treatment with preservation of flow via bypass technique.

    PubMed

    Thines, L; Proust, F; Marinho, P; Durand, A; van der Zwan, A; Regli, L; Lejeune, J-P

    2016-02-01

    Due to their anatomical characteristics and the complexity of the procedures required to obtain their complete occlusion, the treatment of giant intracranial aneurysms is a real challenge. Direct reconstructive strategies, whether by interventional neuroradiology (coils, stents) or microsurgical (clipping) means, are not always applicable and, in patients that would not tolerate parent or collateral artery sacrifice, the adjunction of a revascularization procedure using a bypass technique might be necessary. Cerebral arterial bypasses can be classified according to their function (3 types: flow replacement, flow reversal or protective), the branching mode of the graft used (3 types: pedicled, interpositional or in situ), the sites of anastomosis (2 types: extracranial-intracranial or intracranial-intracranial) and the class of flow they are supposed to provide (3 types: low-, intermediate- or high-flow). In this article, the authors review the different aspects in the management of patients with a giant intracranial aneurysm using a bypass: preoperative work-up, types of bypass and indications, surgical techniques and results.

  13. Treatment of intracellular Mycobacterium avium complex infection by free and liposome-encapsulated sparfloxacin.

    PubMed Central

    Düzgüneş, N; Flasher, D; Reddy, M V; Luna-Herrera, J; Gangadharam, P R

    1996-01-01

    Mycobacterium avium-M. intracellulare complex (MAC) is the most frequent cause of opportunistic bacterial infection in patients with AIDS. Previous studies have indicated that liposome-encapsulated aminoglycosides are highly effective in treating MAC infections in mice. We investigated whether the fluoroquinolone sparfloxacin is effective in treating MAC infection in the murine macrophage-like cell line J774. Sparfloxacin was encapsulated in the membrane phase of multilamellar liposomes composed of phosphatidylglycerol-phosphatidylcholine-cholesterol (1:1:1 molar ratio). MAC-infected macrophages were treated for either 24 h or 4 days with free or liposome-encapsulated sparfloxacin. Treatment with free or liposome-encapsulated sparfloxacin (6 micrograms/ml) for 24 h resulted in the reduction of the growth index to 25 and 30% of that of untreated controls, respectively. When cultures were treated for 4 days, free sparfloxacin reduced the growth index to 6% of that of the untreated control, while liposome-encapsulated sparfloxacin reduced it to 8% of that of the control. PMID:8913475

  14. Evolving paradigms in the treatment of relapsed/refractory multiple myeloma: increased options and increased complexity

    PubMed Central

    Cornell, R F; Kassim, A A

    2016-01-01

    The use of modern therapies such as thalidomide, bortezomib and lenalidomide coupled with upfront high-dose therapy and autologous stem cell transplant (ASCT) has resulted in improved survival in patients with newly diagnosed multiple myeloma (MM). However, patients with relapsed/refractory multiple myeloma (RRMM) often have poorer clinical outcomes and might benefit from novel therapeutic strategies. Emerging therapies, such as deacetylase inhibitors, monoclonal antibodies and new proteasome inhibitors, appear promising and may change the therapeutic landscape in RRMM. A limited number of studies has shown a benefit with salvage ASCT in patients with RRMM, although there remains ongoing debate about its timing and effectiveness. Improvement in transplant outcomes has re-ignited a debate on the timing and possible role for salvage ASCT and allogeneic stem cell transplant in RRMM. As the treatment options for management of patients with RRMM become increasingly complex, physicians must consider both disease- and patient-related factors in choosing the appropriate therapeutic approach, with the goal of improving efficacy while minimizing toxicity. PMID:26726946

  15. Successful treatment of complex traumatic and surgical wounds with a foetal bovine dermal matrix.

    PubMed

    Hayn, Ernesto

    2014-12-01

    A foetal bovine dermal repair scaffold (PriMatrix, TEI Biosciences) was used to treat complex surgical or traumatic wounds where the clinical need was to avoid skin flaps and to build new tissue in the wound that could be reepithelialised from the wound margins or closed with a subsequent application of a split-thickness skin graft (STSG). Forty-three consecutive cases were reviewed having an average size of 79·3 cm(2) , 50% of which had exposed tendon and/or bone. In a subset of wounds (44·7%), the implantation of the foetal dermal collagen scaffold was also augmented with negative pressure wound therapy (NPWT). Complete wound healing was documented in over 80% of the wounds treated, whether the wound was treated with the foetal bovine dermal scaffold alone (95·2%) or when supplemented with NPWT (82·4%). The scaffold successfully incorporated into wounds with exposed tendon and/or bone to build vascularised, dermal-like tissue. The new tissue in the wound supported STSGs however, in the majority of the cases (88·3%); wound closure was achieved through reepithelialisation of the incorporated dermal scaffold by endogenous wound keratinocytes. The foetal bovine dermal repair scaffold was found to offer an effective alternative treatment strategy for definitive closure of challenging traumatic or surgical wounds on patients who were not suitable candidates for tissue flaps.

  16. VAC therapy for the treatment of complex wounds after cardio-thoracic surgery.

    PubMed

    De Caridi, Giovanni; Serra, Raffaele; Massara, Mafalda; Barone, Mario; Grande, Raffaele; Butrico, Lucia; Mastroroberto, Pasquale; de Franciscis, Stefano; Monaco, Francesco

    2016-10-01

    The aim of this study is to report our experience about the treatment of complex sternal and thoracic wounds following cardiothoracic surgery, using vacuum-assisted closure (VAC therapy. Twelve patients presenting with sternal (five cases) and thoracic (seven cases) wounds that were difficult to heal were treated through VAC therapy after the first surgical debridement. The duration of VAC application ranged from 12 to 36 days with an average hospital stay of 24·6 ± 11·4 days. During a mean follow-up of 12 months, we observed complete wound healing in seven cases (58·3%), in an average period of 25·5 ± 14·3 days; one patient died during follow-up, two patients were lost to follow-up and two patients required definitive surgical closure of the wound cavity. In conclusion, VAC therapy promotes faster wound healing, with shorter hospital stay and subsequent lesser in-hospital cost, reducing the mortality rate in the long run. It also promotes early rehabilitation and alleviates the need for a second procedure, thus improving patient satisfaction, with minimal discomfort or inconvenience.

  17. Differentiating the mTOR inhibitors everolimus and sirolimus in the treatment of tuberous sclerosis complex.

    PubMed

    MacKeigan, Jeffrey P; Krueger, Darcy A

    2015-12-01

    Tuberous sclerosis complex (TSC) is a genetic autosomal dominant disorder characterized by benign tumor-like lesions, called hamartomas, in multiple organ systems, including the brain, skin, heart, kidneys, and lung. These hamartomas cause a diverse set of clinical problems based on their location and often result in epilepsy, learning difficulties, and behavioral problems. TSC is caused by mutations within the TSC1 or TSC2 genes that inactivate the genes' tumor-suppressive function and drive hamartomatous cell growth. In normal cells, TSC1 and TSC2 integrate growth signals and nutrient inputs to downregulate signaling to mammalian target of rapamycin (mTOR), an evolutionarily conserved serine-threonine kinase that controls cell growth and cell survival. The molecular connection between TSC and mTOR led to the clinical use of allosteric mTOR inhibitors (sirolimus and everolimus) for the treatment of TSC. Everolimus is approved for subependymal giant cell astrocytomas and renal angiomyolipomas in patients with TSC. Sirolimus, though not approved for TSC, has undergone considerable investigation to treat various aspects of the disease. Everolimus and sirolimus selectively inhibit mTOR signaling with similar molecular mechanisms, but with distinct clinical profiles. This review differentiates mTOR inhibitors in TSC while describing the molecular mechanisms, pathogenic mutations, and clinical trial outcomes for managing TSC.

  18. APINetworks Java. A Java approach to the efficient treatment of large-scale complex networks

    NASA Astrophysics Data System (ADS)

    Muñoz-Caro, Camelia; Niño, Alfonso; Reyes, Sebastián; Castillo, Miriam

    2016-10-01

    We present a new version of the core structural package of our Application Programming Interface, APINetworks, for the treatment of complex networks in arbitrary computational environments. The new version is written in Java and presents several advantages over the previous C++ version: the portability of the Java code, the easiness of object-oriented design implementations, and the simplicity of memory management. In addition, some additional data structures are introduced for storing the sets of nodes and edges. Also, by resorting to the different garbage collectors currently available in the JVM the Java version is much more efficient than the C++ one with respect to memory management. In particular, the G1 collector is the most efficient one because of the parallel execution of G1 and the Java application. Using G1, APINetworks Java outperforms the C++ version and the well-known NetworkX and JGraphT packages in the building and BFS traversal of linear and complete networks. The better memory management of the present version allows for the modeling of much larger networks.

  19. Heavy metal (Zn and Cu) complexation and molecular size distribution in wastewater treatment plant effluent.

    PubMed

    Chaminda, G G T; Nakajima, F; Furumai, H

    2008-01-01

    The size distributions of zinc and copper species in the effluent of a wastewater treatment plant were determined by a combination of ultrafiltration and chelating disk cartridge fractionation. The results showed that 75-87% of total Zn and 84-86% of total Cu were strongly complexed or particle-bound in the final effluents. It was also found that the major part of Cu was bound to ligands in the < 500 Da fraction while the trend for Zn was not so clear and exhibited significant seasonal variability. Labile Cu and Zn were detected not only in the smallest fraction (< 500 Da) but also in the larger fractions. It meant that the labile species in the effluent were not equivalent to free metal ions. Conditional stability constants and ligand concentrations were also determined from the measured metal concentrations by square wave anodic stripping voltammetry. Existence of two types of ligand for each metal was inferred from the experimental data. Conditional stability constant obtained for the stronger type Ligand of Zn was higher than that of Cu, although the estimated Ligand concentrations were almost similar.

  20. Determination of Stability Constants of Cadmium-Glycine Complexes by a Unified Treatment for Potentiometric and Polarographic Data

    NASA Astrophysics Data System (ADS)

    Zhang, Jian-min; Shi, Qiu-zhi

    2006-04-01

    The cadmium(II)-glycine system was studied by the two experimental techniques, ion sensitive electrode (ISE) and differential pulse polarography (DPP), and the experimental data obtained were used by a unified mathematical treatment to calculate the complex stability constants. The combination of the two techniques is of many advantages as ISE can be performed at low [LT]:[MT] ratios and significantly higher [MT], whereas DPP could be used well at large [LT]:[MT] ratios and much smaller [MT]. This makes it possible to study a metal-ligand system in a relatively broader range of experimental conditions that, in turn, provides more information about the metal-ligand system of interest. Applying the unified mathematical treatment to the cadmium-glycine system, two new complexes MHL and ML2(OH) as well as three complexes ML, ML2 and ML3, reported in literatures, could be modeled and all their stability constants have been refined.

  1. Intravenous regional block with phentolamine in the treatment of complex regional pain syndrome.

    PubMed

    Niaki, Asadollah Saadat; Bagherzadi, Kambiz; Momenzadeh, Sirous; Shahriyari, Hooshang; Dori, Mehrdad Mokarram

    2011-01-01

    Complex regional pain syndrome (CRPS) is a variety of painful conditions following injury which appears regionally having a distal predominance of abnormal findings. This study, evaluate the use of phentolamine for sympathetic block and regional anesthesia in treatment of CRPS related pain. In this study, 68 patients with CRPS who were referred to pain clinics of Imam Hossein and Akhtar Hospitals and Gandy Center of Surgery between 2003-2008 were evaluated. Forty three of 87 patients finally undertaken intravenous regional sympatholytic block according to therapeutic protocol. 37 patients (86%) received one block, 2 of them (4.75%) received 2 repetitions of blocks and finally repeated block for three times occurred in 4 patients (9.3%). A week after block pain relief outcomes was recorded as following; excellent in 7 patients (16.3%), good in the 32 patients (74.4%) and moderate in the 4 patients (9.3%). After a month, 8 patients (18.5%) showed excellent relief and it was good and moderate in 32 (78%) and one case (2.4%), respectively. Pain relief after three months was excellent, good and moderate in the 13 patients (31.7%), 25 patients (61%) and 3 patients (7.3%), respectively. In this study level of pain relief was significant in various intervals and it showed significant difference in relief three months after block (P=0.04). CRPS due to SMP(sympathetically maintained pain) is thought to be alleviated by phentolamine. Intravenous phentolamine infusion is potentially a new significant option for the therapy of CRPS.

  2. Computer-aided patch planning for treatment of complex coarctation of the aorta

    NASA Astrophysics Data System (ADS)

    Rietdorf, Urte; Riesenkampff, Eugénie; Kuehne, Titus; Huebler, Michael; Meinzer, Hans-Peter; Wolf, Ivo

    2009-02-01

    Between five and eight percent of all children born with congenitally malformed hearts suffer from coarctations of the aorta. Some severe coarctations can only be treated by surgical repair. Untreated, this defect can cause serious damage to organ development or even lead to death. Patch repair requires open surgery. It can affect patients of any age: newborns with severe coarctation and/or hypoplastic aortic arch as well as older patients with late diagnosis of coarctation of the aorta. Another patient group are patients of varying age with re-coarctation of the aorta or hypoplastic aortic arch after surgical and/or interventional repair. If anatomy is complex and interventional treatment by catheterization, balloon angioplasty or stent placement is not possible, surgery is indicated. The choice of type of surgery depends not only on the given anatomy but also on the experience the surgical team has with each method. One surgical approach is patch repair. A patch of a suitable shape and size is sewed into the aorta to expand the aortic lumen at the site of coarctation. At present, the shape and size of the patch are estimated intra-operatively by the surgeon. We have developed a software application that allows planning of the patch pre-operatively on the basis of magnetic resonance angiographic data. The application determines the diameter of the coarctation and/or hypoplastic segment and constructs a patch proposal by calculating the difference to the normal vessel diameter pre-operatively. Evaluation of MR angiographic datasets from 12 test patients with different kinds of aortic arch stenosis shows a divergence of only (1.5+/-1.2) mm in coarctation diameters between manual segmentations and our approach, with comparable time expenditure. Following this proposal the patch can be prepared and adapted to the patient's anatomy pre-operatively. Ideally, this leads to shorter operation times and a better long-term outcome with a reduced rate of residual stenosis and

  3. Generalization of the Activated Complex Theory of Reaction Rates. I. Quantum Mechanical Treatment

    DOE R&D Accomplishments Database

    Marcus, R. A.

    1964-01-01

    In its usual form activated complex theory assumes a quasi-equilibrium between reactants and activated complex, a separable reaction coordinate, a Cartesian reaction coordinate, and an absence of interaction of rotation with internal motion in the complex. In the present paper a rate expression is derived without introducing the Cartesian assumption. The expression bears a formal resemblance to the usual one and reduces to it when the added assumptions of the latter are introduced.

  4. Formulation, characterization and evaluation of cyclodextrin-complexed bendamustine-encapsulated PLGA nanospheres for sustained delivery in cancer treatment.

    PubMed

    Gidwani, Bina; Vyas, Amber

    2016-03-01

    PLGA nanospheres are considered to be promising drug carrier in the treatment of cancer. Inclusion complex of bendamustine (BM) with epichlorohydrin beta cyclodextrin polymer was prepared by freeze-drying method. Phase solubility study revealed formation of AL type complex with stability constant (Ks = 645 M(-1)). This inclusion complex was encapsulated into PLGA nanospheres using solid-in-oil-in-water (S/O/W) technique. The particle size and zeta potential of PLGA nanospheres loaded with cyclodextrin-complexed BM were about 151.4 ± 2.53 nm and - 31.9 ± (-3.08) mV. In-vitro release study represented biphasic release pattern with 20% burst effect and sustained slow release. DSC studies indicated that inclusion complex incorporated in PLGA nanospheres was not in a crystalline state but existed in an amorphous or molecular state. The cytotoxicity experiment was studied in Z-138 cells and IC50 value was found to be 4.3 ± 0.11 µM. Cell viability studies revealed that the PLGA nanospheres loaded with complex exerts a more pronounced effect on the cancer cells as compared to the free drug. In conclusion, PLGA nanospheres loaded with inclusion complex of BM led to sustained drug delivery. The nanospheres were stable after 3 months of storage conditions with slight change in their particle size, zeta potential and entrapment efficiency.

  5. Complexation of rice starch/flour and maize oil through heat moisture treatment: Structural, in vitro digestion and physicochemical properties.

    PubMed

    Chen, Xu; He, Xiaowei; Fu, Xiong; Zhang, Bin; Huang, Qiang

    2017-05-01

    This study investigated structural, in vitro digestion and physicochemical properties of normal rice starch (NRS)/flour (NRF) complexed with maize oil (MO) through heat-moisture treatment (HMT). The NRS-/NRF-MO complex displayed an increased pasting temperature and a decreased peak viscosity. After HMT, less ordered Maltese and more granule fragments were observed for NRS-/NRF-MO complex. Meanwhile, more aggregation was observed in the HMT samples with higher moisture contents. We found that higher onset temperature, lower enthalpy change and relative crystallinity of the NRS-/NRF-MO complex were associated with a higher moisture content of HMT samples. The higher moisture content of HMT was also favorable for the amylose-lipid complex formation. Differences in starch digestion properties were found for NRS-MO and NRF-MO complex. All of the NRS/NRF complexed MO after cooking showed lower rapidly digestible starch (RDS) contents compared with the control sample, therein NRS-/NRF- MO 20% exhibited the highest sum of the slowly digestible starch and resistant starch contents. In general, HMT had a greater impact on the in vitro digestion and physicochemical properties of flour samples compared with starch counterparts.

  6. Treatment of complex periorbital venolymphatic malformation in a neonate with a combination therapy of sirolimus and prednisolone.

    PubMed

    Kim, David; Benjamin, Latanya; Wysong, Ashley; Hovsepian, David; Teng, Joyce

    2015-01-01

    Venolymphatic malformations (VLMs) are vascular anomalies consisting of both veins and lymph vessels. A 2-week-old newborn presented with large VLMs on the left forehead, temple, preauricular area, and orbit. Patient was at imminent risk for permanent vision loss due to a localized mass effect. Surgical excision or debulking was contraindicated due to its complexity and proximity to the left eye, and the patient failed to respond to the sildenafil treatment and sclerotherapy. Patient was subsequently started on oral sirolimus 0.8 mg/m(2) twice daily in combination with prednisolone 2 mg/kg daily. The patient had an excellent therapeutic outcome for 7 months with complete preservation of vision before treatment was discontinued. However, 2 months after the medical treatments were discontinued, her VLM rebounded. She responded to the combination therapy again after a failed treatment with the mTOR inhibitor alone. This case demonstrates that the sirolimus and prednisolone combination therapy could be beneficial for treatment of complex VLM intractable to other treatments.

  7. Quality assurance for high dose rate brachytherapy treatment planning optimization: using a simple optimization to verify a complex optimization.

    PubMed

    Deufel, Christopher L; Furutani, Keith M

    2014-02-07

    As dose optimization for high dose rate brachytherapy becomes more complex, it becomes increasingly important to have a means of verifying that optimization results are reasonable. A method is presented for using a simple optimization as quality assurance for the more complex optimization algorithms typically found in commercial brachytherapy treatment planning systems. Quality assurance tests may be performed during commissioning, at regular intervals, and/or on a patient specific basis. A simple optimization method is provided that optimizes conformal target coverage using an exact, variance-based, algebraic approach. Metrics such as dose volume histogram, conformality index, and total reference air kerma agree closely between simple and complex optimizations for breast, cervix, prostate, and planar applicators. The simple optimization is shown to be a sensitive measure for identifying failures in a commercial treatment planning system that are possibly due to operator error or weaknesses in planning system optimization algorithms. Results from the simple optimization are surprisingly similar to the results from a more complex, commercial optimization for several clinical applications. This suggests that there are only modest gains to be made from making brachytherapy optimization more complex. The improvements expected from sophisticated linear optimizations, such as PARETO methods, will largely be in making systems more user friendly and efficient, rather than in finding dramatically better source strength distributions.

  8. Quality assurance for high dose rate brachytherapy treatment planning optimization: using a simple optimization to verify a complex optimization

    NASA Astrophysics Data System (ADS)

    Deufel, Christopher L.; Furutani, Keith M.

    2014-02-01

    As dose optimization for high dose rate brachytherapy becomes more complex, it becomes increasingly important to have a means of verifying that optimization results are reasonable. A method is presented for using a simple optimization as quality assurance for the more complex optimization algorithms typically found in commercial brachytherapy treatment planning systems. Quality assurance tests may be performed during commissioning, at regular intervals, and/or on a patient specific basis. A simple optimization method is provided that optimizes conformal target coverage using an exact, variance-based, algebraic approach. Metrics such as dose volume histogram, conformality index, and total reference air kerma agree closely between simple and complex optimizations for breast, cervix, prostate, and planar applicators. The simple optimization is shown to be a sensitive measure for identifying failures in a commercial treatment planning system that are possibly due to operator error or weaknesses in planning system optimization algorithms. Results from the simple optimization are surprisingly similar to the results from a more complex, commercial optimization for several clinical applications. This suggests that there are only modest gains to be made from making brachytherapy optimization more complex. The improvements expected from sophisticated linear optimizations, such as PARETO methods, will largely be in making systems more user friendly and efficient, rather than in finding dramatically better source strength distributions.

  9. [Prolonged blockade of nervus ischiadicus in a system of complex treatment of patients, suffering complicated diabetic foot syndrome].

    PubMed

    Shapoval, S D; Savon, I L; Sofilkanych, M M

    2015-03-01

    General principles of treatment in patients, suffering diabetic foot syndrome, are adduced. There was proved, that reconvalescence of the patients depends not only on quality of complex treatment, but from optimal choice of anesthesia method, its impact on postoperative period course. Application of prolonged blockade of n. ischiadicus gives possibility to perform operative intervention on the lower extremity in full volume, guarantees sufficient motor and sensory block, permits patients to reject from application of narcotic analgetics, to reduce the dose of strong nonnarcotic analgetics, the terms of transition of the wound process phase I into phase II, promotes early activization of patients postoperatively, constitutes alternative for other methods of anesthesiological support.

  10. Technology Evaluation for the Big Spring Water Treatment System at the Y-12 National Security Complex, Oak Ridge, Tennessee

    SciTech Connect

    Becthel Jacobs Company LLC

    2002-11-01

    The Y-12 National Security Complex (Y-12 Complex) is an active manufacturing and developmental engineering facility that is located on the U.S. Department of Energy (DOE) Oak Ridge Reservation. Building 9201-2 was one of the first process buildings constructed at the Y-12 Complex. Construction involved relocating and straightening of the Upper East Fork Poplar Creek (UEFPC) channel, adding large quantities of fill material to level areas along the creek, and pumping of concrete into sinkholes and solution cavities present within the limestone bedrock. Flow from a large natural spring designated as ''Big Spring'' on the original 1943 Stone & Webster Building 9201-2 Field Sketch FS6003 was captured and directed to UEFPC through a drainpipe designated Outfall 51. The building was used from 1953 to 1955 for pilot plant operations for an industrial process that involved the use of large quantities of elemental mercury. Past operations at the Y-12 Complex led to the release of mercury to the environment. Significant environmental media at the site were contaminated by accidental releases of mercury from the building process facilities piping and sumps associated with Y-12 Complex mercury handling facilities. Releases to the soil surrounding the buildings have resulted in significant levels of mercury in these areas of contamination, which is ultimately transported to UEFPC, its streambed, and off-site. Bechtel Jacobs Company LLC (BJC) is the DOE-Oak Ridge Operations prime contractor responsible for conducting environmental restoration activities at the Y-12 Complex. In order to mitigate the mercury being released to UEFPC, the Big Spring Water Treatment System will be designed and constructed as a Comprehensive Environmental Response, Compensation, and Liability Act action. This facility will treat the combined flow from Big Spring feeding Outfall 51 and the inflow now being processed at the East End Mercury Treatment System (EEMTS). Both discharge to UEFPC adjacent to

  11. Predicting stabilizing treatment outcomes for complex posttraumatic stress disorder and dissociative identity disorder: an expertise-based prognostic model.

    PubMed

    Baars, Erik W; van der Hart, Onno; Nijenhuis, Ellert R S; Chu, James A; Glas, Gerrit; Draijer, Nel

    2011-01-01

    The purpose of this study was to develop an expertise-based prognostic model for the treatment of complex posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). We developed a survey in 2 rounds: In the first round we surveyed 42 experienced therapists (22 DID and 20 complex PTSD therapists), and in the second round we surveyed a subset of 22 of the 42 therapists (13 DID and 9 complex PTSD therapists). First, we drew on therapists' knowledge of prognostic factors for stabilization-oriented treatment of complex PTSD and DID. Second, therapists prioritized a list of prognostic factors by estimating the size of each variable's prognostic effect; we clustered these factors according to content and named the clusters. Next, concept mapping methodology and statistical analyses (including principal components analyses) were used to transform individual judgments into weighted group judgments for clusters of items. A prognostic model, based on consensually determined estimates of effect sizes, of 8 clusters containing 51 factors for both complex PTSD and DID was formed. It includes the clusters lack of motivation, lack of healthy relationships, lack of healthy therapeutic relationships, lack of other internal and external resources, serious Axis I comorbidity, serious Axis II comorbidity, poor attachment, and self-destruction. In addition, a set of 5 DID-specific items was constructed. The model is supportive of the current phase-oriented treatment model, emphasizing the strengthening of the therapeutic relationship and the patient's resources in the initial stabilization phase. Further research is needed to test the model's statistical and clinical validity.

  12. Ultrasonography-guided pulsed radiofrequency of sciatic nerve for the treatment of complex regional pain syndrome Type II

    PubMed Central

    Choi, Yi Hwa; Chang, Dong Jin; Hwang, Woon Suk; Chung, Jin Hwan

    2017-01-01

    Although the major mechanism of complex regional pain syndrome (CRPS) involves dysfunctional central or sympathetic nervous system activation, the peripheral nervous system also contributes significantly to its clinical manifestations. Pulsed radiofrequency (PRF) is a recently developed treatment option for neuropathic pain syndromes. Here, we report a case of CRPS Type II after a femur fracture and sciatic nerve injury, in which the pain was treated successfully with ultrasonography-guided selective sciatic nerve PRF application. PMID:28217060

  13. [Class II malocclusion: some aspects of diagnostics and complex orthodontic and surgical treatment].

    PubMed

    Zorich, M E; Iatskevich, O S; Ivanov, S Iu; Muraev, A A

    2014-01-01

    Class II malocclusions are of interest to the practicing orthodontists since they constitute a significant percentage of the cases they treat. The process of establishing a treatment plan requires an assessment of therapeutic modifiability. The purpose of this article is to provide a perspective on the characteristics, development, etiology and broad treatment consideration in Class II malocclusions.

  14. Acute and Chronic Treatments with Quetiapine Increase Mitochondrial Respiratory Chain Complex Activity in the Rat Brain.

    PubMed

    Ignácio, Zuleide M; Réus, Gislaine Z; Abelaira, Helena M; Titus, Stephanie E; Carlessi, Anelise S; da Luz, Jaine R; Matias, Beatriz I; Bruchchen, Livia; Carvalho-Silva, Milena; Gomes, Lara M; Rebelo, Joyce; Streck, Emilio L; Quevedo, João

    2015-01-01

    Several studies have found that the molecular mechanisms of mitochondrial energy metabolism are impaired in major depressive disorder (MDD). Classic antidepressants and atypical antipsychotics can alter the function of enzymes involved in adenosine triphosphate (ATP) metabolism. Quetiapine is an atypical antipsychotic that, in addition to having a therapeutic benefit in treating MDD, appears to exert antioxidant and neuroprotective effects. Therefore, we aimed to evaluate the acute and chronic effects of quetiapine on the activity of enzyme complexes I to IV of the mitochondrial respiratory chain and creatine kinase (CK) in brain regions involved with MDD. After a single dose or serial injections over 14 days of quetiapine (20, 40, and 80 mg) were administered, isolates from the pre- frontal cortex, hippocampus, amygdala and nucleus accumbens were analyzed for enzyme activity levels. The enzyme activity varied according to the dose, brain region, and acute or chronic dosing protocols. In general, complexes I-III activity was increased, especially after acute administration. Acute administration also increased the activity of complex IV and CK in the amygdala while complex I was inhibited in the prefrontal cortex and nucleus accumbens. These results suggest that quetiapine produces an increase in respiratory chain complex activity, which may be underlying its efficacy against psychiatric disorders and neuronal damage.

  15. Personality features, dissociation, self-stigma, hope, and the complex treatment of depressive disorder

    PubMed Central

    Prasko, Jan; Ociskova, Marie; Grambal, Ales; Sigmundova, Zuzana; Kasalova, Petra; Marackova, Marketa; Holubova, Michaela; Vrbova, Kristyna; Latalova, Klara; Slepecky, Milos

    2016-01-01

    Objective Identifying the predictors of response to psychiatric and psychotherapeutic treatments may be useful for increasing treatment efficacy in pharmacoresistant depressive patients. The goal of this study was to examine the influence of dissociation, hope, personality trait, and selected demographic factors in treatment response of this group of patients. Methods Pharmacoresistant depressive inpatients were enrolled in the study. All patients completed Clinical Global Impression – both objective and subjective form (CGI), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) at baseline and after 6 weeks of combined pharmacotherapy and psychotherapy (group cognitive-behavioral or group psychodynamic) treatment as an outcome measures. The Internalized Stigma of Mental Illness Scale (ISMI), Dissociative Experience Scale (DES), Adult Dispositional Hope Scale (ADHS), and Temperament and Character Inventory (TCI-R) were completed at the start of the treatment with the intention to find the predictors of treatment efficacy. Results The study included 72 patients who were hospitalized for the pharmacoresistant major depression; 63 of them completed the study. The mean scores of BDI-II, BAI, subjCGI, and objCGI significantly decreased during the treatment. BDI-II relative change statistically significantly correlated with the total ISMI score, Discrimination Experience (ISMI subscale), and Harm Avoidance (TCI-R personality trait). According to stepwise regression, the strongest factors connected to BDI-II relative change were the duration of the disorder and Discrimination Experience (domain of ISMI). ObjCGI relative change significantly correlated with the level of dissociation (DES), the total ISMI score, hope in ADHS total score, and Self-Directedness (TCI-R). According to stepwise regression, the strongest factor connected to objCGI relative change was Discrimination Experience (domain of ISMI). The existence of comorbid personality disorder did not

  16. [Complex treatment of a large radicular cyst in the anterior region of the maxilla. Case report].

    PubMed

    Szekeres, Györgyi; Tamás, Würsching; Nemes, Júlia; Tóth, Zsuzsanna

    2015-09-01

    As opposed to other odontogenic cysts, the radicular cyst is always produced by intraradicular infection, therefore it is important to eliminate the cause of the inflammation as well. During the healing of the radicular cyst, the infected tooth should be treated by extraction or root canal treatment completed by surgical intervention. The presented case is a 77 year-old male patient with Type II Diabetes, who required oral surgery and endodontic treatment. Despite of the age and diabetes of the patient, the bone regeneration was rapid and complete. Seven months after starting the treatment, the size of the cyst decresed significantly and by 12th month it was perfectly healed.

  17. Image analysis-derived metrics of histomorphological complexity predicts prognosis and treatment response in stage II-III colon cancer

    PubMed Central

    Mezheyeuski, Artur; Hrynchyk, Ina; Karlberg, Mia; Portyanko, Anna; Egevad, Lars; Ragnhammar, Peter; Edler, David; Glimelius, Bengt; Östman, Arne

    2016-01-01

    The complexity of tumor histomorphology reflects underlying tumor biology impacting on natural course and response to treatment. This study presents a method of computer-aided analysis of tissue sections, relying on multifractal (MF) analyses, of cytokeratin-stained tumor sections which quantitatively evaluates of the morphological complexity of the tumor-stroma interface. This approach was applied to colon cancer collection, from an adjuvant treatment randomized study. Metrics obtained with the method acted as independent markers for natural course of the disease, and for benefit of adjuvant treatment. Comparative analyses demonstrated that MF metrics out-performed standard histomorphological features such as tumor grade, budding and configuration of invasive front. Notably, the MF analyses-derived “αmax” –metric constitutes the first response-predictive biomarker in stage II-III colon cancer showing significant interactions with treatment in analyses using a randomized trial-derived study population. Based on these results the method appears as an attractive and easy-to-implement tool for biomarker identification. PMID:27805003

  18. Towards a density functional treatment of chemical reactions in complex media

    SciTech Connect

    Berard, D.R.; Wei, D.; Salahub, D.R. |

    1996-12-31

    We discuss two techniques involving density functional theory (i.e., ab initio molecular dynamics simulations and frozen density functional theory) which show promise for applications directed towards understanding reactions in complex media. Preliminary results for the simulation of the conformational dynamics of an isolated analogue of alanine dipeptide and for the interaction between F{sup -} and H{sub 2}O are included. These results represent the first steps towards a combined theoretical approach of reactions in complex media. 23 refs., 4 figs.

  19. [Comparative assessment of conservative treatment of chronic prostatitis with application of complex unit andro-gin].

    PubMed

    Golubchikova, V A; Alekseev, M Ia; Sitnikov, N V; Kochetov, A G; Podgornyĭ, V F

    2000-01-01

    The Andro-Gin unit used in combined treatment of 78 patients with chronic prostatitis (CP) and 16 women with chronic interstitial cystitis with inflammation in the internal genitalia (56.5% of the patients had sexual and spermatogenesis disorders) employed effects of simultaneous exposure to local magnetic field, electrostimulation of the small pelvis organs and prostate with introduction of contact rectal electrode, neurostimulation of pathogenic zones, low-intensity laser and light-diode radiator and color impulse therapy. Control group consisted of 85 patients with CP who received conventional physiotherapy. The comparative analysis has shown high efficiency of the unit Andro-Gin in the treatment of CP and its complications. Laboratory and clinical convalescence and persistent remission was registered in 98% of the patients of the study group. Combined treatment using Andro-Gin is twice more effective than other treatments.

  20. [Nutricional support in the complex treatment of a patient with esophageal spasm].

    PubMed

    Firsova, L D; Ianova, O B; Vasnev, O S; Kostiuchenko, L N; Pichugina, I M; Efremov, L I

    2013-01-01

    In the presented clinical case the theme of the need for an integrated therapeutic intervention has been disclosed, including nutritional support on the various links of the pathogenesis of esophagospasm to the effectiveness of the patient's treatment.

  1. Felodipine β-cyclodextrin complex as an active core for time delayed chronotherapeutic treatment of hypertension.

    PubMed

    Pagar, Kunal P; Vavia, Pradeep R

    2012-11-01

    The present research work deals with the development of a time delayed chronotherapeutic formulation of felodipine (FD) aimed at rapid drug release after a desired lag time in the management of hypertension. The developed system comprises a drug core embedded within a swellable layer and coated with an insoluble, water permeable polymeric system. FD cyclodextrin complex was used as an active core while ethyl cellulose was used as an effective coating layer. Dissolution studies of the complex revealed that there was a 3-fold increase in dissolution of the complex compared to plain FD. This dissolution enhancement and rapid drug release resulted from FD amorphisation, as confirmed by XRD, DSC and SEM studies. FTIR and ¹H NMR studies confirmed the complex formation between FD and cyclodextrin based on the observed hydrogen bond interactions. FD release was adequately adjusted by using a pH independent polymer, i.e., ethyl cellulose, along with dibutyl phthalate as plasticizer. Influence of formulation variables like polymer viscosity, plasticizer concentration, super disintegrant concentration in the swellable layer and percent coating weight gain was investigated to characterize the lag time. Upon permeation of water, the core tablet swelled, resulting in the rupture of the coating layer, followed by rapid drug release. The developed formulation of FD showed a lag time of 5-7 h, which is desirable for chronotherapeutic application.

  2. Combining Propensity Score Methods and Complex Survey Data to Estimate Population Treatment Effects

    ERIC Educational Resources Information Center

    Stuart, Elizabeth A.; Dong, Nianbo; Lenis, David

    2016-01-01

    Complex surveys are often used to estimate causal effects regarding the effects of interventions or exposures of interest. Propensity scores (Rosenbaum & Rubin, 1983) have emerged as one popular and effective tool for causal inference in non-experimental studies, as they can help ensure that groups being compared are similar with respect to a…

  3. The Prescribed Pediatric Center: A Medical Day Treatment Program for Children with Complex Medical Conditions.

    ERIC Educational Resources Information Center

    Ruppert, Elizabeth S.; Karst, Thomas O.; Brogan, Mark G.

    1998-01-01

    The Prescribed Pediatric Center (Toledo, Ohio) is a community-based, multidisciplinary program for infants and children with chronic, complex medical conditions. This article describes program beginnings; the planning process; and the program's growth, development, and components. Initial program evaluation indicates positive effects on some…

  4. Complex I Disorders: Causes, Mechanisms, and Development of Treatment Strategies at the Cellular Level

    ERIC Educational Resources Information Center

    Valsecchi, Federica; Koopman, Werner J. H.; Manjeri, Ganesh R.; Rodenburg, Richard J.; Smeitink, Jan A. M.; Willems, Peter H. G. M.

    2010-01-01

    Mitochondrial oxidative phosphorylation (OXPHOS) represents the final step in the conversion of nutrients into cellular energy. Genetic defects in the OXPHOS system have an incidence between 1:5,000 and 1:10,000 live births. Inherited isolated deficiency of the first complex (CI) of this system, a multisubunit assembly of 45 different proteins,…

  5. Generalization of the Activated Complex Theory of Reaction Rates. II. Classical Mechanical Treatment

    DOE R&D Accomplishments Database

    Marcus, R. A.

    1964-01-01

    In its usual classical form activated complex theory assumes a particular expression for the kinetic energy of the reacting system -- one associated with a rectilinear motion along the reaction coordinate. The derivation of the rate expression given in the present paper is based on the general kinetic energy expression.

  6. Multiple D2 heteroreceptor complexes: new targets for treatment of schizophrenia

    PubMed Central

    Borroto-Escuela, Dasiel O.; Pintsuk, Julia; Schäfer, Thorsten; Friedland, Kristina; Ferraro, Luca; Tanganelli, Sergio; Liu, Fang; Fuxe, Kjell

    2016-01-01

    The dopamine (DA) neuron system most relevant for schizophrenia is the meso-limbic-cortical DA system inter alia densely innervating subcortical limbic regions. The field of dopamine D2 receptors and schizophrenia changed markedly with the discovery of many types of D2 heteroreceptor complexes in subcortical limbic areas as well as the dorsal striatum. The results indicate that the D2 is a hub receptor which interacts not only with many other G protein-coupled receptors (GPCRs) including DA isoreceptors but also with ion-channel receptors, receptor tyrosine kinases, scaffolding proteins and DA transporters. Disturbances in several of these D2 heteroreceptor complexes may contribute to the development of schizophrenia through changes in the balance of diverse D2 homo- and heteroreceptor complexes mediating the DA signal, especially to the ventral striato-pallidal γ-aminobutyric acid (GABA) pathway. This will have consequences for the control of this pathway of the glutamate drive to the prefrontal cortex via the mediodorsal thalamic nucleus which can contribute to psychotic processes. Agonist activation of the A2A protomer in the A2A–D2 heteroreceptor complex inhibits D2 Gi/o mediated signaling but increases the D2 β-arrestin2 mediated signaling. Through this allosteric receptor–receptor interaction, the A2A agonist becomes a biased inhibitory modulator of the Gi/o mediated D2 signaling, which may the main mechanism for its atypical antipsychotic properties especially linked to the limbic A2A–D2 heterocomplexes. The DA and glutamate hypotheses of schizophrenia come together in the signal integration in D2–N-methyl-d-aspartate (NMDA) and A2A–D2–metabotropic glutamate receptor 5 (mGlu5) heteroreceptor complexes, especially in the ventral striatum. 5-Hydroxytryptamine 2A (5-HT2A)–D2 heteroreceptor complexes are special targets for atypical antipsychotics with high potency to block their 5-HT2A protomer signaling in view of the potential development of

  7. Efficacy of ketoprofen administered in drinking water at a low dose for the treatment of porcine respiratory disease complex.

    PubMed

    Salichs, M; Sabaté, D; Homedes, J

    2013-09-01

    The purpose of this study was to evaluate the efficacy of an oral solution of ketoprofen administered in drinking water at a lower dose as a complement to antimicrobial therapy in a mild outbreak of porcine respiratory disease complex. The study was performed with 120 pigs with rectal temperature between 39.9 and 41°C and at least 1 sign indicating porcine respiratory disease complex (dyspnea, cough, nasal discharge, or depression). Animals were randomly allocated in 2 groups (treated and control group). Animals in both groups received etiological therapy with doxycycline at 10 mg · kg(-1) in drinking water for 5 d. The animals in the treated group also received 1.5 mg · kg(-1) of ketoprofen during the first 3 d. The reduction in rectal temperature in the treated group was significantly greater during the days of ketoprofen administration and up to 1 d after the end of treatment (P < 0.05). The percentage of dyspneic animals was significantly less (P < 0.05) in the treated group from d 2 to 5 of the study. Also, a significant improvement regarding depression and cough was seen in the animals of the treated group. No statistically significant (P > 0.05) differences were evidenced in productive variables. In conclusion, oral treatment with ketoprofen at 1.5 mg · kg(-1) in combination with antimicrobial therapy was found to be a clinically effective approach in outbreaks of mild porcine respiratory disease complex.

  8. Operative versus non-operative treatment in complex proximal humeral fractures: a meta-analysis of randomized controlled trials.

    PubMed

    Xie, Lin; Ding, Fan; Zhao, Zhigang; Chen, Yan; Xing, Danmou

    2015-01-01

    Whether operative treatment for complex proximal humeral fractures (CPHFs) has a greater benefit over non-operative treatment remains controversial. There is no consensus on the optimal treatment in elderly patients with CPHFs. This updated meta-analysis of randomized controlled trials (RCTs) aims to investigate whether operative treatment is superior to non-operative treatment in CPHFs. The authors searched RCTs in the electronic databases (Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Medline, Embase, Springer Link, Web of Knowledge, OVID and Google Scholar) from their establishment to July 2015. Researches on operative and non-operative treatment for CPHFs were selected in this meta-analysis. The quality of all studies was assessed and effective data was pooled for this meta-analysis. Outcome measurements were functional status include constant scores (CS scores) and disabilities of the arm, shoulder and hand scores (DASH scores), total complication rates and healthy-related quality of life. The meta-analysis was performed with software revman 5.3. Nine articles with a total 518 patients (average age 70.93) met inclusion criteria. Patients were followed up for at least 1 year in all the studies. No statistical differences were found between operative and non-operative treatment in CS scores at 12 mo (months) [MD 1.06 95 % CI (-3.51, 5.62)] and 24 mo [MD -0.61 95 % CI (-5.87, 4.65)]. There are also no statistical differences between operative and non-operative treatment in DASH scores at 12 mo [MD -4.51 95 % CI (-13.49, 4.47)] and 24 mo [MD -7.43 95 % CI (-16.14, 1.27)]. Statistical differences were found between operative and non-operative treatment in total complication rates [RR 1.55, 95 % CI (1.24, 1.94)]. Statistical differences in EQ-5D at 24 mo [MD 0.15, 95 % CI (0.05, 0.24)] were found between operative and non-operative treatment but no statistical differences were found in ED-5D at 12 mo [MD 0.08, 95 % CI (-0.01, 0.17)], 15D at

  9. The diverse and complex roles of radiation on cancer treatment: therapeutic target and genome maintenance

    PubMed Central

    Baskar, Rajamanickam; Yap, Swee Peng; Chua, Kevin Lee Min; Itahana, Koji

    2012-01-01

    Cancer is a genetic disease, grows exponentially with the development of intrinsic and acquired treatment resistance. Past decade has witnessed a considerable progress towards the treatment and understanding of proposed hallmarks of cancer and together with advances in early detection and various treatment modalities. Radiation therapy is an integral part of cancer treatment armamentarium. In developed countries more than half of all cancer patients receive radiation therapy during their course of illness. Although radiation damages both cancer and normal cells, the goal of radiation therapy is to maximize the radiation dose to abnormal cancer cells while minimizing exposure to normal cells, which is adjacent to cancer cells or in the path of radiation. In recent years, life expectancy increases among cancer patients and this increase is due to the results of early diagnosis, screening efforts, improved treatments and with less late effects mostly secondary cancer development. Therefore, cancer survivorship issues have been gaining prominence in the area of radiation oncology research. Understanding the tradeoff between the expected decreases in normal tissue toxicity resulting from an improved radiation dose distribution to the targeted site is an increasingly pertinent, yet needed attention and research in the area of radiation oncology. In recent years, a number of potential molecular targets that involve either with radiation increased tumor cell killing or protecting normal cells have been identified. For clinical benefits, translating these findings to maximize the toxicity of radiation on tumor cells while safeguarding early or late normal cell toxicities using molecular targeted radioprotectors will be useful in radiation treatment. PMID:22860229

  10. Surgical treatment of complex proximal humeral fractures with a technique of nail and osteosuture: "NOS".

    PubMed

    Garret, J; Houdré, H; Cievet-Bonfils, M; Godenèche, Arnaud; Duparc, Fabrice; Roussignol, Xavier

    2017-03-14

    Open reduction and internal fixation of complex proximal humeral fracture represents a surgical challenge. The main objective of this procedure is to anatomically reduce the tuberosities. We propose a standardized and reproducible technique that we apply to all complex displaced 3- and 4-part fractures of patients under 50 years. We use an antero-lateral trans-deltoid approach; the humeral head and the tuberosities are reduced under fluoroscopic control. The tuberosities are stabilized with an inter-tuberosity osteosuture, and we then introduce a thin and straight intra-medullary nail (Telegraph IV FH Orthopedics) at the hinge point of the humeral head. The osteosynthesis of the tuberosities is completed by 3- or 4-self-stable divergent screws in the nail. A dynamic distal locking stabilizes the humeral shaft in rotation and facilitates consolidation thanks to micro movements. The removal of the nail with an arthroscopic shoulder arthrolysis in case of stiffness is possible secondarily.

  11. [Depression and benzodiazepine dependence in the elderly. On the complexity of psychiatric manifestations and psychiatric treatment].

    PubMed

    Wolter-Henseler, D K; Gadatsch, M A; Schulte, E

    1994-07-01

    The example of a 70 year old female patient with endogenous depression and benzodiazepine dependency at the same time shows the problems created by the attempt to attribute the clinical picture to only one singular cause. As in the beginning we were not aware of her benzodiazepine dependency, she underwent withdrawal, so that the clinical picture became very complex and lengthy; it should be considered that long-term benzodiazepine use as well as withdrawal might have contributed to genesis, at least to manifestation of the depressive disorder. Apart from the self-contained depressive disorder and benzodiazepine dependency, obviously biographic-psychodynamic and family-dynamic factors have been important in formation, but as well in remittence of the complex clinical picture. An impressive urinary retention without detectable organic origin which persisted for several weeks is remarkable.

  12. Treatment of high-latency microcapsules containing an aluminium complex with an epoxy-functionalised trialkoxysilane.

    PubMed

    Kamiya, Kazunobu; Suzuki, Noboru

    2016-12-01

    Some aluminium complexes are excellent catalysts of cationic polymerisation and are used for low-temperature and fast-curing adhesive, used in electronic part mounting. Microencapsulation is a suitable technique for getting high latency of the catalysts and long shelf life of the adhesives. For the higher latency in a cycloaliphatic epoxy compound, the microcapsule surface which retained small amount of aluminium complex was coated with epoxy polymer and the effect was examined. From the X-ray photoelectron spectroscopic results, the surface was recognised to be sufficiently coated and the differential scanning calorimetric analyses showed that the coating did not significantly affect the low-temperature and fast-curing properties of adhesive. After storing the mixture of cycloaliphatic epoxy compound, coated microcapsules, triphenylsilanol and silane coupling agent for 48 h at room temperature, the increase in viscosity was only 0.01 Pa s, resulting in the excellent shelf life.

  13. Osteoid Osteoma Mimicking Triangular Fibrocartilage Complex Injury: Diagnosis and Review of Treatment

    PubMed Central

    Lamo-Espinosa, J. M.; González, A.; Amillo, S.

    2012-01-01

    We report the case of osteoid osteoma (OO) with ulnar styloid involvement. A review of the literature has been made with the aim of defining the special behaviour of OO when it is near the articular surface. That behaviour can affect the diagnosis, masking the real etiology of the pain, delaying the diagnosis, missing the diagnosis, or what is more serious, conducting an inadequate treatment. We propose a treatment algorithm conducted based on the localization near or far from articular surface and the superficial or deep localization. PMID:22997599

  14. Efficacy of transcranial magnetotherapy in the complex treatment of alcohol withdrawal syndrome.

    PubMed

    Staroverov, A T; Zhukov, O B; Raigorodskii, Yu M

    2009-11-01

    A total of 54 patients with alcoholism were studied during abstinence. Of these, 29 patients in the experimental group received basal therapy supplemented with physical treatment consisting of transcranial dynamic magnetotherapy (TcDMT), while the control group of 25 patients received only basal therapy. Comparison of the status of patients in the experimental and control groups during treatment demonstrated advantages of TcDMT in relation to improving the functional state of the CNS, memory, and attention, the autonomic nervous system, and the psychoemotional status of the patients (with decreases in the severity of anxiety and depression).

  15. Density functional treatment of water-carbon dioxide van der Waals complex

    SciTech Connect

    Abashkin, Y.; Mele, F.; Russo, N.; Toscano, M.

    1994-12-31

    LCGTO-LSD and LCGTO-NLSD methods have been tested for the study of water-carbon dioxide weakly bound binary complex. Different local and nonlocal exchange-correlation energy functionals and many grid radial points have been used. Results show that both nonlocal corrections and a large number of radial points in the grid are mandatory for well reproducing then experimental data. 19 refs., 1 fig., 2 tabs.

  16. Treatment of Complex Intracranial Aneurysms Using Flow-Diverting Silk® Stents

    PubMed Central

    Buyukkaya, Ramazan; Kocaeli, Hasan; Yildirim, Nalan; Cebeci, Hakan; Erdogan, Cüneyt; Hakyemez, Bahattin

    2014-01-01

    Summary This study describes the peri-procedural and late complications and angiographic follow-up results of 32 patients with 34 complex aneurysms treated with flow diverter Silk stents in a single centre. In this retrospective study, 40 Silk stents (SS) were implanted in 34 complex intracranial aneurysms in 32 patients. In our series, 20 (58.8%) carotid-ophthalmic internal carotid artery (ICA), six (17.6%) cavernous ICA, two (5.9%) supraclinoid ICA, two (5.9%) petrosal ICA (the same patient- bilateral) and four (11.8%) posterior circulation aneurysms were treated. One of the posterior circulation lesions was a fenestrated-type aneurysm. Twenty wide-necked, saccular; eight neck remnant; four fusiform and two blister-like aneurysms were included in our series. SS were successfully implanted in all patients (100%). Misdeployment occurred in 17.6% of patients. In two of these patients adequate stent openness was achieved via Hyperglide balloon dilatation. Coil embolization in addition to SS placement was utilized in four aneurysms. One patient (3%) experienced transient morbidity due to a thromboembolic event and there was one mortality (3%) due to remote intraparenchymal haemorrhage. Complete occlusion of 27/33 (81.8 %) and 29/33 (87.9 %) aneurysms was achieved six and 12 months after the procedure, respectively. In-stent intimal hyperplasia was detected in 6.1 % patients. Flow-diverter Silk stent implantation is an effective method of treating complex aneurysms with acceptable mortality and morbidity rates. Complete occlusion is achieved in most of the complex aneurysms. PMID:25496683

  17. Time-dependent reduction of structural complexity of the buccal epithelial cell nuclei after treatment with silver nanoparticles.

    PubMed

    Pantic, I; Paunovic, J; Perovic, M; Cattani, C; Pantic, S; Suzic, S; Nesic, D; Basta-Jovanovic, G

    2013-12-01

    Recent studies have suggested that silver nanoparticles (AgNPs) may affect cell DNA structure in in vitro conditions. In this paper, we present the results indicating that AgNPs change nuclear complexity properties in isolated human epithelial buccal cells in a time-dependent manner. Epithelial buccal cells were plated in special tissue culture chamber / slides and were kept at 37°C in an RPMI 1640 cell culture medium supplemented with L-glutamine. The cells were treated with colloidal silver nanoparticles suspended in RPMI 1640 medium at the concentration 15 mg L⁻¹. Digital micrographs of the cell nuclei in a sample of 30 cells were created at five different time steps: before the treatment (controls), immediately after the treatment, as well as 15 , 30 and 60 min after the treatment with AgNPs. For each nuclear structure, values of fractal dimension, lacunarity, circularity, as well as parameters of grey level co-occurrence matrix (GLCM) texture, were determined. The results indicate time-dependent reduction of structural complexity in the cell nuclei after the contact with AgNPs. These findings further suggest that AgNPs, at concentrations present in today's over-the-counter drug products, might have significant effects on the cell genetic material.

  18. Autonomous Modeling, Statistical Complexity and Semi-annealed Treatment of Boolean Networks

    NASA Astrophysics Data System (ADS)

    Gong, Xinwei

    This dissertation presents three studies on Boolean networks. Boolean networks are a class of mathematical systems consisting of interacting elements with binary state variables. Each element is a node with a Boolean logic gate, and the presence of interactions between any two nodes is represented by directed links. Boolean networks that implement the logic structures of real systems are studied as coarse-grained models of the real systems. Large random Boolean networks are studied with mean field approximations and used to provide a baseline of possible behaviors of large real systems. This dissertation presents one study of the former type, concerning the stable oscillation of a yeast cell-cycle oscillator, and two studies of the latter type, respectively concerning the statistical complexity of large random Boolean networks and an extension of traditional mean field techniques that accounts for the presence of short loops. In the cell-cycle oscillator study, a novel autonomous update scheme is introduced to study the stability of oscillations in small networks. A motif that corrects pulse-growing perturbations and a motif that grows pulses are identified. A combination of the two motifs is capable of sustaining stable oscillations. Examining a Boolean model of the yeast cell-cycle oscillator using an autonomous update scheme yields evidence that it is endowed with such a combination. Random Boolean networks are classified as ordered, critical or disordered based on their response to small perturbations. In the second study, random Boolean networks are taken as prototypical cases for the evaluation of two measures of complexity based on a criterion for optimal statistical prediction. One measure, defined for homogeneous systems, does not distinguish between the static spatial inhomogeneity in the ordered phase and the dynamical inhomogeneity in the disordered phase. A modification in which complexities of individual nodes are calculated yields vanishing

  19. Simple and Complex Post-Traumatic Stress Disorder: Strategies for Comprehensive Treatment in Clinical Practice.

    ERIC Educational Resources Information Center

    Williams, Mary Beth; Sommer, John F., Jr.

    This book delivers state-of-the-art techniques and information for practitioners to help individuals, groups, families, and communities suffering from post-traumatic stress disorder (PTSD). It addresses concerns about the efficacy of critical incident stress debriefing, examines the value of a variety of innovative treatment methods, and explores…

  20. [The Melkersson-Rosenthal syndrome as a problem of complex treatment].

    PubMed

    Trzmiel, Dorota; Kozak-Gawron, Karina; Krauze, Ewa

    2004-01-01

    The Melkersson-Rosenthal syndrome consists of triad of symptoms: recurrent oedema of lips, recurrent facial nerve paralysis and lingua plicata. Treatment is usually symptomatic and required cooperation of different specialists as: dermatologists, neurologists, dentists, laryngologists, surgeons. A rare case of Melkersson-Rosenthal syndrome in 49-year-old man was observed in the Clinic of Dermatology Silesian Medical Academy in Katowice.

  1. Transcranial magnetotherapy in the complex treatment of affective disorders in patients with alcoholism.

    PubMed

    Staroverov, A T; Vil'yanov, V B; Raigorodskii, Yu M; Rogozina, M A

    2009-06-01

    Transcranial magnetotherapy (TMT) was used in 32 patients with alcoholism (study group) on the background of basal treatment (nootropes, hepatoprotectors, vitamin/mineral formulations, etc.). The influence of this treatment was compared with a control group (30 subjects), in which TMT was replaced with an appropriate (placebo) procedure. All patients, who were aged from 35 to 64 years, had second-degree alcoholism with disease durations of 4-12 years. Patients were in a post-abstinence state during the treatment period. Courses of TMT consisted of 10 daily procedures with exposures of 10-20 min. Somatic, neurological, and laboratory studies were performed before and after treatment and included cardiointervalography, electroencephalography, assessments of the state of the autonomic nervous system, and use of psychometric scales to evaluate levels of anxiety and depression. TMT was followed by improvements in wellbeing, mood, and sleep, with increases in physical exercise tolerance and decreases in alcohol craving in 75% of patients in the study group and 30% of patients in the control group. Improvements in patients' status were supported by paraclinical investigations (electrophysiological, measures of the state of the autonomic nervous system, etc.) and psychometric scales.

  2. [Effect of complex sanatorium treatment including magnetotherapy on hemodynamics in patients with arterial hypertension].

    PubMed

    Efremushkin, G G; Duruda, N V

    2003-01-01

    Forty nine patients with arterial hypertension of stage I-II received combined sanatorium treatment. Of them, 21 had adjuvant total magnetotherapy. All the patients were examined for parameters of central, cerebral hemodynamics and microcirculation. The adjuvant magnetotherapy produced a beneficial effect on hypertension: clinical symptoms attenuated, arterial pressure became more stable, hemodynamics improved, duration of hospitalization reduced, requirement in hypotensive drugs diminished.

  3. Anoxic bio-electrochemical system for treatment of complex chemical wastewater with simultaneous bioelectricity generation.

    PubMed

    Velvizhi, G; Goud, R Kannaiah; Venkata Mohan, S

    2014-01-01

    Bioelectrochemical treatment system (BET) with anoxic anodic microenvironment was studied with chemical wastewater (CW) in comparison with anoxic treatment (AxT, sequencing batch reactor (SBR)) with same parent anaerobic consortia. BET system documented relatively higher treatment efficiency at higher organic load (5.0 kg COD/m(3)) accounting for COD removal efficiency of (90%) along with nitrate (48%), phosphate (51%), sulphates (68%), colour (63%) and turbidity (90%) removal, compared to AxT operation (COD, 47%; nitrate, 36%; phosphate, 32%; sulphate, 35%; colour, 45% and turbidity, 54%). The self-induced bio-potential developed due to the electrode assembly in BET resulted in effective treatment with simultaneous bioelectricity generation (631 mA/m(2)). AxT operation showed persistent reduction behaviour, while simultaneous redox behaviour was observed with BET indicating balanced electron transfer. BET operation illustrated higher wastewater toxicity reduction compared to the AxT system which documents the variation in bio-electrocatalytic behaviour of same consortia under different microenvironment.

  4. Progression of Language Complexity during Treatment with the Lidcombe Program for Early Stuttering Intervention

    ERIC Educational Resources Information Center

    Lattermann, Christina; Shenker, Rosalee C.; Thordardottir, Elin

    2005-01-01

    The Lidcombe Program is an operant treatment for early stuttering. Outcomes indicate that the program is effective; however, the underlying mechanisms leading to a successful reduction of stuttering remain unknown. The purpose of this study was to determine whether fluency achieved with the Lidcombe Program was accompanied by concomitant reduction…

  5. Maxillary reconstruction with particulate bone graft and titanium mesh: a treatment option for large complex odontoma of the maxilla.

    PubMed

    Utumi, Estevam Rubens; Cremonini, Caio Cesar; Pedron, Irineu Gregnanin; Zambon, Camila Eduarda; Cavalcanti, Marcelo Gusmão Paraíso; Ceccheti, Marcelo Minharro

    2011-07-01

    Odontomas are the most common type of odontogenic tumor and are generally asymptomatic. The purpose of this paper was to describe the case of a complex odontoma in a patient who had asymptomatic swelling in the central maxillary region, along with unerupted central and lateral incisors. In this case, surgical excision of the lesion was performed and an iliac bone graft was introduced into the defect area with a titanium mesh covering up the grafted harvesting bone. After 2 years of followup, no recurrence was identified. Patient followup is still in progress to evaluate bone graft resorption, and the patient awaits complete bone development. Oral rehabilitation with an osseointegrated titanium implant is expected in the future. An option of the large complex odontoma treatment is discussed.

  6. Single-use NPWT for the treatment of complex orthopaedic surgical and trauma wounds.

    PubMed

    Sharp, E

    2013-10-01

    Orthopaedic limb reconstruction patients often have wounds that are difficult to heal either due to the underlying problems, their surgery, underlying comorbidities or a combination of these factors. Negative pressure wound therapy (NPWT) is a useful tool with which to manage these wounds; however, many systems are not ideal for use in the patient's home, due in part to size and complexity. There are also staff training issues if transferring patients to an area which does not routinely use negative pressure systems. This paper reports the outcomes for some of the patients who were treated with a novel, single-use NPWT device in a orthopaedic trauma/limb reconstruction unit.

  7. Airway response to sirolimus therapy for the treatment of complex pediatric lymphatic malformations.

    PubMed

    Alemi, A Sean; Rosbe, Kristina W; Chan, Dylan K; Meyer, Anna K

    2015-12-01

    Head and neck lymphatic malformations can create airway management challenges requiring tracheotomy. Sirolimus, an inhibitor of mammalian target of rapamycin (mTOR), may inhibit growth of lymphatic malformations. We describe two patients born with large lymphatic malformations with improved airway symptoms following sirolimus therapy. Patient #1 underwent tracheotomy and multi-modal therapy including sirolimus with reduction in airway involvement but regrowth after discontinuation of sirolimus. Patient #2 also experienced a significant response to sirolimus allowing for extubation and discharge without tracheotomy. Early initiation of sirolimus therapy should be considered as a means to avoid tracheotomy in complex head and neck lymphatic malformations.

  8. A Case Report of Renal Sympathetic Denervation for the Treatment of Polymorphic Ventricular Premature Complexes

    PubMed Central

    Kiuchi, Márcio Galindo; Vitorio, Frederico Puppim; da Silva, Gustavo Ramalho; Paz, Luis Marcelo Rodrigues; Souto, Gladyston Luiz Lima

    2015-01-01

    Abstract Premature ventricular complexes are very common, appearing most frequently in patients with hypertension, obesity, sleep apnea, and structural heart disease. Sympathetic hyperactivity plays a critical role in the development, maintenance, and aggravation of ventricular arrhythmias. Recently, Armaganijan et al reported the relevance of sympathetic activation in patients with ventricular arrhythmias and suggested a potential role for catheter-based renal sympathetic denervation in reducing the arrhythmic burden. In this report, we describe a 32-year-old hypertensive male patient presenting with a high incidence of polymorphic premature ventricular complexes on a 24 hour Holter monitor. Beginning 1 year prior, the patient experienced episodes of presyncope, syncope, and tachycardia palpitations. The patient was taking losartan 100 mg/day, which kept his blood pressure (BP) under control, and sotalol 160 mg twice daily. Bisoprolol 10 mg/day was used previously but was not successful for controlling the episodes. The 24 hour Holter performed after the onset of sotalol 160 mg twice daily showed a heart rate ranging between 48 (minimum)–78 (average)–119 (maximum) bpm; 14,286 polymorphic premature ventricular complexes; 3 episodes of nonsustained ventricular tachycardia, the largest composed of 4 beats at a rate of 197 bpm; and 14 isolated atrial ectopic beats. Cardiac magnetic resonance imaging with gadolinium perfusion performed at rest and under pharmacological stress with dipyridamole showed increased left atrial internal volume, preserved systolic global biventricular function, and an absence of infarcted or ischemic areas. The patient underwent bilateral renal sympathetic denervation. The only drug used postprocedure was losartan 25 mg/day. Three months after the patient underwent renal sympathetic denervation, the mean BP value dropped to 132/86 mmHg, the mean systolic/diastolic 24 hour ambulatory BP measurement was reduced to 128/83

  9. Bronchoscopic treatment of complex persistent air leaks with endobronchial one-way valves.

    PubMed

    Fiorelli, Alfonso; Costanzo, Saveria; Carelli, Emanuele; Di Costanzo, Emilio; Santini, Mario

    2016-04-01

    We reported a case series including 5 patients with persistent air-leaks refractory to standard treatment. All patients were unfit for surgery for the presence of co-morbidities and/or severe respiratory failure due to underlying lung diseases. They were successfully treated with bronchoscopic placement of endobronchial one-way valves. Air-leaks stopped in the first 24 h after the procedure in three patients and 3 and 5 days later, respectively, in the remaining two. No complications were observed and follow-up was uneventful in all patients but one died 25 days after the procedure for systemic sepsis due to peritonis. Patients with important, refractory air leaks having clinical repercussions and unfit for surgery should be early reviewed for bronchoscopic valves treatment.

  10. Analyzing Complex Treatment Effects in Nonrandomized Observational Studies: The Case of Retention of Students in Grade.

    PubMed

    West, Stephen G

    2016-01-01

    Should low-achieving students be promoted to the next grade or be retained (held back) in the prior grade? This special section presents a discussion of the application of marginal structural models to the challenging problem of estimating the effect of promotion versus retention in grade on math scores in elementary school. Vandecandelaere, De Fraine, Van Damme, and Vansteelandt provide a didactic presentation of the marginal structural modeling approach, noting retention is a time-varying treatment because promoted low-achieving students may be retained in a subsequent grade. Steiner, Park, and Kim's commentary presents a detailed analysis of the treatment effects being estimated in same-age versus same-grade comparisons from the perspective of the potential outcomes model. Reshetnyak, Cham, and Kim's commentary clarifies the conditions under which same-age versus same-grade comparisons might be preferred; they also identify methods of further improving the estimation of retention effects. In their rejoinder, Vandecandelaere and Vansteelandt discuss tradeoffs in comparing the promoted and retained groups and highlight sensitivity analysis as a method of probing the robustness of treatment effect estimates. Our hope is that this combined didactic presentation and critical evaluation will encourage researchers to add marginal structural models to their methodological toolkits.

  11. Typicality of Inanimate Category Exemplars in Aphasia Treatment: Further Evidence for Semantic Complexity

    PubMed Central

    Kiran, Swathi

    2009-01-01

    Purpose The typicality treatment approach on improving naming was investigated within two inanimate categories (furniture and clothing) using a single subject experimental design across participants and behaviors in five patients with aphasia. Method Participants received a semantic feature treatment to improve naming of either typical or atypical items within semantic categories, while generalization was tested to untrained items of the category. The order of typicality and category trained was counterbalanced across participants. Results Results indicated that two out of four patients trained on naming of atypical examples demonstrated generalization to naming untrained typical examples. One patient showed trends towards generalization but did not achieve criterion. Further, four out of four patients trained on typical examples demonstrated no generalized naming to untrained atypical examples within the category. Also, analysis of errors indicated an evolution of errors as a result of treatment, from those with no apparent relationship to the target to primarily semantic and phonemic paraphasias. Conclusions These results extend our previous findings (Kiran & Thompson, 2003) to patients with nonfluent aphasia and to inanimate categories such as furniture and clothing. Additionally, the results provide support for the claim that training atypical examples is a more efficient method to facilitating generalization to untrained items within a category than training typical examples (Kiran, 2007). PMID:18695023

  12. Ultrastructural analysis of rat articular cartilage following treatment with dexamethasone and glycosaminoglycan-peptide complex.

    PubMed

    Annefeld, M; Erne, B; Rasser, Y

    1990-01-01

    This ultrastructural study describes a stereological analysis of rat articular cartilage, with and without exposure to dexamethasone and a chondroprotective drug used in the treatment of osteoarthritis. Normal rat cartilage was found to contain 27.6 x 10(4) chondrocytes/mm3 which occupied approximately 10% of the cartilage tissue, and the organelle content of each chondrocyte was calculated to be about 20% of the cytoplasmic volume. After 3 weeks of treatment with dexamethasone the chondrocytic volume was increased by 23% with a proportionate increase in the cellular volume of the whole cartilage, and in addition the organelle content was significantly reduced to about half that of the control chondrocytes. By contrast the administration of GP-C (RUMALON) to dexamethasone-treated animals reduced these steroid effects. No significant change was seen in the total chondrocyte numbers with either of the treatments. Whereas dexamethasone inhibits chondrocyte metabolism and produces concomitant ultrastructural changes, GP-C was found to counteract these effects, a result which supports the contention that GP-C helps to preserve chondrocyte function.

  13. Treatment of complex dissociative disorders: a comparison of interventions reported by community therapists versus those recommended by experts.

    PubMed

    Myrick, Amie C; Chasson, Gregory S; Lanius, Ruth A; Leventhal, Barry; Brand, Bethany L

    2015-01-01

    There is a paucity of empirical data to assist clinicians in choosing interventions to use with patients with complex dissociative disorder (DD; i.e., dissociative identity disorder and dissociative disorder not otherwise specified) at different stages in treatment. This study compared interventions used by a sample of international outpatient therapists treating DD clients in the 1st 2 stages of treatment with those recommended by expert DD therapists. There were many similarities between therapists' and experts' interventions, including the use of several emotion regulation and dissociation-focused interventions. However, community therapists reported significantly less focus on relationally oriented interventions, teaching and using grounding and containment skills, and stabilizing patients after revictimization by alleged perpetrators. This study has important implications for the development and implementation of training opportunities for DD therapists.

  14. The Role of Semantic Complexity in Treatment of Naming Deficits: Training Semantic Categories in Fluent Aphasia by Controlling Exemplar Typicality

    PubMed Central

    Kiran, Swathi; Thompson, Cynthia K.

    2007-01-01

    The effect of typicality of category exemplars on naming was investigated using a single subject experimental design across participants and behaviors in 4 patients with fluent aphasia. Participants received a semantic feature treatment to improve naming of either typical or atypical items within semantic categories, while generalization was tested to untrained items of the category. The order of typicality and category trained was counterbalanced across participants. Results indicated that patients trained on naming of atypical exemplars demonstrated generalization to naming of intermediate and typical items. However, patients trained on typical items demonstrated no generalized naming effect to intermediate or atypical examples. Furthermore, analysis of errors indicated an evolution of errors throughout training, from those with no apparent relationship to the target to primarily semantic and phonemic paraphasias. Performance on standardized language tests also showed changes as a function of treatment. Theoretical and clinical implications regarding the impact of considering semantic complexity on rehabilitation of naming deficits in aphasia are discussed. PMID:12959459

  15. Complex-scaling treatment for quantum entanglement in doubly excited helium atom

    NASA Astrophysics Data System (ADS)

    Lin, Chien-Hao; Ho, Yew Kam

    2015-05-01

    Recently, we have investigated entanglement measures in natural atomic systems that involve two highly correlated indistinguishable spin-1/2 fermions (electrons). Linear entropy and von Neumann entropy were calculated for spatial (electron-electron orbital) entanglement measures for ground and singly excited bound states in two-electron atomic systems, such as He, H- and Ps-. In our present work, we carry out an investigation on entanglement in doubly excited resonance states of helium. Since resonance states are lying in the scattering continuum, their energies are no longer bound by the variational theorem; we apply the complex scaling method to solve the complex energy pole with which the resonance energy and resonance width are deduced. Hylleraas-type wave functions are used to consider correlation effects. Once the wave function for a doubly excited state is obtained, we apply the Schmidt decomposition method to calculate the linear entropy and von Neumann entropy for the doubly excited 2s2, 2 s3 s, 2p2, 3s2, and 3p21Se resonance states in the helium atom. Work supported by the Ministry of Science and Technology of Taiwan.

  16. Complex Pattern of Resistance-Associated Substitutions of Hepatitis C Virus after Daclatasvir/Asunaprevir Treatment Failure

    PubMed Central

    Hasebe, Chitomi; Osaki, Yukio; Joko, Kouji; Yagisawa, Hitoshi; Sakita, Shinya; Okushin, Hiroaki; Satou, Takashi; Hisai, Hiroyuki; Abe, Takehiko; Tsuji, Keiji; Tamada, Takashi; Kobashi, Haruhiko; Mitsuda, Akeri; Ide, Yasushi; Ogawa, Chikara; Tsuruta, Syotaro; Takaguchi, Kouichi; Murakawa, Miyako; Asahina, Yasuhiro; Enomoto, Nobuyuki; Izumi, Namiki

    2016-01-01

    Backgrounds & Aims We aimed to clarify the characteristics of resistance-associated substitutions (RASs) after treatment failure with NS5A inhibitor, daclatasvir (DCV) in combination with NS3/4A inhibitor, asunaprevir (ASV), in patients with chronic hepatitis C virus genotype 1b infection. Methods This is a nationwide multicenter study conducted by the Japanese Red Cross Liver Study Group. The sera were obtained from 68 patients with virological failure after 24 weeks of DCV/ASV treatment. RASs in NS5A and NS3 were determined by population sequencing. Results The frequency of signature RASs at position D168 of NS3 was 68%, and at positions L31 and Y93 of NS5A was 79 and 76%, respectively. The frequency of dual signature RASs in NS5A (L31-RAS and Y93-RAS) was 63%. RASs at L28, R30, P32, Q54, P58, and A92 in addition to dual signature RAS were detected in 5, 5, 1, 22, 2, and 0 patients, respectively. In total, triple, quadruple, and quintuple RASs in combination with dual signature RAS were detected in 35, 10, and 1.5% patients, respectively. These RASs were detected in patients without baseline RASs or who prematurely discontinued therapy. Co-existence of D168 RAS in NS3 and L31 and/or Y93 RAS in NS5A was observed in 62% of patients. Conclusion Treatment-emergent RASs after failure with DCV/ASV combination therapy are highly complex in more than 50% of the patients. The identification of complex RAS patterns, which may indicate high levels of resistance to NS5A inhibitors, highlights the need for RAS sequencing when considering re-treatment with regimens including NS5A inhibitors. PMID:27776192

  17. Finite element modeling of endovascular coiling and flow diversion enables hemodynamic prediction of complex treatment strategies for intracranial aneurysm.

    PubMed

    Damiano, Robert J; Ma, Ding; Xiang, Jianping; Siddiqui, Adnan H; Snyder, Kenneth V; Meng, Hui

    2015-09-18

    Endovascular interventions using coil embolization and flow diversion are becoming the mainstream treatment for intracranial aneurysms (IAs). To help assess the effect of intervention strategies on aneurysm hemodynamics and treatment outcome, we have developed a finite-element-method (FEM)-based technique for coil deployment along with our HiFiVS technique for flow diverter (FD) deployment in patient-specific IAs. We tested four clinical intervention strategies: coiling (1-8 coils), single FD, FD with adjunctive coils (1-8 coils), and overlapping FDs. By evaluating post-treatment hemodynamics using computational fluid dynamics (CFD), we compared the flow-modification performance of these strategies. Results show that a single FD provides more reduction in inflow rate than low packing density (PD) coiling, but less reduction in average velocity inside the aneurysm. Adjunctive coils add no additional reduction of inflow rate beyond a single FD until coil PD exceeds 11%. This suggests that the main role of FDs is to divert inflow, while that of coils is to create stasis in the aneurysm. Overlapping FDs decreases inflow rate, average velocity, and average wall shear stress (WSS) in the aneurysm sac, but adding a third FD produces minimal additional reduction. In conclusion, our FEM-based techniques for virtual coiling and flow diversion enable recapitulation of complex endovascular intervention strategies and detailed hemodynamics to identify hemodynamic factors that affect treatment outcome.

  18. Finite Element Modeling of Endovascular Intervention Enables Hemodynamic Prediction of Complex Treatment Strategies for Coiling and Flow Diversion

    PubMed Central

    Damiano, Robert J.; Ma, Ding; Xiang, Jianping; Siddiqui, Adnan H.; Snyder, Kenneth V.; Meng, Hui

    2016-01-01

    Endovascular interventions using coil embolization and flow diversion are becoming the mainstream treatment for intracranial aneurysms (IAs). To help assess the effect of intervention strategies on aneurysm hemodynamics and treatment outcome, we have developed a finite-element-method (FEM)-based technique for coil deployment along with our HiFiVS technique for flow diverter (FD) deployment in patient-specific IAs. We tested four clinical intervention strategies: coiling (1–8 coils), single FD, FD with adjunctive coils (1–8 coils), and overlapping FDs. By evaluating post-treatment hemodynamics using computational fluid dynamics (CFD), we compared the flow-modification performance of these strategies. Results show that a single FD provides more reduction in inflow rate than low PD coiling, but less reduction in average velocity inside the aneurysm. Adjunctive coils add no additional reduction of inflow rate beyond a single FD until coil PD exceeds 11%. This suggests that the main role of FDs is to divert inflow, while that of coils is to create stasis in the aneurysm. Overlapping FDs decreases inflow rate, average velocity, and average wall shear stress (WSS) in the aneurysm sac, but adding a third FD produces minimal additional reduction. In conclusion, our FEM-based techniques for virtual coiling and flow diversion enable recapitulation of complex endovascular intervention strategies and detailed hemodynamics to identify hemodynamic factors that affect treatment outcome. PMID:26169778

  19. Treatment of antimony-unresponsive Indian visceral leishmaniasis with ultra-short courses of amphotericin-B-lipid complex.

    PubMed

    Sundar, S; Goyal, A K; More, D K; Singh, M K; Murray, H W

    1998-10-01

    High cost is the principal drawback of treating visceral leishmaniasis (VL; kala-azar) with any of the new lipid formulations of amphotericin B. The aim of the present study was to see if the costs of treatment with such drugs could be reduced by using ultra-short courses. Amphotericin-B-lipid complex (ABLC) was given to 77 Indian patients with antimony-unresponsive VL, either as a single infusion of 5 mg/kg (Group A) or two infusions, each of 5 mg/kg, given 5 days apart (Group B) or on consecutive days (Group C). Other than the anticipated higher fever and chills, treatment was well-tolerated. On day 19 after first infusion, 72 patients were considered apparent cures: 24 (89%) of the 27 in Group A; all 24 (100%) in Group B; and 24 (92%) of the 26 patients in Group C. Six months after treatment, 19 (70%) of 27 in Group A, 19 (79%) of 24 in Group B, and 21 (81%) of 26 in Group C were healthy, relapse-free and considered definitive cures. These cure rates were not statistically different. All 18 treatment failures (five initial non-responders and 13 relapses) were cured after treatment with a 5-day course of ABLC at a higher dose (10-15 mg/kg.day). In a related analysis of hospital plus drug costs for treating antimony-unresponsive VL, short-course ABLC (1-5 days) was compared with conventional amphotericin B (0.75-1.0 mg/kg on alternate days over 30-34 days). This analysis, which included the cost of re-treatment, identified one short-course ABLC regimen with an overall estimated expense which was only modestly higher than that of amphotericin B. Together, the present results provide further support for the use of ABLC in the management of VL patients who fail antimony therapy.

  20. Combination treatment with atorvastatin plus niacin provides effective control of complex dyslipidemias: a literature review.

    PubMed

    McKenney, James M

    2012-01-01

    Patients with dyslipidemia receive a cardiovascular benefit from lowering low-density lipoprotein cholesterol (LDL-C). Atorvastatin is currently one of the most effective approved medications for lowering LDL-C, and has been shown to significantly reduce cardiovascular risk in many patient groups. However, even with substantial lowering of LDL-C with atorvastatin, patients still have a residual risk for coronary heart disease. Elevated triglyceride levels and low high-density lipoprotein cholesterol (HDL-C) levels may contribute to this risk. Approved medications targeting these secondary lipid parameters include fibrates, omega-3 fatty acids, and niacin. Among these medications, niacin provides the optimal increase in HDL-C levels and has efficacy similar to the other medications in lowering triglyceride levels. However, there are challenges to adherence with niacin treatment. The most common challenge during niacin treatment is flushing, although it typically decreases with ongoing use and can be ameliorated by pretreatment with aspirin and counseling by the prescriber. A combination of atorvastatin and niacin may provide more complete normalization of the lipid profile and increased cardiovascular benefits. A literature review of the PubMed and Embase databases was conducted for clinical studies that reported on the lipid-modifying efficacy of the atorvastatin plus niacin combination. Identified studies involved patients at risk for coronary heart disease and patients with established coronary heart disease. Overall, the studies were small but indicated that atorvastatin in combination with niacin was efficacious in normalizing lipid parameters. Larger lipid studies as well as studies evaluating cardiovascular outcomes during atorvastatin plus niacin treatment are warranted.

  1. Inflammation and neuroaxonal injury in multiple sclerosis and AIDS dementia complex: implications for neuroprotective treatment.

    PubMed

    Rostásy, K M

    2005-08-01

    Multiple sclerosis (MS) and AIDS dementia complex (ADC), also termed HIV-associated dementia (HAD), are two examples of CNS diseases with a strong inflammatory component. In particular, macrophage/microglia activation in the deep white matter (DWM) is a key feature of both diseases. Activated macrophages/microglia have been shown to produce multiple cellular substances which can cause injury and apoptosis to all cell types in the CNS. This potentially provides a link between the initial pathogenic event and subsequent widespread neuroaxonal injury, which recent studies have found to be an early finding and an important determinant of clinical burden in both diseases. This review summarizes important immunopathological and neurobiological aspects of MS and ADC, with a special focus on the relation between macrophage/microglia activation and neuroaxonal injury, and discusses potential neuroprotective strategies.

  2. Combined Parameter and State Estimation Problem in a Complex Domain: RF Hyperthermia Treatment Using Nanoparticles

    NASA Astrophysics Data System (ADS)

    Bermeo Varon, L. A.; Orlande, H. R. B.; Eliçabe, G. E.

    2016-09-01

    The particle filter methods have been widely used to solve inverse problems with sequential Bayesian inference in dynamic models, simultaneously estimating sequential state variables and fixed model parameters. This methods are an approximation of sequences of probability distributions of interest, that using a large set of random samples, with presence uncertainties in the model, measurements and parameters. In this paper the main focus is the solution combined parameters and state estimation in the radiofrequency hyperthermia with nanoparticles in a complex domain. This domain contains different tissues like muscle, pancreas, lungs, small intestine and a tumor which is loaded iron oxide nanoparticles. The results indicated that excellent agreements between estimated and exact value are obtained.

  3. Complex PTSD: research directions for nosology/assessment, treatment, and public health

    PubMed Central

    Ford, Julian D.

    2015-01-01

    Complex posttraumatic stress disorder (CPTSD) in children and adolescents extends beyond the core PTSD symptoms to dysregulation in three psychobiological domains: (1) emotion processing, (2) self-organization (including bodily integrity), and (3) relational functioning. CPTSD research directions for the next decade and beyond are identified in three areas: (1) diagnostic classification (establishing the empirical integrity of CPTSD as a distinct form of psychopathology) and psychometric assessment [validation and refinement of measures of childhood polyvictimization and developmental trauma disorder (DTD)], (2) rigorous evaluation and refinement of interventions (and algorithms for their delivery) developed or adapted for CPTSD and DTD, and (3) the epidemiology of CPTSD and DTD, and their public health and safety impact, across the lifespan and intergenerationally, for populations, nations, and cultures. PMID:25994023

  4. Numerical optimization of targeted delivery of charged nanoparticles to the ostiomeatal complex for treatment of rhinosinusitis

    PubMed Central

    Xi, Jinxiang; Yuan, Jiayao Eddie; Si, Xiuhua April; Hasbany, James

    2015-01-01

    Background Despite the prevalence of rhinosinusitis that affects 10%–15% of the population, current inhalation therapy shows limited efficacy. Standard devices deliver <5% of the drugs to the sinuses due to the complexity of nose structure, secluded location of the sinus, poor ventilation, and lack of control of particle motions inside the nasal cavity. Methods An electric-guided delivery system was developed to guide charged particles to the ostiomeatal complex (OMC). Its performance was numerically assessed in an MRI-based nose–sinus model. Key design variables related to the delivery device, drug particles, and patient breathing were determined using sensitivity analysis. A two-stage optimization of design variables was conducted to obtain the best performance of the delivery system using the Nelder-Mead algorithm. Results and discussion The OMC delivery system exhibited high sensitivity to the applied electric field and electrostatic charges carried by the particles. Through the synthesis of electric guidance and point drug release, the new delivery system eliminated particle deposition in the nasal valve and turbinate regions and significantly enhanced the OMC doses. An OMC delivery efficiency of 72.4% was obtained with the optimized design, which is one order of magnitude higher than the standard nasal devices. Moreover, optimization is imperative to achieve a sound delivery protocol because of the large number of design variables. The OMC dose increased from 45.0% in the baseline model to 72.4% in the optimized system. The optimization framework developed in this study can be easily adapted for the delivery of drugs to other sites in the nose such as the ethmoid sinus and olfactory region. PMID:26257521

  5. Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions.

    PubMed Central

    Marin, M L; Veith, F J; Cynamon, J; Sanchez, L A; Lyon, R T; Levine, B A; Bakal, C W; Suggs, W D; Wengerter, K R; Rivers, S P

    1995-01-01

    OBJECTIVES: Complex arterial occlusive, traumatic, and aneurysmal lesions may be difficult or impossible to treat successfully by standard surgical techniques when severe medical or surgical comorbidities exist. The authors describe a single center's experience over a 2 1/2-year period with 96 endovascular graft procedures performed to treat 100 arterial lesions in 92 patients. PATIENTS AND METHODS: Thirty-three patients had 36 large aortic and/or peripheral artery aneurysms, 48 had 53 multilevel limb-threatening aortoiliac and/or femoropopliteal occlusive lesions, and 11 had traumatic arterial injuries (false aneurysms and arteriovenous fistulas). Endovascular grafts were placed through remote arteriotomies under local (16[17%]), epidural (42[43%]), or general (38[40%]) anesthesia. RESULTS: Technical and clinical successes were achieved in 91% of the patients with aneurysms, 91% with occlusive lesions, and 100% with traumatic arterial lesions. These patients and grafts have been followed from 1 to 30 months (mean, 13 months). The primary and secondary patency rates at 18 months for aortoiliac occlusions were 77% and 95%, respectively. The 18-month limb salvage rate was 98%. Immediately after aortic aneurysm exclusion, a total of 6 (33%) perigraft channels were detected; 3 of these closed within 8 weeks. Endovascular stented graft procedures were associated with a 10% major and a 14% minor complication rate. The overall 30-day mortality rate for this entire series was 6%. CONCLUSIONS: This initial experience with endovascular graft repair of complex arterial lesions justifies further use and careful evaluation of this technique for major arterial reconstruction. Images Figure 1. Figure 4. Figure 5. Figure 5. Figure 6. Figure 7. Figure 8. Figure 9. Figure 11. PMID:7574926

  6. Treatment of complex foot deformities in children with the taylor spatial frame.

    PubMed

    Eidelman, Mark; Katzman, Alexander

    2008-10-01

    The Taylor spatial frame is a relatively new external fixator able to correct 6-axis deformities with computer accuracy using a virtual hinge. The Taylor spatial frame has gained tremendous popularity, but its use for the correction of foot deformities is still limited. Various ring configurations and a new foot program have recently become available and allow correction of the most difficult foot deformities. This article reports the results of 13 patients (15 frames) with various foot deformities treated at our institution with 3 different Taylor spatial frame configurations (standard rings construction, miter frame, and butt frame). Treatment goals were achieved in 11 patients, while mild residual deformities persisted in 2 patients. Most complications during treatment consisted of pin tract infections. One patient had premature consolidation, which was treated with additional midtarsal osteotomy; 1 had metatarsophalangeal joint subluxation, which was fixed with tendon lengthening and pining of the joint; and 1 had talar subluxation, which was reduced with residual program correction. Based on our experience, we believe the Taylor spatial frame is a very powerful and accurate surgical modality with a relatively short learning curve for the correction for most difficult foot deformities.

  7. Studies on an iron-poly(sorbitol-gluconic acid) complex for parenteral treatment of iron deficiency anaemia.

    PubMed

    Domeij, K; Hellström, V; Högberg, K G; Lindvall, S; Rydell, G; Wichman, U; Ortengren, B

    1977-01-01

    A preparation containing an iron-poly(sorbitol-gluconic acid) complex for parenteral treatment of iron deficiency anaemia is described. The physical and chemical properties of the iron complex have been studied by using electrophoresis and gel permeation chromatography. A rapid absorption from the injection site after intramuscular administration to rabbits takes place, 70% of the iron being absorbed after 24-48 hours. Thereafter, the absorption rate is slower, and 32 days after the injection 94% has been absorbed from the injection site. In rabbits the maximum level of iron in serum is reached after 12-24 hours; in dogs after 1-3 hours. Disappearance from the serum takes place slowly. The complex is exclusively absorbed via the lymphatic route. Nine to ten per cent of the given dose is excreted by the kidney within 72 hours in rats and 24 hours in rabbits after intramuscular administration. On administration of the preparation to rats, made anaemic by phlebotomy, a rapid increase of haemoglobin values is observed as well as a very high utilization of the retained amount of the given dose.

  8. Treatment approach in a child with hysterical seizures superimposed on partial complex seizures.

    PubMed

    Parraga, H C; Kashani, J H

    1981-03-01

    This article reports the case of a 9 1/2 year old child with a history of psychomotor epilepsy which was uncontrolled by multiple anticonvulsant medications. When admitted to the psychiatric inpatient service, he was treated with a combination of pharmacological, behavioural and psychodynamically oriented approaches. A period of intensive family counseling was conducted to clarify the parents' concerns about causality of the seizures and methods for dealing with them. This combined approach led to a complete cessation of reported seizures and a decreased number and dosage of anticonvulsant medications. The authors discuss the reluctance of some physicians to accept the co-existence of neurogenic and psychogenic seizures in a given patient. Patients with pharmacologically uncontrolled seizures must be identified and accurately diagnosed (neurogenic and/or psychogenic) to prevent complication such as over-medication and to administer appropriate treatment. Multiple disciplinary therapy including psychodynamic, pharmacological, behavioural and educational approaches should be implemented.

  9. Treatment of complex heavy metal wastewater using a multi-staged ferrite process.

    PubMed

    Tu, Yao-Jen; Chang, Chien-Kuei; You, Chen-Feng; Wang, Shan-Li

    2012-03-30

    Complete removal of heavy metal from complex heavy-metal wastewater (CHMW) requires advanced technology. This study investigated the feasibility of a multi-staged ferrite process (MSFP) for treating CHMW, containing Cd, Cu, Pb, Cr, Zn, Ag, Hg, Ni, Sn and Mn. Our experimental results showed that most of the supernatants after conventional single-step ferrite process could conform to the effluent standard of Environmental Protection Administration in Taiwan. However, the sludge could not satisfy the toxicity characteristic leaching procedure (TCLP) limits due to high Cd, Cu, and Pb concentrations. The performance of MSFP in removing heavy metals from wastewater was subsequently investigated and the parameters of three treating steps in MSFP were optimized under 70°C and 90°C at pH 9, and 80°C at pH 10. After the three-staged procedures, all heavy metals in supernatant and sludge could fulfill the contamination levels regulated by law. In addition, the sludge generated from the MSFP was examined by XRD and forms a stable spinel structure, which could be effectively separated by external magnetic field.

  10. Effect of Fenton's treatment on the biodegradability of chromium-complex azo dyes.

    PubMed

    Arslan-Alaton, I; Kabdaşli, I; Teksoy, S

    2007-01-01

    Pretreatment of an acid dyebath effluent bearing a new generation chromium complex azo dyestuff (C0 = 350 mg/L) with Fenton's reagent was investigated. Preliminary optimisation (baseline) experiments were conducted to determine the Fe2+, H2O2 concentrations and pH required to the highest possible COD and colour removals. Kinetic studies were carried out at varying temperatures (20 degrees C < T < 70 degrees C) to establish a relationship between COD abatement and H2O2 consumption. The activation energy found for catalytic H2O2 decomposition (Ea = 9.8 kJ/mol) appeared to be significantly less than that of fermentative (Ea = 23 kJ/mol) and of thermal (Ea = 76 kJ/mol) H2O2 decomposition, implying that H2O2 decomposition during the Fenton's reaction occurs more spontaneously. The experimental studies indicated that approximately 30% COD and complete colour removal could be achieved under optimised Fenton pretreatment conditions (Fe2+ = 2 mM; H2O2 = 30 mM; pH = 3; at T = 60 degrees C). Long-term activated sludge experiments revealed that although the raw and pretreated acid dyebath effluent contained practically the same amount of "readily biodegradable" COD (inert COD fraction < or = 10%), biodegradation of the chemically pretreated acid dye effluent proceeded appreciably faster than that of the untreated acid dyebath effluent.

  11. Ultrasound-guided pulsed radiofrequency treatment of the cervical sympathetic chain for complex regional pain syndrome

    PubMed Central

    Kim, Eung Don; Yoo, Woo Joo; Kim, Yoo Na; Park, Hue Jung

    2017-01-01

    Abstract The stellate ganglion is a common target to manage neuropathic pain in the upper extremities. However, the effect duration of a single stellate ganglion block is often temporary. To overcome the short-term effects of a single sympathetic block, pulsed radiofrequency (PRF) can be applied. The aim of the present study was to investigate the efficacy of PRF on the cervical sympathetic chain under ultrasound guidance for complex regional pain syndrome (CRPS). Twelve CRPS patients who underwent PRF on the cervical sympathetic chain were enrolled in this retrospective analysis. Under ultrasound guidance, PRF was performed for 420 seconds at 42°C on the C6- and C7-level sympathetic chain. The pain intensity decreased significantly at 1 week after the procedure. Overall, 91.7% of patients experienced at least moderate improvement. A positive correlation was observed between the extent of pain reduction at 1 week after PRF and the degree of overall benefit (r = 0.605, P = 0.037). This reduction in symptoms was maintained for a mean of 31.41 ± 26.07 days after PRF. There were no complications associated with this procedure. PRF on the cervical sympathetic chain, which can be performed easily and safely under ultrasound guidance, should be considered an option for managing CRPS of the upper extremities. PMID:28072749

  12. Evaluation of polyelectrolyte complex-based scaffolds for mesenchymal stem cell therapy in cardiac ischemia treatment.

    PubMed

    Ceccaldi, Caroline; Bushkalova, Raya; Alfarano, Chiara; Lairez, Olivier; Calise, Denis; Bourin, Philippe; Frugier, Celine; Rouzaud-Laborde, Charlotte; Cussac, Daniel; Parini, Angelo; Sallerin, Brigitte; Fullana, Sophie Girod

    2014-02-01

    Three-dimensional (3D) scaffolds hold great potential for stem cell-based therapies. Indeed, recent results have shown that biomimetic scaffolds may enhance cell survival and promote an increase in the concentration of therapeutic cells at the injury site. The aim of this work was to engineer an original polymeric scaffold based on the respective beneficial effects of alginate and chitosan. Formulations were made from various alginate/chitosan ratios to form opposite-charge polyelectrolyte complexes (PECs). After freeze-drying, the resultant matrices presented a highly interconnected porous microstructure and mechanical properties suitable for cell culture. In vitro evaluation demonstrated their compatibility with mesenchymal stell cell (MSC) proliferation and their ability to maintain paracrine activity. Finally, the in vivo performance of seeded 3D PEC scaffolds with a polymeric ratio of 40/60 was evaluated after an acute myocardial infarction provoked in a rat model. Evaluation of cardiac function showed a significant increase in the ejection fraction, improved neovascularization, attenuated fibrosis as well as less left ventricular dilatation as compared to an animal control group. These results provide evidence that 3D PEC scaffolds prepared from alginate and chitosan offer an efficient environment for 3D culturing of MSCs and represent an innovative solution for tissue engineering.

  13. Use of the Environmental Simulation Program (ESP) to Simulate Complex Waste Treatment Processes

    SciTech Connect

    MacLean, G. T.; Ho, Q. T.; Berger, S. R. K.

    2003-02-26

    The Environmental Simulation Program is a process simulator designed for aqueous based chemical processes. ESP, which is produced by OLI Systems, Inc., utilizes sophisticated activity coefficient models and predictive equations that result in the ability to simulate very complex electrolyte systems (OLI, 2002). The software comes with databanks of regressed parameters for a large number of aqueous, vapor, and solid species covering most of the elements. ESP has been used extensively at the U. S. Department of Energy Hanford Site to predict nuclear waste slurry vapor-liquid-solid equilibrium. It has and is being used to model leaching and washing of nuclear waste sludges, evaporation of nuclear waste solutions, crystallization of salts, precipitation of plutonium and other metals from waste solutions, and other processing of dilute and concentrated aqueous solutions, sludges, and slurries. The software is also used extensively to rationalize the characterization of nuclear wastes using limited data from analyses of waste samples. The OLI provided databanks suffer from a legacy interaction model that limits the accuracy when neutral solutes are important. Also, the nitrate-nitrite systems typically found in nuclear wastes are not properly parameterized in ESP databases because of the existence of sodium nitrate and nitrite ion pairs. Properties databanks for ESP have been developed at Flour Federal Services that eliminate the legacy model and provide more accurate simulation results than the OLI supplied databases for such concentrated solutions and slurries.

  14. Clinical Characteristics, Treatment Outcomes, and Resistance Mutations Associated with Macrolide-Resistant Mycobacterium avium Complex Lung Disease.

    PubMed

    Moon, Seong Mi; Park, Hye Yun; Kim, Su-Young; Jhun, Byung Woo; Lee, Hyun; Jeon, Kyeongman; Kim, Dae Hun; Huh, Hee Jae; Ki, Chang-Seok; Lee, Nam Yong; Kim, Hong Kwan; Choi, Yong Soo; Kim, Jhingook; Lee, Seung-Heon; Kim, Chang Ki; Shin, Sung Jae; Daley, Charles L; Koh, Won-Jung

    2016-11-01

    Macrolide antibiotics are key components of the multidrug treatment regimen for treating lung disease (LD) due to Mycobacterium avium complex (MAC). Despite the emergence of macrolide resistance, limited data are available on macrolide-resistant MAC-LD. This study evaluated the clinical features and treatment outcomes of patients with macrolide-resistant MAC-LD and the molecular characteristics of the macrolide-resistant isolates. A retrospective review of the medical records of 34 patients with macrolide-resistant MAC-LD who were diagnosed between January 2002 and December 2014 was performed, along with genetic analysis of 28 clinical isolates. Nineteen (56%) patients had the fibrocavitary form of MAC-LD, and 15 (44%) had the nodular bronchiectatic form. M. intracellulare was the etiologic organism in 21 (62%) patients. Approximately two-thirds (22/34 [65%]) of the patients had been treated with currently recommended multidrug regimens that included macrolide, ethambutol, and rifamycin prior to the emergence of macrolide resistance, and none had been treated with macrolide monotherapy. The median duration of treatment after the detection of macrolide resistance was 23.0 months (interquartile range, 16.8 to 45.3 months). Treatment outcomes were poor after the development of macrolide resistance, with favorable treatment outcomes achieved in only five (15%) patients, including two patients who underwent surgical resection. One-, 3-, and 5-year mortality rates were 9, 24, and 47%, respectively. Molecular analysis of 28 clinical isolates revealed that 96% (27/28) had point mutations at position 2058 or 2059 of the 23S rRNA gene. Our analyses indicate that more effective therapy is needed to treat macrolide-resistant MAC-LD and prevent its development.

  15. Alternative Techniques for Treatment of Complex Below-the Knee Arterial Occlusions in Diabetic Patients With Critical Limb Ischemia

    SciTech Connect

    Gandini, Roberto; Uccioli, Luigi; Spinelli, Alessio; Del Giudice, Costantino Ros, Valerio Da; Volpi, Tommaso; Meloni, Marco; Simonetti, Giovanni

    2013-02-15

    The purpose of this study was to describe alternative endovascular (EV) techniques and assess their feasibility and efficacy in minimizing failure rates in limb salvage for the treatment of complex below-the knee (BTK) occlusions that could not be crossed with a conventional antegrade access. Between December 2007 and November 2010, 1,035 patients (557 male) underwent EV treatment for critical limb ischemia in our institution. In 124 (12% [83 male], mean age 68.2 {+-} 0.5 years) patients, transfemoral antegrade revascularization attempt failed, and an alternative approach was used. Follow-up was performed at 1 and 6 months. Results were compared with 56 patients treated between November 2002 and November 2007, in whom conventional technique was unsuccessful and unconventional techniques were not adopted. Technical success was achieved in 119 (96%) patients. The limb-salvage rates were 96.8% and 83% at 1- and 6-month follow-up, respectively. Sixteen (12.9%) and 33 (26.6%) patients underwent reintervention at 1- and 6-month follow-up, respectively. Transcutaneous oxygen tension increased at 1 month (44.7 {+-} 1.1 vs. 15.7 {+-} 0.8 mmHg; p < 0.001) and remained stable at follow-up. Twenty (16.1%) patients required major amputation. Thirteen (10.4%) patients died during follow-up. In our previous experience, percutaneous transluminal angioplasty failure, amputation, and death rates were 10.9, 39.2, and 23.2%, respectively. Alternative techniques allowed a significant decrease of major amputation and death rates (p = 0.0001 and p = 0.02, respectively). The use of alternative techniques seems feasible in case of a failed antegrade BTK revascularization attempt and could minimize failure rates in the treatment of complex occlusions while providing satisfying clinical success rates at 6 months.

  16. Early treatment of complex located pediatric low-grade gliomas using iodine-125 brachytherapy alone or in combination with microsurgery.

    PubMed

    Kunz, Mathias; Nachbichler, Silke B; Ertl, Lorenz; Fesl, Gunther; Egensperger, Rupert; Niyazi, Maximilian; Schmid, Irene; Tonn, Joerg Christian; Peraud, Aurelia; Kreth, Friedrich Wilhelm

    2016-03-01

    To analyze efficacy, functional outcome, and treatment toxicity of low-dose rate I-125 brachytherapy (SBT) alone or in combination with best safe resection (in case of larger tumor volumes) as first-line treatment for pediatric low-grade gliomas (PLGGs) not suitable for complete resection. Consecutively treated (2000-2014) complex located circumscribed WHO grade I/II PLGGs were included. For small tumors (≤4 cm in diameter) SBT alone was performed; for larger tumors best safe resection and subsequent SBT was chosen. Temporary Iodine-125 seeds were used (median reference dose: 54 Gy). Treatment response was estimated with the modified MacDonald criteria. Analysis of functional outcome included ophthalmological, endocrinological and neurological evaluation. Survival was analyzed with the Kaplan-Meier method. Prognostic factors were obtained from proportional hazards models. Toxicity was categorized according to the Common Terminology Criteria for Adverse Events. Fifty-eight patients were included treated either with SBT alone (n = 39) or with SBT plus microsurgery (n = 19). Five-year progression-free survival was 87%. Two patients had died due to tumor progression. Among survivors, improvement/stabilization/deterioration of functional deficits was seen in 20/14/5 patients, respectively. Complete/partial response had beneficial impact on functional scores (P = 0.02). The 5-year estimated risk to receive adjuvant radiotherapy/chemotherapy was 5.2%. The overall early (delayed) toxicity rate was 8.6% (10.3%), respectively. No permanent morbidity occurred. In complex located PLGGs, early SBT alone or combined with best safe resection preserves/improves functional scores and results in tumor control rates usually achieved with complete resection. Long-term analysis is necessary for confirmation of these results.

  17. In vivo complementation of complex I by the yeast Ndi1 enzyme. Possible application for treatment of Parkinson disease.

    PubMed

    Seo, Byoung Boo; Nakamaru-Ogiso, Eiko; Flotte, Terence R; Matsuno-Yagi, Akemi; Yagi, Takao

    2006-05-19

    Recent studies suggest that dysfunction of the NADH-quinone oxidoreductase (complex I) is associated with a number of human diseases, including neurodegenerative disorders such as Parkinson disease. We have shown previously that the single subunit rotenone-insensitive NADH-quinone oxidoreductase (Ndi1) of Saccharomyces cerevisiae mitochondria can restore NADH oxidation in complex I-deficient mammalian cells. The Ndi1 enzyme is insensitive to complex I inhibitors such as rotenone and 1-methyl-4-phenylpyridinium ion, known as a metabolite of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). To test the possible use of the NDI1 gene as a therapeutic agent in vivo, we chose a mouse model of Parkinson disease. The NDI1-recombinant adeno-associated virus particles (rAAV-NDI1) were injected unilaterally into the substantia nigra of mice. The animals were then subjected to treatment with MPTP. The degree of neurodegeneration in the nigrostriatal system was assessed immunohistochemically through the analysis of tyrosine hydroxylase and glial fibrillary acidic protein. It was evident that the substantia nigra neurons on the side used for injection of rAAV-NDI1 retained a high level of tyrosine hydroxylase-positive cells, and the ipsilateral striatum exhibited significantly less denervation than the contralateral striatum. Furthermore, striatal concentrations of dopamine and its metabolites in the hemisphere that received rAAV-NDI1 were substantially higher than those of the untreated hemisphere, reaching more than 50% of the normal levels. These results indicate that the expressed Ndi1 protein elicits resistance to MPTP-induced neuronal injury. The present study is the first successful demonstration of complementation of complex I by the Ndi1 enzyme in animals.

  18. Azithromycin, rifabutin, and rifapentine for treatment and prophylaxis of Mycobacterium avium complex in rats treated with cyclosporine.

    PubMed Central

    Brown, S T; Edwards, F F; Bernard, E M; Tong, W; Armstrong, D

    1993-01-01

    Azithromycin, rifabutin, and rifapentine were used to treat or prevent disseminated Mycobacterium avium complex (MAC) infections produced in rats immunosuppressed with cyclosporine. Animals with bacteremic infections were treated 1 week after intravenous inoculation with 10(7) CFU of MAC with azithromycin, 100 mg/kg of body weight administered subcutaneously for 5 days and then 75 mg/kg on Monday, Wednesday, and Friday, or with rifabutin or rifapentine, 20 mg/kg administered intraperitoneally on Monday through Friday. All three drugs showed efficacy after 1 and 2 months. Rifabutin cleared the organisms from tissues more rapidly than azithromycin or rifapentine. To approximate prophylaxis, treatment was started 2 weeks before intravenous inoculation with 10(4) organisms. MAC infections were undetectable in treated animals after 4 months, while control animals had disseminated infections. These findings support the rationale for clinical trials of treatment and prophylaxis with these agents. The cyclosporine-treated rat appears to be a useful model in which to evaluate compounds for the treatment and prophylaxis of disseminated MAC infections. PMID:8384809

  19. Pyrosequencing demonstrated complex microbial communities in a membrane filtration system for a drinking water treatment plant.

    PubMed

    Kwon, Soondong; Moon, Eunjeong; Kim, Taek-Seung; Hong, Seungkwan; Park, Hee-Deung

    2011-01-01

    Microbial community composition in a pilot-scale microfiltration plant for drinking water treatment was investigated using high-throughput pyrosequencing technology. Sequences of 16S rRNA gene fragments were recovered from raw water, membrane tank particulate matter, and membrane biofilm, and used for taxonomic assignments, estimations of diversity, and the identification of potential pathogens. Greater bacterial diversity was observed in each sample (1,133-1,731 operational taxonomic units) than studies using conventional methods, primarily due to the large number (8,164-22,275) of sequences available for analysis and the identification of rare species. Betaproteobacteria predominated in the raw water (61.1%), while Alphaproteobacteria were predominant in the membrane tank particulate matter (42.4%) and membrane biofilm (32.8%). The bacterial community structure clearly differed for each sample at both the genus and species levels, suggesting that different environmental and growth conditions were generated during membrane filtration. Moreover, signatures of potential pathogens including Legionella, Pseudomonas, Aeromonas, and Chromobacterium were identified, and the proportions of Legionella and Chromobacterium were elevated in the membrane tank particulate matter, suggesting a potential threat to drinking water treated by membrane filtration.

  20. Fenton treatment of complex industrial wastewater: optimization of process conditions by surface response method.

    PubMed

    Bianco, Barbara; De Michelis, Ida; Vegliò, Francesco

    2011-02-28

    Remediation of industrial wastewaters represents a stringent problem in modern society, which requires particular understanding and ad hoc solutions. In this work, we performed extensive experimental study of chemical Fenton oxidation in order to understand the optimal operative conditions to be applied in real industrial wastewaters treatment. We analyzed the effectiveness of chemical oxygen demand (COD) removal from different wastewaters within a wide range of initial COD content. We observed a maximum COD % removal of about 80%, assessing the efficiency of the process. In order to understand the role of different reagents in the final yield, we performed a factorial experimental approach on the Fenton's reagents (H(2)O(2) and Fe(2+)) and analyzed the results developing an analytical second-order model. The model depends on three variables, namely: the initial [COD(i)] of the sample, the [COD(i)]/[H(2)O(2)] ratio and [H(2)O(2)]/[Fe(2+)] ratio. We obtained an accurate description of the COD % removal in different initial conditions, with a R(2)=0.85. In particular, we observed that optimal quantities of Fenton's reagents are a function of the initial COD of the treated wastes.

  1. Clinical application of operative hysteroscopy in treatment of complex hydrosalpinx prior to IVF

    PubMed Central

    Bao, Hong-Chu; Wang, Mei-Mei; Wang, Xin-Rong; Wang, Wen-Juan; Hao, Cui-Fang

    2015-01-01

    Background: In vitro fertilization and embryo transfer (IVF-ET) is the best option for patients with hydrosalpinx. However, if hydrosalpinges is not pre-treated, the therapeutic outcomes of IVF-ET would be compromised. Objective: This study aims to investigate the safety and effects of operative hysteroscopy in the treatment of patients with hydrosalpinx prior to IVF-ET, who were not indicated for laparotomy due to extensive pelvic adhesion. Materials and Methods: The study analyses retrospectively data from 10 women with hydrosalpinx, who were unable to undergo laparotomy due to extensive pelvic adhesion and treated by operative hysteroscopy prior to IVF-ET, and was assessed the effects and safety of the procedure. Results: Postoperative Hystero-salpingography demonstrated complete tubal occlusion of the diseased side in all cases. Being applied with IVF-ET for fertility after their hysteroscopy operation, 5 out of 10 patients acquired clinical pregnancy. Conclusion: Hysteroscopic tubal occlusion of the proximal part of the hydrosalpinx can effectively prevent the hydrops backflow to endometrial cavity and benefit subsequent implantation in the course of assisted reproduction without significant complications. PMID:26221131

  2. "In reality, it is complex and difficult": UK nurses' perspectives on "treatment as prevention" within HIV care.

    PubMed

    Evans, Catrin; Bennett, Juliet; Croston, Michelle; Brito-Ault, Nathaniel; Bruton, Jane

    2015-01-01

    Globally, clinical guidelines for HIV treatment are being altered to reflect new research showing that successful treatment with antiretroviral therapies (ART) can prevent the onward transmission of HIV. As a result, health care services are being challenged to find ways to roll out "treatment as prevention" (TasP) as a public health measure. In theory, TasP requires individuals to start ART as soon as they are diagnosed - for public health reasons - which may be some time before ART for that individual is required for clinical reasons. There is currently little research on the acceptability of TasP from a patient or provider perspective. This paper reports findings from a qualitative study that sought to explore UK nurses' views and experiences of TasP in HIV care. Ten HIV specialist nurses, purposively selected from across the country, were interviewed. Results suggest that, although positive about TasP in principle, nurses hold several reservations about its implementation in practice. Perceived benefits of TasP include reassurance for patients that their loved ones are protected and that immediate care is available. Concerns include the possibility of sexual dis-inhibition or coercion within sexual relationships. In the UK context, decisions around TasP are still being made on a highly individualised patient by patient basis, within a philosophy of holistic care and partnership working. As such, the research participants called for more resources to support information giving, risk assessment and decision-making. The results show that translating a public health treatment approach into individual patient care is complex, potentially time-consuming and may alter traditional provider-patient dynamics. The findings from this study suggest that in-depth research is needed to understand better the patient, community and provider experience as TasP becomes more widely rolled out.

  3. Impact of reclamation treatment on the biological activity of soils of the solonetz complex in Western Siberia

    NASA Astrophysics Data System (ADS)

    Berezin, L. V.; Khamova, O. F.; Paderina, E. V.; Gindemit, A. M.

    2014-11-01

    The abundance and activity of the soil microflora were studied in a field experiment with the use of green manure crops to assess the impact of reclamation measures on the biological activity of soils of the solonetz complex. The number of microorganisms in the plow soil horizon increased in the background of the green fallows as compared to the black ones. Coefficients of mineralization, immobilization, and transformation of organic compounds were calculated for different variants of the soil treatment. The value of the mineralization coefficient indicates the intense decomposition of the green manure that entered the soil. In the first year, peas were actively decomposed, while oats, in the second year (aftereffect). The activity of the soil enzymes (invertase, urease, and catalase) was determined. A close relationship between the catalase activity and the intensity of the microbiological processes in the soils was revealed.

  4. Tunicate-Inspired Gallic Acid/Metal Ion Complex for Instant and Efficient Treatment of Dentin Hypersensitivity.

    PubMed

    Prajatelistia, Ekavianty; Ju, Sung-Won; Sanandiya, Naresh D; Jun, Sang Ho; Ahn, Jin-Soo; Hwang, Dong Soo

    2016-04-20

    Dentin hypersensitivity is sharp and unpleasant pains caused by exposed dentinal tubules when enamel outside of the tooth wears away. The occlusion of dentinal tubules via in situ remineralization of hydroxyapatite is the best method to alleviate the symptoms caused by dentin hypersensitivity. Commercially available dental desensitizers are generally effective only on a specific area and are relatively toxic, and their performance usually depends on the skill of the clinician. Here, a facile and efficient dentin hypersensitivity treatment with remarkable aesthetic improvement inspired by the tunicate-self-healing process is reported. As pyrogallol groups in tunicate proteins conjugate with metal ions to heal the torn body armor of a tunicate, the ingenious mechanism by introducing gallic acid (GA) as a cheap, abundant, and edible alternative to the pyrogallol groups of the tunicate combined with a varied daily intake of metal ion sources is mimicked. In particular, the GA/Fe(3+) complex exhibits the most promising results, to the instant ≈52% blockage in tubules within 4 min and ≈87% after 7 d of immersion in artificial saliva. Overall, the GA/metal ion complex-mediated coating is facile, instant, and effective, and is suggested as an aesthetic solution for treating dentin hypersensitivity.

  5. TSC1 and TSC2 gene mutations and their implications for treatment in Tuberous Sclerosis Complex: a review.

    PubMed

    Rosset, Clévia; Netto, Cristina Brinckmann Oliveira; Ashton-Prolla, Patricia

    2017-02-20

    Tuberous sclerosis complex is an autosomal dominant disorder characterized by skin manifestations and formation of multiple tumors in different organs, mainly in the central nervous system. Tuberous sclerosis is caused by the mutation of one of two tumor suppressor genes, TSC1 or TSC2. Currently, the development of novel techniques and great advances in high-throughput genetic analysis made mutation screening of the TSC1 and TSC2 genes more widely available. Extensive studies of the TSC1 and TSC2 genes in patients with TSC worldwide have revealed a wide spectrum of mutations. Consequently, the discovery of the underlying genetic defects in TSC has furthered our understanding of this complex genetic disorder, and genotype-phenotype correlations are becoming possible, although there are still only a few clearly established correlations. This review focuses on the main symptoms and genetic alterations described in TSC patients from 13 countries in three continents, as well as on genotype-phenotype correlations established to date. The determination of genotype-phenotype correlations may contribute to the establishment of successful personalized treatment for TSC.

  6. Protein/CaCO3/Chitin Nanofiber Complex Prepared from Crab Shells by Simple Mechanical Treatment and Its Effect on Plant Growth

    PubMed Central

    Aklog, Yihun Fantahun; Egusa, Mayumi; Kaminaka, Hironori; Izawa, Hironori; Morimoto, Minoru; Saimoto, Hiroyuki; Ifuku, Shinsuke

    2016-01-01

    A protein/CaCO3/chitin nanofiber complex was prepared from crab shells by a simple mechanical treatment with a high-pressure water-jet (HPWJ) system. The preparation process did not involve chemical treatments, such as removal of protein and calcium carbonate with sodium hydroxide and hydrochloric acid, respectively. Thus, it was economically and environmentally friendly. The nanofibers obtained had uniform width and dispersed homogeneously in water. Nanofibers were characterized in morphology, transparency, and viscosity. Results indicated that the shell was mostly disintegrated into nanofibers at above five cycles of the HPWJ system. The chemical structure of the nanofiber was maintained even after extensive mechanical treatments. Subsequently, the nanofiber complex was found to improve the growth of tomatoes in a hydroponics system, suggesting the mechanical treatments efficiently released minerals into the system. The homogeneous dispersion of the nanofiber complex enabled easier application as a fertilizer compared to the crab shell flakes. PMID:27669216

  7. Profile of everolimus in the treatment of tuberous sclerosis complex: an evidence-based review of its place in therapy

    PubMed Central

    Capal, Jamie K; Franz, David Neal

    2016-01-01

    Tuberous sclerosis complex (TSC) is a relatively rare genetic disorder, affecting one in 6,000 births. Mammalian target of rapamycin (mTOR) inhibitors, such as everolimus, which have been previously used to prevent solid organ transplant rejection, augment anticancer treatment regimens, and prevent neovascularization of artificial cardiac stents, are now approved for treating TSC-related manifestations, such as subependymal giant cell astrocytomas and renal angiomyolipomas. The use of everolimus in treating subependymal giant cell astrocytomas is supported by long-term Phase II and III clinical trials. Seizures are a common feature in TSC, occurring in up to 96% of patients. While mTOR inhibitors currently do not have regulatory approval in treating this manifestation, small clinical studies have demonstrated beneficial outcomes with everolimus. Further evidence from a forthcoming Phase III clinical study may provide additional support for the use of everolimus for this indication. Also, there are no approved treatments for TSC-associated neuropsychiatric disorders, which include intellectual disability, behavioral difficulties, and autism spectrum disorder, but preclinical data and small studies have suggested that some neuropsychiatric symptoms may be improved through mTOR inhibition therapy. More evidence is needed, particularly regarding safety in young infants. This review focuses on the current evidence supporting the use of everolimus in neurologic and neuropsychiatric manifestations of TSC, and the place of everolimus in therapy. PMID:27601910

  8. Profile of everolimus in the treatment of tuberous sclerosis complex: an evidence-based review of its place in therapy.

    PubMed

    Capal, Jamie K; Franz, David Neal

    2016-01-01

    Tuberous sclerosis complex (TSC) is a relatively rare genetic disorder, affecting one in 6,000 births. Mammalian target of rapamycin (mTOR) inhibitors, such as everolimus, which have been previously used to prevent solid organ transplant rejection, augment anticancer treatment regimens, and prevent neovascularization of artificial cardiac stents, are now approved for treating TSC-related manifestations, such as subependymal giant cell astrocytomas and renal angiomyolipomas. The use of everolimus in treating subependymal giant cell astrocytomas is supported by long-term Phase II and III clinical trials. Seizures are a common feature in TSC, occurring in up to 96% of patients. While mTOR inhibitors currently do not have regulatory approval in treating this manifestation, small clinical studies have demonstrated beneficial outcomes with everolimus. Further evidence from a forthcoming Phase III clinical study may provide additional support for the use of everolimus for this indication. Also, there are no approved treatments for TSC-associated neuropsychiatric disorders, which include intellectual disability, behavioral difficulties, and autism spectrum disorder, but preclinical data and small studies have suggested that some neuropsychiatric symptoms may be improved through mTOR inhibition therapy. More evidence is needed, particularly regarding safety in young infants. This review focuses on the current evidence supporting the use of everolimus in neurologic and neuropsychiatric manifestations of TSC, and the place of everolimus in therapy.

  9. Combined Targeting of mTOR and Akt Using Rapamycin and MK-2206 in The Treatment of Tuberous Sclerosis Complex

    PubMed Central

    Ji, Shuang; Lin, Wei; Wang, Li; Ni, Zhaofei; Jin, Fuquan; Zha, Xiaojun; Fei, Guanghe

    2017-01-01

    Tuberous sclerosis complex (TSC), caused by loss-of-function mutations in the TSC1 or TSC2 genes, is an autosomal dominant disease characterized by benign tumor formation in multiple organs. Hyperactivation of mammalian target of rapamycin (mTOR) is the primary alteration underlying TSC tumor. Thus, rapamycin, as an mTOR specific inhibitor, has been assumed as a potential drug for the treatment of TSC. However, its application in TSC patients has been limited due to side effects. By analyzing Tsc1- or Tsc2-null mouse embryonic fibroblasts (MEFs), we found that loss of TSC1 or TSC2 led to a decreased sensitivity to MK-2206, a novel allosteric Akt inhibitor. Ectopic expression of a constitutively activated Akt (myristoylated Akt-1, myrAkt-1) sensitized Tsc2-null and Tsc1-null MEFs to MK-2206. Furthermore, MK-2206 increased the cytotoxicity of rapamycin in Tsc1-/-or Tsc2-/- MEFs. Moreover, the benefit of the combinatorial treatment was also demonstrated in a TSC xenograft mouse model. We conclude that the combination of rapamycin and MK-2206 may be utilized as a new therapeutic regimen for TSC. PMID:28367235

  10. Formulation and characterization of a 0.1% rapamycin cream for the treatment of Tuberous Sclerosis Complex-related angiofibromas.

    PubMed

    Bouguéon, Guillaume; Lagarce, Frédéric; Martin, Ludovic; Pailhoriès, Hélène; Bastiat, Guillaume; Vrignaud, Sandy

    2016-07-25

    Medicines for the treatment of rare diseases frequently do not attract the interest of the pharmaceutical industry, and hospital pharmacists are thus often requested by physicians to prepare personalized medicines. Tuberous Sclerosis Complex (TSC) is a rare disease that causes disfiguring lesions named facial angiofibromas. Various topical formulations of rapamycin (=sirolimus) have been proved effective in treating these changes in small case series. The present study provides for the first time characterization of a 0.1% rapamycin cream formulation presenting good rapamycin solubilisation. The first step of the formulation is solubilisation of rapamycin in Transcutol(®), and the second step is the incorporation of the mixture in an oil-in-water cream. A HPLC stability-indicating method was developed. Rapamycin concentration in the cream was tested by HPLC and confirmed that it remained above 95% of the initial concentration for at least 85days, without characteristic degradation peaks. The preparation met European Pharmacopoeia microbial specifications throughout storage in aluminum tubes, including when patient use was simulated. Odour, appearance and colour of the preparation were assessed and no change was evidenced during storage. The rheological properties of the cream also remained stable throughout storage. To conclude, we report preparation of a novel cream formulation presenting satisfactory rapamycin solubilisation for the treatment of TSC cutaneous manifestations, with stability data. The cream is currently being used by our patients. Efficacy and tolerance will be reported later.

  11. Negative pressure wound therapy with Bio-Dome dressing technology in the treatment of complex wounds: a case series.

    PubMed

    Penny, H L; Spinazzola, J; Green, A; Rifkah, M; Faretta, M; Youshaw, D; Weaver, A; Zaki, P

    2014-04-01

    The treatment of complex wounds is difficult and not always effective. Various treatment options are used with varying degrees of success. Negative pressure wound therapy (NPWT) is a cost-efficient and effective way to help treat these wounds. The use of a vacuum device applies the negative pressure to the site of the wound and promotes waste removal and increases circulation and tissue formation. While various NPWT systems are currently on the market, we utilised the ConvaTec Engenex® system with Bio-DomeTM technology; however, our case study is not intended to advocate the specific use of this system, but instead focuses on the use of NPWT as a viable option for wound healing. Each of the following case study patients presented with difficult-to-heal wounds that failed traditional therapeutic approaches. Through the use of NPWT, our patients saw major wound size reductions. Each patient exhibited at least a 94% reduction in wound area, wound volume or both.

  12. Pain exposure physical therapy (PEPT) compared to conventional treatment in complex regional pain syndrome type 1: a randomised controlled trial

    PubMed Central

    Barnhoorn, Karlijn J; van de Meent, Henk; van Dongen, Robert T M; Klomp, Frank P; Groenewoud, Hans; Samwel, Han; Nijhuis-van der Sanden, Maria W G; Frölke, Jan Paul M; Staal, J Bart

    2015-01-01

    Objective To compare the effectiveness of pain exposure physical therapy (PEPT) with conventional treatment in patients with complex regional pain syndrome type 1 (CRPS-1) in a randomised controlled trial with a blinded assessor. Setting The study was conducted at a level 1 trauma centre in the Netherlands. Participants 56 adult patients with CRPS-1 participated. Three patients were lost to follow-up. Interventions Patients received either PEPT in a maximum of five treatment sessions, or conventional treatment following the Dutch multidisciplinary guideline. Measurements Outcomes were assessed at baseline and at 3, 6 and 9 months after randomisation. The primary outcome measure was the Impairment level Sum Score—Restricted Version (ISS-RV), consisting of visual analogue scale for pain (VAS-pain), McGill Pain Questionnaire, active range of motion (AROM) and skin temperature. Secondary outcome measures included Pain Disability Index (PDI); muscle strength; Short Form 36 (SF-36); disability of arm, shoulder and hand; Lower Limb Tasks Questionnaire (LLTQ); 10 m walk test; timed up-and-go test (TUG) and EuroQol-5D. Results The intention-to-treat analysis showed a clinically relevant decrease in ISS-RV (6.7 points for PEPT and 6.2 points for conventional treatment), but the between-group difference was not significant (0.96, 95% CI −1.56 to 3.48). Participants allocated to PEPT experienced a greater improvement in AROM (between-group difference 0.51, 95% CI 0.07 to 0.94; p=0.02). The per protocol analysis showed larger and significant between-group effects on ISS-RV, VAS-pain, AROM, PDI, SF-36, LLTQ and TUG. Conclusions We cannot conclude that PEPT is superior to conventional treatment for patients with CRPS-1. Further high-quality research on the effects of PEPT is warranted given the potential effects as indicated by the per protocol analysis. Trial registration numbers NCT00817128 and NTR 2090. PMID:26628523

  13. Comparison of effects of seven treatment methods for distal radius fracture on minimizing complex regional pain syndrome

    PubMed Central

    Sun, Tao

    2016-01-01

    Introduction Using network meta-analysis, we evaluated the adverse effects of the seven most common treatment methods, i.e., bridging external fixation, non-bridging external fixation, K-wire fixation, plaster fixation, dorsal plating, volar plating, and dorsal and volar plating, by their associated risk of developing complex regional pain syndrome (CRPS) in distal radius fracture (DRF) patients. Material and methods Following an exhaustive search of scientific literature databases for high quality studies, randomized controlled trials (RCTs) related to our study topic were screened and selected based on stringent predefined inclusion and exclusion criteria. Data extracted from the selected studies were used for statistical analyses using Stata 12.0 software. Results A total of 17 RCTs, including 1658 DRF patients, were enrolled in this network meta-analysis. Among the 1658 DRF patients, 452 received bridging external fixation, 525 received non-bridging external fixation, 154 received K-wire fixation, 84 received plaster fixation, 132 received dorsal plating, 123 received volar plating, and 188 received dorsal and volar plating. When compared to bridging external fixation patients, there was no marked difference in the CRPS risk in DRF patients receiving different treatments (all p > 0.05). However, the surface under the cumulative ranking curves (SUCRA) for plaster fixation (77.0%) and non-bridging external fixation (71.3%) were significantly higher compared with the other five methods. Conclusions Our findings suggest that compared with bridging external fixation, K-wire fixation, dorsal plating, volar plating, dorsal and volar plating, plaster fixation and non-bridging external fixation might be the better treatment methods to reduce the risk of CRPS in DRF patients. PMID:28144268

  14. Biofilm-Grown Burkholderia cepacia Complex Cells Survive Antibiotic Treatment by Avoiding Production of Reactive Oxygen Species

    PubMed Central

    Van Acker, Heleen; Sass, Andrea; Bazzini, Silvia; De Roy, Karen; Udine, Claudia; Messiaen, Thomas; Riccardi, Giovanna; Boon, Nico; Nelis, Hans J.; Mahenthiralingam, Eshwar; Coenye, Tom

    2013-01-01

    The presence of persister cells has been proposed as a factor in biofilm resilience. In the present study we investigated whether persister cells are present in Burkholderia cepacia complex (Bcc) biofilms, what the molecular basis of antimicrobial tolerance in Bcc persisters is, and how persisters can be eradicated from Bcc biofilms. After treatment of Bcc biofilms with high concentrations of various antibiotics often a small subpopulation survived. To investigate the molecular mechanism of tolerance in this subpopulation, Burkholderia cenocepacia biofilms were treated with 1024 µg/ml of tobramycin. Using ROS-specific staining and flow cytometry, we showed that tobramycin increased ROS production in treated sessile cells. However, approximately 0.1% of all sessile cells survived the treatment. A transcriptome analysis showed that several genes from the tricarboxylic acid cycle and genes involved in the electron transport chain were downregulated. In contrast, genes from the glyoxylate shunt were upregulated. These data indicate that protection against ROS is important for the survival of persisters. To confirm this, we determined the number of persisters in biofilms formed by catalase mutants. The persister fraction in ΔkatA and ΔkatB biofilms was significantly reduced, confirming the role of ROS detoxification in persister survival. Pretreatment of B. cenocepacia biofilms with itaconate, an inhibitor of isocitrate lyase (ICL), the first enzyme in the glyoxylate shunt, reduced the persister fraction approx. 10-fold when the biofilms were subsequently treated with tobramycin. In conclusion, most Bcc biofilms contain a significant fraction of persisters that survive treatment with high doses of tobramycin. The surviving persister cells downregulate the TCA cycle to avoid production of ROS and at the same time activate an alternative pathway, the glyoxylate shunt. This pathway may present a novel target for combination therapy. PMID:23516582

  15. Toxicity Identification and Evaluation for the Effluent from Wastewater Treatment Plant in Industrial Complex using D.magna

    NASA Astrophysics Data System (ADS)

    Lee, S.; Keum, H.; Chun Sang, H.

    2015-12-01

    In recent years, the interests on the impacts of industrial wastewater on aquatic ecosystem have increased with concern about ecosystem protection and human health. Whole effluent toxicity tests are used to monitor toxicity by unknown toxic chemicals as well as conventional pollutants from industrial effluent discharges. This study describes the application of TIE (toxicity identification evaluation) procedures to an acutely toxic effluent from a wastewater treatment plant in industrial complex which was toxic to Daphnia magna. In TIE phase I (characterization step), the toxic effects by heavy metals, organic compounds, oxidants, volatile organic compounds, suspended solids and ammonia were screened and revealed that the source of toxicity is far from these toxicants group. Chemical analysis (TIE phase II) on TDS showed that the concentration of chloride ion (6,900 mg/L) was substantially higher than that predicted from EC50 for D. magna. In confirmation step (TIE phase III), chloride ion was demonstrated to be main toxicant in this effluent by the spiking approach, species sensitivity approach and deletion approach. Calcium, potassium, magnesium, sodium, fluorine, sulfate ion concentration (450, 100, 80, 5,300, 0.66, 2,200mg/L) was not shown toxicity from D. magna. Finally, we concluded that chloride was the most contributing toxicant in the waste water treatment plant. Further research activities are needed for technical support of toxicity identification and evaluation on the various types of wastewater treatment plant discharge in Korea. Keywords : TIE, D. magna, Industrial waste water Acknowledgement This research was supported by a grant (15IFIP-B089908-02) from Plant Research Program funded by Ministry of Land, Infrastructure and Transport of Korean government

  16. [Effectiveness of 3-hydroxypyridine and succinic acid derivatives in complex treatment of primary open-angle glaucoma].

    PubMed

    Volchegorskiĭ, I A; Tur, E V; Soliannikova, O V; Rykun, V S; Sumina, M S; Dmitrienko, V N; Berdnikova, E V

    2012-01-01

    Prospective, placebo-controlled, single-blind, randomized clinical investigation of the influence of domestic 3-hydroxypyridine and succinic acid derivatives (emoxipin, reamberin, mexidol) on the effectiveness of a complex treatment of primary open-angle glaucoma (POAG) has been performed in a group of patients. It is established that intravenous infusion of 3-hydroxypyridine derivatives (emoxipin and mexidol) for two weeks, beginning 14 days after the start of POAG treatment, produced a retinoprotective action, with three months postponed changes in the central retinal artery (CRA) blood velocity. The retinoprotective effect of emoxipin (single dose, 150 mg) was manifested by reduction in the horizontal size of blind spot in two weeks, with the subsequent reduction of the CRA end-diastolic blood velocity observed three months after finish of the infusion therapy. The administration of mexidol (single dose, 300 mg) after 14 days of treatment led to widening of the summarized field of vision (test-object square, 16 mm), accompanied by a decrease in the electrosensitivity threshold of the optic nerve and the intensity of POAG-associated hypothymia. All indices of CRA blood velocity increased three months after termination of mexidol infusions. Reamberin (single dose, 400 ml 1,5% solution of reamberine, containing polyelectrolyte and meglumine succinate mixture) did not show retinoprotective action, but caused proatherogenic changes of blood lipids and 3 months postponed CRA end-diastolic blood velocity increase. The effect of mexidol (which is a derivative of both 3- hydroxypyridine and succinic acid) exceeds that of separate 3-hydroxypyridine (emoxipin) and succinic acid (reamberin) derivatives in the degree of retinoprotection and positive effect on the optic nerve condition and mood of POAG patients.

  17. Clinical Application of Estimating Hepatitis B Virus Quasispecies Complexity by Massive Sequencing: Correlation between Natural Evolution and On-Treatment Evolution

    PubMed Central

    Homs, Maria; Caballero, Andrea; Gregori, Josep; Tabernero, David; Quer, Josep; Nieto, Leonardo; Esteban, Rafael; Buti, Maria; Rodriguez-Frias, Francisco

    2014-01-01

    Aim To evaluate HBV quasispecies (QA) complexity in the preCore/Core regions in relation to HBeAg status, and explore QA changes under natural evolution and nucleoside analogue (NUC) treatment. Methods Ultra-deep pyrosequencing of HBV preCore/Core regions in 30 sequential samples (baseline [diagnosis], treatment-free, and treatment-nonresponse) from 10 retrospectively selected patients grouped according to HBeAg status over time: HBeAg+ (N = 4), HBeAg- (N = 2), and fluctuating HBeAg (transient seroreversion/seroconversion pattern) (N = 4). QA complexity was defined by Shannon entropy, mutation frequency, nucleotide diversity, and mutation frequency of amino acids (MfAA) in preCore and Core. Results The QA was less complex in HBeAg+ than in HBeAg- or fluctuating HBeAg. High complexity in preCore was associated with decreased viral replication (preCore MfAA negatively correlated with HBV-DNA, p = 0.005). QA complexity in the treatment-free period negatively correlated with values seen during treatment. Specific variants were mainly selected in the Core region in HBeAg- and fluctuating HBeAg patients, suggesting higher immune pressure than in HBeAg+. Conclusions The negative correlation between QA natural evolution and on-treatment evolution indicates the importance of pre-treatment QA study to predict QA changes in NUC nonresponders. Study of QA complexity could be useful for managing HBV infection. PMID:25393280

  18. Effects of iron polymaltose complex, ferrous fumarate and ferrous sulfate treatments in anemic pregnant rats, their fetuses and placentas.

    PubMed

    Toblli, Jorge E; Cao, Gabriel; Oliveri, Leda; Angerosa, Margarita

    2013-06-01

    Although oral iron preparations are widely prescribed to prevent and to treat iron deficiency anemia in pregnancy, comparative data on their effects to the mother, fetus and placenta are limited. In this study, the effects of oral iron polymaltose complex (IPC), ferrous fumarate (FF) and ferrous sulfate (FS) were compared in anemic pregnant rats, their fetuses and placentas. Hematological variables and oxidative stress markers in the liver, heart and kidneys of the dams and fetuses as well as the markers for oxidative stress, inflammation and hypoxia in placentas were assessed. Pregnancy outcome was measured by number of fetuses, and by neonate and placental weight. All therapies were comparably effective in correcting anemia. FS and FF, but not IPC, resulted in liver damage in dams and oxidative stress in dams, fetuses and placentas. FS group presented the highest catalase and GPx levels in dams, fetuses and placentas. IPC, but not FF or FS, restored normal TNF-α and IL6 expression levels in placentas whereas FS-treated animals presented the highest cytokine levels, suggesting a local inflammatory reaction. Anemia-induced high levels of HIF-1α were partially lowered by IPC and FF but further elevated by FS. Most of the negative effects associated with IDA were resolved by IPC treatment. Especially FS treatment was found to elicit hepatic damage in the dams, oxidative stress in the dams, fetuses and placenta as well as inflammation and high levels of HIF-1α in the placenta. Pregnancy outcome of FFand FS-treated animals was worse than that of IPC-treated animals.

  19. The Use of Best Practice in the Treatment of a Complex Diabetic Foot Ulcer: A Case Report

    PubMed Central

    Blakely, Melodie

    2016-01-01

    Background and Purpose: Published guidelines for effective management of diabetic foot ulcers (DFU) include total contact casting (TCC). The purpose of this case study is to describe the application of best practice guidelines for the treatment of a diabetic foot ulcer (DFU) in a complex patient where TCC offloading could not be utilized. Case Description: The patient was a 47 year-old female with a five-plus year history of a full-thickness DFU on the left plantar mid-foot. Treatment included sharp and ultrasound debridement, the use of a silver hydrofiber dressing, edema management via compression therapy, negative pressure wound therapy, offloading via customized 1/4 inch adhesive-backed felt applied to the plantar foot in addition to an offloading boot and use of a wheelchair, patient education regarding diabetes management, and the application of a bilayered living skin-equivalent biologic dressing. Outcomes: At 15 weeks the wound was closed and the patient was transitioned into diabetic footwear. Discussion: The felt offloading was a beneficial alternative to TCC. The patient’s longer than average healing rate may have been complicated by the duration of her wound, her 41 year history of diabetes, and the fact that gold standard offloading (TCC) was not able to be used. Further research is needed regarding the use of felt for offloading, such as application technique for wounds on different areas of the foot, comparison of different types of felt, and the use of felt in conjunction with various offloading devices. PMID:27417606

  20. Outlook for the use of focused shock waves and pulsed electric fields in the complex treatment of malignant neoplasms.

    PubMed

    Garilevich, B A; Andrianov, Yu V; Olefir, Yu V; Zubkov, A D; Rotov, A E

    2006-01-01

    The experimental studies the synchronous action of electric field microsecond range with amplitude within the range of 1-7 kV/sm and shock waves with pressure before 100 MPa on cells membrane permeability of the mouse's ascitic tumors in vitro have shown the intensification the efficiency of the forming the irreversible pores under synchronous action. Thereby, enabling the electric field in the compression phase of shock wave pulse which can essentially reduce the electric field intensity required for breakdown cell membrane. In usual condition at amplitude of electric field, specified above, electric breakdown membrane carries basically reversible nature. At the same time in the pressure field tension phase of shock-wave pulse reversible pores, created by electric field, can grow before sizes, under which wholeness membrane is not restored. Under simultaneous action on cellular suspension the shock wave and electric field with moderate intensity cells survival is reduced in 5 once in contrast with occuring at different time's action, and in 10 once in contrast with checking. The most sensitive to influence by under study fields are cells in phase of the syntheses DNA, preparation to fission and in phase of the mitosis. Thereby, continuation of the studies on use synchronous action shock waves and pulsed electric fields in complex treatment of the tumors introduces perspective.

  1. 2-Deoxy-D-glucose treatment changes the Golgi apparatus architecture without blocking synthesis of complex lipids.

    PubMed

    Ranftler, Carmen; Meisslitzer-Ruppitsch, Claudia; Stangl, Herbert; Röhrl, Clemens; Fruhwürth, Stefanie; Neumüller, Josef; Pavelka, Margit; Ellinger, Adolf

    2015-04-01

    The classic Golgi apparatus organization, an arrangement of highly ordered cisternal stacks with tubular-vesicular membrane specializations on both sides, is the functional image of a continuous flow of contents and membranes with input, metabolization, and output in a dynamic steady state. In response to treatment with 2-deoxy-D-glucose (2-DG), which lowers the cellular ATP level by about 70% within minutes, this organization is rapidly replaced by tubular-glomerular membrane convolutes described as Golgi networks and bodies. 2-DG is a non-metabolizable glucose analogue and competitive inhibitor of glycolysis, which has become attractive in the context of therapeutic approaches for several kinds of tumors specifically targeting glycolysis in cancer. With the question of whether the functions of the Golgi apparatus in lipid synthesis would be influenced by the 2-DG-induced Golgi apparatus reorganization, we focused on lipid metabolism within the Golgi bodies. For this, we applied a fluorophore-labeled short-chain ceramide (BODIPY-Cer) in various combinations with 2-DG treatment to HepG2 cell cultures and followed uptake, enrichment and metabolization to higher ordered lipids. The cellular ATP status in each experiment was controlled with a bioluminescence assay, and the response of the Golgi apparatus was tracked by immunostaining of the trans-Golgi network protein TGN46. For electron microscopy, the fluorescent BODIPY-Cer signals were converted into electron-dense precipitates by photooxidation of diaminobenzidine (DAB); DAB precipitates labeled trans-Golgi areas in control cultures but also compartments at the periphery of the Golgi bodies formed in response to 2-DG treatment, thus indicating that concentration of ceramide takes place in spite of the Golgi apparatus reorganization. Lipid analyses by thin-layer chromatography (TLC) performed in parallel showed that BODIPY-Cer is not only concentrated in compartments of the 2-DG-induced Golgi bodies but is partly

  2. An investigation of multidisciplinary complex health care interventions - steps towards an integrative treatment model in the rehabilitation of People with Multiple Sclerosis

    PubMed Central

    2012-01-01

    Background The Danish Multiple Sclerosis Society initiated a large-scale bridge building and integrative treatment project to take place from 2004–2010 at a specialized Multiple Sclerosis (MS) hospital. In this project, a team of five conventional health care practitioners and five alternative practitioners was set up to work together in developing and offering individualized treatments to 200 people with MS. The purpose of this paper is to present results from the six year treatment collaboration process regarding the development of an integrative treatment model. Discussion The collaborative work towards an integrative treatment model for people with MS, involved six steps: 1) Working with an initial model 2) Unfolding the different treatment philosophies 3) Discussing the elements of the Intervention-Mechanism-Context-Outcome-scheme (the IMCO-scheme) 4) Phrasing the common assumptions for an integrative MS program theory 5) Developing the integrative MS program theory 6) Building the integrative MS treatment model. The model includes important elements of the different treatment philosophies represented in the team and thereby describes a common understanding of the complexity of the courses of treatment. Summary An integrative team of practitioners has developed an integrative model for combined treatments of People with Multiple Sclerosis. The model unites different treatment philosophies and focuses on process-oriented factors and the strengthening of the patients’ resources and competences on a physical, an emotional and a cognitive level. PMID:22524586

  3. Building the rationale and structure for a complex physical therapy intervention within the context of a clinical trial: a multimodal individualized treatment for patients with hip osteoarthritis.

    PubMed

    Bennell, Kim L; Egerton, Thorlene; Pua, Yong-Hao; Abbott, J Haxby; Sims, Kevin; Buchbinder, Rachelle

    2011-10-01

    Evaluating the efficacy of complex interventions such as multimodal, impairment-based physical therapy treatments in randomized controlled trials is essential to inform practice and compare relative benefits of available treatment options. Studies of physical therapy interventions using highly standardized intervention protocols, although methodologically rigorous, do not necessarily reflect "real-world" clinical practice, and in many cases results have been disappointing. Development of a complex intervention that includes multiple treatment modalities and individualized treatment technique selection requires a systematic approach to designing all aspects of the intervention based on theory, evidence, and practical constraints. This perspective article outlines the development of the rationale and structure of a multimodal physical therapy program for painful hip osteoarthritis to be assessed in a clinical trial. The resulting intervention protocol comprises a semi-structured program of exercises and manual therapy, advice, physical activity, and optional prescription of a gait aid that is standardized, yet can be individualized according to physical assessment and radiographic findings. The program is evidence based and reflects contemporary physical therapist practice, while also being reproducible and reportable. This perspective article aims to encourage physical therapy researchers involved in evaluation of complex interventions to better document their own intervention development, as well as the outcomes, thus generating a body of knowledge about the development processes and protocols that is generalizable to the real-world complexity of providing physical therapy to individual patients.

  4. [Dynamics of clinical changes and healing of purulent wounds in application of nanocapsules of phosphatidylcholine in complex of treatment of patients, suffering the oral cavity floor phlegmon].

    PubMed

    Avetikov, D S; Kuong, Vu Vyet; Stavytskiy, S O; Lokes, K P; Voloshyna, L I

    2015-03-01

    Substantiation of expediency for nanocapsules of phosphatidylcholine (lipin) application, owing antihypoxant, antioxydant and immunostimulating action in complex of treatment of patients, suffering odontogenic phlegmon of oral cavity floor (OPHOCF), is presented. The preparation application have promoted a trustworthy reduction of exudation of purulent content, as well as more rapid occurrence of granulations and the wound epithelization.

  5. Treatment

    MedlinePlus

    ... Ban For Clinicians Clinical Recognition Specimen Collection Treatment Smallpox Vaccine Guidance Infection Control: Hospital Infection Control: Home ... Mouth Infection) Poxvirus and Rabies Branch Travelers’ Health: Smallpox & Other Orthopoxvirus-Associated Infections Poxvirus Treatment Recommend on ...

  6. Temporal changes of symbiont density and host fitness after rifampicin treatment in a whitefly of the Bemisia tabaci species complex.

    PubMed

    Shan, Hong-Wei; Zhang, Chang-Rong; Yan, Ting-Ting; Tang, Hai-Qin; Wang, Xiao-Wei; Liu, Shu-Sheng; Liu, Yin-Quan

    2016-04-01

    Microbial symbionts are essential or important partners to phloem-feeding insects. Antibiotics have been used to selectively eliminate symbionts from their host insects and establish host lines with or without certain symbionts for investigating functions of the symbionts. In this study, using the antibiotic rifampicin we attempted to selectively eliminate certain symbionts from a population of the Middle East-Asia Minor 1 whitefly of the Bemisia tabaci species complex, which harbors the primary symbiont "Candidatus Portiera aleyrodidarum" and two secondary symbionts "Candidatus Hamiltonella defensa" and Rickettsia. Neither the primary nor the secondary symbionts were completely depleted in the adults (F0) that fed for 48 h on a diet treated with rifampicin at concentrations of 1-100 μg/mL. However, both the primary and secondary symbionts were nearly completely depleted in the offspring (F1) of the rifampicin-treated adults. Although the F1 adults produced some eggs (F2), most of the eggs failed to hatch and none of them reached the second instar, and consequently the rifampicin-treated whitefly colony vanished at the F2 generation. Interestingly, quantitative polymerase chain reaction assays showed that in the rifampicin-treated whiteflies, the density of the primary symbiont was reduced at an obviously slower pace than the secondary symbionts. Mating experiments between rifampicin-treated and untreated adults demonstrated that the negative effects of rifampicin on host fitness were expressed when the females were treated by the antibiotic, and whether males were treated or not by the antibiotic had little contribution to the negative effects. These observations indicate that with this whitefly population it is not feasible to selectively eliminate the secondary symbionts using rifampicin without affecting the primary symbiont and establish host lines for experimental studies. However, the extinction of the whitefly colony at the second generation after

  7. Simultaneous treatment of chlorinated organics and removal of metals and radionuclides with bimetals and complexing acids - application to surfactant solutions

    SciTech Connect

    Korte, N.E.; Gu, B.

    1997-10-01

    Currently available methods for separation and treatment of radioactive mixed waste are typically energy-intensive, and often require high temperatures. Passive methods that operate at ambient temperatures are needed. The purpose of this task is to develop bimetallic substrates, using a base metal such as iron and a promoter metal such as palladium (Pd), to provide a passive, low-energy solution to a substantial portion of DOE`s mixed-waste problem. This technology consists of a porous medium that can simultaneously dechlorinate hazardous organics such as TCE and polychlorinated biphenyls (PCBs) at the same time that it removes metallic and hazardous wastes from a solvent/surfactant solution. The porous medium consists of a bimetallic substrate such as palladized iron (Pd/Fe). Palladium is readily chemically plated on iron and preliminary studies suggest that only 0.05 to 0.1% Pd is needed for an efficient reaction. Thus, the cost of the material is reasonable especially is it is long-lived or can be regenerated. Field implementation would consist of the passage of a surfactant-laden, mixed waste through a column or bed of the bimetallic substrate. The organic component of this mixed waste may contain semivolatile compounds such as PCBs or pesticides and herbicides. The bimetal simultaneously removes radionuclides and metals and degrades halogenated hydrocarbons. Virtually any concentration can be treated. Following reaction of the bimetal with the waste stream, the resulting effluent will consist of an uncontaminated aqueous solution of surfactant or solvent that can be reused. The bimetal would then be rinsed with a dilute mineral acid or a mild complexing acid (e.g., oxalic or citric acid) to regenerate the surface and to remove sorbed metals and non-hazardous organic residue. The latter effluent would be low-level radioactive waste in some cases, but it would now be much easier to manage and be of a lower volume than the original mixed waste.

  8. The effect of conventional mechanical periodontal treatment on red complex microorganisms and clinical parameters in Down syndrome periodontitis patients: a pilot study.

    PubMed

    Tanaka, M H; Rodrigues, T O; Finoti, L S; Teixeira, S R L; Mayer, M P A; Scarel-Caminaga, R M; Giro, E M A

    2015-03-01

    Periodontal disease (PD) is induced by a complex microbiota, such as Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola (together called the red complex), which triggers intense inflammatory reaction. Down syndrome (DS) individuals demonstrate a high prevalence of PD compared with those who are otherwise chromosomally normal (euploids). This pilot study aimed to evaluate the effect of non-surgical periodontal treatment in DS chronic periodontitis patients on clinical and microbiological parameters. Patients with chronic periodontitis, 23 DS and 12 euploids (control group), were submitted to non-surgical mechanical periodontal treatment, followed by maintenance for 45 days. Clinical parameters after periodontal treatment were similar in diseased and healthy sites, independent of the genetic background. Diseased sites of DS and control patients harbored similar levels of P. gingivalis and T. forsythia at baseline, but significantly higher levels of T. denticola were found in DS patients. Increased levels of P. gingivalis at healthy sites were found in DS individuals. Non-surgical periodontal therapy decreased the levels of red complex microorganisms and improved the tested clinical parameters of diseased sites in both groups. However, the levels of red complex bacteria were higher in diseased sites of DS patients after the periodontal treatment. We conclude in this pilot study that, although the mechanical periodontal treatment seemed to be effective in DS subjects over a short-term period, the red complex bacteria levels did not decrease significantly in diseased sites, as occurred in controls. Therefore, for DS patients, it seems that the conventional non-surgical periodontal therapy should be improved by utilizing adjuvants to reduce the presence of periodontopathogens.

  9. Dosimetric characterization of hypofractionated Gamma Knife radiosurgery of large or complex brain tumors versus linear accelerator-based treatments.

    PubMed

    Dong, Peng; Pérez-Andújar, Angélica; Pinnaduwage, Dilini; Braunstein, Steve; Theodosopoulos, Philip; McDermott, Michael; Sneed, Penny; Ma, Lijun

    2016-12-01

    OBJECTIVE Noninvasive Gamma Knife (GK) platforms, such as the relocatable frame and on-board imaging, have enabled hypofractionated GK radiosurgery of large or complex brain lesions. This study aimed to characterize the dosimetric quality of such treatments against linear accelerator-based delivery systems that include the CyberKnife (CK) and volumetric modulated arc therapy (VMAT). METHODS Ten patients treated with VMAT at the authors' institution for large brain tumors (> 3 cm in maximum diameter) were selected for the study. The median prescription dose was 25 Gy (range 20-30 Gy) in 5 fractions. The median planning target volume (PTV) was 9.57 cm(3) (range 1.94-24.81 cm(3)). Treatment planning was performed using Eclipse External Beam Planning V11 for VMAT on the Varian TrueBeam system, Multiplan V4.5 for the CyberKnife VSI System, and Leksell GammaPlan V10.2 for the Gamma Knife Perfexion system. The percentage of the PTV receiving at least the prescription dose was normalized to be identical across all platforms for individual cases. The prescription isodose value for the PTV, conformity index, Paddick gradient index, mean and maximum doses for organs at risk, and normal brain dose at variable isodose volumes ranging from the 5-Gy isodose volume (V5) to the 15-Gy isodose volume (V15) were compared for all of the cases. RESULTS The mean Paddick gradient index was 2.6 ± 0.2, 3.2 ± 0.5, and 4.3 ± 1.0 for GK, CK, and VMAT, respectively (p < 0.002). The mean V15 was 7.5 ± 3.7 cm(3) (range 1.53-13.29 cm(3)), 9.8 ± 5.5 cm(3) (range 2.07-18.45 cm(3)), and 16.1 ± 10.6 cm(3) (range 3.58-36.53 cm(3)) for GK, CK, and VMAT, respectively (p ≤ 0.03, paired 2-tailed t-tests). However, the average conformity index was 1.18, 1.12, and 1.21 for GK, CK, and VMAT, respectively (p > 0.06). The average prescription isodose values were 52% (range 47%-69%), 60% (range 46%-68%), and 88% (range 70%-94%) for GK, CK, and VMAT, respectively, thus producing significant variations in

  10. Clinical Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder (Bipolar CHOICE): A Pragmatic Trial of Complex Treatment for a Complex Disorder

    PubMed Central

    Nierenberg, Andrew A.; Sylvia, Louisa G.; Leon, Andrew C.; Reilly-Harrington, Noreen; Shesler, Leah W.; McElroy, Susan L.; Friedman, Edward S.; Thase, Michael E.; Shelton, Richard C.; Bowden, Charles; Tohen, Mauricio; Singh, Vivek; Deckersbach, Thilo; Ketter, Terence; Kocsis, James; McInnis, Melvin G.; Schoenfeld, David; Bobo, William V.; Calabrese, Joseph R.

    2015-01-01

    Background Classic and second generation antipsychotic mood stabilizers are recommended for treatment of bipolar disorder, yet there are no randomized comparative effectiveness studies that have examined the “real-world” advantages and disadvantages of these medications Purpose We describe the strategic decisions in the design of the Clinical and Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder (Bipolar CHOICE). This paper outlines the key issues and solutions the investigators faced in designing a clinical trial that would maximize generalizability and inform real-world clinical treatment of bipolar disorder. Methods Bipolar CHOICE was a 6-month, multi-site, prospective, randomized clinical trial of outpatients with bipolar disorder. This study compares the effectiveness of quetiapine versus lithium, each with adjunctive personalized treatments. The co-primary outcomes selected are the overall benefits and harms of the study medications (as measured by the Clinical Global Impression-Efficacy Index) and the Necessary Clinical Adjustments (a measure of the number of medication changes). Secondary outcomes are continuous measures of mood, the Framingham General Cardiovascular Risk Score and the Longitudinal Interval Follow up Evaluation Range of Impaired Functioning Tool. Results The final study design consisted of a single-blind, randomized comparative effectiveness trial of quetiapine versus lithium, plus adjunctive personalized treatment (APT), across ten sites. Other important study considerations included limited exclusion criteria to maximize generalizability, flexible dosing of APT medications to mimic real-world treatment, and an intent-to-treat analysis plan. 482 participants were randomized to the study and 364 completed. Limitations The potential limitations of the study include the heterogeneity of APT, selection of study medications, lack of a placebo-control group, and participants’ ability to pay for study medications

  11. Optimization Review: Bunker Hill Mining and Metallurgical Complex Superfund Site, Central Treatment Plant (CTP), Kellogg, Shoshone County, Idaho

    EPA Pesticide Factsheets

    The Bunker Hill Mining and Metallurgical Complex Superfund Site includes all areas of the Coeur d’Alene Basin where mining-related contamination occurred and encompasses a 21-square mile “Box” along Interstate 90 surrounding the former smelter complex.

  12. Control Point Analysis comparison for 3 different treatment planning and delivery complexity levels using a commercial 3-dimensional diode array

    SciTech Connect

    Abdellatif, Ady; Gaede, Stewart

    2014-07-01

    To investigate the use of “Control Point Analysis” (Sun Nuclear Corporation, Melbourne, FL) to analyze and compare delivered volumetric-modulated arc therapy (VMAT) plans for 3 different treatment planning complexity levels. A total of 30 patients were chosen and fully anonymized for the purpose of this study. Overall, 10 lung stereotactic body radiotherapy (SBRT), 10 head-and-neck (H and N), and 10 prostate VMAT plans were generated on Pinnacle{sup 3} and delivered on a Varian linear accelerator (LINAC). The delivered dose was measured using ArcCHECK (Sun Nuclear Corporation, Melbourne, FL). Each plan was analyzed using “Sun Nuclear Corporation (SNC) Patient 6” and “Control Point Analysis.” Gamma passing percentage was used to assess the differences between the measured and planned dose distributions and to assess the role of various control point binning combinations. Of the different sites considered, the prostate cases reported the highest gamma passing percentages calculated with “SNC Patient 6” (97.5% to 99.2% for the 3%, 3 mm) and “Control Point Analysis” (95.4% to 98.3% for the 3%, 3 mm). The mean percentage of passing control point sectors for the prostate cases increased from 51.8 ± 7.8% for individual control points to 70.6 ± 10.5% for 5 control points binned together to 87.8 ± 11.0% for 10 control points binned together (2%, 2-mm passing criteria). Overall, there was an increasing trend in the percentage of sectors passing gamma analysis with an increase in the number of control points binned together in a sector for both the gamma passing criteria (2%, 2 mm and 3%, 3 mm). Although many plans passed the clinical quality assurance criteria, plans involving the delivery of high Monitor Unit (MU)/control point (SBRT) and plans involving high degree of modulation (H and N) showed less delivery accuracy per control point compared with plans with low MU/control point and low degree of modulation (prostate)

  13. Light-Sensitive Ruthenium Complex-Loaded Cross-linked Polymeric Nanoassemblies for the Treatment of Cancer.

    PubMed

    Dickerson, M; Howerton, B; Bae, Y; Glazer, E

    2016-01-21

    This work focuses on improving the efficacy of photoactivatable Ru complexes for photodynamic therapy by employing cross-linked nanoassemblies (CNAs) as a delivery approach. The effects of complex photoactivation, hydrophobicity, and solution ionic strength and pH on complex loading and release from CNAs were analyzed. The cell cytotoxicity of CNA formulations was similar to free Ru complexes despite reduced or eliminated DNA interactions. The release rate and the amount of each Ru complex released (%) varied inversely with complex hydrophobicity, while the effect of solution ionic strength was dependent on complex hydrophobicity. Premature release of two photoactivatable prodrugs prior to irradiation was believed to account for higher activity in cells studies compared to DNA interaction studies; however, for photostable (1)O2 generator-loaded CNAs this cannot explain the high cytotoxicity and lack of DNA interactions because release was incomplete after 48 hrs. The cause remains unclear, but among other possibilities, accelerated release in a cell culture environment may be responsible.

  14. Light-Sensitive Ruthenium Complex-Loaded Cross-linked Polymeric Nanoassemblies for the Treatment of Cancer

    PubMed Central

    Dickerson, M; Howerton, B.; Bae, Y.; Glazer, E.

    2016-01-01

    This work focuses on improving the efficacy of photoactivatable Ru complexes for photodynamic therapy by employing cross-linked nanoassemblies (CNAs) as a delivery approach. The effects of complex photoactivation, hydrophobicity, and solution ionic strength and pH on complex loading and release from CNAs were analyzed. The cell cytotoxicity of CNA formulations was similar to free Ru complexes despite reduced or eliminated DNA interactions. The release rate and the amount of each Ru complex released (%) varied inversely with complex hydrophobicity, while the effect of solution ionic strength was dependent on complex hydrophobicity. Premature release of two photoactivatable prodrugs prior to irradiation was believed to account for higher activity in cells studies compared to DNA interaction studies; however, for photostable 1O2 generator-loaded CNAs this cannot explain the high cytotoxicity and lack of DNA interactions because release was incomplete after 48 hrs. The cause remains unclear, but among other possibilities, accelerated release in a cell culture environment may be responsible. PMID:26855780

  15. Vibrational spectra, normal coordinate treatment and simulation of the vibrational spectra of piperazine glyoxime and its Co(III) complex

    NASA Astrophysics Data System (ADS)

    Özpozan, T.; Küçükusta, D.; Büyükmumcu, Z.

    2003-12-01

    Newly synthesized Co(III) complexes of piperazine glyoxime (PGO) are examined from the vibrational spectroscopy point of view. A complete interpretation of the vibrational spectra of both the ligand and the complex has been carried out on the basis of normal coordinate analysis. A valence force field has been developed for both of the compounds. The vibrational spectra of the compounds are simulated by a visual basic program prepared to run on an MS Excel data sheet.

  16. Theoretical treatment of double photoionization of helium using a B-spline implementation of exterior complex scaling

    SciTech Connect

    McCurdy, C. William; Horner, Daniel A.; Rescigno, Thomas N.; Martin, Fernando

    2004-02-19

    Calculations of absolute triple differential and single differential cross sections for helium double photoionization are performed using an implementation of exterior complex scaling in B-splines. Results for cross sections, well-converged in partial waves, are presented and compared with both experiment and earlier theoretical calculations. These calculations establish the practicality and effectiveness of the complex B-spline approach to calculations of double ionization of atomic and molecular systems.

  17. Carbonic Anhydrase Inhibitors. Part 91. Metal Complexes of Heterocyclic Sulfonamides as Potential Pharmacological Agents in the Treatment of Gastric Acid Secretion Imbalances

    PubMed Central

    Ilies, Marc A.; Scozzafava, Andrea

    2000-01-01

    Zinc, magnesium, aluminum and copper complexes of several potent, clinically used carbonic anhydrase (CA) sulfonamide inhibitors, such as acetazolamide, methazolamide, ethoxzolamide and benzolamide were tested for their possible applications as antacids, in experimental animals. Gastric acid secretion parameters 3 days after treatment with these CA inhibitors (2 × 500 mg, twice a day), in dogs with chronic gastric fistulas, led to the observation that the gastric acid parameters BAO (the basal acid output), and MAO (the maximal acid output after stimulation with histamine) were drastically reduced, as compared to the same parameters in animals that did not receive these enzyme inhibitors. These are promising results for the possible use of metal complexes of heterocyclic sulfonamides as treatment alternatives (alone or in combination with other drugs) for gastric acid secretion imbalances. PMID:18475926

  18. Reversal of brain metabolic abnormalities following treatment of AIDS dementia complex with 3'-azido-2',3'-dideoxythymidine (AZT, zidovudine): a PET-FDG study

    SciTech Connect

    Brunetti, A.; Berg, G.; Di Chiro, G.; Cohen, R.M.; Yarchoan, R.; Pizzo, P.A.; Broder, S.; Eddy, J.; Fulham, M.J.; Finn, R.D.

    1989-05-01

    Brain glucose metabolism was evaluated in four patients with acquired immunodeficiency syndrome (AIDS) dementia complex using (/sup 18/F)fluorodeoxyglucose (FDG) and positron emission tomography (PET) scans at the beginning of therapy with 3'-azido-2',3'-dideoxythymidine (AZT, zidovudine), and later in the course of therapy. In two patients, baseline, large focal cortical abnormalities of glucose utilization were reversed during the course of therapy. In the other two patients, the initial PET study did not reveal pronounced focal alterations, while the post-treatment scans showed markedly increased cortical glucose metabolism. The improved cortical glucose utilization was accompanied in all patients by immunologic and neurologic improvement. PET-FDG studies can detect cortical metabolic abnormalities associated with AIDS dementia complex, and may be used to monitor the metabolic improvement in response to AZT treatment.

  19. A case report on the treatment of complex chronic pain and opioid dependence by a multidisciplinary transitional pain service using the ACT Matrix and buprenorphine/naloxone

    PubMed Central

    Weinrib, Aliza Z; Burns, Lindsay C; Mu, Alex; Azam, Muhammad Abid; Ladak, Salima SJ; McRae, Karen; Katznelson, Rita; Azargive, Saam; Tran, Cieran; Katz, Joel; Clarke, Hance

    2017-01-01

    In an era of growing concern about opioid prescribing, the postsurgical period remains a critical window with the risk of significant opioid dose escalation, particularly in patients with a history of chronic pain and presurgical opioid use. The purpose of this case report is to describe the multidisciplinary care of a complex, postsurgical pain patient by an innovative transitional pain service (TPS). A 59-year-old male with complex chronic pain, as well as escalating long-term opioid use, presented with a bleeding duodenal ulcer requiring emergency surgery. After surgery, the TPS provided integrated pharmacological and behavioral treatment, including buprenorphine combined with naloxone and acceptance and commitment therapy (ACT) using the ACT Matrix. The result was dramatic pain reduction and improved functioning and quality of life after 40+ years of chronic pain, thus changing the pain trajectory of a chronic, complex, opioid-dependent patient. PMID:28392713

  20. Operation of a two-stage treatment train for the remediation of volatile organic compounds (VOCs) from a complex air stream

    SciTech Connect

    Manninen, M.R.; Kleinheinz, G.T.; Niemi, B.A.; Hose, J.T.

    1999-07-01

    The use of aqueous biological systems to remove contaminants from waste streams has been well documented. However, in complex waste streams containing compounds of varying chemical properties, the use of only one type of treatment system may not be the best alternative. When treating a complex waste stream, the use of treatment trains, or coupled systems, may be advantageous when compared with any single technology. The purpose of this project was to design and operate a treatment train for the effective removal and biodegradation of a complex mixture of VOCs with varying chemical properties. A bench-scale system was designed consisting of a liquid bioreactor coupled to a biofilter for removal of acetone, methanol, methyl ethyl ketone, naphthalene, alpha-pinene, and toluene. The liquid bioreactor contained an aqueous medium and an inert solid support (polystyrene bioballs) which immobilized a characterized microbial population. The biofiltration portion of the system utilized the same microbial inoculum, but employed Douglas fir bark as its solid support. As the air stream bubbled into the liquid bioreactor, the VOCs were made available to the bacteria for destruction in the aqueous medium or on the polystyrene solid support. The fugitive VOCs from the liquid bioreactor were then subsequently treated by the biofiltration unit. The six-compound VOC mixture was added to the air stream via in-line syringe pump injection. Concentrations of the VOC mixture in the main influent air stream, the effluent air stream from the liquid bioreactor, the aqueous medium in the liquid bioreactor, and the effluent air stream from the biofilter were monitored on a regular basis via an on-line gas chromatograph with a flame ionization detector (GC-FID). Successful biodegradation of the complex VOC mixture was accomplished with this treatment train, the average total VOC removal efficiency being 96.2% ({+-}2.6).

  1. Reduction in mechanical allodynia in complex regional pain syndrome patients with ultrasound-guided pulsed radiofrequency treatment of the superficial peroneal nerve

    PubMed Central

    Chae, Won Soek; Kim, Sang Hyun; Cho, Sung Hwan; Lee, Mi Sun

    2016-01-01

    The superficial peroneal nerve is vulnerable to damage from ankle sprain injuries and fractures as well as surgery to this region. And it is also one of the most commonly involved nerves in complex regional pain syndrome type II in the foot and ankle region. We report two cases of ultrasound-guided pulsed radiofrequency treatment of superficial peroneal nerve for reduction of allodynia in CRPS patients. PMID:27738506

  2. Treatment of simple and complex endometrial non-atypical hyperplasia with natural progesterone: response rate to different doses.

    PubMed

    Marra, Chiara; Penati, Cristina; Ferrari, Luisa; Cantù, Maria Grazia; Bargossi, Lorena; Fruscio, Robert

    2014-01-01

    The aim of this study is to evaluate the response rate to natural progesterone in non-atypical endometrial hyperplasia and to identify the lowest effective dose. A total of 197 patients of childbearing age with simple or complex hyperplasia were retrospectively identified. The women were treated with a cyclic administration of progesterone at different dosages (100 versus 200 versus 300 mg daily). Endometrial biopsies were performed at 6, 12, 18 months. In comparing progesterone to a regimen of no therapy, a significantly higher remission rate was observed in the progesterone group than in the latter (95 versus 75%, p = 0.05 for simple hyperplasia; 89 versus 35%, p < 0.001 for complex hyperplasia). Out of 60 women with simple hyperplasia, remission was observed in 9/11 (81.8%), 40/41 (97.5%) and 8/8 (100%) patients treated, respectively, with progesterone 100, 200 and 300 mg daily. Out of 72 women with complex hyperplasia, remission was observed in 3/5 (60%), 49/53 (92.4%) and 12/14 (85.7%) patients treated with progesterone 100, 200 and 300 mg daily, respectively. There was no statistically significant difference in the response rate in the two groups, neither with simple nor with complex hyperplasia. In conclusion, progesterone increased the regression rate of both simple and complex hyperplasia.

  3. [Differential diagnosis and treatment of complex renal cysts detected by ultrasound screening of the abdominal cavity organs].

    PubMed

    Ukhal', M I; Ukhal', E M; Kvasha, A N

    2014-01-01

    Ultrasound screening of the abdominal cavity organs was performed in 98 patients, and renal cysts were revealed in 31 patientsare. 11 (26,6%) of 31 patients had renal cysts with complex structure. In 4 patients, complex cysts were located in parapelvic zone, in 7 patients - in different parts of the renal parenchyma. Pharmaco-Doppler sonography and computed tomography with bolus contrast enhancement in 7 patients with complex parenchymal cysts had revealed indirect signs of a malignant process - septums, thickening of the walls of cysts and septums, foci of calcination, increased blood circulation in the thickened renal cyst walls, venous stasis on the periphery of cysts and renal medulla, increasing the density of the thickened walls. Results of morphological studies have confirmed the presence of a malignant process in 5 of these 7 patients. In 4 patients with parapelvic cysts malignant process in ectomized layers was not revealed.

  4. Healing of an extensive periradicular lesion subsequent to a proper endodontic treatment of a mandibular first premolar with complex anatomy.

    PubMed

    Ashraf, Hengameh; Paymanpour, Payam; Bidabadi, Maryam Mojtahed; Hajrezai, Reihaneh

    2013-01-01

    Long-term success of endodontic treatment is strictly dependent on proper shaping and cleaning of the root canal system followed by obturation of entire prepared space. Anatomical variations should be considered during radiographic and clinical evaluation as parts of endodontic treatment. A mandibular premolar with three canals is quite rare and such a tooth requires special canal preparation and obturation techniques. An astute clinician should identify different canal configurations and treat them endodontically well, because presence of an untreated canal could be a reason for failure of endodontic treatment. This paper describes the conventional orthograde endodontic therapy on an unusual mandibular first premolar with three root canals.

  5. Healing of an Extensive Periradicular Lesion Subsequent to a Proper Endodontic Treatment of a Mandibular First Premolar with Complex Anatomy

    PubMed Central

    Ashraf, Hengameh; Paymanpour, Payam; Bidabadi, Maryam Mojtahed; Hajrezai, Reihaneh

    2013-01-01

    Long-term success of endodontic treatment is strictly dependent on proper shaping and cleaning of the root canal system followed by obturation of entire prepared space. Anatomical variations should be considered during radiographic and clinical evaluation as parts of endodontic treatment. A mandibular premolar with three canals is quite rare and such a tooth requires special canal preparation and obturation techniques. An astute clinician should identify different canal configurations and treat them endodontically well, because presence of an untreated canal could be a reason for failure of endodontic treatment. This paper describes the conventional orthograde endodontic therapy on an unusual mandibular first premolar with three root canals. PMID:24383015

  6. [HYALURONIC ACID: STRUCTURE, FUNCTIONS, THE POSSIBILITES OF APPLYING IN THE COMPLEX TREATMENT OF THE TEMPOROMANDIBULAR JOINT DISEASES. A REWIEW].

    PubMed

    Volovar, O S; Malanchuk, V A; Kryzhanivska, O A

    2014-01-01

    Over the last decade the use of hyaluronic acid has become increasingly important in treatment of degenerative disorders of the temporomandibular joint. Urgency is caused by numerous studies in biology and pharmacology on structure and function of hyaluronic acid and its influence on the processes of repair damaged bone and articular cartilage restoration, as well as the positive long-term results of treatment in this group of patients.

  7. Changes in Serum IgA Antibody Levels against the Glycopeptidolipid Core Antigen during Antibiotic Treatment of Mycobacterium avium Complex Lung Disease.

    PubMed

    Jhun, Byung Woo; Kim, Su-Young; Park, Hye Yun; Jeon, Kyeongman; Shin, Sung Jae; Koh, Won-Jung

    2017-03-28

    We evaluated serial changes in the levels of serum immunoglobulin A (IgA) antibody to the glycopeptidolipid (GPL) core antigen during antibiotic treatment in 57 patients with M. avium complex (MAC) lung disease, at baseline (T0) and after 3 months (T3) and 6 months (T6) of treatment. The median patient age was 59 years and 37 (65%) were female. Etiologic organisms included M. avium in 32 (56%) patients and M. intracellulare in 25 (44%). Seven (12%) patients had the fibrocavitary form of the disease on computed tomography. After 12 months of treatment, 42 (74%) patients achieved favorable responses, whereas 15 (26%) patients had unfavorable responses defined as no sputum culture conversion within 12 months of treatment. The initial median serum anti-GPL IgA levels in the 57 patients was 3.50 U/mL, and measurements at T0 (median 3.50 U/mL), T3 (median 2.71 U/mL), and T6 (median 2.61 U/mL) revealed significant decreases following treatment (P < 0.001). Multivariate analysis showed that an initially elevated anti-GPL IgA level (> 3.50 U/mL) was associated with an unfavorable response (P = 0.049). Our data suggest that elevated anti-GPL IgA levels may reflect disease activity, which may help to predict treatment response in patients with MAC lung disease.

  8. A complete mass balance of a complex combined anaerobic/aerobic municipal source-separated waste treatment plant.

    PubMed

    Pognani, Michele; Barrena, Raquel; Font, Xavier; Sánchez, Antoni

    2012-05-01

    In this study a combined anaerobic/aerobic full-scale treatment plant designed for the treatment of the source-separated organic fraction of municipal solid waste (OFMSW) was monitored over a period of one year. During this period, full information was collected about the waste input material, the biogas production, the main rejects and the compost characteristics. The plant includes mechanical pre-treatment, dry thermophilic anaerobic digestion, tunnel composting system and a curing phase to produce compost. To perform the monitoring of the entire plant and the individual steps, traditional chemical methods were used but they present important limitations in determining the critical points and the efficiency of the stabilization of the organic matter. Respiration indices (dynamic and cumulative) allowed for the quantitative calculation of the efficiency of each treatment unit. The mass balance was calculated and expressed in terms of Mgy(-1) of wet (total) matter, carbon, nitrogen and phosphorus. Results show that during the pre-treatment step about 32% of the initial wet matter is rejected without any treatment. This also reduces the biodegradability of the organic matter that continues to the treatment process. About 50% of the initial nitrogen and 86.4% of the initial phosphorus are found in the final compost. The final compost also achieves a high level of stabilization with a dynamic respiration index of 0.3±0.1g O(2) per kg of total solids per hour, which implies a reduction of 93% from that of the raw OFMSW, without considering the losses of biodegradable organic matter in the refuse (32% of the total input). The anaerobic digestion process is the main contributor to this stabilization.

  9. Endoscopic Radiofrequency Ablation of the Sacroiliac Joint Complex in the Treatment of Chronic Low Back Pain: A Preliminary Study of Feasibility and Efficacy of a Novel Technique.

    PubMed

    Choi, Won-Suh; Kim, Jin-Sung; Ryu, Kyeong-Sik; Hur, Jung-Woo; Seong, Ji-Hoon; Cho, Hyun-Jin

    2016-01-01

    Background. Radiofrequency ablation (RFA) is a less invasive technique for treatment of sacroiliac joint (SIJ) pain. Objective. To evaluate the feasibility and efficacy of endoscope-guided RFA for the treatment of CLBP from the SIJ complex. Methods. In this retrospective study, the medical records of 17 patients who underwent endoscope-guided RFA of the SIJ complex were reviewed. A bipolar radiofrequency probe was used to lesion the posterior capsule of the SIJ as well as the lateral branches of S1, S2, S3, and the L5 dorsal ramus in multiple locations. We visualized the ablation area using endoscope. We assessed visual analogue scale (VAS) and the Oswestry disability index (ODI) preoperatively, immediately postop, and at 1-, 3-, and 6-month postop outpatient clinic visits. Patient satisfaction of the procedure was assessed in percentages. Results. The mean duration of operation was 20 to 50 minutes. The mean VAS and the ODI scores decreased significantly immediately after the procedure and were kept significantly lower than baseline levels during the follow-up periods. No complications occurred perioperatively and during the follow-up periods. 88.6% of patients were satisfied with the procedure. Conclusions. Our preliminary results suggest that endoscope-guided RFA may be alternative option to treat CLBP secondary to SIJ complex.

  10. Endoscopic Radiofrequency Ablation of the Sacroiliac Joint Complex in the Treatment of Chronic Low Back Pain: A Preliminary Study of Feasibility and Efficacy of a Novel Technique

    PubMed Central

    Ryu, Kyeong-Sik; Hur, Jung-Woo; Seong, Ji-Hoon; Cho, Hyun-Jin

    2016-01-01

    Background. Radiofrequency ablation (RFA) is a less invasive technique for treatment of sacroiliac joint (SIJ) pain. Objective. To evaluate the feasibility and efficacy of endoscope-guided RFA for the treatment of CLBP from the SIJ complex. Methods. In this retrospective study, the medical records of 17 patients who underwent endoscope-guided RFA of the SIJ complex were reviewed. A bipolar radiofrequency probe was used to lesion the posterior capsule of the SIJ as well as the lateral branches of S1, S2, S3, and the L5 dorsal ramus in multiple locations. We visualized the ablation area using endoscope. We assessed visual analogue scale (VAS) and the Oswestry disability index (ODI) preoperatively, immediately postop, and at 1-, 3-, and 6-month postop outpatient clinic visits. Patient satisfaction of the procedure was assessed in percentages. Results. The mean duration of operation was 20 to 50 minutes. The mean VAS and the ODI scores decreased significantly immediately after the procedure and were kept significantly lower than baseline levels during the follow-up periods. No complications occurred perioperatively and during the follow-up periods. 88.6% of patients were satisfied with the procedure. Conclusions. Our preliminary results suggest that endoscope-guided RFA may be alternative option to treat CLBP secondary to SIJ complex. PMID:28105414

  11. Illustrating idiographic methods for translation research: moderation effects, natural clinical experiments, and complex treatment-by-subgroup interactions.

    PubMed

    Ridenour, Ty A; Wittenborn, Andrea K; Raiff, Bethany R; Benedict, Neal; Kane-Gill, Sandra

    2016-03-01

    A critical juncture in translation research involves the preliminary studies of intervention tools, provider training programs, policies, and other mechanisms used to leverage knowledge garnered at one translation stage into another stage. Potentially useful for such studies are rigorous techniques for conducting within-subject clinical trials, which have advanced incrementally over the last decade. However, these methods have largely not been utilized within prevention or translation contexts. The purpose of this manuscript is to demonstrate the flexibility, wide applicability, and rigor of idiographic clinical trials for preliminary testing of intervention mechanisms. Specifically demonstrated are novel uses of state-space modeling for testing intervention mechanisms of short-term outcomes, identifying heterogeneity in and moderation of within-person treatment mechanisms, a horizontal line plot to refine sampling design during the course of a clinic-based experimental study, and the need to test a treatment's efficacy as treatment is administered along with (e.g., traditional 12-month outcomes).

  12. Early bactericidal activity of rifabutin versus that of placebo in treatment of disseminated Mycobacterium avium complex bacteremia in AIDS patients.

    PubMed Central

    Dautzenberg, B; Castellani, P; Pellegrin, J L; Vittecoq, D; Truffot-Pernot, C; Pirotta, N; Sassella, D

    1996-01-01

    Rifabutin, 600 mg/day, was compared with a placebo in the early treatment of culture-proven Mycobacterium avium bacteremia in patients with AIDS. Following 14 days' treatment, bacteriological success, defined as a negative culture or a reduction in the number of CFU of M. avium organisms per milliliter of blood by a factor of > or = 0.5 log from the baseline, was observed in 7 of 10 (70%) evaluable rifabutin patients and in 1 of 13 (8%) evaluable placebo patients (P = 0.002). Rifabutin is active against M. avium as a single agent and can make a significant contribution to combination regimens for the treatment of disseminated M. avium infection in AIDS patients. PMID:8807071

  13. Thermal treatment effects imposed on solid DNA cationic lipid complex with hexadecyltrimethylammonium chloride, observed by variable angle spectroscopic ellipsometry

    SciTech Connect

    Nizioł, Jacek

    2014-12-21

    DNA cationic lipid complexes are materials of properties required for applications in organic electronics and optoelectronics. Often, their thermal stability demonstrated by thermogravimetry is cited in the literature as important issue. However, little is known about processes occurring in heated solid DNA cationic lipid complexes. In frame of this work, thin films of Deoxyribonucleic acid-hexadecyltrimethylammonium chloride (DNA-CTMA) were deposited on silicon wafers. Samples were thermally annealed, and simultaneously, their optical functions were measured by spectroscopic ellipsometry. At lower temperatures, thermal expansion coefficient of solid DNA-CTMA was negative, but at higher temperatures positive. Thermally induced modification of absorption spectrum in UV-vis was observed. It occurred at a range of temperatures higher than this of DNA denaturation in solution. The observed phenomenon was irreversible, at least in time scale of the experiment (one day)

  14. Comparative effectiveness of a complex Ayurvedic treatment and conventional standard care in osteoarthritis of the knee – study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Traditional Indian Ayurvedic medicine uses complex treatment approaches, including manual therapies, lifestyle and nutritional advice, dietary supplements, medication, yoga, and purification techniques. Ayurvedic strategies are often used to treat osteoarthritis (OA) of the knee; however, no systematic data are available on their effectiveness in comparison with standard care. The aim of this study is to evaluate the effectiveness of complex Ayurvedic treatment in comparison with conventional methods of treating OA symptoms in patients with knee osteoarthritis. Methods and design In a prospective, multicenter, randomized controlled trial, 150 patients between 40 and 70 years, diagnosed with osteoarthritis of the knee, following American College of Rheumatology criteria and an average pain intensity of ≥40 mm on a 100 mm visual analog scale in the affected knee at baseline will be randomized into two groups. In the Ayurveda group, treatment will include tailored combinations of manual treatments, massages, dietary and lifestyle advice, consideration of selected foods, nutritional supplements, yoga posture advice, and knee massage. Patients in the conventional group will receive self-care advice, pain medication, weight-loss advice (if overweight), and physiotherapy following current international guidelines. Both groups will receive 15 treatment sessions over 12 weeks. Outcomes will be evaluated after 6 and 12 weeks and 6 and 12 months. The primary endpoint is a change in the score on the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) after 12 weeks. Secondary outcome measurements will use WOMAC subscales, a pain disability index, a visual analog scale for pain and sleep quality, a pain experience scale, a quality-of-life index, a profile of mood states, and Likert scales for patient satisfaction, patient diaries, and safety. Using an adapted PRECIS scale, the trial was identified as lying mainly in the middle of the efficacy

  15. Treatment of complex intracranial aneurysms using flow-diverting silk® stents. An analysis of 32 consecutive patients.

    PubMed

    Buyukkaya, Ramazan; Kocaeli, Hasan; Yildirim, Nalan; Cebeci, Hakan; Erdogan, Cüneyt; Hakyemez, Bahattin

    2014-12-01

    This study describes the peri-procedural and late complications and angiographic follow-up results of 32 patients with 34 complex aneurysms treated with flow diverter Silk stents in a single centre. In this retrospective study, 40 Silk stents (SS) were implanted in 34 complex intracranial aneurysms in 32 patients. In our series, 20 (58.8%) carotid-ophthalmic internal carotid artery (ICA), six (17.6%) cavernous ICA, two (5.9%) supraclinoid ICA, two (5.9%) petrosal ICA (the same patient- bilateral) and four (11.8%) posterior circulation aneurysms were treated. One of the posterior circulation lesions was a fenestrated-type aneurysm. Twenty wide-necked, saccular; eight neck remnant; four fusiform and two blister-like aneurysms were included in our series. SS were successfully implanted in all patients (100%). Misdeployment occurred in 17.6% of patients. In two of these patients adequate stent openness was achieved via Hyperglide balloon dilatation. Coil embolization in addition to SS placement was utilized in four aneurysms. One patient (3%) experienced transient morbidity due to a thromboembolic event and there was one mortality (3%) due to remote intraparenchymal haemorrhage. Complete occlusion of 27/33 (81.8 %) and 29/33 (87.9 %) aneurysms was achieved six and 12 months after the procedure, respectively. In-stent intimal hyperplasia was detected in 6.1 % patients. Flow-diverter Silk stent implantation is an effective method of treating complex aneurysms with acceptable mortality and morbidity rates. Complete occlusion is achieved in most of the complex aneurysms.

  16. Treatment of complex nonunion of the shaft of the tibia using Ilizarov technique and its functional outcome

    PubMed Central

    Sahu, Ramji Lal; Ranjan, Rajni

    2016-01-01

    Background: A complex nonunion of the shaft of the tibia is a major cause of morbidity and mortality in patients with lower extremity injuries. Aims: The aim of this study was to evaluate the outcome of the functional and radiological outcome of complex nonunion shaft of tibia, treated by radical debridement, Ilizarov ring fixator with compression and distraction osteogenesis. Methods: From 2005 to 2010, sixty cases of complex nonunion shaft of tibia were included in our study. All infected nonunions were managed by radical debridement, fixed with Ilizarov ring fixator, monofocal/bifocal compression, and distraction osteogenesis. The average duration of follow-up is 36 months (26–50 months). The functional evaluation was done by using Association for the Study and Application of Methods of Ilizarov (ASAMI) scoring system and bone union with serial radiographs. Results: All patients had a successful union. The mean time for union was 7 months (5–9 months). The mean time of fixator removal is 12 months (8–14 months). Every patient had pin tract infections which were successfully treated with oral antibiotics. Four patients had an equinus deformity, one patient had insignificant limb shortening (1.5 cm), and three patients had soft tissue dystrophy. Using the ASAMI scoring system, we obtained 45 excellent, 10 good, 3 fair, and 2 poor functional results. Conclusions: The Ilizarov technique for complex nonunions has a high rate of success in achieving union and eradicating infection, bone loss, and malalignment. Radical debridement is the key step to control bone infection. PMID:27226689

  17. A dual pH/Redox responsive copper-ligand nanoliposome bioactive complex for the treatment of chronic inflammation.

    PubMed

    Mavuso, Simphiwe; Choonara, Yahya E; Marimuthu, Thashree; Kumar, Pradeep; du Toit, Lisa C; Kondiah, Pierre P D; Pillay, Viness

    2016-07-25

    A novel dual pH/redox-responsive polymeric nanoliposome system (NLs) loaded with a copper-liganded bioactive complex was prepared and designed as a controlled delivery system for the management of inflammation. The NLs were synthesised after preparation of the copper-glyglycine-prednisolone succinate] ([(Cu(glygly)(PS)]) complex, and the dual pH/redox responsive biopolymer respectively. The methodology undertaken for the development of the drug delivery system involved coordination of the bioactive to Copper (II), preparation of dual pH/redox responsive biopolymer, and the synthesis of dual pH/redox nanoliposomes. Characterisations of the prepared copper-liganded bioactive [Copper-glyglycine-prednisolone succinate] ([(Cu(glygly)(PS)]) complex, dual pH/redox responsive biopolymer (Eudragit E100-cystamine) and [(Cu(glygly)(PS)]-loaded NLs were carried out using spectroscopic and physicochemical techniques. Results indicated a high inflammatory/oxidant inhibitory activity of [Cu(glygly)(PS)] in comparison to the free PS drug. The [Cu(glygly)(PS)] complex exhibited a significant free radical-scavenging activity (60.1±1.2%) and lipoxygenase (LOX-5) inhibitory activity (36.6±1.3%) in comparison to PS which resulted in activity of 4.4±1.4% and inhibition of 6.1±2.6% respectively. The [Cu(glygly)(PS)] loaded NLs demonstrated low release profiles of 22.9±5.4% in 6h at pH 7.4, in comparison to a significant accelerated release at pH 5 in a reducing environment of 75.9±3.7% over 6h duration. Results suggest that the novel copper-liganded bioactive delivery system with controlled drug release mechanism could serve as a potential drug delivery system candidate in the management of inflammation.

  18. Long-term surveillance and treatment of subclinical cryptococcosis and nasal colonization by Cryptococcus neoformans and C. gattii species complex in captive koalas (Phascolarctes cinereus).

    PubMed

    Kido, Nobuhide; Makimura, Koichi; Kamegaya, Chihiro; Shindo, Izumi; Shibata, Eri; Omiya, Tomoko; Yamamoto, Yasuhiko

    2012-04-01

    Cryptococcosis is an important systemic mycosis caused by members of the Cryptococcus neoformans species complex. This disease is potentially fatal in various animals, including koalas. We describe the long-term surveillance and treatment of subclinical cryptococcosis and nasal colonization of koalas by Cryptococcus neoformans and C. gattii. Of the 15 animals investigated through the use of samples obtained by nasal swabs, antigen titer measurements, and pathologic examination, C. neoformans was found associated with nine koalas and C. gattii with one animal. Nine koalas showed subclinical disease and one clinical infections and antigenemia. Treatment with fluconazole, itraconazole and amphotericin B upon detection of C. neoformans or C. gattii was not effective. The results of the present study showed that C. neoformans was the predominant species isolated from the nasal swab samples and the fungus might have naturally become associated with the koalas' nasal cavities at Kanazawa Zoological Gardens. The unclear treatment effectiveness might have been caused by a shorter treatment period that is routinely used and unstable itraconazole absorption. This investigation also underscores the need for identifying effective treatment regimens for subclinical cryptococcosis and efficient measures for eradicating C. neoformans and C. gattii in koalas.

  19. [Application of direct electric current and intravenous ozone therapy in the complex treatment of destructive forms of acute pancreatitis in experiment].

    PubMed

    Zhakiev, B S; Zhumabaeva, A N; Kaliev, A A; Kazbekova, G A

    2013-01-01

    The results of experimental study which have carried out on 40 outbread dogs were analyzed in this thesis. Modeling of destructive pancreatitis in animals has been achieved via canalicular-hypertensive model by S.A. Shalimov. 4 series of experimental study were made to achieve the targeted goal. The first series 10 dogs without treatment, the second series 10 dogs in which conventional conservative therapy was used for the treatment of acute experimental destructive pancreatitis in animals, the third series 10 dogs that underwent intravenous ozone therapy in the complex together with medication therapy, the forth series the effectiveness of combined administration of intravenous ozone therapy and small doses of direct current in 10 dogs was evaluated. Combined administration of small doses of DC and intravenous ozone therapy in the complex treatment of destructive pancreatitis shows antiphlogistic action, favors accelerated rejection of necrotic tissue, remits inflammatory process as well as encourages regeneration process in pancreas whereby allows to decrease the mortality in experimental animals from 60% to 20%.

  20. Efficacy of sclerotherapy with radio-opaque foam guided by digital subtraction angiography for the treatment of complex venous malformations of the head and neck.

    PubMed

    Chen, A-W; Liu, Y-R; Li, K; Zhang, K; Wang, T; Liu, S-H

    2015-11-01

    Our aim was to evaluate the efficacy of sclerotherapy using radio-opaque foam and guided by digital subtraction angiography (DSA) for complex venous malformations in the head and neck in 11 selected patients between 2011 and 2013. The sclerosing foam was manufactured by the classic Tessari method and consisted of air, 1% polidocanol, and radio-opaque media iopromide (Ultravist(®)300) in a ratio of 7:2:1. We recorded the site and size of the lesion, time and duration of treatment, and therapeutic response. The lesions were on the face, cheek, temporal region, parotid region, neck, tongue, floor of the mouth, parapharyngeal space, and soft palate. The sclerosing foam was radio-opaque under DSA, and the mean (range) dose was 21 (3-65) ml. A mean (range) of 4 (2-7) treatments was required, and 10 of the 11 patients responded well. In 4 of the 11 cases the lesion resolved completely and in 6 there was a good response. Only one lesion recurred. Early complications included immediate swelling in injected areas, snoring, and pain on swallowing, but there were no air emboli or signs of cutaneous necrosis, and the complications were self-limiting. DSA-guided sclerotherapy with radio-opaque foam was safe and effective for the treatment of complex vascular malformations of the head and neck.

  1. Long-lasting effects of neonatal dexamethasone treatment on spatial learning and hippocampal synaptic plasticity: involvement of the NMDA receptor complex.

    PubMed

    Kamphuis, Patrick J G H; Gardoni, Fabrizio; Kamal, Amer; Croiset, Gerda; Bakker, Joost M; Cattabeni, Flaminio; Gispen, Willem Hendrik; van Bel, Frank; Di Luca, Monica; Wiegant, Victor M

    2003-05-01

    The effects of neonatal dexamethasone (DEX) treatment on spatial learning and hippocampal synaptic plasticity were investigated in adult rats. Spatial learning in reference and working memory versions of the Morris maze was impaired in DEX-treated rats. In hippocampal slices of DEX rats, long-term depression was facilitated and potentiation was impaired. Paired-pulse facilitation was normal, suggesting a postsynaptic defect as cause of the learning and plasticity deficits. Western blot analysis of hippocampal postsynaptic densities (PSD) revealed a reduction in NR2B subunit protein, whereas the abundance of the other major N-methyl-D-aspartate (NMDA) receptor subunits (NR1, NR2A), AMPA receptor subunits (GluR2/3), scaffolding proteins, and Ca2+/calmodulin-dependent protein kinase II (alphaCaMKII) were unaltered. This selective reduction in NR2B likely resulted from altered receptor assembly rather than subunit expression, because the abundance of NR2B in the homogenate and crude synaptosomal fractions was unaltered. In addition, the activity of alphaCaMKII, an NMDA receptor complex associated protein kinase, was increased in PSD of DEX rats. The results indicate that neonatal treatment with DEX causes alterations in composition and function of the hippocampal NMDA receptor complex that persist into adulthood. These alterations likely explain the deficits in hippocampal synaptic plasticity and spatial learning induced by neonatal DEX treatment.

  2. Integrating sequencing batch reactor with bio-electrochemical treatment for augmenting remediation efficiency of complex petrochemical wastewater.

    PubMed

    Yeruva, Dileep Kumar; Jukuri, Srinivas; Velvizhi, G; Naresh Kumar, A; Swamy, Y V; Venkata Mohan, S

    2015-01-01

    The present study evaluates the sequential integration of two advanced biological treatment methods viz., sequencing batch reactor (SBR) and bioelectrochemical treatment systems (BET) for the treatment of real-field petrochemical wastewater (PCW). Initially two SBR reactors were operated in aerobic (SBR(Ae)) and anoxic (SBR(Ax)) microenvironments with an organic loading rate (OLR) of 9.68 kg COD/m(3)-day. Relatively, SBR(Ax) showed higher substrate degradation (3.34 kg COD/m(3)-day) compared to SBR(Ae) (2.9 kg COD/m(3)-day). To further improve treatment efficiency, the effluents from SBR process were fed to BET reactors. BET(Ax) depicted higher SDR (1.92 kg COD/m(3)-day) with simultaneous power generation (17.12 mW/m(2)) followed by BET(Ae) (1.80 kg COD/m(3)-day; 14.25 mW/m(2)). Integrating both the processes documented significant improvement in COD removal efficiency due to the flexibility of combining multiple microenvironments sequentially. Results were supported with GC-MS and FTIR, which confirmed the increment in biodegradability of wastewater.

  3. [New aspects of efficacy of using apparatus-programming complex "andro-gin" in the treatment of chronic prostatitis].

    PubMed

    Pereverzev, A S; Chepenko, A V

    2006-01-01

    The results of usage of Andro-Gin unit in 187 patients with chronic prostatitis have shown that in most cases prostatitis is caused by bacteria. Andro-gin unit included in combined treatment of chronic prostatitis provides good results as it turns biofil bacteria into planktonic ones.

  4. Fertility-preserving treatment in complex atypical hyperplasia and early endometrial cancer in young women with oral progestin: Is it effective?

    PubMed Central

    Baek, Ji Sun; Lee, Wan Ho; Kang, Woo Dae

    2016-01-01

    Objective The aim of this study is to assess the effectiveness of oral progestin treatment in women diagnosed with complex atypical hyperplasia (CAH) or grade 1 endometrial cancer (G1EC), who desire to preserve their fertility, as alternative treatment to a hysterectomy. Methods We reviewed the medical records of women younger than 45 years old that had been diagnosed with CAH or G1EC, who expressed a desire to preserve their fertility using alternative treatment at our institution. Women without evidence of myometrial invasion on pelvic magnetic resonance imaging scans were included. The study period was between 2004 and 2014. Endometrial biopsies were taken at follow-up appointments. Results We identified 31 young women with CAH or G1EC. The median age was 33 years old (range, 20 to 41), and the median period of time undertaking the treatment was 5 months (range, 1 to 12). Twenty-three patients (74.2%) achieved complete remission (CR; median time to CR was 3 months; range, 1 to 22), 16 patients (88.9%) with CAH and 7 (53.8%) with G1EC achieved CR. 6 patients (26.1%) who had achieved CR, had recurrence of the disease (median time from CR to recurrence was 12.5 months; range, 4 to 18). Eight patients (25.8%) finally underwent a hysterectomy. Conclusion Oral progestin therapy is an alternative treatment for women with CAH or G1EC who desire fertility preservation. However, more prospective studies are needed for standard progestin regimen. Also, there still remains a risk of disease progression and recurrence. Therefore, close follow-up is important during treatment and after CR. In addition, a hysterectomy is recommended as a definitive treatment after completion of childbearing. PMID:26866032

  5. WE-F-16A-06: Using 3D Printers to Create Complex Phantoms for Dose Verification, Quality Assurance, and Treatment Planning System Commissioning in Radiotherapy

    SciTech Connect

    Kassaee, A; Ding, X; McDonough, J; Reiche, M; Witztum, A; Teo, B

    2014-06-15

    Purpose: To use 3D printers to design and construct complex geometrical phantoms for commissioning treatment planning systems, dose calculation algorithms, quality assurance (QA), dose delivery, and patient dose verifications. Methods: In radiotherapy, complex geometrical phantoms are often required for dose verification, dose delivery and calculation algorithm validation. Presently, fabrication of customized phantoms is limited due to time, expense and challenges in machining of complex shapes. In this work, we designed and utilized 3D printers to fabricate two phantoms for QA purposes. One phantom includes hills and valleys (HV) for verification of intensity modulated radiotherapy for photons, and protons (IMRT and IMPT). The other phantom includes cylindrical cavities (CC) of various sizes for dose verification of inhomogeneities. We evaluated the HV phantoms for an IMPT beam, and the CC phantom to study various inhomogeneity configurations using photon, electron, and proton beams. Gafcromic ™ films were used to quantify the dose distributions delivered to the phantoms. Results: The HV phantom has dimensions of 12 cm × 12 cm and consists of one row and one column of five peaks with heights ranging from 2 to 5 cm. The CC phantom has a size 10 cm × 14 cm and includes 6 cylindrical cavities with length of 7.2 cm and diameters ranging from 0.6 to 1.2 cm. The IMPT evaluation using the HV phantom shows good agreement as compared to the dose distribution calculated with treatment planning system. The CC phantom also shows reasonable agreements for using different algorithms for each beam modalities. Conclusion: 3D printers with submillimiter resolutions are capable of printing complex phantoms for dose verification and QA in radiotherapy. As printing costs decrease and the technology becomes widely available, phantom design and construction will be readily available to any clinic for testing geometries that were not previously feasible.

  6. Materials and Fuels Complex Hazardous Waste Management Act/Resource Conservation and Recovery Act Storage and Treatment Permit Reapplication, Environmental Protection Agency Number ID4890008952

    SciTech Connect

    Holzemer, Michael J.; Hart, Edward

    2015-04-01

    Hazardous Waste Management Act/Resource Conservation and Recovery Act Storage and Treatment Permit Reapplication for the Idaho National Laboratory Materials and Fuels Complex Hazardous Waste Management Act/Resource Conservation and Recovery Act Partial Permit, PER-116. This Permit Reapplication is required by the PER-116 Permit Conditions I.G. and I.H., and must be submitted to the Idaho Department of Environmental Quality in accordance with IDAPA 58.01.05.012 [40 CFR §§ 270.10 and 270.13 through 270.29].

  7. [Complex conservative treatment of patients with chronic vertebral-basilar insufficiency against a background of cervical osteochondrosis].

    PubMed

    Gol'dblat, Iu V

    1978-01-01

    The paper contains a description, concerning medicative treatment of 55 patients with chronic vertebro-basilar deficiency in cervical osteochondrosis. The purpose of this study was to remove irritation of the spinal plexus, insufficiency of the cerebral blood flow and secondary astheno-depressive conditions. The following measures were applied: physiotherapy (influences of sinusoidal modulated currents on the cervical part of the spine, massage), special medical gymnastics, drugs (vitamins of the B group, biogenic stimuli, spasmolytical and antihistamine drugs, tranquilizers) and psychotherapy. A comprehensive treatment leads to a steady improvment in 91% of the treated patients, and according to the REG data, to an activization of the blood supply in the zone of vascularization by spinal arteries, especially in the hemispheres with the largest initial blood repletion deficit.

  8. The efficient synthesis of a molybdenum carbide catalyst via H2-thermal treatment of a Mo(VI)-hexamethylenetetramine complex.

    PubMed

    Wang, Zhi-Qiang; Zhang, Zhong-Biao; Zhang, Ming-Hui

    2011-02-07

    An efficient method for preparation of Mo(2)C catalyst is described, where Mo(2)C is obtained by the heat treatment of a single solid precursor containing (NH(4))(6)Mo(7)O(24) and hexamethylenetetramine (HMT) at 923 K in H(2) flow without conventional prolonged carbonization. The catalysts are characterized by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), BET surface area measurement, and transmission electron microscopy (TEM). Furthermore, these catalysts are evaluated in the dibenzothiophene (DBT) hydrodesulfurization (HDS) reaction, and proved to be superior to those prepared by a temperature-programmed reduction (TPRe) method. The better catalytic performance is ascribed to higher dispersion of Mo(2)C on the support and a lower surface polymeric carbon content. This hydrogen thermal treatment (HTT) method provided a new strategy for the preparation of a highly active molybdenum carbide catalyst.

  9. Fluorine distribution during thermal treatment of sulfuric acid leaching products of complex beryllium raw materials at JSC UMP

    NASA Astrophysics Data System (ADS)

    Borsuk, A. N.; Zherin, I. I.; Amelina, G. N.; Pivovarov, I.

    2016-06-01

    X-ray diffraction, infrared spectroscopy, thermogravimetry and mass spectrometry were employed to study the behavior and distribution of fluorine in sulfuric acid treatment of the melt of beryl-bertrandite-phenakite-fluorite concentrates with alkali fluxes. It was established that fluorine in a solid phase is predominantly present in the form of sodium and calcium fluorosilicates and in a gaseous phase it is evolved in the form of silicon tetrafluoride and fluorosulfonic acid.

  10. Application of the upflow anaerobic sludge bed (UASB) process for treatment of complex wastewaters at low temperatures

    SciTech Connect

    Koster, I.W.; Lettinga, G.

    1985-10-01

    The feasibility of the upflow anaerobic sludge bed (UASB) process for the treatment of potato starch wastewater at low ambient temperatures was demonstrated by operating two 5.65 l reactors at 14 degrees C and 20 degrees C, respectively. The organic space loading rates achieved in these laboratory-scale reactors were 3 kg COD/cubic m/day at 14 degrees C and 4-5 kg COD/cubic m/day at 20 degrees C. The corresponding sludge loading rates were 0.12 kg COD/kg VSS/day at 14 degrees C and 0.16-0.18 kg COD/kg VSS/day at 20 degrees C. These findings are of considerable practical importance because application of anaerobic treatment at low ambient temperatures will lead to considerable savings in energy needed for operating the process. As compared with various other anaerobic wastewater treatment processes, a granular sludge upflow process represents one of the best options developed so far. Although the overall sludge yield under psychrophilic conditions is slightly higher than under optimal mesophilic conditions, this doesn't seriously hamper the operation of the process. The extra sludge yield, due to accumulation of slowly hydrolyzing substrate ingredients, was 4.75% of the COD input at 14 degrees C and 1.22% of the COD input at 20 degrees C. 26 references.

  11. [EFFICACY AND SECURITY OF A CONVENTIONAL PROCEDURE OF PLASMAPHERESIS IN COMPLEX OF TREATMENT OF NONBILIARY ACUTE PANCREATITIS IN EARLY PHASE OF THE DISEASE].

    PubMed

    Mishalov, V G; Markulan, L Yu; Matveyev, R M

    2016-02-01

    Abstract Efficacy and security of a plasmapheresis procedure in complex of treatment of nonbiliary acute pancreatitis in early phase of the disease were established, basing on the treatment results analysis in 48 patients. The plasmapheresis results were estimated in accordance to changes revealed in the intoxication leukocytic index (ILI), a general protein (GP) content, general calcium (GC) in the blood plasm and of the activated partial thrombin time (APTHT). Application of plasmapheresis in patients, suffering purulent pancreatitis in the enzymal phase, have guaranteed a staged reduction of ILI by (34.86 ± 1.27)%, the APTHT enhancement from (35.15 ± 0.37) to (52.01 ± 0.62) sec, a trustworthy lowering of the GP by (4.35 ± 0.02) g/L at average and of GC in a blood plasmby (10.45 ± 0.38)%.

  12. Insights into the influence of dispersion correction in the theoretical treatment of guanidine-quinoline copper(I) complexes.

    PubMed

    Hoffmann, Alexander; Grunzke, Richard; Herres-Pawlis, Sonja

    2014-10-15

    For the description of steric effects, dispersion correction is important in density functional theory. By investigation of sterically encumbered guanidine-quinoline copper bis(chelate) complexes, we could show that the correct description requires modern dispersion correction using Becke-Johnson (BJ) damping and that earlier dispersion corrections are not sufficient. The triple-zeta basis set def2-TZVP of the Ahlrichs series is balanced and converged for the structural description. With regard to functionals, the best structural description is obtained with the TPSSh functional but B3LYP is very suited as well. Cutting of ligand substituents leads to distortions which limit the predictive ability of such calculations. We recommend the calculation of "full" chemical systems with inclusion of dispersion correction using BJ damping. In the further analysis of the regarded copper bis(chelate) complexes, we found that the theoretical description of optical and Raman spectra is not much affected by the dispersion although charge transfer excitations come into play and that B3LYP/def2-TZVP is the best choice. Hence, we can derive the result that the correct structural description with dispersion serves as crucial basis for subsequent calculation steps.

  13. Complex electronic waste treatment - An effective process to selectively recover copper with solutions containing different ammonium salts.

    PubMed

    Sun, Z H I; Xiao, Y; Sietsma, J; Agterhuis, H; Yang, Y

    2016-11-01

    Recovery of valuable metals from electronic waste has been highlighted by the EU directives. The difficulties for recycling are induced by the high complexity of such waste. In this research, copper could be selectively recovered using an ammonia-based process, from industrially processed information and communication technology (ICT) waste with high complexity. A detailed understanding on the role of ammonium salt was focused during both stages of leaching copper into a solution and the subsequent step for copper recovery from the solution. By comparing the reactivity of the leaching solution with different ammonium salts, their physiochemical behaviour as well as the leaching efficiency could be identified. The copper recovery rate could reach 95% with ammonium carbonate as the leaching salt. In the stage of copper recovery from the solution, electrodeposition was introduced without an additional solvent extraction step and the electrochemical behaviour of the solution was figured out. With a careful control of the electrodeposition conditions, the current efficiency could be improved to be 80-90% depending on the ammonia salts and high purity copper (99.9wt.%). This research provides basis for improving the recyclability and efficiency of copper recovery from such electronic waste and the whole process design for copper recycling.

  14. Vanadium and cancer treatment: antitumoral mechanisms of three oxidovanadium(IV) complexes on a human osteosarcoma cell line.

    PubMed

    León, I E; Butenko, N; Di Virgilio, A L; Muglia, C I; Baran, E J; Cavaco, I; Etcheverry, S B

    2014-05-01

    We report herein the antitumor actions of three oxidovanadium(IV) complexes on MG-63 human osteosarcoma cell line. The three complexes: VO(oda), VO(oda)bipy and VO(oda)phen (oda=oxodiacetate), caused a concentration dependent inhibition of cell viability. The antiproliferative action of VO(oda)phen could be observed in the whole range of concentrations (at 2.5 μM), while VO(oda)bipy and VO(oda) showed a decrease of cell viability only at higher concentrations (at 50 and 75 μM, respectively) (p<0.01). Moreover, VO(oda)phen caused a decrease of lysosomal and mitochondrial activities at 2.5 μM, while VO(oda) and VO(oda)bipy affected neutral red uptake and mitochondrial metabolism at 50 μM (p<0.01). On the other hand, no DNA damage studied by the Comet assay could be observed in MG-63 cells treated with VO(oda) at 2.5-10 μM. Nevertheless, VO(oda)phen and VO(oda)bipy induced DNA damage at 2.5 and 10 μM, respectively (p<0.01). The generation of reactive oxygen species increased at 10 μM of VO(oda)phen and only at 100 μM of VO(oda) and VO(oda)bipy (p<0.01). Besides, VO(oda)phen and VO(oda)bipy triggered apoptosis as determined by externalization of the phosphatidylserine. The determination of DNA cleavage by agarose gel electrophoresis showed that the ability of VO(oda)(bipy) is similar to that of VO(oda), while VO(oda)(phen) showed the highest nuclease activity in this series. Overall, our results showed a good relationship between the bioactivity of the complexes and their structures since VO(oda)phen presented the most potent antitumor action in human osteosarcoma cells followed by VO(oda)bipy and then by VO(oda) according to the number of intercalating heterocyclic moieties.

  15. The long and complex road in the search for treatment for mental disorders: An analysis of the process in five groups of patients.

    PubMed

    Del Valle, Gema; Belloch, Amparo; Carrió, Carmen

    2017-03-15

    Seeking treatment for mental-health problems is a complex process, with different underlying motives in each stage. However, the entire process and these motives have hardly been investigated. This study aims to analyze the different stages of the help-seeking process and their underlying motives in five groups of patients with different mental disorders. In all, 156 patients seeking treatment in outpatient mental health clinics were individually interviewed: 71 had Obsessive-Compulsive Disorder (OCD), 21 had Agoraphobia (AGO), 18 had Major Depressive Disorder (MDD), 20 had Anorexia Nervosa (AN), and 22 had Cocaine Dependence (COC). The AGO and MDD patients delayed significantly less time in recognizing their mental health symptoms. Moreover, MDD patients disclosed their symptoms and searched for professional help faster than the other groups. The most relevant variables in the recognition of disorders were the loss of control over the symptoms, the interference produced by these symptoms, and their negative impact on the person's emotional state. The most frequent barriers to seeking treatment were related to minimizing the symptoms and fear of stigma. Finally, the most important motivator for seeking treatment was the awareness that minimizing the symptoms did not help to reduce them, lessen their interference, or make them disappear.

  16. Evolution of phosphorus complexation and mineralogy during (hydro)thermal treatments of activated and anaerobically digested sludge: Insights from sequential extraction and P K-edge XANES.

    PubMed

    Huang, Rixiang; Tang, Yuanzhi

    2016-09-01

    (Hydro)thermal treatments of sewage sludge is a promising option that can simultaneously target safe waste disposal, energy recovery, and nutrient recovery/recycling. The speciation of phosphorus (P) in sludge is of great relevance to P reclamation/recycling and soil application of sludge-derived products, thus it is critical to understand the effects of different treatment techniques and conditions on P speciation. This study systematically characterized P speciation (i.e. complexation and mineral forms) in chars derived from pyrolysis and hydrothermal carbonization (HTC) of municipal sewage sludges. Combined sequential extraction and P K-edge X-ray absorption near edge structure (XANES) spectroscopy analysis revealed the dependence of P transformation on treatment conditions and metal composition in the feedstocks. Pyrolysis of sludges decreased the relative abundance of phytic acid while increased the abundance of Al-associated P. HTC thoroughly homogenized and exposed P for interaction with various metals/minerals, with the final P speciation closely related to the composition/speciation of metals and their affinities to P. Results from this study revealed the mechanisms of P transformation during (hydro)thermal treatments of sewage sludges, and might be applicable to other biosolids. It also provided fundamental knowledge basis for the design and selection of waste management strategies for better P (re)cycling and reclamation.

  17. Intramedullary Allograft Fibula as a Reduction and Fixation Tool for Treatment of Complex Proximal Humerus Fractures with Diaphyseal Extension.

    PubMed

    Berkes, Marschall B; Little, Milton Tm; Lazaro, Lionel E; Cymerman, Rachel M; Pardee, Nadine C; Helfet, David L; Dines, Joshua S; Lorich, Dean G

    2013-05-15

    SUMMARY:: In this study, we present a novel technique for reduction and fixation of complex, unstable, proximal humerus fractures with diaphyseal extension with the assistance of fibula allograft. We treated 14 patients using this technique since 2009 and found that it improves the reduction and enhances fixation while making the surgical procedure technically more manageable, and allows for early postoperative motion. In the first part of this study, we describe in detail the indications and surgical technique applied to these fractures. In the second part, we review the clinical and radiographic outcomes of these patients. Using this new technique, we have achieved an excellent union rate with minimal incidence of complications when treating these challenging fractures.

  18. Special Features of Electron-Beam Alloying of Replaceable Polyhedral Hard-Alloy Plates Under a Complex Surface Treatment

    NASA Astrophysics Data System (ADS)

    Fedorov, S. V.; Oganyan, G. V.

    2016-01-01

    Thermochemical treatment of a hard alloy is implemented by alloying its surface with the help of a low-energy strong-current electron beam prior to depositing a wear-resistant coating. The method increases substantially the service life of the tool. The laws of formation of refractory compounds in the surface layer due to initiation of a reaction of self-propagating high-temperature synthesis in the mode of thermal explosion are determined. The change in the wear behavior of the modified tools is studied.

  19. Characteristics of Youth Presenting to a Canadian Youth Concurrent Disorders Program: Clinical Complexity, Trauma, Adaptive Functioning and Treatment Priorities

    PubMed Central

    Catchpole, Rosalind E. H.; Brownlie, E. B.

    2016-01-01

    Objective: This study describes clinical characteristics of youth presenting for service at a Canadian youth concurrent mental health and substance use disorders (SUD) program. Method: Participants were 100 adolescents and emerging adults (aged 14–25) who attended a Canadian concurrent mental health and substance use disorders outpatient program. SUDs were assigned using the Structured Clinical Interview for DSM-IV. Self-reported mental health symptoms, trauma exposure and adaptive functioning were also assessed. Results: Eighty-three percent of participants scored over the clinical cut-off on at least one mental health scale and 33% reported at least one suicide attempt. Sixty-six percent met criteria for a current SUD; 96% met lifetime criteria. Exposure to adverse events was nearly universal (94%). Almost half of female (46%) and almost a third of male (31%) participants endorsed symptoms consistent with posttraumatic stress disorder (PTSD). Youth reported impairment and need for support in multiple domains of functioning, including school, peer, family and mental health. Substance use was least likely to be identified as a treatment priority. Conclusions: High rates of adverse events and PTSD highlight the need for trauma-informed care when providing services to this vulnerable population. Functional impairment in domains related to developmental transitions and tasks underscores the need for a developmental lens and integrated treatment that goes beyond mental health and SUD symptoms and addresses developmentally relevant domains during this transitional age. PMID:27274746

  20. Accounting for interactions and complex inter-subject dependency in estimating treatment effect in cluster randomized trials with missing outcomes

    PubMed Central

    Prague, Melanie; Wang, Rui; Stephens, Alisa; Tchetgen Tchetgen, Eric; DeGruttola, Victor

    2016-01-01

    Summary Semi-parametric methods are often used for the estimation of intervention effects on correlated outcomes in cluster-randomized trials (CRTs). When outcomes are missing at random (MAR), Inverse Probability Weighted (IPW) methods incorporating baseline covariates can be used to deal with informative missingness. Also, augmented generalized estimating equations (AUG) correct for imbalance in baseline covariates but need to be extended for MAR outcomes. However, in the presence of interactions between treatment and baseline covariates, neither method alone produces consistent estimates for the marginal treatment effect if the model for interaction is not correctly specified. We propose an AUG-IPW estimator that weights by the inverse of the probability of being a complete case and allows different outcome models in each intervention arm. This estimator is doubly robust (DR), it gives correct estimates whether the missing data process or the outcome model is correctly specified. We consider the problem of covariate interference which arises when the outcome of an individual may depend on covariates of other individuals. When interfering covariates are not modeled, the DR property prevents bias as long as covariate interference is not present simultaneously for the outcome and the missingness. An R package is developed implementing the proposed method. An extensive simulation study and an application to a CRT of HIV risk reduction-intervention in South Africa illustrate the method. PMID:27060877

  1. Feasibility of Training Frontline Therapists in Prolonged Exposure: A Randomized Controlled Pilot Study of Treatment of Complex Trauma in Diverse Victims of Crime and Violence.

    PubMed

    Ghafoori, Bita; Hansen, Marissa C; Garibay, Erika; Korosteleva, Olga

    2017-04-01

    The study aims were to determine whether prolonged exposure (PE) improved mental health and was feasible to implement by frontline clinicians in a culturally diverse sample with complex trauma. Seventy-one individuals were randomly assigned to PE or person-centered therapy (PCT). Outcome measures were administered at baseline and sessions 3, 6, 9, and 12. Mixed modeling was used to regress outcome measures on time, treatment group, and number of visits. Individuals who received PE showed significant moderate association with decline in reported posttraumatic stress disorder (PTSD) symptoms as noted by the PTSD Checklist for DSM-5 (p = 0.05) compared with PCT. Results indicated improved scores on all measures at each follow-up time point compared with baseline (p ≤ 0.01). PE was feasible, shown by positive recruitment and ability of clinicians to effectively implement and maintain treatment fidelity. Findings suggest that PE can be effective for treating complex trauma when used by clinicians in community settings.

  2. Synergistic effects of resveratrol (free and inclusion complex) and sulfamethoxazole-trimetropim treatment on pathology, oxidant/antioxidant status and behavior of mice infected with Toxoplasma gondii.

    PubMed

    Bottari, Nathieli B; Baldissera, Matheus D; Tonin, Alexandre A; Rech, Virginia C; Alves, Catiane B; D'Avila, Fernanda; Thomé, Gustavo R; Guarda, Naiara S; Moresco, Rafael N; Camillo, Giovana; Vogel, Fernanda F; Luchese, Cristiane; Schetinger, Maria Rosa C; Morsch, Vera M; Tochetto, Camila; Fighera, Rafael; Nishihira, Vivian S K; Da Silva, Aleksandro S

    2016-06-01

    This study aimed to investigate the synergistic effects of resveratrol and sulfamethoxazole-trimethoprim (ST) on the treatment of mice experimentally infected by Toxoplasma gondii during the chronic phase of the disease considering infection, behavior, and oxidative/antioxidants profile aspects. For the study, 60 mice were initially divided into two groups: uninfected (n = 24) and infected by T. gondii (n = 36). These two groups were later subdivided into other groups and treated with resveratrol (free and inclusion complex containing resveratrol) alone and co-administered with ST: groups A to D were composed by healthy mice and groups E to J were consisted of animals infected by T. gondii (VEG strain). Treatments began 20 days post-infection for 10 consecutive days with oral doses of 0.5 mg kg(-1) of ST (groups B and F), 100 mg kg(-1) of free resveratrol (groups C and G) and inclusion complex of resveratrol (nanoparticles containing resveratrol) (groups D and H), and lastly an co-administration of both drugs (groups I and J). Behavioral tests (memory, anxiety and locomotion) were performed after treatment. Liver and brain fragments were collected to evaluate pathological changes, brain cysts counts, as well as oxidant and antioxidant levels. A reduction on the number of cysts in the brain of animals treated with both drugs combined was observed; there was also reduced number of lesions on both organs. This drug combined effect was also able to reduce oxidative and increase antioxidant levels in infected mice, which might be interpreted as a resveratrol protective effect. In addition, the combination of ST and resveratrol was able to prevent behavioral changes in infected mice. Therefore, the use of co-administration drugs enhances the therapeutic effect acting on a synergic way, reducing the oxidizing effects of the chemical treatment for toxoplasmosis. In addition, resveratrol in inclusion complex when co-administered with ST showed an improved

  3. Doxorubicin Lipid Complex Injection

    MedlinePlus

    Doxorubicin lipid complex is used to treat ovarian cancer that has not improved or that has worsened after treatment with other medications. Doxorubicin lipid complex is also used to treat Kaposi's sarcoma ( ...

  4. Irinotecan Lipid Complex Injection

    MedlinePlus

    Irinotecan lipid complex is used in combination with other medications to treat pancreatic cancer that has spread to other ... worsened after treatment with other chemotherapy medications. Irinotecan lipid complex is in a class of antineoplastic medications ...

  5. Vincristine Lipid Complex Injection

    MedlinePlus

    Vincristine lipid complex is used to treat a certain type of acute lymphoblastic leukemia (ALL; a type ... at least two different treatments with other medications. Vincristine lipid complex is in a class of medications ...

  6. Recent Advances and Challenges of mTOR Inhibitors Use in the Treatment of Patients with Tuberous Sclerosis Complex

    PubMed Central

    Robalo, Conceição

    2017-01-01

    Tuberous sclerosis complex (TSC) is a genetic condition characterized by the presence of benign, noninvasive, and tumor-like lesions called hamartomas that can affect multiple organ systems and are responsible for the clinical features of the disease. In the majority of cases, TSC results from mutations in the TSC1 and TSC2 genes, leading to the overactivation of the mammalian target of rapamycin (mTOR) signalling pathway, which controls several cell functions, including cell growth, proliferation, and survival. The establishment of a connection between TSC and mTOR led to the clinical use of drugs known as mTOR inhibitors (like rapamycin, also known as sirolimus and everolimus), which are becoming an increasingly interesting tool in the management of TSC-associated features, such as subependymal giant cell astrocytomas, renal angiomyolipomas, and also epilepsy. However, the intrinsic characteristics of these drugs and their systemic effects in such a heterogeneous condition pose many challenges in clinical practice, so that some questions remain unanswered. This article provides an overview of the pharmacological aspects of mTOR inhibitors about the clinical trials leading to their approval in TSC-related conditions and exposes current challenges and future directions associated with this promising therapeutic line. PMID:28386314

  7. [Physico-chemistry of dinitrosyl iron complexes with thiol-containing ligands underlying their beneficial treatment of endometriosis].

    PubMed

    Vanin, A F; Adamian, L V; Burgova, E N; Tkachev, N A

    2014-01-01

    Exogenous dinitrosyl iron complexes (DNIC) with thiol-containing ligands as NO and NO+ donors are capable of exerting both regulatory and cytotoxic effects on diverse biological processes similarly to those characteristic of endogenous nitric oxide. Regulatory activity of DNIC (vasodilation, hypotension, trombosis suppression, red blood cell elasticity increasing, skin wound healing acceleration, penile erection inducing, etc) is determined by their capacity of NO and NO+ transfer to biological targets of the latter (hemo- and thiol-containing proteins, respectively) due to higher affinity of the proteins for NO and NO+ than that of DNIC. Cytotoxic activity of DNIC is endowed with rapid DNIC decomposition under action of iron-chelating compounds resulting in appearance of NO and NO+ in cells and tissues in high amount. The latter mechanism is suggested to cause the blocking effect of DNIC as cytotoxic effectors on the development of benign endometrial tumors in rats with experimental endometriosis. It is also proposed that. a similar mechanism can operate causing at least a delay of malignant tumor proliferation under action of DNIC.

  8. Pharmacological studies on an iron-poly-(sorbitol-gluconic acid) complex for parenteral treatment of iron deficiency anaemia.

    PubMed

    Eriksson, H; Svärd, P O

    1977-01-01

    Intravenous injection of the iron-poly(sorbitol-gluconic acid) complex (IPSG) to cats anaesthetized with sodium pentobarbitone caused a transient decrease in mean arterial blood pressure and a temporary increase in central venous pressure, heart rate and femoral blood flow at large doses (cumulative doses up to 744 mg/kg). Tachyphylaxis developed upon repeated administration. A temporary reduction in the magnitude of the blood pressure responses to noradrenaline and isoprenaline was obtained after large doses of IPSG. The blood pressure effects of acetylcholine, histamine and bilateral carotid occlusion were not affected. No definite effects were seen on the electrocardiograms. The transient cardiovascular effects were interpreted as being due to the presence of small amounts of ferrous iron in the preparation. IPSG did not significantly affect blood coagulation or platelet aggregation as judged from results of in vitro and in vivo experiments. Immunogenicity studies in rabbits and antibody analyses of sera from patients treated with IPSG failed to demonstrate any effect of IPSG on the immune system.

  9. Heparin cofactor II-thrombin complex and dermatan sulphate:chondroitin sulphate ratio are biomarkers of short- and long-term treatment effects in mucopolysaccharide diseases.

    PubMed

    Langford-Smith, Kia Jane; Mercer, Jean; Petty, June; Tylee, Karen; Church, Heather; Roberts, Jane; Moss, Gill; Jones, Simon; Wynn, Rob; Wraith, J Ed; Bigger, Brian W

    2011-04-01

    Early detection of mucopolysaccharidosis (MPS) is an important factor in treatment success; therefore, good disease biomarkers are vital. We evaluate heparin cofactor II-thrombin complex (HCII-T) as a biomarker in serum and dried blood spots (DBS) of MPS patients. Serum HCII-T and urine dermatan sulphate:chondroitin sulphate (DS:CS) ratio are also compared longitudinally against clinical outcomes in MPSI, II and VI patients following treatment. Samples were collected from MPS patients at the Royal Manchester Children's Hospital. DS:CS ratio was obtained by measuring the area density of spots from 2D electrophoresis of urinary glycosaminoglycans. Serum and DBS HCII-T was measured by sandwich ELISA. Serum HCII-T is elevated approximately 25-fold in MPS diseases that store DS, clearly distinguishing untreated MPSI, II and VI patients from unaffected age-matched controls. Serum HCII-T is also elevated in MPSIII, which leads to storage of heparan sulphate, with an increase of approximately 4-fold over unaffected age-matched controls. Urine DS:CS ratio and serum HCII-T decrease in response to treatment of MPSI, II and VI patients. HCII-T appears to respond rapidly to perturbations in treatment, whilst DS:CS ratio responds more slowly. HCII-T is a suitable biomarker for MPSI, II and VI, and it may also be informative for MPS diseases storing HS alone, such as MPSIII, although the elevation observed is smaller. In treated MPS patients, HCII-T and DS:CS ratio appear to measure short-term and long-term treatment outcomes, respectively. The potential value of HCII-T measurement in DBS for newborn screening of MPS diseases warrants further investigation.

  10. Complexation of imazalil with beta-cyclodextrin, residue uptake, persistence, and activity against penicillium decay in citrus fruit following postharvest dip treatments.

    PubMed

    Schirra, Mario; Delogu, Giovanna; Cabras, Paolo; Angioni, Alberto; D'hallewin, Guy; Veyrat, Ana; Marcos, Jose F; Candelas, Luis González

    2002-11-06

    A method for the inclusion of imazalil (IMZ) in the beta-cyclodextrin (betaCD), structural characterization of the inclusion complex and its antifungal activity against Penicillium digitatum and P. italicum assessed by in vitro and in vivo tests are reported. According to the starting stoichiometry of betaCD with respect to IMZ, an equimolar ratio beta-cyclodextrin-IMZ (betaCD-IMZ) was detected by (1)H NMR. In vitro assays showed that the freshly prepared betaCD-IMZ was as effective as IMZ, although 1- and 4-day-old betaCD-IMZ mixtures were more effective. Studies on Star Ruby grapefruit showed no significant differences in residue uptake between treatments with an IMZ commercially available fungicide (Deccozil) or betaCD-IMZ when equal active ingredient (a.i.) concentrations (250 mg/L) and dip temperatures (20 or 50 degrees C) were used. By contrast, treatments of Tarocco oranges and Di Massa lemons with 250 mg/L betaCD-IMZ at 50 degrees C produced significant differences in residue uptake in comparison with 250 mg/L Deccozil treatments at 50 degrees C. The a.i. degradation rate in grapefruit during postquarantine and simulated marketing period (SMP) at 20 degrees C was not affected by the type of formulation used, whether at 20 or 50 degrees C. Conversely, IMZ in oranges and lemons had greater persistence when applied at 50 degrees C. All fungicide treatments showed a comparable efficacy against decay in grapefruit and oranges, whereas treatment in lemons at 250 mg/L a.i. of heated fungicides had higher suppressive effects against decay than unheated chemicals having equal a.i. concentrations and comparable activity at 1200 mg/L IMZ at 20 degrees C.

  11. Complex Apical Intraradicular Infection and Extraradicular Mineralized Biofilms as the Cause of Wet Canals and Treatment Failure: Report of 2 Cases.

    PubMed

    Ricucci, Domenico; Candeiro, George T M; Bugea, Calogero; Siqueira, José F

    2016-03-01

    This article describes 2 cases that showed persistent intracanal exudation (wet canal) even after several visits of antimicrobial endodontic treatment. Histologic and histobacteriologic investigation was conducted for determination of the cause. The 2 cases involved teeth with apical periodontitis lesions, which presented persistent exudation refractory to treatment after several visits. In case 1, it was not possible to achieve a dry canal, and surgery had to be performed. In case 2, attempts to dry the canal succeeded and the canal was filled, but follow-up examination showed an enlarged apical periodontitis lesion and extraction was performed. Biopsy specimens consisting of the root apex and apical periodontitis lesion for case 1 and the whole root for case 2 were subjected to histologic and histobacteriologic analyses. Both cases showed complex bacterial infection in the apical root, affecting both the intraradicular space and the outer root surface. Case 1 showed bacterial biofilms in ramifications, on untouched walls, and extending to the external root surface to form a thick and partially mineralized structure with high bacterial density. Different bacterial morphotypes were evidenced. Case 2 had a ledge on the apical canal wall created during instrumentation, which was filled with necrotic debris, filling material, and bacteria. The walls of the apical portion of the canal were covered by a bacterial biofilm, which was continuous with a thick extraradicular biofilm covering the cementum and dentin in resorptive defects. The extraradicular biofilm showed areas of mineralization and was dominated by filamentous bacteria. The 2 cases with wet canals and treatment failure were associated with complex persistent infection in the apical part of the root canal system extending to form thick and partially mineralized biofilm structures (calculus) on the outer apical root surface.

  12. Effect of solution properties, competing ligands, and complexing metal on sorption of tetracyclines on Al-based drinking water treatment residuals.

    PubMed

    Punamiya, Pravin; Sarkar, Dibyendu; Rakshit, Sudipta; Datta, Rupali

    2015-05-01

    In the current batch study, we investigated the effect of solution properties, competing ligands (phosphate (P(V)) and sulfate), and complexing metal (calcium (Ca(2+))) on tetracycline (TTC) and oxytetracycline (OTC) sorption by Al-based drinking water treatment residuals (Al-WTR). The sorption behavior for both TTC and OTC on Al-WTR was pH dependent. The sorption in absence of competing ligands and complexing metal increased with increasing pH up to circum-neutral pH and then decreased at higher pH. The presence of P(V) when added simultaneously had a significant negative effect (p < 0.001) on the sorption of TTC and OTC adsorbed by Al-WTR at higher TTC/OTC:P ratios. However, when P(V) was added after the equilibration of TTC and OTC by Al-WTR, the effect was minimal and insignificant (p > 0.1). The presence of sulfate had a minimal/negligible effect on the sorption of TCs by Al-WTR. A significant negative effect (p < 0.001) on the adsorption of TCs by Al-WTR was observed in the pH range below 5 and at higher TCs:Ca(2+) ratios, probably due to TCs-Ca(2+) complex formation. Fourier transform infrared (FTIR) analysis indicated the possibility of inner-sphere-type bonding by the functional groups of OTC/TTC on Al-WTR surface. Results from the batch sorption study indicate high affinity of Al-WTR for TCs in the pH range 4-8 (majorly encountered pH in the environment) in the presence of competing ligands and complexing metal.

  13. Rationale for targeting the thalamic centre-median parafascicular complex in the surgical treatment of Parkinson's disease.

    PubMed

    Kerkerian-Le Goff, Lydia; Jouve, Loreline; Melon, Christophe; Salin, Pascal

    2009-12-01

    The thalamic centre median-parafascicular complex (CM/Pf), a main input and output station of the basal ganglia, is attracting increasing interest in the field of movement disorders, including Parkinson's disease (PD). CM/Pf undergoes partial neurodegeneration in PD patients and some rodent models. Cellular evidence has been provided in experimental animals that thalamic degeneration may not aggravate but rather counteract the effects of dopamine lesion. But functional changes in the circuits involving the spared neurons could play a detrimental role. This view fits with converging anecdotic and recent direct experience in patients that stress the potential of CM/PF deep brain stimulation (DBS) to alleviate motor disorders, notably tremor and dyskinesias. As a preclinical contribution to the characterization of this target, we investigated the functional impact of CM/Pf-DBS in the 6-hydroxydopamine hemiparkinsonian rat model of PD. When testing different frequencies (25, 60, 130 Hz), only high frequency stimulation (HFS) had significant antiakinetic action as evidenced by alleviation of limb use asymmetry in the cylinder test. Although less efficient than HFS of the subthalamic nucleus in the latter task, CM/PF-HFS completely corrected lateralized neglect in the corridor task. Unlike subthalamic nucleus, CM/Pf-HFS did not induce per se dyskinesias. Finally, the benefits provided by CM/Pf-HFS were associated with widespread impact on the changes in neuronal metabolic activity induced by the dopamine depletion in the basal ganglia. These data point to own particular outcome of CM/Pf-DBS that may be of interest in currently developing multi-target strategies.

  14. Dual-targeted and pH-sensitive Doxorubicin Prodrug-Microbubble Complex with Ultrasound for Tumor Treatment

    PubMed Central

    Luo, Wanxian; Wen, Ge; Yang, Li; Tang, Jiao; Wang, Jianguo; Wang, Jihui; Zhang, Shiyu; Zhang, Li; Ma, Fei; Xiao, Liling; Wang, Ying; Li, Yingjia

    2017-01-01

    In this study, we investigated the potential of a dual-targeted pH-sensitive doxorubicin prodrug-microbubble complex (DPMC) in ultrasound (US)-assisted antitumor therapy. The doxorubicin prodrug (DP) consists of a succinylated-heparin carrier conjugated with doxorubicin (DOX) via hydrazone linkage and decorated with dual targeting ligands, folate and cRGD peptide. Combination of microbubble (MB) and DP, generated via avidin-biotin binding, promoted intracellular accumulation and improved therapeutic efficiency assisted by US cavitation and sonoporation. Aggregates of prepared DP were observed with an inhomogeneous size distribution (average diameters: 149.6±29.8 nm and 1036.2±38.8 nm, PDI: 1.0) while DPMC exhibited a uniform distribution (average diameter: 5.804±2.1 μm), facilitating its usage for drug delivery. Notably, upon US exposure, DPMC was disrupted and aggregated DP dispersed into homogeneous small-sized nanoparticles (average diameter: 128.6±42.3 nm, PDI: 0.21). DPMC could target to angiogenic endothelial cells in tumor region via αvβ3-mediated recognition and subsequently facilitate its specific binding to tumor cells mediated via recognition of folate receptor (FR) after US exposure. In vitro experiments showed higher tumor specificity and killing ability of DPMC with US than free DOX and DP for breast cancer MCF-7 cells. Furthermore, significant accumulation and specificity for tumor tissues of DPMC with US were detected using in vivo fluorescence and ultrasound molecular imaging, indicating its potential to integrate tumor imaging and therapy. In particular, through inducing apoptosis, inhibiting cell proliferation and antagonizing angiogenesis, DPMC with US produced higher tumor inhibition rates than DOX or DPMC without US in MCF-7 xenograft tumor-bearing mice while inducing no obvious body weight loss. Our strategy provides an effective platform for the delivery of large-sized or aggregated particles to tumor sites, thereby extending their

  15. The Role of mTOR Inhibitors in the Treatment of Patients with Tuberous Sclerosis Complex: Evidence-based and Expert Opinions.

    PubMed

    Curatolo, Paolo; Bjørnvold, Marit; Dill, Patricia E; Ferreira, José Carlos; Feucht, Martha; Hertzberg, Christoph; Jansen, Anna; Jóźwiak, Sergiusz; Kingswood, J Christopher; Kotulska, Katarzyna; Macaya, Alfons; Moavero, Romina; Nabbout, Rima; Zonnenberg, Bernard A

    2016-04-01

    Tuberous sclerosis complex (TSC) is a genetic disorder arising from mutations in the TSC1 or TSC2 genes. The resulting over-activation of the mammalian target of rapamycin (mTOR) signalling pathway leaves patients with TSC susceptible to the growth of non-malignant tumours in multiple organs. Previously, surgery was the main therapeutic option for TSC. However, pharmacological therapy with mTOR inhibitors such as everolimus and sirolimus is now emerging as an alternate approach. Everolimus and sirolimus have already been shown to be effective in treating subependymal giant cell astrocytoma (SEGA) and renal angiomyolipoma (AML), and everolimus is currently being evaluated in treating TSC-related epilepsy. In November 2013 a group of European experts convened to discuss the current options and practical considerations for treating various manifestations of TSC. This article provides evidence-based recommendations for the treatment of SEGA, TSC-related epilepsy and renal AML, with a focus on where mTOR inhibitor therapy may be considered alongside other treatment options. Safety considerations regarding mTOR inhibitor therapy are also reviewed. With evidence of beneficial effects in neurological and non-neurological TSC manifestations, mTOR inhibitors may represent a systemic treatment for TSC.

  16. Advanced monitoring and supervision of biological treatment of complex dairy effluents in a full-scale plant.

    PubMed

    Carrasco, Eugenio F; Omil, Francisco; Garrido, Juan M; Arrojo, Belén; Méndez, Ramón

    2004-01-01

    The operation of a wastewater treatment plant treating effluents from a dairy laboratory was monitored by an advanced system. This plant comprises a 12 m(3) anaerobic filter (AF) reactor and a 28 m(3) sequential batch reactor (SBR) coupled in series and is equipped with the following on-line measurement devices: biogas flow meter, feed and recycling flow meters, temperature sensor, dissolved oxygen analyzer, and redox meter. Other parameters such as chemical oxygen demand (COD), volatile fatty acids (VFA), etc. were determined off-line. The plant has been in operation for 634 days, the influent flow rate being 6-8 m(3)/d. COD concentration of the influent ranged between 8 and 12 kg COD/m(3), resulting in COD values in the effluent around 50-200 mg/L. The behavior of the system was studied using the set of measurements collected by the data acquisition program especially developed for this purpose. Monitoring of variables such as anaerobic reactor temperature permitted the detection and prevention of several failures such as temperature shocks in the AF reactor. Besides, off-line measurements such as the alkalinity or the VFA content, together with the on-line measurements, provided immediate information about the state of the plant and the detection of several anomalies, such as organic overloads in the SBR, allowing the implementation of several fast control actions.

  17. Complex interactions among nutrients, chlorophyll-a, and microcystins in three stormwater wet detention basins with floating treatment wetlands.

    PubMed

    Hartshorn, Nicholas; Marimon, Zachary; Xuan, Zhemin; Cormier, Jessica; Chang, Ni-Bin; Wanielista, Martin

    2016-02-01

    Stormwater wet detention ponds hold a permanent pool of water and offer many beneficial uses including flood mitigation, pollution prevention, downstream erosion control, increased aesthetics, and recreational uses. Although the removal of nutrients is generally low for stormwater wet detention ponds in urban areas, floating treatment wetlands (FTWs) can be installed to offer an innovative solution toward naturally removing excess nutrients and aiding in stormwater management. To improve the stormwater reuse potential, this study assessed nutrient, microcystin, and chlorophyll-a interactions in three Florida stormwater wet detention ponds with recently implemented FTWs. Both episodic (storm events) and routine (non-storm events) sampling campaigns were carried out at the three ponds located in Ruskin, Gainesville, and Orlando. The results showed a salient negative correlation between total phosphorus and microcystin concentrations for both storm and non-storm events across all three ponds. The dominant nutrient species in correlation seemed to be total phosphorus, which correlated positively with chlorophyll-a concentrations at all ponds and sampling conditions, with the exception of Orlando non-storm events. These results showed a correlation conditional to the candidate pond and sampling conditions for microcystin and chlorophyll-a concentrations.

  18. Application of Fe(VI) in the treatment of Zn(II)-NTA complexes in aqueous solutions.

    PubMed

    Yang, J; Tiwari, D; Yu, M; Pachuau, L; Kim, W; Lee, S

    2010-06-01

    The higher oxidation state of iron, i.e. Fe(VI), was exploited to treat the synthetic wastewater containing Zn(II)-NTA. The decomposition of Zn(II)-NTA by Fe(VI) was investigated with the help of analytical data obtained for the change in Fe(VI) concentration, dissolved organic carbon (DOC) and total soluble Zn(II) concentration as a function of time at various concentrations of Zn(II)-NTA and at constant Fe(VI) concentration. The UV-Visible data was used to explain the reaction kinetics for redox reactions between Fe(VI) and Zn(II)-NTA. The pseudo-first-order rate constant was calculated keeping the Zn(II)-NTA concentration in excess and hence the overall second-order-rate constant was obtained. Fe(VI) reduction was almost unaffected with the 1000 times increase in ionic strength (NaNO3), as well as in the presence of completely oxidized background electrolytes. However, Fe(VI) reduction was greatly affected in the presence of both SO3(2-) and NO2(-) especially at higher concentrations, indicating a competitive reduction took place between Zn(II)-NTA and Na2SO3 or NaNO2 in the Fe(VI) treatment. These results were again supported by the dissolved organic carbon observations since relatively very low removal of the dissolved organic carbon occurred in the presence of Na2SO3 and NaNO2.

  19. New fly ash TiO2 composite for the sustainable treatment of wastewater with complex pollutants load

    NASA Astrophysics Data System (ADS)

    Visa, Maria; Isac, Luminita; Duta, Anca

    2015-06-01

    The goal of this paper was to develop a new composite obtained in mild hydrothermal conditions starting from fly ash (a waste raising significant environmental problems), and TiO2. The composite was characterized through XRD, SEM/EDX, AFM, and BET surface measurements. The composite was further used for the advanced treatment of wastewaters with multiple-pollutants load. The photocatalytic efficiency of the powder composite was tested on synthetic solutions containing a heavy metal cation (copper), a dye (methyl orange), and a surfactant (sodium dodecylbenzenesulfonate), under UV and simulated solar radiation. Comparative experiments were done in systems with and without H2O2 showing a significant increase in efficiency for methyl orange removal from mono-, bi-, and tri-pollutants solutions. The process parameters were optimized and the adsorption mechanisms are discussed, outlining that adsorption is the limiting step. Experiments also outlined that homogeneous photocatalysis (using H2O2) is less efficient then the heterogeneous process using the novel composite, both under UV and simulated solar radiation.

  20. The Ilizarov method for the treatment of complex tibial fractures and non-unions in a mass casualty setting: the 2005 earthquake in Pakistan.

    PubMed

    Tilkeridis, Konstantinos; Chari, Basavraj; Cheema, Nusrat; Tryfonidis, Marios; Khaleel, Arshad

    2015-04-01

    We report our experience in treating victims of the recent earthquake disaster in Pakistan. Our experience was based on two humanitarian missions to Islamabad: one in October 2005, 10 days after the earthquake, and the second in January 2006. The mission consisted of a team of orthopaedic surgeons and a second team of plastic surgeons. The orthopaedic team bought all the equipment for application of Ilizarov external fixators. We treated patients who had already received basic treatment in the region of the disaster and subsequently had been evacuated to Islamabad. During the first visit, we treated 12 injured limbs in 11 patients. Four of these patients were children. All cases consisted of complex multifragmentary fractures associated with severe crush injuries. All fractures involved the tibia, which were treated with Ilizarov external fixators. Nine fractures were type 3b open injuries. Eight were infected requiring debridement of infected bone and acute shortening. During a second visit, we reviewed all patients treated during our first mission. In addition, we treated 13 new patients with complex non-unions. Eight of these patients were deemed to be infected. All patients had previous treatment with monolateral fixators as well as soft tissue coverage procedures, except one patient who had had an IEF applied by another team. All these patients had revision surgery with circular frames. All patients from both groups were allowed to fully weight-bear post-operatively, after a short period of elevation to allow the flaps to take. Overall, all fractures united except one case who eventually had an amputation. Four patients had a corticotomy and lengthening, and three of them had a successful restoration of limb length. The fourth patient was the one with the eventual amputation.

  1. Assessment of the SonixGPS system for its application in real-time ultrasonography navigation-guided percutaneous nephrolithotomy for the treatment of complex kidney stones.

    PubMed

    Li, Xiang; Long, Qingzhi; Chen, Xingfa; He, Dalin; He, Hui

    2017-04-01

    SonixGPS is a novel real-time ultrasonography navigation technology, which has been demonstrated to promote accuracy of puncture in surgical operations. The aim of this study is to evaluate its application in guiding the puncture during percutaneous nephrolithotomy (PCNL). We retrospectively reviewed our experience in treating a total of 74 patients with complex kidney stones with PCNL, in which puncture in 37 cases were guided by SonixGPS system, while the other 37 by conventional ultrasound. The effectiveness of operation was evaluated in terms of stone clearance rate, operation time, time to successful puncture, number of attempts for successful puncture and hospital stay. The safety of operation was examined by evaluating postoperative complications. Our retrospective review showed that although there were no significant differences in stone clearance rates between the groups, SonixGPS guidance resulted in more puncture accuracy with shorter puncture time and higher successful puncture rate. Under the help of SonixGPS, most patients (92 %) had no or just mild complications, compared to that (73 %) in conventional ultrasound group. Post-operative decrease of hemoglobin in SonixGPS group was 13.79 (7-33) mg/dl, significantly lower than that 20.97 (8-41) mg/dl in conventional ultrasound group. Our experience demonstrates that SonixGPS is superior to conventional ultrasound in guiding the puncture in PCNL for the treatment of complex kidney stone.

  2. Results of volume-staged fractionated Gamma Knife radiosurgery for large complex arteriovenous malformations: obliteration rates and clinical outcomes of an evolving treatment paradigm.

    PubMed

    Franzin, Alberto; Panni, Pietro; Spatola, Giorgio; Vecchio, Antonella Del; Gallotti, Alberto L; Gigliotti, Carmen R; Cavalli, Andrea; Donofrio, Carmine A; Mortini, Pietro

    2016-12-01

    OBJECTIVE There are few reported series regarding volume-staged Gamma Knife radiosurgery (GKRS) for the treatment of large, complex, cerebral arteriovenous malformations (AVMs). The object of this study was to report the results of using volume-staged Gamma Knife radiosurgery for patients affected by large and complex AVMs. METHODS Data from 20 patients with large AVMs were prospectively included in the authors' AVM database between 2004 and 2012. A staging strategy was used when treating lesion volumes larger than 10 cm(3). Hemorrhage and seizures were the presenting clinical feature for 6 (30%) and 8 (40%) patients, respectively. The median AVM volume was 15.9 cm(3) (range 10.1-34.3 cm(3)). The mean interval between stages (± standard deviation) was 15 months (± 9 months). The median margin dose for each stage was 20 Gy (range 18-25 Gy). RESULTS Obliteration was confirmed in 8 (42%) patients after a mean follow-up of 45 months (range 19-87 months). A significant reduction (> 75%) of the original nidal volume was achieved in 4 (20%) patients. Engel Class I-II seizure status was reported by 75% of patients presenting with seizures (50% Engel Class I and 25% Engel Class II) after radiosurgery. After radiosurgery, 71.5% (5/7) of patients who had presented with a worsening neurological deficit reported a complete resolution or amelioration. None of the patients who presented acutely because of hemorrhage experienced a new bleeding episode during follow-up. One (5%) patient developed radionecrosis that caused sensorimotor hemisyndrome. Two (10%) patients sustained a bleeding episode after GKRS, although only 1 (5%) was symptomatic. High nidal flow rate and a time interval between stages of less than 11.7 months were factors significantly associated with AVM obliteration (p = 0.021 and p = 0.041, respectively). Patient age younger than 44 years was significantly associated with a greater than 75% reduction in AVM volume but not with AVM obliteration (p = 0

  3. Delta III reverse shoulder arthroplasty in the treatment of complex 3- and 4-part fractures of the proximal humerus: 6 to 42 months of follow up

    PubMed Central

    2013-01-01

    Background There is a growing tendency for complex proximal humerus fractures (PHF) in osteoporotic patients to be treated with reverse shoulder arthroplasty (RSA). It has been proposed that RSA has more benefits than other treatment options. The aim of our study was to investigate preoperative characteristics as well as clinical and radiological outcomes in patients with complex 3- or 4-part PHF who had undergone primary RSA. Methods Patients with a minimum follow-up of 6 months who had undergone a primary RSA after 3- or 4-part PHF in the period between 2008 and 2011 were eligible for the study. Clinical records, X-rays and CT-scans were investigated and a clinical examination was performed. Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant-Murley score (CMS) were calculated. Sixteen patients were examined as part of the study. The mean follow-up was 20 months (range 6-42 months). According to Codman-Hertel classification we encountered 15 Hertel “12” and 1 Hertel “8” type fractures. Results Thirty-two patients (27 female – 84.4%) with a mean age of 72 years underwent operations to treat complex 3- and 4-part fractures of the proximal humerus. Sixteen patients were reexamined. In 14 cases the dominant upper extremity was on the right, in 2 cases it was on the left, in 6 cases the right side was affected and in 10 cases the left side was affected. The mean CMS was 54.8 (range 18-95) and the mean DASH was 37.5 (range 2.9-81). A trend was established between the CMS and dominance of the affected shoulder. The CMS was better if the affected shoulder was on the non-dominant side (p-value 0.051). No statistical difference was noted between age and clinical outcome. Conclusions Our mid-term follow-up shows satisfying results in terms of the treatment of severe displaced fractures in elderly patients with RSA. RSA can provide immediate relief and good shoulder function in elderly patients. Nevertheless, the question of longevity of these

  4. Constructing a Theory- and Evidence-Based Treatment Rationale for Complex eHealth Interventions: Development of an Online Alcohol Intervention Using an Intervention Mapping Approach

    PubMed Central

    Johansen, Ayna; Nesvåg, Sverre; Kok, Gerjo; Duckert, Fanny

    2013-01-01

    Background Due to limited reporting of intervention rationale, little is known about what distinguishes a good intervention from a poor one. To support improved design, there is a need for comprehensive reports on novel and complex theory-based interventions. Specifically, the emerging trend of just-in-time tailoring of content in response to change in target behavior or emotional state is promising. Objective The objective of this study was to give a systematic and comprehensive description of the treatment rationale of an online alcohol intervention called Balance. Methods We used the intervention mapping protocol to describe the treatment rationale of Balance. The intervention targets at-risk drinking, and it is delivered by email, mobile phone text messaging, and tailored interactive webpages combining text, pictures, and prerecorded audio. Results The rationale of the current treatment was derived from a self-regulation perspective, and the overarching idea was to support continued self-regulation throughout the behavior change process. Maintaining the change efforts over time and coping adaptively during critical moments (eg, immediately before and after a lapse) are key factors to successful behavior change. Important elements of the treatment rationale to achieving these elements were: (1) emotion regulation as an inoculation strategy against self-regulation failure, (2) avoiding lapses by adaptive coping, and (3) avoiding relapse by resuming the change efforts after a lapse. Two distinct and complementary delivery strategies were used, including a day-to-day tunnel approach in combination with just-in-time therapy. The tunnel strategy was in accordance with the need for continuous self-regulation and it functions as a platform from which just-in-time therapy was launched. Just-in-time therapy was used to support coping during critical moments, and started when the client reports either low self-efficacy or that they were drinking above target levels

  5. Targeting oxidative injury and cytokines' activity in the treatment with anti-tumor necrosis factor-α antibody for complex regional pain syndrome 1.

    PubMed

    Miclescu, Adriana A; Nordquist, Lena; Hysing, Eva-Britt; Butler, Stephen; Basu, Samar; Lind, Anne-Li; Gordh, Torsten

    2013-11-01

    Cytokines and oxygen free radicals have been implicated in the potential pathogenic development of complex regional pain syndrome (CRPS). We aimed to analyze the relationship between clinical status, circulating levels of cytokines, and markers of oxidative damage during the treatment with anti-TNFα antibodies. The patient chosen for treatment had not had improvement through a number of conventional therapies and fulfilled the current diagnostic criteria for CRPS-1. We investigated the clinical variables before and after systemic administration of 1.4 mg/kg anti-TNFα antibody (infliximab), repeated after 1 month in a dose of 3 mg/kg. Blood samples were collected before and after anti-TNFα antibodies administration, and plasma was analyzed for 8-isoprostane-prostaglandin F2α (8-iso-PGF2α, a marker of oxidative injury) and cytokines (TNF-α, IL-4, IL-6, IL-7, IL-8, IL-10, IL-17A). Plasma concentrations of 8-iso-PGF2α were measured with radioimmunoassay (RIA), and the kinetics of cytokines were detected in plasma by antibody-based proximity ligation (PLA). Pathologically high levels of 8-iso-PGF2α were found in the patient. Immediately after each administration of infliximab, the levels of 8-iso-PGF2α decreased. Although the patient showed an improvement of the cutaneous dystrophic symptoms and diminished pain associated with these lesions, the levels of circulating TNFα increased after the administration of anti-TNFα antibodies. In a patient with CRPS-1 treated with anti-TNFα antibodies, we report increased levels of circulating TNFα and a temporary mitigation of oxidative stress as measured by plasma F2 -isoprostane. This case report provides evidence 2 supporting the indication of monitoring the oxidative stress biomarkers during treatment with anti-TNFα antibodies in CRPS 1.

  6. Pilot Quasi-Randomized Controlled Study of Herbal Medicine Hochuekkito as an Adjunct to Conventional Treatment for Progressed Pulmonary Mycobacterium avium Complex Disease

    PubMed Central

    Enomoto, Yasunori; Hagiwara, Eri; Komatsu, Shigeru; Nishihira, Ryuichi; Baba, Tomohisa; Kitamura, Hideya; Sekine, Akimasa; Nakazawa, Atsuhito; Ogura, Takashi

    2014-01-01

    Introduction Hochuekkito, a traditional herbal medicine, is occasionally prescribed in Japan to treat patients with a poor general condition. We aimed to examine whether this medicine was beneficial and tolerable for patients with progressed pulmonary Mycobacterium avium complex (MAC) disease. Methods This pilot open-label quasi-randomized controlled trial enrolled 18 patients with progressed pulmonary MAC disease who had initiated antimycobacterial treatment over one year ago but were persistently culture-positive or intolerant. All patients continued their baseline treatment regimens with (n = 9) or without (n = 9) oral Hochuekkito for 24 weeks. Results Baseline characteristics were generally similar between the groups. Most patients were elderly (median age 70 years), female, had a low body mass index (<20 kg/m2), and a long-term disease duration (median approximately 8 years). After the 24-week treatment period, no patient achieved sputum conversion. Although the number of colonies in sputum tended to increase in the control group, it generally remained stable in the Hochuekkito group. Radiological disease control was frequently observed in the Hochuekkito group than the control group (8/9 vs. 3/9; p = 0.05). Patients in the Hochuekkito group tended to experience increase in body weight and serum albumin level compared with those in the control group (median body weight change: +0.4 kg vs. −0.8 kg; median albumin change: +0.2 g/dl vs. ±0.0 g/dl). No severe adverse events occurred. Conclusions Hochuekkito could be an effective, feasible adjunct to conventional therapy for patients with progressed pulmonary MAC disease. Future study is needed to explore this possibility. Trial Registration UMIN Clinical Trials Registry UMIN000009920 PMID:25093868

  7. Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial

    PubMed Central

    Deer, Timothy R.; Levy, Robert M.; Kramer, Jeffery; Poree, Lawrence; Amirdelfan, Kasra; Grigsby, Eric; Staats, Peter; Burton, Allen W.; Burgher, Abram H.; Obray, Jon; Scowcroft, James; Golovac, Stan; Kapural, Leonardo; Paicius, Richard; Kim, Christopher; Pope, Jason; Yearwood, Thomas; Samuel, Sam; McRoberts, W. Porter; Cassim, Hazmer; Netherton, Mark; Miller, Nathan; Schaufele, Michael; Tavel, Edward; Davis, Timothy; Davis, Kristina; Johnson, Linda; Mekhail, Nagy

    2016-01-01

    Abstract Animal and human studies indicate that electrical stimulation of dorsal root ganglion (DRG) neurons may modulate neuropathic pain signals. ACCURATE, a pivotal, prospective, multicenter, randomized comparative effectiveness trial, was conducted in 152 subjects diagnosed with complex regional pain syndrome or causalgia in the lower extremities. Subjects received neurostimulation of the DRG or dorsal column (spinal cord stimulation, SCS). The primary end point was a composite of safety and efficacy at 3 months, and subjects were assessed through 12 months for long-term outcomes and adverse events. The predefined primary composite end point of treatment success was met for subjects with a permanent implant who reported 50% or greater decrease in visual analog scale score from preimplant baseline and who did not report any stimulation-related neurological deficits. No subjects reported stimulation-related neurological deficits. The percentage of subjects receiving ≥50% pain relief and treatment success was greater in the DRG arm (81.2%) than in the SCS arm (55.7%, P < 0.001) at 3 months. Device-related and serious adverse events were not different between the 2 groups. Dorsal root ganglion stimulation also demonstrated greater improvements in quality of life and psychological disposition. Finally, subjects using DRG stimulation reported less postural variation in paresthesia (P < 0.001) and reduced extraneous stimulation in nonpainful areas (P = 0.014), indicating DRG stimulation provided more targeted therapy to painful parts of the lower extremities. As the largest prospective, randomized comparative effectiveness trial to date, the results show that DRG stimulation provided a higher rate of treatment success with less postural variation in paresthesia intensity compared to SCS. PMID:28030470

  8. Treatment of Children with Protein – Losing Enteropathy After Fontan and Other Complex Congenital Heart Disease Procedures in Condition with Limited Human and Technical Resources

    PubMed Central

    Bejiqi, Ramush; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Vuqiterna, Armend; Maloku, Arlinda

    2014-01-01

    Background Protein-losing enteropathy (PLE) is a disorder characterized by abnormal and often profound enteric protein loss. It’s relatively uncommon complication of Fontan and other complex congenital heart disease (CCHD) procedures. Because of the complexity and rarity of this disease process, the pathogenesis and pathophysiology of protein-losing enteropathy remain poorly understood, and attempts at treatment seldom yield long-term success. Aim of presentation is to describe single centre experience in diagnosis, evaluation, management and treatment of children with protein-losing enteropathy after Fontan and other CCHD procedures in the current era and in centre with limited human and technical resources, follows with a comprehensive review of protein-losing enteropathy publications, and concludes with suggestions for prevention and treatment. Material and methodology Retrospectively we analyzed patients with CCHD and protein-losing enteropathy in our institution, starting from January 2000 to December 2012. The including criteria were age between two and 17 years, to have a complex congenital heart disease and available complete documentation of cardiac surgery under cardiopulmonary bypass. Results Of all patients we evaluated 18 cases with protein-losing enteropathy, aged 6 to 19 years (mean 14±9); there were three children who had undergone screening procedure for D-transposition, one Tetralogy of Fallot, and remaining 14 patients had undergone Fontan procedures; (anatomic diagnosis are: six with tricuspid atresia, seven with d-transposition, double outlet right ventricle and pulmonary atresia and two with hypoplastic left heart syndrome). The diagnosis of protein-losing enteropathy was made at median age of 5.6 years, ranging from 13 months to 15 years. Diagnosis was made using alpha 1-antitrypsin as a gold marker in stool. By physical examination in 14 patients edema was found, in three ascites, and six patients had pleural effusion. Laboratory findings

  9. Treatment of Leishmania (Leishmania) Amazonensis-Infected Mice with a Combination of a Palladacycle Complex and Heat-Killed Propionibacterium acnes Triggers Protective Cellular Immune Responses

    PubMed Central

    Paladi, Carolina S.; da Silva, Danielle A. M.; Motta, Priscila D.; Garcia, Daniel M.; Teixeira, Daniela; Longo-Maugéri, Ieda M.; Katz, Simone; Barbiéri, Clara L.

    2017-01-01

    Palladacycle complex DPPE 1.2 was previously reported to inhibit the in vitro and in vivo infection by Leishmania (Leishmania) amazonensis. The aim of the present study was to compare the effect of DPPE 1.2, in association with heat-killed Propionibacterium acnes, on L. (L.) amazonensis infection in two mouse strains, BALB/c and C57BL/6, and to evaluate the immune responses of the treated animals. Foot lesions of L. (L.) amazonensis-infected mice were injected with DPPE 1.2 alone, or associated with P. acnes as an adjuvant. Analysis of T-cell populations in the treated mice and in untreated controls was performed by FACS. Detection of IFN-γ-secreting lymphocytes was carried out by an ELISPOT assay and active TGF-β was measured by means of a double-sandwich ELISA test. The treatment with DPPE 1.2 resulted in a significant reduction of foot lesion sizes and parasite burdens in both mouse strains, and the lowest parasite burden was found in mice treated with DPPE 1.2 plus P. acnes. Mice treated with DPPE 1.2 alone displayed a significant increase of TCD4+ and TCD8+ lymphocytes and IFN-γ secretion which were significantly higher in animals treated with DPPE 1.2 plus P. acnes. A significant reduction of active TGF-β was observed in mice treated with DPPE 1.2 alone or associated with P. acnes. Moreover, DPPE 1.2 associated to P. acnes was non-toxic to treated animals. The destruction of L. (L.) amazonensis by DPPE 1.2 was followed by host inflammatory responses which were exacerbated when the palladacycle complex was associated with P. acnes. PMID:28321209

  10. Treatment of Leishmania (Leishmania) Amazonensis-Infected Mice with a Combination of a Palladacycle Complex and Heat-Killed Propionibacterium acnes Triggers Protective Cellular Immune Responses.

    PubMed

    Paladi, Carolina S; da Silva, Danielle A M; Motta, Priscila D; Garcia, Daniel M; Teixeira, Daniela; Longo-Maugéri, Ieda M; Katz, Simone; Barbiéri, Clara L

    2017-01-01

    Palladacycle complex DPPE 1.2 was previously reported to inhibit the in vitro and in vivo infection by Leishmania (Leishmania) amazonensis. The aim of the present study was to compare the effect of DPPE 1.2, in association with heat-killed Propionibacterium acnes, on L. (L.) amazonensis infection in two mouse strains, BALB/c and C57BL/6, and to evaluate the immune responses of the treated animals. Foot lesions of L. (L.) amazonensis-infected mice were injected with DPPE 1.2 alone, or associated with P. acnes as an adjuvant. Analysis of T-cell populations in the treated mice and in untreated controls was performed by FACS. Detection of IFN-γ-secreting lymphocytes was carried out by an ELISPOT assay and active TGF-β was measured by means of a double-sandwich ELISA test. The treatment with DPPE 1.2 resulted in a significant reduction of foot lesion sizes and parasite burdens in both mouse strains, and the lowest parasite burden was found in mice treated with DPPE 1.2 plus P. acnes. Mice treated with DPPE 1.2 alone displayed a significant increase of TCD4(+) and TCD8(+) lymphocytes and IFN-γ secretion which were significantly higher in animals treated with DPPE 1.2 plus P. acnes. A significant reduction of active TGF-β was observed in mice treated with DPPE 1.2 alone or associated with P. acnes. Moreover, DPPE 1.2 associated to P. acnes was non-toxic to treated animals. The destruction of L. (L.) amazonensis by DPPE 1.2 was followed by host inflammatory responses which were exacerbated when the palladacycle complex was associated with P. acnes.

  11. The diagnostic accuracy of X-ray arthrography for triangular fibrocartilaginous complex injury: a systematic review and meta-analysis.

    PubMed

    Smith, T O; Drew, B T; Toms, A P; Chojnowski, A J

    2012-11-01

    The purpose of this study was to evaluate the diagnostic test accuracy of X-ray arthrography in the detection of TFCC tear. Both published and unpublished databases were searched from their inception to August 2010. All studies comparing the diagnostic accuracy of X-ray arthrography (index test) to arthroscopy (reference standard) for patients with suspected TFCC tears were included in this review. Twelve studies assessing 430 patients (430 wrists) satisfied the eligibility criteria and were included. X-ray arthrography presented with a pooled sensitivity of 76.2% and specificity of 92.5% for the detection of complete TFCC tear. The triple-compartment injection X-ray arthrography was superior to the single-compartment injection technique. To conclude, the diagnostic test accuracy of X-ray arthrography is limited. Neither the single- nor the triple-compartment injection arthrography method is acceptable, given their reported low sensitivities. Further evaluation of the diagnostic test accuracy of Magnetic Resonance Arthrography and Magnetic Resonance Imaging is therefore warranted.

  12. [Application of three-dimensional printing personalized acetabular wing-plate in treatment of complex acetabular fractures via lateral-rectus approach].

    PubMed

    Mai, J G; Gu, C; Lin, X Z; Li, T; Huang, W Q; Wang, H; Tan, X Y; Lin, H; Wang, Y M; Yang, Y Q; Jin, D D; Fan, S C

    2017-03-01

    Objective: To investigate reduction and fixation of complex acetabular fractures using three-dimensional (3D) printing technique and personalized acetabular wing-plate via lateral-rectus approach. Methods: From March to July 2016, 8 patients with complex acetabular fractures were surgically managed through 3D printing personalized acetabular wing-plate via lateral-rectus approach at Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University. There were 4 male patients and 4 female patients, with an average age of 57 years (ranging from 31 to 76 years). According to Letournel-Judet classification, there were 2 anterior+ posterior hemitransverse fractures and 6 both-column fractures, without posterior wall fracture or contralateral pelvic fracture. The CT data files of acetabular fracture were imported into the computer and 3D printing technique was used to print the fractures models after reduction by digital orthopedic technique. The acetabular wing-plate was designed and printed with titanium. All fractures were treated via the lateral-rectus approach in a horizontal position after general anesthesia. The anterior column and the quadrilateral surface fractures were fixed by 3D printing personalized acetabular wing-plate, and the posterior column fractures were reduction and fixed by antegrade lag screws under direct vision. Results: All the 8 cases underwent the operation successfully. Postoperative X-ray and CT examination showed excellent or good reduction of anterior and posterior column, without any operation complications. Only 1 case with 75 years old was found screw loosening in the pubic bone with osteoporosis after 1 month's follow-up, who didn't accept any treatment because the patient didn't feel discomfort. According to the Matta radiological evaluation, the reduction of the acetabular fracture was rated as excellent in 3 cases, good in 4 cases and fair in 1 case. All patients were followed up for 3 to 6 months and all

  13. Aerosolized Amphotericin B Lipid Complex as Adjunctive Treatment for Fungal Lung Infection in Patients with Cancer-Related Immunosuppression and Recipients of Hematopoietic Stem Cell Transplantation

    PubMed Central

    Safdar, Amar; Rodriguez, Gilhen H.

    2013-01-01

    Aerosolized amphotericin B lipid complex (aeABLC) has been successfully used to prevent fungal disease. Experience with aeABLC as treatment of fungal lung disease is limited. We evaluated the safety and efficacy of aeABLC adjunct therapy for fungal lung disease in a retrospective study of 32 immunosuppressed adults. Acute leukemia (69%) and severe neutropenia (63%) were common. The median duration of aeABLC was 185 ± 424 days in patients who underwent allogeneic stem cell transplantation (56%). High-dose corticosteroids were administered during aeABLC in 28% of patients. Fungal lung disease was proven or probable in 41% of patients. Most patients (78%) received systemic antifungal therapy for a median of 14 ± 18 days before aeABLC. The median cumulative aeABLC dose was 1,050 ± 2,368 mg, and the median duration of aeABLC therapy was 28 ± 130 days. Most patients (78%) received 50 mg aeABLC twice daily. Partial or complete resolution of fungal lung disease was noted in 50% of patients. In 3 patients (9%) modest cough, mild bronchospasm, and transient chest pain with accompanying nausea and vomiting resolved completely after discontinuation of aeABLC. No patient required hospitalization for drug toxicity or had a serious (grade III or IV) drug toxicity. Treatment with aeABLC was tolerated without serious toxicity and may be considered in the setting of severe immunosuppression, cancer, and/or stem cell transplantation in patients with difficult-to-treat fungal lung disease. PMID:23784915

  14. Ionic complex systems based on hyaluronic acid and PEGylated TNF-related apoptosis-inducing ligand for treatment of rheumatoid arthritis.

    PubMed

    Kim, Yu-Jeong; Chae, Su Young; Jin, Cheng-Hao; Sivasubramanian, M; Son, Sohee; Choi, Ki Young; Jo, Dong-Gyu; Kim, Kwangmeyung; Chan Kwon, Ick; Lee, Kang Choon; Park, Jae Hyung

    2010-12-01

    The clinical applications of tumor necrosis factor (TNF)-related apoptosis inducing ligand (TRAIL), an emerging therapeutic protein for cancer and rheumatoid arthritis (RA), are limited by its instability and short biological half-life. In this study, efficient therapeutic modalities for RA treatment were developed in the form of nano-sized complexes (nanocomplexes) based on hyaluronic acid (HA) and polyethylene glycol (PEG)-derivatized TRAIL (PEG-TRAIL) formed by N-terminal specific PEGylation. The nanocomplexes were prepared by simply mixing the positively charged PEG-TRAIL and negatively charged HA, and showed negligible loss of bioactivity compared with the PEG-TRAIL. The in vivo biodistribution and diffusion kinetics of Cy5.5-labeled PEG-TRAIL in mice were observed using a near-infrared optical imaging system after subcutaneous injection of three different formulations: PEG-TRAIL in phosphate-buffered saline (PBS, pH 7.4), nanocomplex in PBS, or nanocomplex in 1% HA solution. The results suggested that PEG-TRAIL is released slowly in vivo from the nanocomplex in 1% HA. Experiments in a collagen-induced arthritis mouse model demonstrated that the magnitudes of therapeutic effects, as judged by clinical scores and histology, were significantly enhanced by the sustained delivery of PEG-TRAIL, with the order of nanocomplex in 1% HA>nanocomplex in PBS>PEG-TRAIL in PBS. In addition, sustained delivery of PEG-TRAIL from the nanocomplex in 1% HA resulted in significant reduction of serum inflammatory cytokines and collagen-specific antibodies that are responsible for the pathogenesis of RA. These results imply that HA/PEG-TRAIL nanocomplex formulations are promising therapeutic modalities for the treatment of RA.

  15. Radioisotope trithiol complexes

    DOEpatents

    Jurisson, Silvia S.; Cutler, Cathy S.; Degraffenreid, Anthony J.

    2016-08-30

    The present invention is directed to a series of stable radioisotope trithiol complexes that provide a simplified route for the direct complexation of radioisotopes present in low concentrations. In certain embodiments, the complex contains a linking domain configured to conjugate the radioisotope trithiol complex to a targeting vector. The invention is also directed to a novel method of linking the radioisotope to a trithiol compound to form the radioisotope trithiol complex. The inventive radioisotope trithiol complexes may be utilized for a variety of applications, including diagnostics and/or treatment in nuclear medicine.

  16. Efficient Cleavage of Lignin-Carbohydrate Complexes and Ultrafast Extraction of Lignin Oligomers from Wood Biomass by Microwave-Assisted Treatment with Deep Eutectic Solvent.

    PubMed

    Liu, Yongzhuang; Chen, Wenshuai; Xia, Qinqin; Guo, Bingtuo; Wang, Qingwen; Liu, Shouxin; Liu, Yixing; Li, Jian; Yu, Haipeng

    2017-01-05

    Lignocellulosic biomass is an abundant and renewable resource for the production of biobased value-added fuels, chemicals, and materials, but its effective exploitation by an energy-efficient and environmentally friendly strategy remains a challenge. Herein, a facile approach for efficiently cleaving lignin-carbohydrate complexes and ultrafast fractionation of components from wood by microwave-assisted treatment with deep eutectic solvent is reported. The solvent was composed of sustainable choline chloride and oxalic acid dihydrate, and showed a hydrogen-bond acidity of 1.31. Efficient fractionation of lignocellulose with the solvent was realized by heating at 80 °C under 800 W microwave irradiation for 3 min. The extracted lignin showed a low molecular weight of 913, a low polydispersity of 1.25, and consisted of lignin oligomers with high purity (ca. 96 %), and thus shows potential in downstream production of aromatic chemicals. The other dissolved matter mainly comprised glucose, xylose, and hydroxymethylfurfural. The undissolved material was cellulose with crystal I structure and a crystallinity of approximately 75 %, which can be used for fabricating nanocellulose. Therefore, this work promotes an ultrafast lignin-first biorefinery approach while simultaneously keeping the undissolved cellulose available for further utilization. This work is expected to contribute to improving the economics of overall biorefining of lignocellulosic biomass.

  17. In vitro and in vivo anticancer properties of a Calcarea carbonica derivative complex (M8) treatment in a murine melanoma model

    PubMed Central

    2010-01-01

    Background Melanoma is the most aggressive form of skin cancer and the most rapidly expanding cancer in terms of worldwide incidence. Chemotherapeutic approaches to treat melanoma have had only marginal success. Previous studies in mice demonstrated that a high diluted complex derived from Calcarea carbonica (M8) stimulated the tumoricidal response of activated lymphocytes against B16F10 melanoma cells in vitro. Methods Here we describe the in vitro inhibition of invasion and the in vivo anti-metastatic potential after M8 treatment by inhalation in the B16F10 lung metastasis model. Results We found that M8 has at least two functions, acting as both an inhibitor of cancer cell adhesion and invasion and as a perlecan expression antagonist, which are strongly correlated with several metastatic, angiogenic and invasive factors in melanoma tumors. Conclusion The findings suggest that this medication is a promising non-toxic therapy candidate by improving the immune response against tumor cells or even induce direct dormancy in malignancies. PMID:20338038

  18. “Quantum Leap” in Photobiomodulation Therapy Ushers in a New Generation of Light-Based Treatments for Cancer and Other Complex Diseases: Perspective and Mini-Review

    PubMed Central

    Rodríguez-Santana, Elizabeth; Santana-Rodríguez, Karin E.; Reyes, Heberto

    2016-01-01

    Abstract Objective: Set within the context of the 2015 International Year of Light and Light-Based Technologies,and of a growing and aging world population with ever-rising healthcare needs, this perspective and mini-review focuses on photobiomodulation (PBM) therapy as an emerging, cost-effective, treatment option for cancer (i.e., solid tumors) and other complex diseases, particularly, of the eye (e.g., age-related macular degeneration, diabetic retinopathy, glaucoma, retinitis pigmentosa) and the central nervous system (e.g., Alzheimer's and Parkinson's disease). Background data: Over the last decades, primary and secondary mechanisms of PBM have been revealed. These include oxygen-dependent and oxygen-independent structural and functional action pathways. Signal and target characteristics determine biological outcome, which is optimal (or even positive) only within a given set of parameters. Methods: This study was a perspective and nonsystematic literature mini-review. Results: Studies support what we describe as a paradigm shift or “quantum leap” in the understanding and use of light and its interaction with water and other relevant photo-cceptors to restore physiologic function. Conclusions: Based on existing evidence, it is argued that PBM therapy can raise the standard of care and improve the quality of life of patients for a fraction of the cost of many current approaches. PBM therapy can, therefore,benefit large, vulnerable population groups, including the elderly and the poor, whilehaving a major impact on medical practice and public finances. PMID:26890728

  19. Human granulocyte-macrophage colony-stimulating factor DNA cationic-lipid complexed autologous tumour cell vaccination in the treatment of canine B-cell multicentric lymphoma.

    PubMed

    Turek, M M; Thamm, D H; Mitzey, A; Kurzman, I D; Huelsmeyer, M K; Dubielzig, R R; Vail, D M

    2007-12-01

    This study describes the development of an human granulocyte-macrophage colony-stimulating factor DNA cationic-lipid complexed autologous tumour cell vaccine (hGM-CSF CLDC ATCV) and its implementation, following a chemotherapy treatment protocol, in a randomized, placebo-controlled, double-blinded clinical trial in pet dogs with naturally occurring lymphoma. We hypothesized that the use of this vaccine would result in an antitumour immune response leading to improved first remission duration and overall survival in dogs with B-cell lymphoma when compared with chemotherapy alone. Immune stimulation generated by hGM-CSF CLDC ATCV was assessed by means of surrogate in vivo analysis (delayed-type hypersensitivity [DTH]) as well as an ex vivo cellular assay (lymphocyte proliferation assay). The vaccine approach considered in the current report did not result in clinically improved outcomes. A small measure of immunomodulation was documented by DTH and several modifications to the approach are suggested. This report illustrates the feasibility of clinical trials with vaccine strategies using companion animals with non-Hodgkin's lymphoma.

  20. MS-CASPT2 study of hole transfer in guanine-indole complexes using the generalized Mulliken-Hush method: effective two-state treatment.

    PubMed

    Butchosa, C; Simon, S; Blancafort, L; Voityuk, A

    2012-07-12

    Because hole transfer from nucleobases to amino acid residues in DNA-protein complexes can prevent oxidative damage of DNA in living cells, computational modeling of the process is of high interest. We performed MS-CASPT2 calculations of several model structures of π-stacked guanine and indole and derived electron-transfer (ET) parameters for these systems using the generalized Mulliken-Hush (GMH) method. We show that the two-state model commonly applied to treat thermal ET between adjacent donor and acceptor is of limited use for the considered systems because of the small gap between the ground and first excited states in the indole radical cation. The ET parameters obtained within the two-state GMH scheme can deviate significantly from the corresponding matrix elements of the two-state effective Hamiltonian based on the GMH treatment of three adiabatic states. The computed values of diabatic energies and electronic couplings provide benchmarks to assess the performance of less sophisticated computational methods.

  1. Fast and accurate Monte Carlo modeling of a kilovoltage X-ray therapy unit using a photon-source approximation for treatment planning in complex media

    PubMed Central

    Zeinali-Rafsanjani, B.; Mosleh-Shirazi, M. A.; Faghihi, R.; Karbasi, S.; Mosalaei, A.

    2015-01-01

    To accurately recompute dose distributions in chest-wall radiotherapy with 120 kVp kilovoltage X-rays, an MCNP4C Monte Carlo model is presented using a fast method that obviates the need to fully model the tube components. To validate the model, half-value layer (HVL), percentage depth doses (PDDs) and beam profiles were measured. Dose measurements were performed for a more complex situation using thermoluminescence dosimeters (TLDs) placed within a Rando phantom. The measured and computed first and second HVLs were 3.8, 10.3 mm Al and 3.8, 10.6 mm Al, respectively. The differences between measured and calculated PDDs and beam profiles in water were within 2 mm/2% for all data points. In the Rando phantom, differences for majority of data points were within 2%. The proposed model offered an approximately 9500-fold reduced run time compared to the conventional full simulation. The acceptable agreement, based on international criteria, between the simulations and the measurements validates the accuracy of the model for its use in treatment planning and radiobiological modeling studies of superficial therapies including chest-wall irradiation using kilovoltage beam. PMID:26170553

  2. Getting an Insight into the Complexity of Major Chronic Inflammatory and Degenerative Diseases: A Potential New Systemic Approach to Their Treatment.

    PubMed

    Biava, Pier M; Norbiato, Guido

    2015-01-01

    As the modern society is troubled by multi-factorial diseases, research has been conducted on complex realities including chronic inflammation, cancer, obesity, HIV infection, metabolic syndrome and its detrimental cardiovascular complications as well as depression and other brain disorders. Deterioration of crucial homeostatic mechanisms in such diseases invariably results in activation of inflammatory mediators, chronic inflammation, loss in immunological function, increased susceptibility to diseases, alteration of metabolism, decrease of energy production and neuro-cognitive decline. Regulation of genes expression by epigenetic code is the dominant mechanism for the transduction of environmental inputs, such as stress and inflammation to lasting physiological changes. Acute and chronic stress determines DNA methylation and histone modifications in brain regions which may contribute to neuro-degenerative disorders. Nuclear glucocorticoids receptor interacts with the epigenoma resulting in a cortisol resistance status associated with a deterioration of the metabolic and immune functions. Gonadal steroids receptors have a similar capacity to produce epigenomic reorganization of chromatine structure. Epigenomic-induced reduction in immune cells telomeres length has been observed in many degenerative diseases, including all types of cancer. The final result of these epigenetic alterations is a serious damage to the neuro-endocrine-immune-metabolic adaptive systems. In this study, we propose a treatment with stem cells differentiation stage factors taken from zebrafish embryos which are able to regulate the genes expression of normal and pathological stem cells in a different specific way.

  3. Phosphorylation of the pyruvate dehydrogenase complex precedes HIF-1-mediated effects and pyruvate dehydrogenase kinase 1 upregulation during the first hours of hypoxic treatment in hepatocellular carcinoma cells

    PubMed Central

    Zimmer, Andreas David; Walbrecq, Geoffroy; Kozar, Ines; Behrmann, Iris; Haan, Claude

    2016-01-01

    The pyruvate dehydrogenase complex (PDC) is an important gatekeeper enzyme connecting glycolysis to the tricarboxylic acid (TCA) cycle and oxidative phosphorylation (OXPHOS). Thereby, it has a strong impact on the glycolytic flux as well as the metabolic phenotype of a cell. PDC activity is regulated via reversible phosphorylation of three serine residues on the pyruvate dehydrogenase (PDH) E1α subunit. Phosphorylation of any of these residues by the PDH kinases (PDKs) leads to a strong decrease in PDC activity. Under hypoxia, the inactivation of the PDC has been described to be dependent on the hypoxia-inducible factor 1 (HIF-1)-induced PDK1 protein upregulation. In this study, we show in two hepatocellular carcinoma cell lines (HepG2 and JHH-4) that, during the adaptation to hypoxia, PDH is already phosphorylated at time points preceding HIF-1-mediated transcriptional events and PDK1 protein upregulation. Using siRNAs and small molecule inhibitor approaches, we show that this inactivation of PDC is independent of HIF-1α expression but that the PDKs need to be expressed and active. Furthermore, we show that reactive oxygen species might be important for the induction of this PDH phosphorylation since it correlates with the appearance of an altered redox state in the mitochondria and is also inducible by H2O2 treatment under normoxic conditions. Overall, these results show that neither HIF-1 expression nor PDK1 upregulation is necessary for the phosphorylation of PDH during the first hours of the adaptation to hypoxia. PMID:27800515

  4. Galactose conjugated platinum(II) complex targeting the Warburg effect for treatment of non-small cell lung cancer and colon cancer.

    PubMed

    Wu, Meng; Li, Hong; Liu, Ran; Gao, Xiangqian; Zhang, Menghua; Liu, Pengxing; Fu, Zheng; Yang, Jinna; Zhang-Negrerie, Daisy; Gao, Qingzhi

    2016-03-03

    Malignant neoplasms exhibit a higher rate of glycolysis than normal cells; this is known as the Warburg effect. To target it, a galactose-conjugated (trans-R,R-cyclohexane-1,2-diamine)-2-chloromalonato-platinum(II) complex (Gal-Pt) was designed, synthesized, and evaluated in five human cancer cell lines and against two different xenograft tumour models. Gal-Pt exhibits much higher aqueous solubility (over 25 times) and improved cytotoxicity than oxaliplatin, especially in human colon (HT29) and lung (H460) cancer cell lines. The safety profile of Gal-Pt was investigated in vivo by exploring the maximum tolerated dose (MTD) and animal mortality rate. The ratios of the animal lethal dosage values to the cytotoxicity in HT29 (LD50/IC50) showed that Gal-Pt was associated with an increased therapeutic index by over 30-fold compared to cisplatin and oxaliplatin. We evaluated in vivo antitumor activity by single agent intravenous treatment comparison studies of Gal-Pt (50 mg/kg as 65% MTD) and cisplatin (3 mg/kg, as 80% MTD) in a H460 lung cancer xenograft model, and with oxaliplatin (7 mg/kg, as 90% MTD) in a HT29 colon cancer xenograft model. The results show that Gal-Pt was more efficacious against H460 than cisplatin, and had superior potency in HT29 cells compared to oxaliplatin under nontoxic dosage conditions. The dependency between cytotoxicity of Gal-Pt and glucose transporters (GLUTs) was investigated by using quercetin as an inhibitor of GLUTs in HT29 cells. The cytotoxic potency of Gal-Pt was highly reduced by the inhibitor, suggesting that the uptake of Gal-Pt was regulated by glucose transporters. The GLUT mediated transportability and cellular uptake of Gal-Pt was also demonstrated using a fluorescent glucose bioprobe in HT29 competition assay.

  5. Guideline-concordant administration of prothrombin complex concentrate and vitamin K is associated with decreased mortality in patients with severe bleeding under vitamin K antagonist treatment (EPAHK study)

    PubMed Central

    2014-01-01

    Introduction In vitamin K antagonist (VKA)-treated patients with severe hemorrhage, guidelines recommend prompt VKA reversal with prothrombin complex concentrate (PCC) and vitamin K. The aim of this observational cohort study was to evaluate the impact of guideline concordant administration of PCC and vitamin K on seven-day mortality. Methods Data from consecutive patients treated with PCC were prospectively collected in 44 emergency departments. Type of hemorrhage, coagulation parameters, type of treatment and seven-day mortality mortality were recorded. Guideline-concordant administration of PCC and vitamin K (GC-PCC-K) were defined by at least 20 IU/kg factor IX equivalent PCC and at least 5 mg of vitamin K performed within a predefined time frame of eight hours after admission. Multivariate analysis was used to assess the effect of appropriate reversal on seven-day mortality in all patients and in those with intracranial hemorrhage (ICH). Results Data from 822 VKA-treated patients with severe hemorrhage were collected over 14 months. Bleeding was gastrointestinal (32%), intracranial (32%), muscular (13%), and “other” (23%). In the whole cohort, seven-day mortality was 13% and 33% in patients with ICH. GC-PCC-K was performed in 38% of all patients and 44% of ICH patients. Multivariate analysis showed a two-fold decrease in seven-day mortality in patients with GC-PCC-K (odds ratio (OR) = 2.15 (1.20 to 3.88); P = 0.011); this mortality reduction was also observed when only ICH was considered (OR = 3.23 (1.53 to 6.79); P = 0.002). Conclusions Guideline-concordant VKA reversal with PCC and vitamin K within eight hours after admission was associated with a significant decrease in seven-day mortality. PMID:24762166

  6. An evaluation of bovine respiratory disease complex in feedlot cattle: Impact on performance and carcass traits using treatment records and lung lesion scores.

    PubMed

    Schneider, M J; Tait, R G; Busby, W D; Reecy, J M

    2009-05-01

    The objective of this study was to investigate the effects of bovine respiratory disease (BRD) complex on economically important production traits with the use of health records in combination with lung lesion scores obtained at slaughter. Records from 5,976 animals were used in this study from cattle that were managed in Midwestern feedlots. Average daily gain for 3 different feeding periods (acclimation, on-test, and overall test) along with final BW were evaluated as performance measures. Hot carcass weight, LM area, subcutaneous fat cover, and marbling score were collected at slaughter. All calves were monitored by experienced feedlot personnel and treated according to the specific health protocol of each feedlot. Incidence of BRD was observed at a rate of 8.17%, and lung lesions at slaughter were present in 61.9% of cattle from a subpopulation (n = 1,665). From this group of cattle, the overall incidence of BRD, which was defined as cattle that had lung lesions, that were treated for BRD in the feedlot, or both, was 64.4%. Incidence of BRD in the feedlot decreased ADG during both the acclimation period (0.37 +/- 0.03 kg) and the overall test period (0.07 +/- 0.01 kg). Incidence of BRD also had significant effects on HCW and marbling score with reduction of 8.16 +/- 1.38 kg and 0.13 +/- 0.04, respectively, in treated cattle. The adverse effects on production traits tended to increase as the number of treatments increased. Potential decrease in performance and carcass merit observed in this study were associated with a decline of $23.23, $30.15, and $54.01 in carcass value when comparing cattle never treated with cattle treated once, twice, or 3 or more times, respectively. The presence of lung lesions did not have a significant effect on any of the traits; however, there was an association between the presence of active bronchial lymph nodes and less productivity of feedlot cattle.

  7. EPR spectroscopy of a clinically active (1:2) copper(II)-histidine complex used in the treatment of Menkes disease: a Fourier transform analysis of a fluid CW-EPR spectrum.

    PubMed

    Gala, Lukas; Lawson, Michael; Jomova, Klaudia; Zelenicky, Lubomir; Congradyova, Andrea; Mazur, Milan; Valko, Marian

    2014-01-15

    Redox active transition metal ions (e.g., iron and copper) have been implicated in the etiology of many oxidative stress-related diseases including also neurodegenerative disorders. Unbound copper can catalyze formation of reactive oxygen species (hydroxyl radicals) via Fenton reaction/Haber-Weiss chemistry and therefore, under physiological conditions, free copper is potentially toxic and very rarely exists inside cells. Copper(II) bound to the aminoacid L-histidine represents a species discovered in blood in the mid 60s and since then extensive research on this complex was carried out. Copper bound to L-histidine represents an exchangeable pool of copper(II) in equilibrium with the most abundant blood plasma protein, human serum albumin. The structure of this complex, in aqueous solution, has been a subject of many studies and reviews, however without convincing success. The significance of the (1:2) copper(II)-L-histidine complex at physiological pH documents its therapeutic applications in the treatment of Menkes disease and more recently in the treatment of infantile hypertrophic cardioencephalomyopathy. While recently the (1:2) Cu(II)-L-His complex has been successfully crystallized and the crystal structure was solved by X-ray diffraction, the structure of the complex in fluid solution at physiological pH is not satisfactorily known. The aim of this paper is to study the (1:2) Cu(II)-L-histidine complex at low temperatures by X-band and S-band EPR spectroscopy and at physiological pH at room temperature by Fourier transform CW-EPR spectroscopy.

  8. Synthesis, characterization and evaluation of the suppression of insulin resistance in Type-II diabetes mellitus animals by treatment with metal complex

    PubMed Central

    Phanse, Mohini A.; Patil, Manohar J.; Abbulu, Konde

    2015-01-01

    The present study is characterized toward thespesone isolation from Thespesia populnea (Malvaceae). Subsequently it was modified and characterized to study its effect on diabetes related symptoms. The complex is administered to diabetes induced mice with the doses of 5, 10 and 20 mg/kg, p.o. and the effect of complex on the level of body weight, lipid profile and blood glucose was studied after 22 days. The results have indicated that diabetic mice show a significant (p < 0.01) decrease in the level of serum triglyceride, plasma glucose and increase in body weight. Hence the present investigation reveals that newly synthesized complex is useful in the management of Type-II diabetes mellitus because of its ability to reduce insulin resistance. PMID:27081369

  9. Topical Treatment With Liposomal Sodium Copper Chlorophyllin Complex in Subjects With Facial Redness and Erythematotelangiectatic Rosacea: Case Studies.

    PubMed

    Vasily, David B

    2015-10-01

    Physicians are often presented with patients complaining of facial redness and difficult to control rosacea. The water soluble sodium copper chlorophyllin complex has been shown to have anti-oxidant, anti-inflammatory, and anti-bacterial activities in vitro and anti-redness, pore reduction, and anti-acne activities in pilot clinical studies. In these case studies, the safety and efficacy of a topical gel containing a liposomal suspension of sodium copper chlorophyllin complex was assessed in subjects with facial redness and erythematotelangiectatic rosacea.

  10. Activation of the complement system and accumulation of hemoglobin-haptoglobin complexes in plasma during an adverse reaction to penicillin treatment.

    PubMed

    Brandslund, I; Svehag, S E; Teisner, B; Hyltoft Petersen, P

    1983-01-01

    A patient treated with penicillin intravenously developed a serum sickness-like reaction. Classical pathway complement (C) activation was indicated by quantitation of the split products C3c and C3d as well as demonstration of C4 conversion. Circulating immune complexes could, however, not be detected by the solid-phase Clq and PEG-precipitation methods. A concomitant accumulation of circulating hemoglobin-haptoglobin complexes and a marked fall in serum-fibronectin concentrations suggested saturation of the reticuloendothelial system. The plasma became a deep-red color, and a diffuse intravascular coagulation followed. The patient recovered completely upon discontinuation of penicillin administration.

  11. Complexity and emergent phenomena.

    PubMed

    Suki, Béla; Bates, Jason H T; Frey, Urs

    2011-04-01

    Complex biological systems operate under non-equilibrium conditions and exhibit emergent properties associated with correlated spatial and temporal structures. These properties may be individually unpredictable, but tend to be governed by power-law probability distributions and/or correlation. This article reviews the concepts that are invoked in the treatment of complex systems through a wide range of respiratory-related examples. Following a brief historical overview, some of the tools to characterize structural variabilities and temporal fluctuations associated with complex systems are introduced. By invoking the concept of percolation, the notion of multiscale behavior and related modeling issues are discussed. Spatial complexity is then examined in the airway and parenchymal structures with implications for gas exchange followed by a short glimpse of complexity at the cellular and subcellular network levels. Variability and complexity in the time domain are then reviewed in relation to temporal fluctuations in airway function. Next, an attempt is given to link spatial and temporal complexities through examples of airway opening and lung tissue viscoelasticity. Specific examples of possible and more direct clinical implications are also offered through examples of optimal future treatment of fibrosis, exacerbation risk prediction in asthma, and a novel method in mechanical ventilation. Finally, the potential role of the science of complexity in the future of physiology, biology, and medicine is discussed.

  12. Complexity Survey.

    ERIC Educational Resources Information Center

    Gordon, Sandra L.; Anderson, Beth C.

    To determine whether consensus existed among teachers about the complexity of common classroom materials, a survey was administered to 66 pre-service and in-service kindergarten and prekindergarten teachers. Participants were asked to rate 14 common classroom materials as simple, complex, or super-complex. Simple materials have one obvious part,…

  13. Synthesis and characterization of Cu(II), Co(II) and Ni(II) complexes of a number of sulfadrug azodyes and their application for wastewater treatment.

    PubMed

    El-Baradie, K; El-Sharkawy, R; El-Ghamry, H; Sakai, K

    2014-01-01

    The azodye ligand (HL(1)) was synthesized from the coupling of sulfaguanidine diazonium salt with 2,4-dihydroxy-benzaldehyde while the two ligands, HL(2) and HL(3), were prepared by the coupling of sulfadiazine diazonium salt with salicylaldehyde (HL(2)) and 2,4-dihydroxy-benzaldehyde (HL(3)). The prepared ligands were characterized by elemental analysis, IR, (1)H NMR and mass spectra. Cu(II), Co(II) and Ni(II) complexes of the prepared ligands have been synthesized and characterized by various spectroscopic techniques like IR, UV-Visible as well as magnetic and thermal (TG and DTA) measurements. It was found that all the ligands behave as a monobasic bidentate which coordinated to the metal center through the azo nitrogen and α-hydroxy oxygen atoms in the case of HL(1) and HL(3). HL(2) coordinated to the metal center through sulfonamide oxygen and pyrimidine nitrogen. The applications of the prepared complexes in the oxidative degradation of indigo carmine dye exhibited good catalytic activity in the presence of H2O2 as an oxidant. The reactions followed first-order kinetics and the rate constants were determined. The degradation reaction involved the catalytic action of the azo-dye complexes toward H2O2 decomposition, which can lead to the generation of HO radicals as a highly efficient oxidant attacking the target dye. The detailed kinetic studies and the mechanism of these catalytic reactions are under consideration in our group.

  14. Synthesis and characterization of Cu(II), Co(II) and Ni(II) complexes of a number of sulfadrug azodyes and their application for wastewater treatment

    NASA Astrophysics Data System (ADS)

    El-Baradie, K.; El-Sharkawy, R.; El-Ghamry, H.; Sakai, K.

    2014-03-01

    The azodye ligand (HL1) was synthesized from the coupling of sulfaguanidine diazonium salt with 2,4-dihydroxy-benzaldehyde while the two ligands, HL2 and HL3, were prepared by the coupling of sulfadiazine diazonium salt with salicylaldehyde (HL2) and 2,4-dihydroxy-benzaldehyde (HL3). The prepared ligands were characterized by elemental analysis, IR, 1H NMR and mass spectra. Cu(II), Co(II) and Ni(II) complexes of the prepared ligands have been synthesized and characterized by various spectroscopic techniques like IR, UV-Visible as well as magnetic and thermal (TG and DTA) measurements. It was found that all the ligands behave as a monobasic bidentate which coordinated to the metal center through the azo nitrogen and α-hydroxy oxygen atoms in the case of HL1 and HL3. HL2 coordinated to the metal center through sulfonamide oxygen and pyrimidine nitrogen. The applications of the prepared complexes in the oxidative degradation of indigo carmine dye exhibited good catalytic activity in the presence of H2O2 as an oxidant. The reactions followed first-order kinetics and the rate constants were determined. The degradation reaction involved the catalytic action of the azo-dye complexes toward H2O2 decomposition, which can lead to the generation of HOrad radicals as a highly efficient oxidant attacking the target dye. The detailed kinetic studies and the mechanism of these catalytic reactions are under consideration in our group.

  15. Prosthodontic treatment in a partially edentulous patient with a complex medical history of epilepsy and deep vein thrombosis: a case report.

    PubMed

    Kosyfaki, Panagiota; Woerner, Wolf; Att, Wael

    2011-05-01

    This report describes the prosthodontic rehabilitation of a partially edentulous patient by means of a maxillary implant-supported removable dental prosthesis and mandibular telescopic crown prosthesis. Due to the patient's contributory medical history for epilepsy and deep vein thrombosis, clinical management considerations are outlined along with an evidence-based, medically oriented treatment sequence concerning the surgical and prosthodontic stages of the case.

  16. Anaerobic treatment of complex chemical wastewater in a sequencing batch biofilm reactor: process optimization and evaluation of factor interactions using the Taguchi dynamic DOE methodology.

    PubMed

    Venkata Mohan, S; Chandrasekhara Rao, N; Krishna Prasad, K; Murali Krishna, P; Sreenivas Rao, R; Sarma, P N

    2005-06-20

    The Taguchi robust experimental design (DOE) methodology has been applied on a dynamic anaerobic process treating complex wastewater by an anaerobic sequencing batch biofilm reactor (AnSBBR). For optimizing the process as well as to evaluate the influence of different factors on the process, the uncontrollable (noise) factors have been considered. The Taguchi methodology adopting dynamic approach is the first of its kind for studying anaerobic process evaluation and process optimization. The designed experimental methodology consisted of four phases--planning, conducting, analysis, and validation connected sequence-wise to achieve the overall optimization. In the experimental design, five controllable factors, i.e., organic loading rate (OLR), inlet pH, biodegradability (BOD/COD ratio), temperature, and sulfate concentration, along with the two uncontrollable (noise) factors, volatile fatty acids (VFA) and alkalinity at two levels were considered for optimization of the anae robic system. Thirty-two anaerobic experiments were conducted with a different combination of factors and the results obtained in terms of substrate degradation rates were processed in Qualitek-4 software to study the main effect of individual factors, interaction between the individual factors, and signal-to-noise (S/N) ratio analysis. Attempts were also made to achieve optimum conditions. Studies on the influence of individual factors on process performance revealed the intensive effect of OLR. In multiple factor interaction studies, biodegradability with other factors, such as temperature, pH, and sulfate have shown maximum influence over the process performance. The optimum conditions for the efficient performance of the anaerobic system in treating complex wastewater by considering dynamic (noise) factors obtained are higher organic loading rate of 3.5 Kg COD/m3 day, neutral pH with high biodegradability (BOD/COD ratio of 0.5), along with mesophilic temperature range (40 degrees C), and

  17. Global Post-Authorization Safety Surveillance Study: real-world data on prophylaxis and on-demand treatment using FEIBA (an activated prothrombin complex concentrate)

    PubMed Central

    Negrier, Claude; Voisin, Sophie; Baghaei, Fariba; Numerof, Robert; Novack, Aaron; Doralt, Jennifer E.; Romanov, Vadim; Gringeri, Alessandro

    2016-01-01

    This prospective, Post-Authorization Safety Surveillance (PASS) study was carried out in patients with hemophilia A or B and inhibitors treated with FEIBA for 1 year to collect real-world data on safety and effectiveness of FEIBA. The study followed a cohort design and did not make stipulations on treatment or observation schedule, as it was designed to observe routine medical practices based on physicians’ treatment decisions, including whether patients received on-demand or prophylaxis with FEIBA. The attending physician maintained documentation, including medical records, laboratory reports, adverse event reports, and so on and a subject diary was used. Eighty-one patients were treated with FEIBA at 40 sites in 10 countries over a 4-year period. Sixty-nine patients (85.2%) had hemophilia A, two had (2.5%) hemophilia B, and ten (12.3%) had acquired hemophilia A. At baseline 45 patients (55.6%) were prescribed prophylaxis and 36 (44.6%) on-demand treatment. This study was novel in following safety and effectiveness in ‘real world’ on-demand and prophylactic use of FEIBA, and was able to collect data in these rare patients under routine clinical practice. PMID:26829366

  18. [COMPLEX OF THE TREATMENT MEASURES IN A SYSTEM OF THE MEDICAL CARE DELIVERY TO WOUNDED PERSONS WITH THE GUN-SHOT AND MINE-EXPLOSIVE INJURIES OF THE FOOT].

    PubMed

    Korohl, S O

    2015-11-01

    Complex of the treatment measures, conducted in 302 wounded persons, suffering the gun-shot and mine-explosive injuries of the foot in 2014 - 2015 yrs, was analyzed. Primary surgical processing of the wound was conducted in all injured persons, secondary surgical processing--in 64.6%, the foot bones osteosynthesis--in 13.9%, primary immobilization, using improvised tire--in 77.8%, secondary immobilization, using the plaster splint--in 48.1%, llizarov's spokes--in 35.2%, Ilizarov's apparatus--in 18.5%, the rods apparatuses of external fixation--in 16.7%. For improvement of functioning of a modern system for the treatment-evacuation provision it is necessary, to reduce the quantity of levels of the medical help provision maximally.

  19. Hyaluronan viscosupplementation: state of the art and insight into the novel cooperative hybrid complexes based on high and low molecular weight HA of potential interest in osteoarthritis treatment.

    PubMed

    Schiraldi, Chiara; Stellavato, Antonietta; de Novellis, Francesca; La Gatta, Annalisa; De Rosa, Mario

    2016-01-01

    Osteoarthritis (OA) represents a group of chronic, painful, disabling conditions affecting synovial joints. It is characterized by degeneration of articular cartilage, alterations of peri-articular and subchondral bone, low-grade synovial inflammation (synovitis). Despite OA is commonly described as a non-inflammatory disease, it is known that its progression and the subsequent increment of symptoms correlate to the production of inflammatory factors that induce the secretion of enzymes responsible for cartilage degradation. In clinical practice, to alleviate pain and stiffness, not only during acute phases but also as maintenance therapy, intra-articular injections of corticosteroids or similar drugs are used, besides it is well diffused the viscosupplementation procedure based on hyaluronan gel. There are many different products containing high molecular weight linear HA or cross-linked derivatives, however the novelty in the field consist in the hybrid cooperative complexes derived from high and low molecular weight HA through a patented processing. This technique permit to double the amount of HA delivered to the injured site without increasing the injected volume, beside in vitro assay on human chondrocytes suggested hybrid complexes as effective in the modulation of several inflammatory cytokines in joints.

  20. A psychological intervention for smoking cessation delivered as treatment for smokers with chronic obstructive pulmonary disease: Multiple needs of a complex group and recommendations for novel service development.

    PubMed

    Yap, Su Yin; Lunn, Sarah; Pang, Elizabeth; Croft, Carla; Stern, Myra

    2015-08-01

    This pilot study investigated the benefits of adjunctive psychological intervention for smokers accessing standard smoking cessation interventions. Chronic obstructive pulmonary disease (COPD) smokers attending a smoking cessation service were offered up to 12 adjunctive clinical psychology sessions. Baseline data included demographics, smoking history, and disease severity. Outcomes included attendance and quit rate. In all, 59 patients with moderate COPD were referred. Of the 20 patients who attended training sessions, 7 (35%) were relapse prevention referrals and 13 (65%) were current smokers. Of the seven relapse prevention referrals, six (86%) maintained their quit, 2 of 13 (15%) of the current smoker group maintained a 28-day quit and 3 of 13 (23%) of current smokers reduced their tobacco intake. For COPD smokers with a heavy smoking history and multiple past quit attempts, there was insufficient evidence to show that additional psychological intervention leads to higher quit rates. Significant barriers to quitting and complex medical and psychosocial needs were identified in this group, suggesting that the current 'one-size-fits-all' approach to smoking cessation may not be sufficient to meet the needs of such a complex group.

  1. A new multi-frequency approach based on Padé approximants for the treatment of transient dynamics problems with the variational theory of complex rays

    NASA Astrophysics Data System (ADS)

    Rouzaud, C.; Gatuingt, F.; Hervé, G.; Dorival, O.

    2017-03-01

    Frequency-based methods were set up in order to circumvent the limits of classical finite element methods in fast dynamic simulations due to discretizations. In this approach the dynamic loading was shifted in the frequency domain by FFT, then treated by the Variational Theory of Complex Rays, and then the time response was reconstructed through an IFFT. This strategy proved to be very efficient due to the CPU VTCR very low cost. However in the case of a large loading spectrum this frequency-by-frequency approach could seriously degrade the computational performances of the strategy. This paper addresses this point by proposing the use of Padé approximants in order to limit the number of frequencies at which the response should be calculated. Padé approximation is applied to the overall VTCR system based on its frequency dependency. Finally, as simulations on a simple academic case and on a civil engineering structure show, this method is found to be very efficient for interpolating the frequency response functions of a complex structure. This is a key point to preserve the efficiency of the complete VTCR strategy for transient dynamic problems.

  2. Hyaluronan viscosupplementation: state of the art and insight into the novel cooperative hybrid complexes based on high and low molecular weight HA of potential interest in osteoarthritis treatment

    PubMed Central

    Schiraldi, Chiara; Stellavato, Antonietta; de Novellis, Francesca; La Gatta, Annalisa; De Rosa, Mario

    2016-01-01

    Summary Osteoarthritis (OA) represents a group of chronic, painful, disabling conditions affecting synovial joints. It is characterized by degeneration of articular cartilage, alterations of peri-articular and subchondral bone, low-grade synovial inflammation (synovitis). Despite OA is commonly described as a non-inflammatory disease, it is known that its progression and the subsequent increment of symptoms correlate to the production of inflammatory factors that induce the secretion of enzymes responsible for cartilage degradation. In clinical practice, to alleviate pain and stiffness, not only during acute phases but also as maintenance therapy, intra-articular injections of corticosteroids or similar drugs are used, besides it is well diffused the viscosupplementation procedure based on hyaluronan gel. There are many different products containing high molecular weight linear HA or cross-linked derivatives, however the novelty in the field consist in the hybrid cooperative complexes derived from high and low molecular weight HA through a patented processing. This technique permit to double the amount of HA delivered to the injured site without increasing the injected volume, beside in vitro assay on human chondrocytes suggested hybrid complexes as effective in the modulation of several inflammatory cytokines in joints. PMID:27252742

  3. Phonological Complexity and Language Learnability

    PubMed Central

    Gierut, Judith A.

    2008-01-01

    Purpose To extend formal models of language learnability to applications in clinical treatment of children with functional phonological delays. Method The focus of the narrative review is on phonological complexity. This follows from learnability theory, whereby complexity in the linguistic input to children has been shown to trigger language learning. Drawing from the literature, phonological complexity is defined from epistemic, ontological, and functional perspectives, with specific emphasis on the application of language universals in the selection of target sounds for treatment. Results The cascading effects of phonological complexity on children’s generalization learning are illustrated, and frequently asked questions about complexity in treatment are addressed. Conclusion The role of complexity in cognitive development is introduced to demonstrate the apparent robustness of effects. PMID:17329671

  4. Oral everolimus treatment in a preterm infant with multifocal inoperable cardiac rhabdomyoma associated with tuberous sclerosis complex and a structural heart defect.

    PubMed

    Mohamed, Ibrahim; Ethier, Guillaume; Goyer, Isabelle; Major, Philippe; Dahdah, Nagib

    2014-11-26

    Rhabdomyoma (RHM) is a benign cardiac tumour usually associated with tuberous sclerosis complex (TSC). Most RHMs are asymptomatic and regress spontaneously during the first years of life. Haemodynamically significant RHMs are classically treated with surgical excision. We present a case of a premature infant, born to a mother having TSC, with a prenatal diagnosis of pulmonary valve atresia and a large ventricular septal defect. Multiple cardiac RHMs were also present, including a large tumour affecting the right ventricular filling. Owing to the prematurity and low birth weight, the infant was inoperable. In this report, we describe our approach to pharmacologically reduce the RHM size using oral everolimus in preparation for a two-ventricle surgical repair of the structural cardiac defect. We also specifically describe the dose of everolimus that was used in this case to achieve therapeutic serum levels, which was seven times lower than the conventional dose applicable for older infants.

  5. Participation-engagement: a philosophically based heuristic for prioritizing clinical interventions in the treatment of comorbid, complex, and chronic psychiatric conditions.

    PubMed

    Shahar, Golan; Davidson, Larry

    2009-01-01

    We propose Participation-Engagement (PAR-EN) as a philosophically based heuristic for prioritizing interventions in comorbid, complex, and chronic psychiatric conditions. Drawing from 1) the sociologist Talcott Parsons, 2) the continental-philosophical tradition, and 3) our own previous work (Davidson & Shahar, 2009; Shahar, 2004, 2006), we argue that participation in personally meaningful life goals represents a hallmark of mental health. Symptoms and vulnerabilities that impede such participation should therefore be targeted vigorously, whereas others which do not pose such imminent threats should assume a secondary focus, if at all. Winnicott's (1987) notion of the spontaneous gesture, the importance of daily activities as reflecting patients' participation, and the dialectics of interpersonal relatedness and self-definition, are introduced as guidelines for implementing PAR-EN. Implications for clinical assessment and the therapeutic relationship are discussed.

  6. Mentalizing as a framework for integrating therapeutic exposure and relationship repair in the treatment of a patient with complex posttraumatic psychopathology.

    PubMed

    Stein, Helen; Allen, Jon G

    2007-01-01

    The concept of mentalizing-attending to mental states in oneself and others-provides an integrative conceptual framework to characterize the psychotherapeutic treatment of a patient with a history of attachment trauma and a comorbid schizoaffective disorder. The authors construe mentalizing failures in childhood attachment relationships as integral to the trauma and the promotion of mentalizing in the psychotherapy relationship as the cornerstone of healing. They employ mentalizing to conceptualize both the exposure-based interventions and the equally essential interruption of a problematic pattern of reenactment that continually fueled the patient's posttraumatic symptoms.

  7. [Temporary percutaneous spondylodesis C1/2 and halo vest immobilisation. An alternative treatment of complex injuries of the upper cervical spine].

    PubMed

    Dudda, M; Frangen, T M; Russe, O; Muhr, G; Schinkel, C

    2006-12-01

    Dislocated combined injuries of the upper cervical spine such as C 1/2 fractures require occipitocervical fusion, especially if the dislocation can not be redressed using halo vest immobilisition. We report on the clinical course and outcome of a young woman who sustained complex cervical spine injuries. Closed reduction and a percutaneous transfixation of C 1/2 with k-wires (Magerl) and an additional halo vest immobilisition was performed to avoid permanent fusion. The 25 year old patient was involved in a motor vehicle accident that resulted in a dislocated Jefferson's fracture, an odontoid fracture type II (Anderson and d'Alonso) with protrusion into the foramen magnum, and a dislocated C 6/7 fracture. A ventral spondylodesis C6/7 was followed by temporary dorsal spondylodesis C1/2 with k-wires (Magerl) and additional halo vest immobilisition after closed reduction. The temporary percutaneous fixation C1/2 was removed after 11 weeks, as was the halo vest immobilisition. After removing the temporary percutaneous fixation (k-wires) and the halo system, the patient showed very good functional results in terms of range of motion with only minor discomfort. Complex injuries of the upper cervical spine that cannot be retained by external fixation often require an occipitocervical fusion or fixation of C1/2. In the case presented, the temporary percutaneous fixation (Magerl) with k-wires was terminated after 3 months to avoid significant functional impairment. Younger patients benefit most from temporary fusion of the upper cervical spine, which results in better functional outcome and only minor pain.

  8. Ulnar Impaction Syndrome: A case series investigating the appropriate diagnosis, management, and post-operative considerations

    PubMed Central

    Woitzik, Erin; deGraauw, Chris; Easter, Brock

    2014-01-01

    Ulnar sided wrist pain is a common site for upper extremity disability. Ulnar impaction syndrome results in a spectrum of triangular fibrocartilage complex (TFCC) injuries and associated lunate, triquetrum, and ligamentous damage. Patients commonly present with insidious ulnar sided wrist pain and clicking, and a history of trauma or repetitive axial loading and rotation. In this case series, three patients presented to a sports chiropractor for evaluation and were subsequently diagnosed with ulnar impaction syndrome. Treatment strategies consist of conservative management, arthroscopic debridement or repair, arthroscopic wafer procedure, or ulnar shortening osteotomy. For the athlete, intervention should be individualized and sport-specific, considering athletic priorities, healing potential, return to play, and long-term health concerns. PMID:25550665

  9. The Tom Core Complex

    PubMed Central

    Ahting, Uwe; Thun, Clemens; Hegerl, Reiner; Typke, Dieter; Nargang, Frank E.; Neupert, Walter; Nussberger, Stephan

    1999-01-01

    Translocation of nuclear-encoded preproteins across the outer membrane of mitochondria is mediated by the multicomponent transmembrane TOM complex. We have isolated the TOM core complex of Neurospora crassa by removing the receptors Tom70 and Tom20 from the isolated TOM holo complex by treatment with the detergent dodecyl maltoside. It consists of Tom40, Tom22, and the small Tom components, Tom6 and Tom7. This core complex was also purified directly from mitochondria after solubilization with dodecyl maltoside. The TOM core complex has the characteristics of the general insertion pore; it contains high-conductance channels and binds preprotein in a targeting sequence-dependent manner. It forms a double ring structure that, in contrast to the holo complex, lacks the third density seen in the latter particles. Three-dimensional reconstruction by electron tomography exhibits two open pores traversing the complex with a diameter of ∼2.1 nm and a height of ∼7 nm. Tom40 is the key structural element of the TOM core complex. PMID:10579717

  10. Complex derivatives

    NASA Astrophysics Data System (ADS)

    Battiston, Stefano; Caldarelli, Guido; Georg, Co-Pierre; May, Robert; Stiglitz, Joseph

    2013-03-01

    The intrinsic complexity of the financial derivatives market has emerged as both an incentive to engage in it, and a key source of its inherent instability. Regulators now faced with the challenge of taming this beast may find inspiration in the budding science of complex systems.

  11. Designing Complexity

    ERIC Educational Resources Information Center

    Glanville, Ranulph

    2007-01-01

    This article considers the nature of complexity and design, as well as relationships between the two, and suggests that design may have much potential as an approach to improving human performance in situations seen as complex. It is developed against two backgrounds. The first is a world view that derives from second order cybernetics and radical…

  12. Complex odontoma.

    PubMed

    Preetha, A; Balikai, Bharati S; Sujatha, D; Pai, Anuradha; Ganapathy, K S

    2010-01-01

    Odontomas are hamartomatous lesions or malformations composed of mature enamel, dentin, and pulp. They may be compound or complex, depending on the extent of morphodifferentiation or their resemblance to normal teeth. The etiology of odontoma is unknown, although several theories have been proposed. This article describes a case of a large infected complex odontoma in the residual mandibular ridge, resulting in considerable mandibular expansion.

  13. Toward a 3D cellular model for studying in vitro the outcome of photodynamic treatments: accounting for the effects of tissue complexity.

    PubMed

    Alemany-Ribes, Mireia; García-Díaz, María; Busom, Marta; Nonell, Santi; Semino, Carlos E

    2013-08-01

    Clinical therapies have traditionally been developed using two-dimensional (2D) cell culture systems, which fail to accurately capture tissue complexity. Therefore, three-dimensional (3D) cell cultures are more attractive platforms to integrate multiple cues that arise from the extracellular matrix and cells, closer to an in vivo scenario. Here we report the development of a 3D cellular model for the in vitro assessment of the outcome of oxygen- and drug-dependent therapies, exemplified by photodynamic therapy (PDT). Using a synthetic self-assembling peptide as a cellular scaffold (RAD16-I), we were able to recreate the in vivo limitation of oxygen and drug diffusion and its biological effect, which is the development of cellular resistance to therapy. For the first time, the production and decay of the cytotoxic species singlet oxygen could be observed in a 3D cell culture. Results revealed that the intrinsic mechanism of action is maintained in both systems and, hence, the dynamic mass transfer effects accounted for the major differences in efficacy between the 2D and 3D models. We propose that this methodological approach will help to improve the efficacy of future oxygen- and drug-dependent therapies such as PDT.

  14. Long-term use of a high-complex-carbohydrate, high-fiber, low-fat diet and exercise in the treatment of NIDDM patients.

    PubMed

    Barnard, R J; Massey, M R; Cherny, S; O'Brien, L T; Pritikin, N

    1983-01-01

    The purpose of this study was to assess the long-term effects of a high-complex-carbohydrate, high-fiber, low-fat diet and exercise on 69 NIDDM patients. During the initial 26-day program, fasting glucose was reduced from 179.5 +/- 10.6 to 133.5 +/- 4.0 mg/dl. This decrease in fasting glucose was achieved along with the discontinuation of oral hypoglycemic agents in 24 of 31 patients and of insulin in 13 of 18 patients; one patient was placed on insulin. Serum cholesterol and triglycerides were reduced by 25% and 27%, respectively. At 2-3 yr of follow-up, fasting glucose was not significantly different from the value observed at the end of the 26-day program. Compared with the end of the 26-day program, seven more patients were taking oral agents and four more were on insulin. Exercise and diet inventories obtained at follow-up indicated good compliance to the program and also indicated that the main difference between those patients who went back on medication at follow-up compared with those remaining off medication was the percent of calories derived from fat.

  15. The timing of onset of mechanical systole and diastole in reference to the QRS-T complex: a study to determine performance criteria for a non-invasive diastolic timed vibration massage system in treatment of potentially unstable cardiac disorders.

    PubMed

    Gill, Harjit; Hoffmann, Andrew

    2010-12-01

    Our institution is in development of a low frequency, non-invasive Diastolic Timed Vibrator (DTV) for use in emergency treatment of ST Elevation Myocardial Infarction (STEMI). It is preferable to avoid vibration emissions during the IsoVolumetric Contraction Period (IVCP) and at least the majority of mechanical systole thereafter, as systolic vibration may cause a negative inotropic effect in the ischemic heart. Furthermore diastolic vibration should preferably include the IsoVolumetric Relaxation Period (IVRP) which has been shown in clinical studies to improve cardiac performance and enhance coronary flow. Electrocardiographic (ECG) monitoring can be used to enable diastolic tracking, however, the timing of the phases of the cardiac cycle in relation to the ECG waveform must first be verified. The objective of this study was therefore to determine timing of onset of mechanical systole and diastole in reference to the QRS-T Complex. One hundred and twenty-three adult echocardiographic studies were assessed for the point of mitral and aortic valve closure in relation to the QRS complex and T wave in a representative population. We found that onset of mechanical systole occurred on and usually shortly after the peak of a first dominant QRS complex deflection, and onset of diastole occurred at the earliest on and most commonly beyond the peak or midpoint of the T wave. A DTV should ideally be able to stop vibrating on or before the peak of the first dominant deflection of a QRS complex, and begin vibrating near the peak of the T wave. Given early detection of ventricular depolarization can occur 10-20 ms prior to R wave peak, it is proposed that a DTV should preferably be able to stop vibrating within 10 ms of a triggered stop command. Onset of vibration during peak of T wave could be approximated by a rate adapted Q-T interval regression equation, and then fine tuned by manual adjustment during therapy.

  16. Hyaluronic acid co-functionalized gold nanoparticle complex for the targeted delivery of metformin in the treatment of liver cancer (HepG2 cells).

    PubMed

    Kumar, C Senthil; Raja, M D; Sundar, D Sathish; Gover Antoniraj, M; Ruckmani, K

    2015-09-05

    In this study, green synthesis of gold nanoparticles (AuNPs) was achieved using the extract of eggplant as a reducing agent. Hyaluronic acid (HA) serves as a capping and targeting agent. Metformin (MET) was successfully loaded on HA capped AuNPs (H-AuNPs) and this formulation binds easily on the surface of the liver cancer cells. The synthesized nanoparticles were characterized by UV-Vis spectrophotometer, HR-TEM, particle size analyser and zeta potential measurement. Toxicity studies of H-AuNPs in zebra fish confirmed the in vivo safety of the AuNPs. The in vitro cytotoxicity results showed that the amount of MET-H-AuNPs enough to achieve 50% inhibition (IC50) was much lower than free MET. Flow cytometry analysis showed the significant reduction in G2/M phase after treatment with MET-H-AuNPs, and molecular level apoptosis were studied using western blotting. The novelty of this study is the successful synthesis of AuNPs with a higher MET loading and this formulation exhibited better targeted delivery as well as increased regression activity than free MET in HepG2 cells.

  17. Fourier-transform spectroscopy and coupled-channels deperturbation treatment of the A {sup 1{Sigma}+}-b {sup 3{Pi}} complex of KCs

    SciTech Connect

    Kruzins, A.; Klincare, I.; Nikolayeva, O.; Tamanis, M.; Ferber, R.; Pazyuk, E. A.; Stolyarov, A. V.

    2010-04-15

    The laser-induced fluorescence (LIF) A {sup 1{Sigma}+}-b {sup 3{Pi}{yields}}X {sup 1{Sigma}+} spectra of the KCs molecule were recorded in a near infrared region by a Fourier-transform spectrometer with a resolution of 0.03 cm{sup -1}. Overall more than 200 collisionally enhanced LIF spectra were rotationally assigned to {sup 39}K{sup 133}Cs and {sup 41}K{sup 133}Cs isotopomers yielding more than 3400 rovibronic term values of the strongly mixed singlet A {sup 1{Sigma}+} and triplet b {sup 3{Pi}} states with the uncertainty of 0.003-0.01 cm{sup -1}. Experimental data massive starts from the lowest vibrational level v{sub A}=0 of the singlet and nonuniformly covers the energy range E is an element of [10 040,13 250] cm{sup -1} with rotational quantum numbers J{sup '} is an element of [7,225]. Besides the dominating regular A {sup 1{Sigma}+}-b {sup 3{Pi}}{sub {Omega}=0} interactions, the weak local heterogeneous A {sup 1{Sigma}+}-b {sup 3{Pi}}{sub {Omega}=1} perturbations have been discovered and analyzed. Coupled-channels deperturbation analysis of the experimental {sup 39}K{sup 133}Cs e-parity term values of the A {sup 1{Sigma}+}-b {sup 3{Pi}}{sub {Omega}=0,1,2} complex was accomplished in the framework of the phenomenological 4x4 Hamiltonian accounting implicitly for regular interactions with the remote {sup 1{Pi}} and {sup 3{Sigma}+} states. The diabatic potential energy curves of the A {sup 1{Sigma}+} and b {sup 3{Pi}} states, as well as relevant spin-orbit coupling matrix elements, were defined analytically with the expanded Morse oscillators model. The obtained parameters reproduce 95% of experimental data field of the {sup 39}K{sup 133}Cs isotopomer with a standard deviation of 0.004 cm{sup -1}, which is consistent with the uncertainty of the experiment. Reliability of the derived parameters was confirmed by a good agreement between the predicted and experimental term values of the {sup 41}K{sup 133}Cs isotopomer. The calculated relative intensity

  18. Incontinence Treatment: Surgical Treatments

    MedlinePlus

    ... Bowel Incontinence Signs & Symptoms Symptoms of Incontinence Diarrhea Treatment Lifestyle Changes Dietary Tips Medication Bowel Management Biofeedback Surgical Treatments Newer Treatment Options Tips on Finding a Doctor ...

  19. Amorphic complexity

    NASA Astrophysics Data System (ADS)

    Fuhrmann, G.; Gröger, M.; Jäger, T.

    2016-02-01

    We introduce amorphic complexity as a new topological invariant that measures the complexity of dynamical systems in the regime of zero entropy. Its main purpose is to detect the very onset of disorder in the asymptotic behaviour. For instance, it gives positive value to Denjoy examples on the circle and Sturmian subshifts, while being zero for all isometries and Morse-Smale systems. After discussing basic properties and examples, we show that amorphic complexity and the underlying asymptotic separation numbers can be used to distinguish almost automorphic minimal systems from equicontinuous ones. For symbolic systems, amorphic complexity equals the box dimension of the associated Besicovitch space. In this context, we concentrate on regular Toeplitz flows and give a detailed description of the relation to the scaling behaviour of the densities of the p-skeletons. Finally, we take a look at strange non-chaotic attractors appearing in so-called pinched skew product systems. Continuous-time systems, more general group actions and the application to cut and project quasicrystals will be treated in subsequent work.

  20. Complex interactions

    NASA Astrophysics Data System (ADS)

    de Régules, Sergio

    2016-04-01

    Complexity science - which describes phenomena such as collective and emergent behaviour - is the focus of a new centre where researchers are examining everything from the spread of influenza to what a healthy heartbeat looks like. Sergio de Régules reports.

  1. Complex Clouds

    Atmospheric Science Data Center

    2013-04-16

    ...     View Larger Image The complex structure and beauty of polar clouds are highlighted by these images acquired ... corner, the edge of the Antarctic coastline and some sea ice can be seen through some thin, high cirrus clouds. The right-hand panel ...

  2. Researching Complexity.

    ERIC Educational Resources Information Center

    Sumara, Dennis J.

    2000-01-01

    Discusses what Complexity Theory (presented as a rubric that collects theoretical understandings from a number of domains such as ecology, biology, neurology, and education) suggests about mind, selfhood, intelligence, and practices of reading, and the import of these reconceptualizations to reader-response researchers. Concludes that developing…

  3. Biomechanics of complex shoulder instability.

    PubMed

    Degen, Ryan M; Giles, Joshua W; Thompson, Stephen R; Litchfield, Robert B; Athwal, George S

    2013-10-01

    Identification and treatment of the osseous lesions associated with complex shoulder instability remains challenging. Further biomechanical testing is required to delineate critical defect values and determine which treatments provide improved glenohumeral joint stability for the various defect sizes, while minimizing the associated complications.

  4. Complex chemistry with complex compounds

    NASA Astrophysics Data System (ADS)

    Eichler, Robert; Asai, M.; Brand, H.; Chiera, N. M.; Di Nitto, A.; Dressler, R.; Düllmann, Ch. E.; Even, J.; Fangli, F.; Goetz, M.; Haba, H.; Hartmann, W.; Jäger, E.; Kaji, D.; Kanaya, J.; Kaneya, Y.; Khuyagbaatar, J.; Kindler, B.; Komori, Y.; Kraus, B.; Kratz, J. V.; Krier, J.; Kudou, Y.; Kurz, N.; Miyashita, S.; Morimoto, K.; Morita, K.; Murakami, M.; Nagame, Y.; Ooe, K.; Piguet, D.; Sato, N.; Sato, T. K.; Steiner, J.; Steinegger, P.; Sumita, T.; Takeyama, M.; Tanaka, K.; Tomitsuka, T.; Toyoshima, A.; Tsukada, K.; Türler, A.; Usoltsev, I.; Wakabayashi, Y.; Wang, Y.; Wiehl, N.; Wittwer, Y.; Yakushev, A.; Yamaki, S.; Yano, S.; Yamaki, S.; Qin, Z.

    2016-12-01

    In recent years gas-phase chemical studies assisted by physical pre-separation allowed for the investigation of fragile single molecular species by gas-phase chromatography. The latest success with the heaviest group 6 transactinide seaborgium is highlighted. The formation of a very volatile hexacarbonyl compound Sg(CO)6 was observed similarly to its lighter homologues molybdenum and tungsten. The interactions of these gaseous carbonyl complex compounds with quartz surfaces were investigated by thermochromatography. Second-generation experiments are under way to investigate the intramolecular bond between the central metal atom of the complexes and the ligands addressing the influence of relativistic effects in the heaviest compounds. Our contribution comprises some aspects of the ongoing challenging experiments as well as an outlook towards other interesting compounds related to volatile complex compounds in the gas phase.

  5. [Complex injuries associated with somnambulism].

    PubMed

    Sillesen, Nanna Hylleholt; Nielsen, Lisa Toft; Bonde, Christian

    2010-12-13

    Up to 3% of adults walk in their sleep and some perform complex behaviours. Treatment recommendations for sleepwalking are inconsistent. This case report describes a 64-year-old man who climbed out of a 2nd floor toilet window during somnambulism. He fell 6-8 meters and fractured the tibia, fibula, cervical columna, lumbal columna, calcaneus, costae and suffered a pneumothorax. Evidence to support sleepwalking treatment is lacking and besides benzodiazepines, prevention is the preferred treatment choice according to the literature.

  6. Managing Complexity

    SciTech Connect

    Chassin, David P.; Posse, Christian; Malard, Joel M.

    2004-08-01

    Physical analogs have shown considerable promise for understanding the behavior of complex adaptive systems, including macroeconomics, biological systems, social networks, and electric power markets. Many of today’s most challenging technical and policy questions can be reduced to a distributed economic control problem. Indeed, economically-based control of large-scale systems is founded on the conjecture that the price-based regulation (e.g., auctions, markets) results in an optimal allocation of resources and emergent optimal system control. This paper explores the state of the art in the use physical analogs for understanding the behavior of some econophysical systems and to deriving stable and robust control strategies for them. In particular we review and discussion applications of some analytic methods based on the thermodynamic metaphor according to which the interplay between system entropy and conservation laws gives rise to intuitive and governing global properties of complex systems that cannot be otherwise understood.

  7. Dorsal Capsuloplasty for Dorsal Instability of the Distal Ulna

    PubMed Central

    Kouwenhoven, S.T.P.; de Jong, T.; Koch, A.R.

    2013-01-01

    Background Dorsal instability of the distal ulna can lead to chronic wrist pain and loss of function. Structural changes to the dorsal radioulnar ligaments (DRUL) of the triangular fibrocartilage complex (TFCC) and the dorsal capsule around the ulnar head with or without foveal detachment can lead to volar subluxation of the distal radius e.g., dorsal instability of the distal ulna. Purpose Is to evaluate the post-operative results of reinstituting distal radioulnar joint (DRUJ) stability through reefing of the dorsal capsule and dorsal radioulnar ligaments, with and without a foveal reattachment of the TFCC. Methods A total of 37 patients were included in this retrospective study. Diagnosis and treatment was based strictly on dry wrist arthroscopy. In 17 patients isolated reefing of the DRUL and their collateral tissue extension was performed. In 20 patients an additional foveal reinsertion was performed. Postoperative results were evaluated with the DASH questionnaire, VAS scores, grip strength and range of motion. These findings were extrapolated in the Mayo wrist score. The two subgroups were compared. Results Mayo wrist scores of the whole population had a mean of 73. There was no difference between the group that was treated with reefing of the DRUL only and the group that was treated with a combined foveal reinsertion. Conclusion This relatively simple 'dorsal reefing' procedure, with foveal reinsertion when indicated, is a reliable method to restore volar-dorsal DRUJ stability with a significant decrease in pain sensation, good DASH scores and restoration of functional grip strength and ROM. Type of Study/Level of Evidence Therapeutic, Level IV. PMID:24436811

  8. Complex Systems

    PubMed Central

    Goldberger, Ary L.

    2006-01-01

    Physiologic systems in health and disease display an extraordinary range of temporal behaviors and structural patterns that defy understanding based on linear constructs, reductionist strategies, and classical homeostasis. Application of concepts and computational tools derived from the contemporary study of complex systems, including nonlinear dynamics, fractals and “chaos theory,” is having an increasing impact on biology and medicine. This presentation provides a brief overview of an emerging area of biomedical research, including recent applications to cardiopulmonary medicine and chronic obstructive lung disease. PMID:16921107

  9. Smart Cu(II)-aptamer complexes based gold nanoplatform for tumor micro-environment triggered programmable intracellular prodrug release, photodynamic treatment and aggregation induced photothermal therapy of hepatocellular carcinoma

    PubMed Central

    Zhang, Da; Zheng, Aixian; Li, Juan; Wu, Ming; Wu, Lingjie; Wei, Zuwu; Liao, Naishun; Zhang, Xiaolong; Cai, Zhixiong; Yang, Huanghao; Liu, Gang; Liu, Xiaolong; Liu, Jingfeng

    2017-01-01

    This study describes smart Cu(II)-aptamer complexes based gold nanoplatform for tumor micro-environment triggered programmable prodrug release, in demand photodynamic therapy and aggregation induced photothermal ablation of hepatocellular carcinoma. The nanoplatform is consist of monodispersed gold nanoparticle (GNP) that is binding to HCC cell specific targeting aptamers (TLS11a) through Au-S bond; the aptamer is labeled with Ce6 at the 5'end and coordinated with Cu(II) through (GA)10 repeating bases to load AQ4N at the 3' end. In normal physiological conditions, the fluorescence and ROS generation ability of Ce6 are quenched by GNPs via RET; but in cancerous cells, the fluorescence and the ROS generation of Ce6 could be recovered by cleavage of Au-S bond through high level of intracellular GSH for real-time imaging and in demand PDT. Meanwhile, the prodrug AQ4N release could be triggered by acid-cleavage of coordination bonds, then accompanied by a release of Cu(II) that would induce the electrostatic aggregation of GNPs for photo-thermal ablation; furthermore, the significantly enhanced chemotherapy efficiency could be achieved by PDT produced hypoxia to convert AQ4N into AQ4. In summary, here described nanoplatform with tumor cell specific responsive properties and programmable PDT/PTT/chemotherapy functions, might be an interesting synergistic strategy for HCC treatment. PMID:28042325

  10. Cosmic Complexity

    NASA Technical Reports Server (NTRS)

    Mather, John C.

    2012-01-01

    What explains the extraordinary complexity of the observed universe, on all scales from quarks to the accelerating universe? My favorite explanation (which I certainty did not invent) ls that the fundamental laws of physics produce natural instability, energy flows, and chaos. Some call the result the Life Force, some note that the Earth is a living system itself (Gaia, a "tough bitch" according to Margulis), and some conclude that the observed complexity requires a supernatural explanation (of which we have many). But my dad was a statistician (of dairy cows) and he told me about cells and genes and evolution and chance when I was very small. So a scientist must look for me explanation of how nature's laws and statistics brought us into conscious existence. And how is that seemll"!gly Improbable events are actually happening a!1 the time? Well, the physicists have countless examples of natural instability, in which energy is released to power change from simplicity to complexity. One of the most common to see is that cooling water vapor below the freezing point produces snowflakes, no two alike, and all complex and beautiful. We see it often so we are not amazed. But physlc!sts have observed so many kinds of these changes from one structure to another (we call them phase transitions) that the Nobel Prize in 1992 could be awarded for understanding the mathematics of their common features. Now for a few examples of how the laws of nature produce the instabilities that lead to our own existence. First, the Big Bang (what an insufficient name!) apparently came from an instability, in which the "false vacuum" eventually decayed into the ordinary vacuum we have today, plus the most fundamental particles we know, the quarks and leptons. So the universe as a whole started with an instability. Then, a great expansion and cooling happened, and the loose quarks, finding themselves unstable too, bound themselves together into today's less elementary particles like protons and

  11. Cosmic Complexity

    NASA Technical Reports Server (NTRS)

    Mather, John C.

    2012-01-01

    What explains the extraordinary complexity of the observed universe, on all scales from quarks to the accelerating universe? My favorite explanation (which I certainty did not invent) ls that the fundamental laws of physics produce natural instability, energy flows, and chaos. Some call the result the Life Force, some note that the Earth is a living system itself (Gaia, a "tough bitch" according to Margulis), and some conclude that the observed complexity requires a supernatural explanation (of which we have many). But my dad was a statistician (of dairy cows) and he told me about cells and genes and evolution and chance when I was very small. So a scientist must look for me explanation of how nature's laws and statistics brought us into conscious existence. And how is that seemll"!gly Improbable events are actually happening a!1 the time? Well, the physicists have countless examples of natural instability, in which energy is released to power change from simplicity to complexity. One of the most common to see is that cooling water vapor below the freezing point produces snowflakes, no two alike, and all complex and beautiful. We see it often so we are not amazed. But physlc!sts have observed so many kinds of these changes from one structure to another (we call them phase transitions) that the Nobel Prize in 1992 could be awarded for understanding the mathematics of their common features. Now for a few examples of how the laws of nature produce the instabilities that lead to our own existence. First, the Big Bang (what an insufficient name!) apparently came from an instability, in which the "false vacuum" eventually decayed into the ordinary vacuum we have today, plus the most fundamental particles we know, the quarks and leptons. So the universe as a whole started with an instability. Then, a great expansion and cooling happened, and the loose quarks, finding themselves unstable too, bound themselves together into today's less elementary particles like protons and

  12. Complex bile duct injuries: management

    PubMed Central

    Ardiles, V.; Pekolj, J.

    2008-01-01

    Background. Laparoscopic cholecystectomy is the present treatment of choice for patients with gallbladder stones, despite its being associated with a higher incidence of biliary injuries compared with the open procedure. Injuries occurring during the laparoscopic approach seem to be more complex. A complex biliary injury is a disease that is difficult to diagnose and treat. We considered complex injuries: 1) injuries that involve the confluence; 2) injuries in which repair attempts have failed; 3) any bile duct injury associated with a vascular injury; 4) or any biliary injury in association with portal hypertension or secondary biliary cirrhosis. The present review is an evaluation of our experience in the treatment of these complex biliary injuries and an analysis of the international literature on the management of patients. PMID:18695753

  13. Multimodal treatment of pain.

    PubMed

    Mathews, Manu

    2014-10-01

    Chronic pain is a complex disorder with extensive overlap in sensory and limbic pathways. It needs systemic therapy in addition to focused local treatment. This article discusses treatment modalities other than surgical and interventional approaches and also discusses the literature regarding these treatment modalities, including pharmacotherapy, physical and occupational therapy, psychological approaches including cognitive behavior therapy, and other adjunctive treatments like yoga and tai chi.

  14. Carney Complex: an update

    PubMed Central

    Correa, Ricardo; Salpea, Paraskevi; Stratakis, Constantine

    2015-01-01

    Carney Complex (CNC) is a rare autosomal dominant syndrome, characterized by pigmented lesions of the skin and mucosa, cardiac, cutaneous and other myxomas, and multiple endocrine tumors. The disease is caused by inactivating mutations or large deletions of the PRKAR1A gene located at 17q22–24 coding for the regulatory subunit type I alpha of protein kinase A (PKA) gene. Most recently, components of the complex have been associated with defects of other PKA subunits, such as the catalytic subunits PRKACA (adrenal hyperplasia) and PRKACB (pigmented spots, myxomas, pituitary adenomas). In this report, we review CNC, its clinical features, diagnosis, treatment, and molecular etiology including PRKAR1A mutations and the newest on PRKACA and PRKACB defects especially as they pertain to adrenal tumors and Cushing’s syndrome. PMID:26130139

  15. Complex regional pain syndrome

    PubMed Central

    Sebastin, Sandeep J

    2011-01-01

    Complex regional pain syndrome (CRPS) previously known as reflex sympathetic dystrophy is a chronic neurological disorder involving the limbs characterized by disabling pain, swelling, vasomotor instability, sudomotor abnormality, and impairment of motor function. CRPS is not uncommon after hand surgery and may complicate post-operative care. There is no specific diagnostic test for CRPS and the diagnosis is based on history, clinical examination, and supportive laboratory findings. Recent modifications to diagnostic criteria have enabled clinicians to diagnose this disease more consistently. This review gives a synopsis of CRPS and discusses the diagnosis, pathophysiology, and treatment options based on the limited evidence in the literature. PMID:22022040

  16. Packaged Waste Treatment

    NASA Technical Reports Server (NTRS)

    1977-01-01

    This Jacksonville, Florida, apartment complex has a wastewater treatment system which clears the water, removes harmful microorganisms and reduces solid residue to ash. It is a spinoff from spacecraft waste management and environmental control technology.

  17. Land Treatment Digital Library

    USGS Publications Warehouse

    Pilliod, David S.; Welty, Justin L.

    2013-01-01

    The Land Treatment Digital Library (LTDL) was created by the U.S. Geological Survey to catalog legacy land treatment information on Bureau of Land Management lands in the western United States. The LTDL can be used by federal managers and scientists for compiling information for data-calls, producing maps, generating reports, and conducting analyses at varying spatial and temporal scales. The LTDL currently houses thousands of treatments from BLM lands across 10 states. Users can browse a map to find information on individual treatments, perform more complex queries to identify a set of treatments, and view graphs of treatment summary statistics.

  18. Tuberous sclerosis complex.

    PubMed

    Henske, Elizabeth P; Jóźwiak, Sergiusz; Kingswood, J Christopher; Sampson, Julian R; Thiele, Elizabeth A

    2016-05-26

    Tuberous sclerosis complex (TSC) is an autosomal dominant disorder that affects multiple organ systems and is caused by loss-of-function mutations in one of two genes: TSC1 or TSC2. The disorder can affect both adults and children. First described in depth by Bourneville in 1880, it is now estimated that nearly 2 million people are affected by the disease worldwide. The clinical features of TSC are distinctive and can vary widely between individuals, even within one family. Major features of the disease include tumours of the brain, skin, heart, lungs and kidneys, seizures and TSC-associated neuropsychiatric disorders, which can include autism spectrum disorder and cognitive disability. TSC1 (also known as hamartin) and TSC2 (also known as tuberin) form the TSC protein complex that acts as an inhibitor of the mechanistic target of rapamycin (mTOR) signalling pathway, which in turn plays a pivotal part in regulating cell growth, proliferation, autophagy and protein and lipid synthesis. Remarkable progress in basic and translational research, in addition to several randomized controlled trials worldwide, has led to regulatory approval of the use of mTOR inhibitors for the treatment of renal angiomyolipomas, brain subependymal giant cell astrocytomas and pulmonary lymphangioleiomyomatosis, but further research is needed to establish full indications of therapeutic treatment. In this Primer, we review the state-of-the-art knowledge in the TSC field, including the molecular and cellular basis of the disease, medical management, major knowledge gaps and ongoing research towards a cure.

  19. Complexed iron removal from groundwater

    SciTech Connect

    Munter, R.; Ojaste, H.; Sutt, J.

    2005-07-01

    The paper demonstrates an intensive work carried out and results obtained on the pilot plant of the City of Kogalym Water Treatment Station (Tjumen, Siberia, Russian Federation) to elaborate on a contemporary nonreagent treatment technology for the local iron-rich groundwater. Several filter materials (Birm, Pyrolox, hydroanthracite, Everzit, granulated activated carbon) and chemical oxidants (ozone, chlorine, hydrogen peroxide, oxygen, and potassium permanganate) were tested to solve the problem with complexed iron removal from groundwater. The final elaborated technology consists of raw water intensive aeration in the gas-degas treatment unit followed by sequential filtration through hydroanthracite and the special anthracite Everzit.

  20. Complexity and the Arrow of Time

    NASA Astrophysics Data System (ADS)

    Lineweaver, Charles H.; Davies, Paul C. W.; Ruse, Michael

    2013-08-01

    1. What is complexity? Is it increasing? Charles H. Lineweaver, Paul C. W. Davies and Michael Ruse; 2. Directionality principles from cancer to cosmology Paul C. W. Davies; 3. A simple treatment of complexity: cosmological entropic boundary conditions on increasing complexity Charles H. Lineweaver; 4. Using complexity science to search for unity in the natural sciences Eric J. Chaisson; 5. On the spontaneous generation of complexity in the universe Seth Lloyd; 6. Emergent spatiotemporal complexity in field theory Marcelo Gleiser; 7. Life: the final frontier for complexity? Simon Conway Morris; 8. Evolution beyond Newton, Darwin, and entailing law: the origin of complexity in the evolving biosphere Stuart A. Kauffman; 9. Emergent order in processes: the interplay of complexity, robustness, correlation, and hierarchy in the biosphere D. Eric Smith; 10. The inferential evolution of biological complexity: forgetting nature by learning to nurture David C. Krakauer; 11. Information width: a way for the second law to increase complexity David Wolpert; 12. Wrestling with biological complexity: from Darwin to Dawkins Michael Ruse; 13. The role of generative entrenchment and robustness in the evolution of complexity William C. Wimsatt; 14. On the plurality of complexity-producing mechanisms Philip Clayton; Index.

  1. Complex regional pain syndrome

    PubMed Central

    Carr, Emily S.; De La Cerda, Ashley

    2016-01-01

    Complex regional pain syndrome (CRPS) is a neurologic disorder that often results in debilitating chronic pain, but the diagnosis may elude providers as it is one of exclusion. A history of trauma may be elucidated. We report a case of CRPS and review the clinical findings, appropriate workup, and treatment options for the patient. The patient we describe went through an extensive workup before receiving the correct diagnosis. Delay in diagnosis leads to prolonged suffering for the patient and, at times, unnecessary invasive debridement procedures. Raising awareness of this entity may help physicians make the correct diagnosis early, as well as initiate a collaborative effort between neurology, anesthesiology, and dermatology to provide the patient the most favorable outcome. PMID:27365892

  2. On State Complexes and Special Cube Complexes

    ERIC Educational Resources Information Center

    Peterson, Valerie J.

    2009-01-01

    This thesis presents the first steps toward a classification of non-positively curved cube complexes called state complexes. A "state complex" is a configuration space for a "reconfigurable system," i.e., an abstract system in which local movements occur in some discrete manner. Reconfigurable systems can be used to describe, for example,…

  3. Three-month treatment with pioglitazone reduces circulating C1q-binding adiponectin complex to total-adiponectin ratio, without changes in body mass index, in people with type 2 diabetes.

    PubMed

    Nakatsuji, Hideaki; Kishida, Ken; Kobayashi, Hironori; Funahashi, Tohru; Shimomura, Iichiro

    2013-01-01

    We measured circulating C1q-binding adiponectin (C1q-APN) levels before and after 3-month treatment with pioglitazone in people with type 2 diabetes. The results indicate 3-month treatment with pioglitazone reduces circulating levels of C1q-APN/total-adiponectin ratio without changes in body mass index.

  4. ICD Complex Operations and Maintenance Plan

    SciTech Connect

    Gibson, P. L.

    2007-06-25

    This Operations and Maintenance (O&M) Plan describes how the Idaho National Laboratory (INL) conducts operations, winterization, and startup of the Idaho CERCLA Disposal Facility (ICDF) Complex. The ICDF Complex is the centralized INL facility responsible for the receipt, storage, treatment (as necessary), and disposal of INL Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation waste.

  5. Matrix Fourth-Complex Variables

    NASA Astrophysics Data System (ADS)

    Dimiev, Stancho; Marinov, Marin S.; Stoev, Peter

    2009-11-01

    In the paper we consider quasi-cyclic hyper-complex variables which are naturally related to the partial differential equations with complex variables. In fact, we develop a matrix 4×4 generalization of the classical bicomplex numbers [1], [2]. We recall that a matrix 2×2 isomorphic type treatment of the classical bicomplex numbers was developed in [3]. Here we develop a matrix 4×4 generalization of the bicomplex numbers including some improvement of the papers [3] and [4]. Let us remark that a deep generalization of the considered ideas was sketch in [5] before us.

  6. Complex soundproofing of industrial rooms

    NASA Technical Reports Server (NTRS)

    Pocsa, V.; Veres, A.; Biborosch, L.

    1974-01-01

    Some structures treated for sound absorption are described that are used to soundproof industrial rooms with a very high noise level. Soundproofing treatments for the walls and coilings or only for the ceilings are considered. In the case of relatively small rooms having a noise source with a high level, complex treatments involve, in addition to soundproofing of the walls and ceiling, suspended panels specially oriented with respect to the noise source. The efficiency of the adopted solutions is compared with calculated damping values.

  7. The Mycobacterium avium complex.

    PubMed Central

    Inderlied, C B; Kemper, C A; Bermudez, L E

    1993-01-01

    Mycobacterium avium complex (MAC) disease emerged early in the epidemic of AIDS as one of the common opportunistic infections afflicting human immunodeficiency virus-infected patients. However, only over the past few years has a consensus developed about its significance to the morbidity and mortality of AIDS. M. avium was well known to mycobacteriologists decades before AIDS, and the MAC was known to cause disease, albeit uncommon, in humans and animals. The early interest in the MAC provided a basis for an explosion of studies over the past 10 years largely in response to the role of the MAC in AIDS opportunistic infection. Molecular techniques have been applied to the epidemiology of MAC disease as well as to a better understanding of the genetics of antimicrobial resistance. The interaction of the MAC with the immune system is complex, and putative MAC virulence factors appear to have a direct effect on the components of cellular immunity, including the regulation of cytokine expression and function. There now is compelling evidence that disseminated MAC disease in humans contributes to both a decrease in the quality of life and survival. Disseminated disease most commonly develops late in the course of AIDS as the CD4 cells are depleted below a critical threshold, but new therapies for prophylaxis and treatment offer considerable promise. These new therapeutic modalities are likely to be useful in the treatment of other forms of MAC disease in patients without AIDS. The laboratory diagnosis of MAC disease has focused on the detection of mycobacteria in the blood and tissues, and although the existing methods are largely adequate, there is need for improvement. Indeed, the successful treatment of MAC disease clearly will require an early and rapid detection of the MAC in clinical specimens long before the establishment of the characteristic overwhelming infection of bone marrow, liver, spleen, and other tissue. Also, a standard method of susceptibility testing

  8. Carney complex (CNC)

    PubMed Central

    Bertherat, Jérôme

    2006-01-01

    The Carney complex (CNC) is a dominantly inherited syndrome characterized by spotty skin pigmentation, endocrine overactivity and myxomas. Skin pigmentation anomalies include lentigines and blue naevi. The most common endocrine gland manifestations are acromegaly, thyroid and testicular tumors, and adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome due to primary pigmented nodular adrenocortical disease (PPNAD). PPNAD, a rare cause of Cushing's syndrome, is due to primary bilateral adrenal defect that can be also observed in some patients without other CNC manifestations or familial history of the disease. Myxomas can be observed in the heart, skin and breast. Cardiac myxomas can develop in any cardiac chamber and may be multiple. One of the putative CNC genes located on 17q22-24, (PRKAR1A), has been identified to encode the regulatory subunit (R1A) of protein kinase A. Heterozygous inactivating mutations of PRKAR1A were reported initially in 45 to 65 % of CNC index cases, and may be present in about 80 % of the CNC families presenting mainly with Cushing's syndrome. PRKAR1A is a key component of the cAMP signaling pathway that has been implicated in endocrine tumorigenesis and could, at least partly, function as a tumor suppressor gene. Genetic analysis should be proposed to all CNC index cases. Patients with CNC or with a genetic predisposition to CNC should have regular screening for manifestations of the disease. Clinical work-up for all the manifestations of CNC should be performed at least once a year in all patients and should start in infancy. Cardiac myxomas require surgical removal. Treatment of the other manifestations of CNC should be discussed and may include follow-up, surgery, or medical treatment depending on the location of the tumor, its size, the existence of clinical signs of tumor mass or hormonal excess, and the suspicion of malignancy. Bilateral adrenalectomy is the most common treatment for Cushing's syndrome due to PPNAD

  9. Enhanced Analgesic Properties and Reduced Ulcerogenic Effect of a Mononuclear Copper(II) Complex with Fenoprofen in Comparison to the Parent Drug: Promising Insights in the Treatment of Chronic Inflammatory Diseases

    PubMed Central

    Gumilar, Fernanda; Boeris, Mónica; Toso, Ricardo; Minetti, Alejandra

    2014-01-01

    Analgesic and ulcerogenic properties have been studied for the copper(II) coordination complex of the nonsteroidal anti-inflammatory drug Fenoprofen and imidazole [Cu(fen)2(im)2] (Cu: copper(II) ion; fen: fenoprofenate anion from Fenoprofen, im: imidazole). A therapeutic dose of 28 mg/kg was tested for [Cu(fen)2(im)2] and 21 mg/kg was employed for Fenoprofen calcium, administered by oral gavage in female mice to compare the therapeutic properties of the new entity. The acetic acid induced writhing test was employed to study visceral pain. The percentage of inhibition in writhing and stretching was 78.9% and 46.2% for the [Cu(fen)2(im)2] and Fenoprofen calcium, respectively. This result indicates that the complex could be more effective in diminishing visceral pain. The formalin test was evaluated to study the impact of the drugs over nociceptive and inflammatory pain. The complex is a more potent analgesic on inflammatory pain than the parent drug. Ulcerogenic effects were evaluated using a model of gastric lesions induced by hypothermic-restraint stress. Fenoprofen calcium salt caused an ulcer index of about 79 mm2 while the one caused by [Cu(fen)2(im)2] was 22 mm2. The complex diminished the development of gastric mucosal ulcers in comparison to the uncomplexed drug. Possible mechanisms of action related to both therapeutic properties have been discussed. PMID:25050353

  10. Phosphoroorganic Metal Complexes in Therapeutics.

    PubMed

    Demkowicz, Sebastian; Kozak, Witold; Daśko, Mateusz; Rachon, Janusz

    2016-01-01

    The present mini-review highlights recent developments on antitumor activity of metal-based therapeutics which have been a subject of researches for the last few decades. In 1965, Rosenberg found that during an electrolysis on platinum electrodes a complex of Pt is generated which inhibited to a great extent a binary fission in Escherichia coli bacteria. This discovery started a new chapter in medicinal chemistry and the interesting properties of cisplatin were soon applied in cancer therapy especially in curing genitourinary tumors. However, various side effects limited its use in medical treatment. Since then a great number of other metal-organic complexes based on platinum, palladium, ruthenium, gold, copper, silver, rhodium, osmium, rhenium, iridium and others have been synthesized. Among them, NAMI-A and KP1019 have recently undergone clinical trials. In this review paper we report a detailed account of metal complexes with phosphorus-based ligands which are of particular interest in therapeutics.

  11. Maxillofacial esthesioneuroblastoma: A diagnostic complexity

    PubMed Central

    Raj, G Shyam; Rao, Guttikonda Venkateswara; Kumar, Manchikatla Praveen; Sudheerkanth, Kondamari

    2016-01-01

    Esthesioneuroblastoma is a rare malignant tumor of the sinonasal tract. Oral and maxillofacial pathologists rarely encounter this tumor in their daily practice. Because of their complex anatomic location, non-specific symptoms, varied histomorphology and unfamiliarity, most of the times, the tumor is diagnosed as benign tumor and thereby conservative treatment results in multiple recurrences. A recurrent case of esthesioneuroblastoma in a 24-year-old female patient describing the clinical, histopathological and immunohistochemical features along with differential diagnosis is discussed. PMID:27601839

  12. Maxillofacial esthesioneuroblastoma: A diagnostic complexity.

    PubMed

    Raj, G Shyam; Rao, Guttikonda Venkateswara; Kumar, Manchikatla Praveen; Sudheerkanth, Kondamari

    2016-01-01

    Esthesioneuroblastoma is a rare malignant tumor of the sinonasal tract. Oral and maxillofacial pathologists rarely encounter this tumor in their daily practice. Because of their complex anatomic location, non-specific symptoms, varied histomorphology and unfamiliarity, most of the times, the tumor is diagnosed as benign tumor and thereby conservative treatment results in multiple recurrences. A recurrent case of esthesioneuroblastoma in a 24-year-old female patient describing the clinical, histopathological and immunohistochemical features along with differential diagnosis is discussed.

  13. Natural complexity, computational complexity and depth.

    PubMed

    Machta, J

    2011-09-01

    Depth is a complexity measure for natural systems of the kind studied in statistical physics and is defined in terms of computational complexity. Depth quantifies the length of the shortest parallel computation required to construct a typical system state or history starting from simple initial conditions. The properties of depth are discussed and it is compared with other complexity measures. Depth can only be large for systems with embedded computation.

  14. Glenohumeral instability associated with Buford complex.

    PubMed

    del Rey, Fernando Canillas; Vázquez, Diego García-Germán; López, Daniel Nieto

    2009-12-01

    Buford complex is described as a normal anatomical variant of the anterosuperior part of the glenoid consisting of the absence of the anterosuperior labrum with the presence of a cord-like middle glenohumeral ligament. Traditionally, reattachment to the glenoid has been discouraged. We present a case of a Buford complex associated with glenohumeral instability. The patient was operated for recurrent instability without a preoperative diagnosis of Buford complex. The diagnosis was made during shoulder arthroscopy and reattachment to the glenoid was performed with a satisfactory outcome. Here, we discuss the relationship of the Buford complex with intraarticular pathology and the surgical treatment in cases when this variant is associated with instability.

  15. [Complexity of land ecosystem].

    PubMed

    Wu, Cifang; Chen, Meiqiu

    2002-06-01

    In recent years, complexity studies has become a new research region and been widely applied in engineering, biology, economy, management, military, police and sociology. In this paper, from the view of complex science, the main complexity characteristics of land ecosystem were described, furthermore, the application of fractal, chaos, and artificial neural network on the complexity of land ecosystem were also discussed.

  16. Hyperbaric treatment

    NASA Technical Reports Server (NTRS)

    Amoroso, Michael T.

    1990-01-01

    Viewgraphs on hyperbaric treatment are presented. Topics covered include: hyperbaric treatment - purpose; decompression sickness; sources of decompression sickness; physical description; forms of decompression sickness; hyperbaric treatment of decompression sickness; and duration of treatment.

  17. SCFA lead lab technical assistance at Oak Ridge Y-12 nationalsecurity complex: Evaluation of treatment and characterizationalternatives of mixed waste soil and debris at disposal area remedialaction DARA solids storage facility (SSF)

    SciTech Connect

    Hazen, Terry

    2002-08-26

    On July 17-18, 2002, a technical assistance team from the U.S. Department of Energy (DOE) Subsurface Contaminants Focus Area (SCFA) met with the Bechtel Jacobs Company Disposal Area Remedial Action (DARA) environmental project leader to review treatment and characterization options for the baseline for the DARA Solids Storage Facility (SSF). The technical assistance request sought suggestions from SCFA's team of technical experts with experience and expertise in soil treatment and characterization to identify and evaluate (1) alternative treatment technologies for DARA soils and debris, and (2) options for analysis of organic constituents in soil with matrix interference. Based on the recommendations, the site may also require assistance in identifying and evaluating appropriate commercial vendors.

  18. Complexity analysis of angiogenesis vasculature

    NASA Astrophysics Data System (ADS)

    Mahadevan, Vijay; Tyrell, James A.; Tong, Ricky T.; Brown, Edward B.; Jain, Rakesh K.; Roysam, Badrinath

    2005-04-01

    Tumor vasculature has a high degree of irregularity as compared to normal vasculature. The quantification of the morphometric complexity in tumor images can be useful in diagnosis. Also, it is desirable in several other medical applications to have an automated complexity analysis to aid in diagnosis and prognosis under treatment. e.g. in diabetic retinopathy and in arteriosclerosis. In addition, prior efforts at segmentation of the tumor vasculature using matched filtering, template matching and splines have been hampered by the irregularity of these vessels. We try to solve both problems by introducing a novel technique for vessel detection, followed by a tracing-independent complexity analysis based on a combination of ideas. First, the vessel cross-sectional profile is modeled using a continuous and everywhere differentiable family of super-Gaussian curves. This family generates rectangular profiles that can accurately localize the vessel boundaries in microvasculature images. Second, a robust non-linear regression algorithm based on M-estimators is used to estimate the parameters that optimally characterize the vessel"s shape. A framework for the quantitative analysis of the complexity of the vasculature based on the vessel detection is presented. A set of measures that quantify the complexity are proposed viz. Squared Error, Entropy-based and Minimum Description Length-based Shape Complexities. They are completely automatic and can deal with complexities of the entire vessel unlike existing tortuousity measures which deal only with vessel centerlines. The results are validated using carefully constructed phantom and real image data with ground truth information from an expert observer.

  19. Complex networks analysis of language complexity

    NASA Astrophysics Data System (ADS)

    Amancio, Diego R.; Aluisio, Sandra M.; Oliveira, Osvaldo N., Jr.; Costa, Luciano da F.

    2012-12-01

    Methods from statistical physics, such as those involving complex networks, have been increasingly used in the quantitative analysis of linguistic phenomena. In this paper, we represented pieces of text with different levels of simplification in co-occurrence networks and found that topological regularity correlated negatively with textual complexity. Furthermore, in less complex texts the distance between concepts, represented as nodes, tended to decrease. The complex networks metrics were treated with multivariate pattern recognition techniques, which allowed us to distinguish between original texts and their simplified versions. For each original text, two simplified versions were generated manually with increasing number of simplification operations. As expected, distinction was easier for the strongly simplified versions, where the most relevant metrics were node strength, shortest paths and diversity. Also, the discrimination of complex texts was improved with higher hierarchical network metrics, thus pointing to the usefulness of considering wider contexts around the concepts. Though the accuracy rate in the distinction was not as high as in methods using deep linguistic knowledge, the complex network approach is still useful for a rapid screening of texts whenever assessing complexity is essential to guarantee accessibility to readers with limited reading ability.

  20. Evolution of biological complexity

    PubMed Central

    Adami, Christoph; Ofria, Charles; Collier, Travis C.

    2000-01-01

    To make a case for or against a trend in the evolution of complexity in biological evolution, complexity needs to be both rigorously defined and measurable. A recent information-theoretic (but intuitively evident) definition identifies genomic complexity with the amount of information a sequence stores about its environment. We investigate the evolution of genomic complexity in populations of digital organisms and monitor in detail the evolutionary transitions that increase complexity. We show that, because natural selection forces genomes to behave as a natural “Maxwell Demon,” within a fixed environment, genomic complexity is forced to increase. PMID:10781045

  1. Therapeutic Doll Making in Art Psychotherapy for Complex Trauma

    ERIC Educational Resources Information Center

    Stace, Sonia M.

    2014-01-01

    Therapeutic doll making can hold diverse functions for clients in therapy, particularly for those clients who are working through complex trauma histories. Recent literature pertaining to the treatment of complex trauma suggests that talking treatments have their limits; supplementary therapeutic approaches that focus on sensory, physical,…

  2. Mitochondrial complex I-linked disease.

    PubMed

    Rodenburg, Richard J

    2016-07-01

    Complex I deficiency is the most frequently encountered single mitochondrial single enzyme deficiency in patients with a mitochondrial disorder. Although specific genotype-phenotype correlations are very difficult to identify, the majority of patients present with symptoms caused by leukodystrophy. The poor genotype-phenotype correlations can make establishing a diagnosis a challenge. The classical way to establish a complex I deficiency in patients is by performing spectrophotometric measurements of the enzyme in a muscle biopsy or other patient-derived material (liver or heart biopsy, cultured skin fibroblasts). Complex I is encoded by both the mtDNA and nuclear DNA and pathogenic mutations have been identified in the majority of the 44 genes encoding the structural subunits of complex I. In recent years, the increasing possibilities for diagnostic molecular genetic tests of large gene panels, exomes, and even entire genomes has led to the identification of many novel genetic defects causing complex I deficiency. Complex I mutations not only result in a reduced enzyme activity but also induce secondary effects at the cellular level, such as elevated reactive oxygen species production, altered membrane potential and mitochondrial morphology. At this moment there is no cure for complex I deficiency and the treatment options for complex I patients are restricted to symptomatic treatment. Recent developments, amongst others based on the treatment of the secondary effects of complex I deficiency, have shown to be promising as new therapeutic strategies in vitro and have entered clinical trials. This article is part of a Special Issue entitled Respiratory complex I, edited by Volker Zickermann and Ulrich Brandt.

  3. [A 2-month-old child with complex tracheal hypoplasia].

    PubMed

    De Cloedt, L; Papadopoulos, J; Corouge, P; Khalil, T; Van Laer, P

    2013-12-01

    We describe the case of a 2-month-old child with complex tracheal hypoplasia with bilateral bronchial hypoplasia and left pulmonary hypoplasia. Tracheal hypoplasia is complex when it is associated with critical stenosis, cricoid stenosis, bronchial hypoplasia, tracheal bronchus, or esophageal atresia with severe tracheomalacia. Slide tracheoplasty is the gold standard treatment for the complex tracheal hypoplasia.

  4. Daunorubicin Lipid Complex Injection

    MedlinePlus

    Daunorubicin lipid complex is used to treat advanced Kaposi's sarcoma (a type of cancer that causes abnormal tissue to ... body) related to acquired immunodeficiency syndrome (AIDS). Daunorubicin lipid complex is in a class of medications called ...

  5. Oligocyclopentadienyl transition metal complexes

    SciTech Connect

    de Azevedo, Cristina G.; Vollhardt, K. Peter C.

    2002-01-18

    Synthesis, characterization, and reactivity studies of oligocyclopentadienyl transition metal complexes, namely those of fulvalene, tercyclopentadienyl, quatercyclopentadienyl, and pentacyclopentadienyl(cyclopentadienyl) are the subject of this account. Thermal-, photo-, and redox chemistries of homo- and heteropolynuclear complexes are described.

  6. Crystallization of macromolecular complexes: combinatorial complex crystallization

    NASA Astrophysics Data System (ADS)

    Stura, Enrico A.; Graille, Marc; Charbonnier, Jean-Baptiste

    2001-11-01

    The usefulness of antibody complexation, as a way of increasing the chances of crystallization needs to be re-evaluated after many antibody complexes have been crystallized and their structure determined. It is somewhat striking that among these, only a small number is a complex with a large protein antigen. The problem is that the effort of raising, cleaving and purifying an Fab is rewarded only by an extra chance of getting crystals; depending on the relative likelihood of crystallization of the complexed and uncomplexed protein. The example of the complex between HIV gp120, CD4 and an Fab fragment from a neutralizing antibody suggests that further complexation of an antigen-antibody complex with a third protein could, by increasing the number of possible combinations, improve the likelihood of crystallization. We propose the use of Ig-binding proteins as a way of extending the method from HIV gp120 to all proteins for which there are monoclonal antibodies. We discuss this technique, combinatorial complex crystallization (CCC), as part of a multi-component system for the enhancement of crystallization of macromolecular complexes. The method makes use of single Ig-binding domains from Staphylococcus aureus protein A (SpA), Peptostreptococcus magnus protein L (PpL) and the streptococcal protein G (SpG). The generality of the method depends on the ability of these domains to interact with a large repertoire of antibodies without affecting antigen binding. There is strong evidence to suggest that these Ig-binding domains bind outside the antigen-combining site of the antibody without perturbing antigen binding. It is clear from the crystal structure of the single SpG domain complexed with an Fab that the interaction involves mainly the immunoglobulin CH1 domain, a region not involved in antigen recognition. We have recently determined the structure of the complex between a human Fab and the domain D from SpA and found that steric hindrance is unlikely even for large

  7. Acetic acid treatment in S. cerevisiae creates significant energy deficiency and nutrient starvation that is dependent on the activity of the mitochondrial transcriptional complex Hap2-3-4-5

    PubMed Central

    Kitanovic, Ana; Bonowski, Felix; Heigwer, Florian; Ruoff, Peter; Kitanovic, Igor; Ungewiss, Christin; Wölfl, Stefan

    2012-01-01

    Metabolic pathways play an indispensable role in supplying cellular systems with energy and molecular building blocks for growth, maintenance and repair and are tightly linked with lifespan and systems stability of cells. For optimal growth and survival cells rapidly adopt to environmental changes. Accumulation of acetic acid in stationary phase budding yeast cultures is considered to be a primary mechanism of chronological aging and induction of apoptosis in yeast, which has prompted us to investigate the dependence of acetic acid toxicity on extracellular conditions in a systematic manner. Using an automated computer controlled assay system, we investigated and model the dynamic interconnection of biomass yield- and growth rate-dependence on extracellular glucose concentration, pH conditions and acetic acid concentration. Our results show that toxic concentrations of acetic acid inhibit glucose consumption and reduce ethanol production. In absence of carbohydrates uptake, cells initiate synthesis of storage carbohydrates, trehalose and glycogen, and upregulate gluconeogenesis. Accumulation of trehalose and glycogen, and induction of gluconeogenesis depends on mitochondrial activity, investigated by depletion of the Hap2-3-4-5 complex. Analyzing the activity of glycolytic enzymes, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), pyruvate kinase (PYK), and glucose-6-phosphate dehydrogenase (G6PDH) we found that while high acetic acid concentration increased their activity, lower acetic acids concentrations significantly inhibited these enzymes. With this study we determined growth and functional adjustment of metabolism to acetic acid accumulation in a complex range of extracellular conditions. Our results show that substantial acidification of the intracellular environment, resulting from accumulation of dissociated acetic acid in the cytosol, is required for acetic acid toxicity, which creates a state of energy deficiency and nutrient starvation. PMID:23050242

  8. Acetic acid treatment in S. cerevisiae creates significant energy deficiency and nutrient starvation that is dependent on the activity of the mitochondrial transcriptional complex Hap2-3-4-5.

    PubMed

    Kitanovic, Ana; Bonowski, Felix; Heigwer, Florian; Ruoff, Peter; Kitanovic, Igor; Ungewiss, Christin; Wölfl, Stefan

    2012-01-01

    Metabolic pathways play an indispensable role in supplying cellular systems with energy and molecular building blocks for growth, maintenance and repair and are tightly linked with lifespan and systems stability of cells. For optimal growth and survival cells rapidly adopt to environmental changes. Accumulation of acetic acid in stationary phase budding yeast cultures is considered to be a primary mechanism of chronological aging and induction of apoptosis in yeast, which has prompted us to investigate the dependence of acetic acid toxicity on extracellular conditions in a systematic manner. Using an automated computer controlled assay system, we investigated and model the dynamic interconnection of biomass yield- and growth rate-dependence on extracellular glucose concentration, pH conditions and acetic acid concentration. Our results show that toxic concentrations of acetic acid inhibit glucose consumption and reduce ethanol production. In absence of carbohydrates uptake, cells initiate synthesis of storage carbohydrates, trehalose and glycogen, and upregulate gluconeogenesis. Accumulation of trehalose and glycogen, and induction of gluconeogenesis depends on mitochondrial activity, investigated by depletion of the Hap2-3-4-5 complex. Analyzing the activity of glycolytic enzymes, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), pyruvate kinase (PYK), and glucose-6-phosphate dehydrogenase (G6PDH) we found that while high acetic acid concentration increased their activity, lower acetic acids concentrations significantly inhibited these enzymes. With this study we determined growth and functional adjustment of metabolism to acetic acid accumulation in a complex range of extracellular conditions. Our results show that substantial acidification of the intracellular environment, resulting from accumulation of dissociated acetic acid in the cytosol, is required for acetic acid toxicity, which creates a state of energy deficiency and nutrient starvation.

  9. Improvement in the suspension-culture production of recombinant adeno-associated virus-LacZ in HEK-293 cells using polyethyleneimine-DNA complexes in combination with hypothermic treatment.

    PubMed

    Feng, Lei; Guo, Meijin; Zhang, Shuxiang; Chu, Ju; Zhuang, Yingping; Zhang, Siliang

    2008-06-01

    rAAV (recombinant adeno-associated virus) has become a very useful gene-delivery vector for gene therapy. However, it is very difficult to generate rAAV using triple transfection on a commercial scale, owing to its low transfection efficiency. An optimal procedure for transfection in suspension-culture mode was developed for rAAV-LacZ production in suspension-cultured HEK-293 (human embryonic kidney-293) cells mediated by PEI (polyethyleneimine)-DNA complexes in combination with transient severe hypothermia at 4 degrees C for 1 h in the present study (LacZ is the product of the reporter gene lacZ, which codes for beta-D-galactosidase). It showed that the PEI/DNA ratio, cell density at the beginning of transfection and cell-cycle arrest in G2/M-phase were key factors affecting suspension-culture triple-transfection efficiency and rAAV-LacZ productivity. After incubation at 4 degrees C for 1 h and re-warming at 37 degrees C for 18 h, HEK-293 cells at 1x10(6) cells/ml were transfected with PEI-DNA complexes at a PEI/DNA ratio of 5:1 (w/w) with final concentrations of 30 mug/ml 25 kDa linear PEI and 6 mug/ml plasmid DNA in culture. After 6 h incubation for transfection, an equal volume of medium was added to the culture for additional 48 h growth until harvest. Finally, the high transfection efficiency of some 75% and rAAV-LacZ titre of (7.48+/-0.59)x10(11) physical particles or 1.86+/-0.96x10(10) infectious particles were achieved in 250 ml shake flasks with 60 ml working volume, indicating a promising application for scale-up.

  10. Comparison of conventional MRI and MR arthrography in the evaluation of wrist ligament tears: A preliminary experience

    PubMed Central

    Pahwa, Shivani; Srivastava, Deep N; Sharma, Raju; Gamanagatti, Shivanand; Kotwal, Prakash P; Sharma, Vijay

    2014-01-01

    Aims: To compare conventional magnetic resonance imaging (MRI) and direct magnetic resonance (MR) arthrography in the evaluation of triangular fibrocartilage complex (TFCC) and intrinsic wrist ligament tears. Materials and Methods: T1-weighted, fat suppressed (FS) proton density plus T2-weighted (FS PD/T2), 3D multiple-echo data image combination (MEDIC) sequences and direct MR arthrography were performed in 53 patients with wrist pain. Images were evaluated for the presence and location of TFCC, scapholunate ligament (SLL) and lunatotriquetral ligament (LTL) tears, and imaging findings were compared with operative findings in 16 patients who underwent arthroscopy or open surgery (gold standard). Results: Sixteen patients underwent arthroscopy/open surgery: 12 TFCC tears were detected arthroscopically out of which 9 were detected on FS PD/T2 sequence, 10 on MEDIC sequence, and all 12 were detected on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in the detection of TFCC tears were 75%, 83.3%, and 100%, respectively. Out of the eight arthroscopically confirmed SLL tears, three tears were detected on FS PD/T2 sequence, five on MEDIC sequence, and all eight were visualized on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in detecting SLL tears were 37.5%, 62.5%, and 100%, respectively. One arthroscopically confirmed LTL tear was diagnosed on FS PD/T2 sequence, three on MEDIC sequence, and all five arthroscopically confirmed LTL tears were detected with MR arthrography. The sensitivities of PD, MEDIC sequences, and MR arthrography in detecting LTL tears were 20%, 40%, and 100%, respectively. Conclusions: MR arthrography is the most sensitive and specific imaging modality for the evaluation of wrist ligament tears. PMID:25114389

  11. Complex Correspondence Principle

    SciTech Connect

    Bender, Carl M.; Meisinger, Peter N.; Hook, Daniel W.; Wang Qinghai

    2010-02-12

    Quantum mechanics and classical mechanics are distinctly different theories, but the correspondence principle states that quantum particles behave classically in the limit of high quantum number. In recent years much research has been done on extending both quantum and classical mechanics into the complex domain. These complex extensions continue to exhibit a correspondence, and this correspondence becomes more pronounced in the complex domain. The association between complex quantum mechanics and complex classical mechanics is subtle and demonstrating this relationship requires the use of asymptotics beyond all orders.

  12. The effects of infrared laser therapy and weightbath traction hydrotherapy as components of complex physical treatment in disorders of the lumbar spine: a controlled pilot study with follow-up

    NASA Astrophysics Data System (ADS)

    Oláh, Csaba; Oláh, Mihály; Demeter, Béla; Jancsó, Zoltán; Páll, Valéria; Bender, Tamás

    2010-02-01

    Introduction: The therapeutic modalities available for the conservative management of chronic lumbar pain included infrared laser therapy and underwater traction, which usefulness is not universally acknowledged. This study was intended to ascertain any beneficial impact of infrared laser therapy and weightbath treatment on the clinical parameters and quality of life of patients with lumbar discopathy. Material and methods: The study population comprised 54 randomised subjects. I. group of 18 patents received only infrared laser therapy to lumbar region and painful Valley points. II. group of 18 subjects each received underwater traction therapy of lumbar spine with add-on McKenzie exercise and iontophoresis. The remaining III. group treated with exercise and iontophoresis, served as control. VAS, Oswestry index, SF36 scores, range of motion, neurological findings and thermography were monitored to appraise therapeutic afficacy in lumbar discopathy. A CT or MRI scan was done at baseline and after 3 months follow-up. Result:Infrared laser therapy and underwater traction for discopathy achieved significant improvement of all study parameters, which was evident 3 months later. Among the controls, significant improvement of only a single parameter was seen in patients with lumbar discopathy. Conclusions: Infrared laser therapy and underwater traction treatment effectively mitigate pain, muscle spasms, enhance joint flexibility, and improve the quality of life of patients with lumbar discopathy.

  13. [Orthodontic treatment for adults].

    PubMed

    Kuitert, R B

    2000-04-01

    The number of adults undergoing orthodontic treatment has increased strongly and the average age that adult patients undergo orthodontic treatment increased steadily although 3/4 is still younger than 27 years. In adults the facial skeletal pattern can only be changed in a very confined way, consequently in case of an abnormal skeletal pattern one has to choose between a combined orthodontic-surgical approach (which is the case in 18% of the patients) and a compromised orthodontic treatment, if necessary combined with other disciplines. It is still controversial whether tooth movement in adults is slower and more difficult than in adolescents. The same holds true for the risk for loss of periodontal support, for root resorption, for gnathologic problems and for relapse. As related to these variables there appears to be a large individual variation. Many adults show one or more problems in their dentition that may influence their orthodontic treatment. About 60% of the adult patients need a multidisciplinary approach. The development of implantology and of bone regeneration and bone grafting has lead to more combined treatments. The risks of such complex treatment plans are generally larger than those for more simple kinds of treatment. A very careful treatment planning and good communication between the different specialists is essential. Moreover the treatment plan with all its (dis)advantages has to be extensively discussed with the patient.

  14. Complex virial theorem and complex scaling

    SciTech Connect

    Junker, B.R.

    1983-06-01

    We present the simple generalization to complex energies of the normal global real scaling used for bound-state calculations to produce a variational energy which satisfies the virial theorem. We show that in two limiting cases, one or the other of which is almost always p satisfied in all calculations, the virially stabilized complex energy is sensitive to only the real part or the imaginary part of the complex virial expression. We then compute the virial expression for a number of wave functions for the 1s2s/sup 2/ /sup 2/S He/sup -/, 1s2s2p /sup 2/P/sup o/ He/sup -/, and 1s/sup 2/2s/sup 2/kp /sup 2/P/sup o/ Be/sup -/ resonances and the corresponding virially stabilized resonance energies. In all calculations one of the limiting cases was applicable.

  15. Absorption of iron from ferric hydroxypyranone complexes.

    PubMed

    Maxton, D G; Thompson, R P; Hider, R C

    1994-02-01

    The absorption of 59Fe from preparations of FeSO4 and the ferric hydroxypyranone complexes maltol and ethyl maltol was studied by whole-body counting in normal subjects and patients with Fe deficiency. Fe in the Fe3+ complexes was in general absorbed almost as well as Fe2+. It is concluded that the absorption of Fe3+ from hydroxypyranone complexes is much greater than that from simple Fe3+ salts; this may prove an efficient and less toxic form of Fe for the treatment of deficiency.

  16. Current status of cannabis treatment of multiple sclerosis with an illustrative case presentation of a patient with MS, complex vocal tics, paroxysmal dystonia, and marijuana dependence treated with dronabinol.

    PubMed

    Deutsch, Stephen I; Rosse, Richard B; Connor, Julie M; Burket, Jessica A; Murphy, Mary E; Fox, Fiona J

    2008-05-01

    Pain, spasticity, tremor, spasms, poor sleep quality, and bladder and bowel dysfunction, among other symptoms, contribute significantly to the disability and impaired quality of life of many patients with multiple sclerosis (MS). Motor symptoms referable to the basal ganglia, especially paroxysmal dystonia, occur rarely and contribute to the experience of distress. A substantial percentage of patients with MS report subjective benefit from what is often illicit abuse of extracts of the Cannabis sativa plant; the main cannabinoids include delta-9-tetrahydrocannabinol (delta9-THC) and cannabidiol. Clinical trials of cannabis plant extracts and synthetic delta9-THC provide support for therapeutic benefit on at least some patient self-report measures. An illustrative case is presented of a 52-year-old woman with MS, paroxysmal dystonia, complex vocal tics, and marijuana dependence. The patient was started on an empirical trial of dronabinol, an encapsulated form of synthetic delta9-THC that is usually prescribed as an adjunctive medication for patients undergoing cancer chemotherapy. The patient reported a dramatic reduction of craving and illicit use; she did not experience the "high" on the prescribed medication. She also reported an improvement in the quality of her sleep with diminished awakenings during the night, decreased vocalizations, and the tension associated with their emission, decreased anxiety and a decreased frequency of paroxysmal dystonia.

  17. Assessing physiological complexity.

    PubMed

    Burggren, W W; Monticino, M G

    2005-09-01

    Physiologists both admire and fear complexity, but we have made relatively few attempts to understand it. Inherently complex systems are more difficult to study and less predictable. However, a deeper understanding of physiological systems can be achieved by modifying experimental design and analysis to account for complexity. We begin this essay with a tour of some mathematical views of complexity. After briefly exploring chaotic systems, information theory and emergent behavior, we reluctantly conclude that, while a mathematical view of complexity provides useful perspectives and some narrowly focused tools, there are too few generally practical take-home messages for physiologists studying complex systems. Consequently, we attempt to provide guidelines as to how complex systems might be best approached by physiologists. After describing complexity based on the sum of a physiological system's structures and processes, we highlight increasingly refined approaches based on the pattern of interactions between structures and processes. We then provide a series of examples illustrating how appreciating physiological complexity can improve physiological research, including choosing experimental models, guiding data collection, improving data interpretations and constructing more rigorous system models. Finally, we conclude with an invitation for physiologists, applied mathematicians and physicists to collaborate on describing, studying and learning from studies of physiological complexity.

  18. 1. VIEW OF SEWAGE TREATMENT PLANT (BLDG. 769) SOUTH OF ...

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

    1. VIEW OF SEWAGE TREATMENT PLANT (BLDG. 769) SOUTH OF STORAGE SHED (BLDG 773). SECURITY FENCE EAST OF SEWAGE TREATMENT PLANT. - Vandenberg Air Force Base, Space Launch Complex 3, Sewage Treatment Plant, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  19. Complexation of Optoelectronic Systems

    NASA Astrophysics Data System (ADS)

    Boreisho, A. S.; Il‧in, M. Yu.; Konyaev, M. A.; Mikhailenko, A. S.; Morozov, A. V.; Strakhov, S. Yu.

    2016-05-01

    Problems of increasing the efficiency and the functionality of complex optoelectronic systems for monitoring real atmospheric conditions and of their use are discussed. It is shown by the example of a meteorological complex comprising an infrared wind-sensing lidar and an X-range Doppler radar that the complexation of probing systems working in different electromagnetic-radiation ranges opens up new opportunities for determining the meteorological parameters of a turbulent atmosphere and investigating the interaction of radiation with it.

  20. Complexity and schizophrenia.

    PubMed

    Fernández, Alberto; Gómez, Carlos; Hornero, Roberto; López-Ibor, Juan José

    2013-08-01

    Complexity estimators have been broadly utilized in schizophrenia investigation. Early studies reported increased complexity in schizophrenia patients, associated with a higher variability or "irregularity" of their brain signals. However, further investigations showed reduced complexities, thus introducing a clear divergence. Nowadays, both increased and reduced complexity values are reported. The explanation of such divergence is a critical issue to understand the role of complexity measures in schizophrenia research. Considering previous arguments a complementary hypothesis is advanced: if the increased irregularity of schizophrenia patients' neurophysiological activity is assumed, a "natural" tendency to increased complexity in EEG and MEG scans should be expected, probably reflecting an abnormal neuronal firing pattern in some critical regions such as the frontal lobes. This "natural" tendency to increased complexity might be modulated by the interaction of three main factors: medication effects, symptomatology, and age effects. Therefore, young, medication-naïve, and highly symptomatic (positive symptoms) patients are expected to exhibit increased complexities. More importantly, the investigation of these interacting factors by means of complexity estimators might help to elucidate some of the neuropathological processes involved in schizophrenia.

  1. Visual complexity: a review.

    PubMed

    Donderi, Don C

    2006-01-01

    The idea of visual complexity, the history of its measurement, and its implications for behavior are reviewed, starting with structuralism and Gestalt psychology at the beginning of the 20th century and ending with visual complexity theory, perceptual learning theory, and neural circuit theory at the beginning of the 21st. Evidence is drawn from research on single forms, form and texture arrays and visual displays. Form complexity and form probability are shown to be linked through their reciprocal relationship in complexity theory, which is in turn shown to be consistent with recent developments in perceptual learning and neural circuit theory. Directions for further research are suggested.

  2. Frequency of Natural Resistance within NS5a Replication Complex Domain in Hepatitis C Genotypes 1a, 1b: Possible Implication of Subtype-Specific Resistance Selection in Multiple Direct Acting Antivirals Drugs Combination Treatment

    PubMed Central

    Bagaglio, Sabrina; Andolina, Andrea; Merli, Marco; Uberti-Foppa, Caterina; Morsica, Giulia

    2016-01-01

    Different HCV subtypes may naturally harbor different resistance selection to anti-NS5a inhibitors. 2761 sequences retrieved from the Los Alamos HCV database were analyzed in the NS5a domain 1, the target of NS5a inhibitors. The NS5a resistance-associated polymorphisms (RAPs) were more frequently detected in HCV G1b compared to G1a. The prevalence of polymorphisms associated with cross-resistance to compounds in clinical use (daclatasvir, DCV, ledipasvir, LDV, ombitasvir, and OMV) or scheduled to come into clinical use in the near future (IDX719, elbasvir, and ELV) was higher in G1b compared to G1a (37/1552 (2.4%) in 1b sequences and 15/1209 (1.2%) in 1a isolates, p = 0.040). Interestingly, on the basis of the genotype-specific resistance pattern, 95 (6.1%) G1b sequences had L31M RAP to DCV/IDX719, while 6 sequences of G1a (0.5%) harbored L31M RAP, conferring resistance to DCV/LDV/IDX719/ELV (p < 0.0001). Finally, 28 (2.3%) G1a and none of G1b isolates harbored M28V RAP to OMV (p < 0.0001). In conclusion, the pattern of subtype-specific resistance selection in the naturally occurring strains may guide the treatment option in association with direct acting antivirals (DAAs) targeting different regions, particularly in patients that are difficult to cure, such as those with advanced liver disease or individuals who have failed previous DAAs. PMID:27023593

  3. Child health in complex emergencies.

    PubMed Central

    Moss, William J.; Ramakrishnan, Meenakshi; Storms, Dory; Henderson Siegle, Anne; Weiss, William M.; Lejnev, Ivan; Muhe, Lulu

    2006-01-01

    Coordinated and effective interventions are critical for relief efforts to be successful in addressing the health needs of children in situations of armed conflict, population displacement, and/or food insecurity. We reviewed published literature and surveyed international relief organizations engaged in child health activities in complex emergencies. Our aim was to identify research needs and improve guidelines for the care of children. Much of the literature details the burden of disease and the causes of morbidity and mortality; few interventional studies have been published. Surveys of international relief organizations showed that most use World Health Organization (WHO), United Nations Children's Fund (UNICEF), and ministry of health guidelines designed for use in stable situations. Organizations were least likely to have formal guidelines on the management of asphyxia, prematurity, and infection in neonates; diagnosis and management of children with human immunodeficiency virus (HIV) infection; active case-finding and treatment of tuberculosis; paediatric trauma; and the diagnosis and management of mental-health problems in children. Guidelines often are not adapted to the different types of health-care workers who provide care in complex emergencies. Evidence-based, locally adapted guidelines for the care of children in complex emergencies should be adopted by ministries of health, supported by WHO and UNICEF, and disseminated to international relief organizations to ensure appropriate, effective, and uniform care. PMID:16501716

  4. School Phobia: Understanding a Complex Behavioural Response

    ERIC Educational Resources Information Center

    Chitiyo, Morgan; Wheeler, John J.

    2006-01-01

    School phobia affects about 5% of the school-age population. If left untreated, school phobia can have devastating long-term consequences in children challenged by this condition. Various treatment approaches have been used to explore this complex behavioural response, major among them being the psychoanalytic, psychodynamic, pharmacological and…

  5. Adaptive Leadership: Fighting Complexity with Complexity

    DTIC Science & Technology

    2014-06-01

    It appears that, as Jorge Luis Borges put it, “Everything touches everything.”39 Army ants and the World Wide Web are exemplars of complex systems...Star Trek: USS Enterprise: Haynes Manual (San Jose , CA: Simon and Schuster, 2010). 66 Spillane, Distributed Leadership. 24... Jose , CA: Simon and Schuster, 2010. Smythe, Elizabeth, and Andrew Norton. “Thinking as Leadership/Leadership As Thinking.” Leadership 3, no. 1 (2007

  6. U1A Complex

    SciTech Connect

    2014-10-28

    Some of the most sophisticated experiments in the stockpile stewardship program are conducted in an environmentally safe manner, nearly 1000 feet below the ground at the site. The U1a complex a sprawling underground laboratory and tunnel complex is home to a number of unique capabilities.

  7. U1A Complex

    ScienceCinema

    None

    2016-07-12

    Some of the most sophisticated experiments in the stockpile stewardship program are conducted in an environmentally safe manner, nearly 1000 feet below the ground at the site. The U1a complex a sprawling underground laboratory and tunnel complex is home to a number of unique capabilities.

  8. Bacterial formate hydrogenlyase complex

    PubMed Central

    McDowall, Jennifer S.; Murphy, Bonnie J.; Haumann, Michael; Palmer, Tracy; Armstrong, Fraser A.; Sargent, Frank

    2014-01-01

    Under anaerobic conditions, Escherichia coli can carry out a mixed-acid fermentation that ultimately produces molecular hydrogen. The enzyme directly responsible for hydrogen production is the membrane-bound formate hydrogenlyase (FHL) complex, which links formate oxidation to proton reduction and has evolutionary links to Complex I, the NADH:quinone oxidoreductase. Although the genetics, maturation, and some biochemistry of FHL are understood, the protein complex has never been isolated in an intact form to allow biochemical analysis. In this work, genetic tools are reported that allow the facile isolation of FHL in a single chromatographic step. The core complex is shown to comprise HycE (a [NiFe] hydrogenase component termed Hyd-3), FdhF (the molybdenum-dependent formate dehydrogenase-H), and three iron-sulfur proteins: HycB, HycF, and HycG. A proportion of this core complex remains associated with HycC and HycD, which are polytopic integral membrane proteins believed to anchor the core complex to the cytoplasmic side of the membrane. As isolated, the FHL complex retains formate hydrogenlyase activity in vitro. Protein film electrochemistry experiments on Hyd-3 demonstrate that it has a unique ability among [NiFe] hydrogenases to catalyze production of H2 even at high partial pressures of H2. Understanding and harnessing the activity of the FHL complex is critical to advancing future biohydrogen research efforts. PMID:25157147

  9. Complexity and Relations

    ERIC Educational Resources Information Center

    Lancaster, Jeanette Elizabeth

    2013-01-01

    A central feature of complexity is that it is based on non-linear, recursive relations. However, in most current accounts of complexity such relations, while non-linear, are based on the reductive relations of a Newtonian onto-epistemological framework. This means that the systems that are emergent from the workings of such relations are a…

  10. COMPLEXITY IN ECOLOGICAL SYSTEMS

    EPA Science Inventory

    The enormous complexity of ecosystems is generally obvious under even the most cursory examination. In the modern world, this complexity is further augmented by the linkage of ecosystems to economic and social systems through the human use of the environment for technological pu...

  11. Performance Improvement Assuming Complexity

    ERIC Educational Resources Information Center

    Rowland, Gordon

    2007-01-01

    Individual performers, work teams, and organizations may be considered complex adaptive systems, while most current human performance technologies appear to assume simple determinism. This article explores the apparent mismatch and speculates on future efforts to enhance performance if complexity rather than simplicity is assumed. Included are…

  12. Visual Complexity: A Review

    ERIC Educational Resources Information Center

    Donderi, Don C.

    2006-01-01

    The idea of visual complexity, the history of its measurement, and its implications for behavior are reviewed, starting with structuralism and Gestalt psychology at the beginning of the 20th century and ending with visual complexity theory, perceptual learning theory, and neural circuit theory at the beginning of the 21st. Evidence is drawn from…

  13. Complexity and behavioral economics.

    PubMed

    Rosser, J Barkley; Rosser, Marina V

    2015-04-01

    This paper will consider the relationship between complexity economics and behavioral economics. A crucial key to this is to understand that Herbert Simon was both the founder of explicitly modern behavioral economics as well as one of the early developers of complexity theory. Bounded rationality was essentially derived from Simon's view of the impossibility of full rationality on the part of economic agents. Modern complexity theory through such approaches as agent-based modeling offers an approach to understanding behavioral economics by allowing for specific behavioral responses to be assigned to agents who interact within this context, even without full rationality. Other parts of modern complexity theory are considered in terms of their relationships with behavioral economics. Fundamentally, complexity provides an ultimate foundation for bounded rationality and hence the need to use behavioral economics in a broader array of contexts than most economists have thought appropriate.

  14. Complexity: against systems.

    PubMed

    Chu, Dominique

    2011-09-01

    This article assumes a specific intuitive notion of complexity as a difficulty to generate and/or assess the plausibility of models. Based on this intuitive understanding of complexity, it identifies two main causes of complexity, namely, radical openness and contextuality. The former is the idea that there are no natural systems. The modeler always needs to draw artificial boundaries around phenomena to generate feasible models. Contextuality is intimately connected to the requirement to simplify models and to leave out most aspects. Complexity occurs when contextuality and radical openness cannot be contained that is when it is not clear where the boundaries of the system are and which abstractions are the correct ones. This concept of complexity is illustrated using a number of example from evolution.

  15. Stroke Treatments

    MedlinePlus

    ... the base of the aneurysm. Treatment to Maximize Recovery Your medical professional can tell you which treatment ... important in helping you achieve the best possible recovery and independence. A number of types of therapy ...

  16. [Complex pelvic injury in childhood].

    PubMed

    Schmal, H; Klemt, C; Haag, C; Bonnaire, F

    2002-08-01

    Pelvic disruptions are rare in children caused by the flexible anchoring of bony parts associated with a high elasticity of the skeleton. Portion of pelvic fractures in infants is lower than 5% even when reviewing cases of specialized centers. The part of complex pelvic injuries and multiple injured patients in infants is higher when compared to adults, a fact caused by the more intense forces that are necessary to lead to pelvic disruption in children. Combination of a rare injury and the capability of children to compensate blood loss for a long time may implicate a wrong security and prolong diagnostic and therapeutic procedures--a problem that definitely should be avoided. Three cases were analyzed and established algorithms for treatment of patients matching these special injury-features demonstrated. A good outcome may only be achieved when all components of injury pattern get recognized and treatment is organized following the hierarchy of necessity. Therefore in the time table first life-saving steps have to be taken and then accompanying injuries can be treated that often decisively influence life quality. As seen in our cases unstable and dislocated fractures require open reduction and internal fixation ensuring nerval decompression, stop of hemorrhage and realizing the prerequisite for effective treatment of soft tissue damage. The acute hemorrhagic shock is one of the leading causes of death following severe pelvic injuries. After stabilization of fracture, surgical treatment of soft tissue injuries and intraabdominal bleeding sources the immediate diagnostic angiography possibly in combination with a therapeutic selective embolization is a well established part of the treatment. The aim of complete restitution can only be accomplished by cooperation of several different specialists and consultants in a trauma center.

  17. Treatment of Thoracolumbar Fracture

    PubMed Central

    Kim, Byung-Guk; Shin, Dong-Eun

    2015-01-01

    The most common fractures of the spine are associated with the thoracolumbar junction. The goals of treatment of thoracolumbar fracture are leading to early mobilization and rehabilitation by restoring mechanical stability of fracture and inducing neurologic recovery, thereby enabling patients to return to the workplace. However, it is still debatable about the treatment methods. Neurologic injury should be identified by thorough physical examination for motor and sensory nerve system in order to determine the appropriate treatment. The mechanical stability of fracture also should be evaluated by plain radiographs and computed tomography. In some cases, magnetic resonance imaging is required to evaluate soft tissue injury involving neurologic structure or posterior ligament complex. Based on these physical examinations and imaging studies, fracture stability is evaluated and it is determined whether to use the conservative or operative treatment. The development of instruments have led to more interests on the operative treatment which saves mobile segments without fusion and on instrumentation through minimal invasive approach in recent years. It is still controversial for the use of these treatments because there have not been verified evidences yet. However, the morbidity of patients can be decreased and good clinical and radiologic outcomes can be achieved if the recent operative treatments are used carefully considering the fracture pattern and the injury severity. PMID:25705347

  18. Effects of chemical and enzymatic modifications on starch-linoleic acid complex formation.

    PubMed

    Arijaje, Emily Oluwaseun; Wang, Ya-Jane

    2017-02-15

    This study investigated the complexation yield and physicochemical properties of soluble and insoluble starch complexes with linoleic acid when a β-amylase treatment was applied to acetylated and debranched potato starch. The degree of acetylation was generally higher in the soluble complexes than in the insoluble ones. The insoluble complexes from the acetylated starch displayed the V-type pattern, whereas, the soluble complexes displayed a mixture of either the A-/V-type or the B-/V-type pattern. Acetylation decreased onset and peak melting temperatures for the insoluble complexes, whereas no melting endotherm was observed in the soluble complexes. Acetylation substantially increased the amount of complexed linoleic acid in the insoluble complexes, but had little positive effect on the formation of the soluble complexes. The β-amylase treatment significantly increased the complexed linoleic content in both soluble and insoluble complexes for the low acetylated starch, but not for the high acetylated starch.

  19. Lightening up Ruthenium Complexes to Fight Cancer?

    PubMed

    Mari, Cristina; Gasser, Gilles

    2015-01-01

    In medicine, light is used in a medical treatment called photodynamic therapy (PDT) to treat some types of cancer and skin diseases. This technique generally allows for reduced side effects compared to traditional chemotherapy. However, PDT is not fully effective on hypoxic tumors (i.e. lacking oxygen). To overcome this important drawback, photoactivated chemotherapy (PACT) agents have been designed to obtain light-mediated cancer cell death via an oxygen-independent mechanism. Ruthenium complexes have already been and are currently deeply explored as traditional anticancer agents. However, as reported in this short review article, such compounds can also bring novel opportunities in the field of light-mediated cancer treatment. Herein, we report on our findings in the optimization of Ru(II) polypyridyl complexes as PDT and PACT agents for the potential treatment of cancer and, interestingly, also of bacterial infections.

  20. [Headache Treatment].

    PubMed

    Diener, Hans Christoph; Holle-Lee, Dagny; Nägel, Steffen; Gaul, Charly

    2017-03-01

    A precondition for the successful treatment of headaches is the correct headache diagnosis. Triptans are effective for attack treatment of migraine and cluster headache. However, there are not effective for the treatment of tension-type headache. For the prevention of frequent episodic migraine betablockers, flunarizine, topiramate and amitriptyline are recommended. For the prevention of chronic migraine evidence is only available for onabotulinumtoxinA and topiramate. For prophylactic treatment of tension-type headaches tricyclic antidepressants are used. In cluster headache verapamil (in combination with steroids) is the most frequently used prophylactic agent. This article focusses on the current acute and prophylactic treatment of common headache syndromes.

  1. Selenophene transition metal complexes

    SciTech Connect

    White, Carter James

    1994-07-27

    This research shows that selenophene transition metal complexes have a chemistry that is similar to their thiophene analogs. Selenophene coordination has been demonstrated and confirmed by molecular structure in both the η5- and the η1(Se)-coordination modes. The reaction chemistry of selenophene complexes closely resembles that of the analogous thiophene complexes. One major difference, however, is that selenophene is a better donor ligand than thiophene making the selenophene complexes more stable than the corresponding thiophene complexes. The 77Se NMR chemical shift values for selenophene complexes fall within distinct regions primarily depending on the coordination mode of the selenophene ligand. In the final paper, the C-H bond activation of η1(S)-bound thiophenes, η1(S)-benzothiophene and η1(Se)-bound selenophenes has been demonstrated. The deprotonation and rearrangement of the η1(E)-bound ligand to the carbon bound L-yl complex readily occurs in the presence of base. Reprotonation with a strong acid gives a carbene complex that is unreactive towards nucleophilic attack at the carbene carbon and is stable towards exposure to air. The molecular structure of [Cp(NO)(PPh3)Re(2-benzothioenylcarbene)]O3SCF3 was determined and contains a Re-C bond with substantial double bond character. Methyl substitution for the thienylcarbene or selenylcarbene gives a carbene that rearranges thermally to give back the η1(E)-bound complex. Based on these model reactions, a new mechanism for the H/D exchange of thiophene over the hydrodesulfurization catalyst has been proposed.

  2. Afterglow Complex Plasma

    SciTech Connect

    Samarian, A. A.; Boufendi, L.; Mikikian, M.

    2008-09-07

    The review of the first detailed experimental and theoretical studies of complex plasma in RF discharge afterglow is presented. The studies have been done in a frame of FAST collaborative research project between Complex Plasma Laboratory of the University of Sydney and the GREMI laboratory of Universite d'Orleans. We examined the existing models of plasma decay, presents experimental observations of dust dynamics under different afterglow complex plasma conditions, presents the experimental data obtained (in particular the presence of positively charged particles in discharge afterglow), discusses the use of dust particles as a probe to study the diffusion losses in afterglow plasmas.

  3. Complexity and robustness

    PubMed Central

    Carlson, J. M.; Doyle, John

    2002-01-01

    Highly optimized tolerance (HOT) was recently introduced as a conceptual framework to study fundamental aspects of complexity. HOT is motivated primarily by systems from biology and engineering and emphasizes, (i) highly structured, nongeneric, self-dissimilar internal configurations, and (ii) robust yet fragile external behavior. HOT claims these are the most important features of complexity and not accidents of evolution or artifices of engineering design but are inevitably intertwined and mutually reinforcing. In the spirit of this collection, our paper contrasts HOT with alternative perspectives on complexity, drawing on real-world examples and also model systems, particularly those from self-organized criticality. PMID:11875207

  4. Complexity and forensic pathology.

    PubMed

    Jones, Richard Martin

    2015-12-01

    It has become increasingly apparent that nonlinearity and complexity are the norm in human physiological systems, the relevance of which is informing an enhanced understanding of basic pathological processes such as inflammation, the host response to severe trauma, and critical illness. This article will explore how an understanding of nonlinear systems and complexity might inform the study of the pathophysiology of deaths of medicolegal interest, and how 'complexity thinking' might usefully be incorporated into modern forensic medicine and forensic pathology research, education and practice.

  5. A complex legacy

    NASA Astrophysics Data System (ADS)

    Moore, Cristopher

    2011-11-01

    In his tragically short life, Alan Turing helped define what computing machines are capable of, and where they reach inherent limits. His legacy is still felt every day, in areas ranging from computational complexity theory to cryptography and quantum computing.

  6. Indicators: Physical Habitat Complexity

    EPA Pesticide Factsheets

    Physical habitat complexity measures the amount and variety of all types of cove at the water’s edge in lakes. In general, dense and varied shoreline habitat is able to support more diverse communities of aquatic life.

  7. Complex Regional Pain Syndrome

    MedlinePlus

    Complex regional pain syndrome (CRPS) is a chronic pain condition. It causes intense pain, usually in the arms, hands, legs, or feet. ... in skin temperature, color, or texture Intense burning pain Extreme skin sensitivity Swelling and stiffness in affected ...

  8. Reconstruction Using Witness Complexes

    PubMed Central

    Oudot, Steve Y.

    2010-01-01

    We present a novel reconstruction algorithm that, given an input point set sampled from an object S, builds a one-parameter family of complexes that approximate S at different scales. At a high level, our method is very similar in spirit to Chew’s surface meshing algorithm, with one notable difference though: the restricted Delaunay triangulation is replaced by the witness complex, which makes our algorithm applicable in any metric space. To prove its correctness on curves and surfaces, we highlight the relationship between the witness complex and the restricted Delaunay triangulation in 2d and in 3d. Specifically, we prove that both complexes are equal in 2d and closely related in 3d, under some mild sampling assumptions. PMID:21643440

  9. Complex Flow Workshop Report

    SciTech Connect

    none,

    2012-05-01

    This report documents findings from a workshop on the impacts of complex wind flows in and out of wind turbine environments, the research needs, and the challenges of meteorological and engineering modeling at regional, wind plant, and wind turbine scales.

  10. Complex and unpredictable Cardano

    NASA Astrophysics Data System (ADS)

    Ekert, Artur

    2008-08-01

    This purely recreational paper is about one of the most colorful characters of the Italian Renaissance, Girolamo Cardano, and the discovery of two basic ingredients of quantum theory, probability and complex numbers.

  11. Mycobacterium abscessus complex bacteremia due to prostatitis after prostate biopsy.

    PubMed

    Chen, Chung-Hua; Lin, Jesun; Lin, Jen-Shiou; Chen, Yu-Min

    2016-10-01

    We present the case of a 49-year-old man, who developed Mycobacterium abscessus complex (M. abscessus complex) bacteremia and prostatitis after prostate biopsy. The patient was successfully treated with amikacin with imipenem-cilastatin with clarithromycin. Infections caused by M. abscessus complex have been increasingly described as a complication associated with many invasive procedures. Invasive procedures might have contributed to the occurrence of the M. abscessus complex. Although M. abscessus complex infection is difficult to diagnose and treat, we should pay more attention to this kind of infection, and the correct treatment strategy will be achieved by physicians.

  12. Inside the complexity labyrinth

    NASA Astrophysics Data System (ADS)

    Fraser, Gordon

    2010-02-01

    Although the world we live in is complex, complexity as a science does not have a long history. For generations, most physicists tried to understand everything in terms of interactions between pairs of idealized "test particles". Then, about a 100 years ago, Henri Poincaré pointed out that a fully interacting three-body system was not just the sum of its three component pairs. The famous "three-body problem" was born.

  13. Electrospun complexes - functionalised nanofibres

    NASA Astrophysics Data System (ADS)

    Meyer, T.; Wolf, M.; Dreyer, B.; Unruh, D.; Krüger, C.; Menze, M.; Sindelar, R.; Klingelhöfer, G.; Renz, F.

    2016-12-01

    Here we present a new approach of using iron-complexes in electro-spun fibres. We modify poly(methyl methacrylate) (PMMA) by replacing the methoxy group with Diaminopropane or Ethylenediamine. The complex is bound covalently via an imine-bridge or an amide. The resulting polymer can be used in the electrospinning process without any further modifications in method either as pure reagent or mixed with small amounts of not functionalised polymer resulting in fibres of different qualities (Fig. 1).

  14. An erupted complex odontoma.

    PubMed

    Tozoglu, Sinan; Yildirim, Umran; Buyukkurt, M Cemil

    2010-01-01

    Odontomas are benign tumors of odontogenic origin. The cause of the odontoma is unknown, but it is believed to be hereditary or due to a disturbance in tooth development triggered by trauma or infection. Odontomas may be either compound or complex. Although these tumors are seen frequently, erupted odontomas are rare. The purpose of this study is to present a rare case of complex odontoma that erupted into the oral cavity.

  15. Side-on bound diazene and hydrazine complexes of ruthenium.

    PubMed

    Field, Leslie D; Li, Hsiu L; Dalgarno, Scott J

    2010-07-05

    The reaction of cis-[RuCl(2)(PP)(2)] (PP = depe, dmpe) with hydrazine afforded end-on bound ruthenium(II) hydrazine complexes. Treatment of the hydrazine complexes with strong base afforded the side-on bound ruthenium(0) diazene complexes cis-[Ru(eta(2)-NH=NH)(PP)(2)]. Treatment of cis-[Ru(eta(2)-NH=NH)(depe)(2)] with weak acid under chloride-free conditions afforded the side-on bound hydrazine complex cis-[Ru(eta(2)-N(2)H(4))(depe)(2)](2+). These are the first reported side-on bound diazene and hydrazine complexes of ruthenium, and they have been characterized by NMR spectroscopy ((1)H, (31)P, (15)N) and by X-ray crystallography. The interconversion between the ruthenium diazene and the ruthenium hydrazine by acid-base treatment was reversible.

  16. Treatment of Lyme borreliosis

    PubMed Central

    2009-01-01

    Borrelia burgdorferi sensu lato is the causative agent of Lyme borreliosis in humans. This inflammatory disease can affect the skin, the peripheral and central nervous system, the musculoskeletal and cardiovascular system and rarely the eyes. Early stages are directly associated with viable bacteria at the site of inflammation. The pathogen-host interaction is complex and has been elucidated only in part. B. burgdorferi is highly susceptible to antibiotic treatment and the majority of patients profit from this treatment. Some patients develop chronic persistent disease despite repeated antibiotics. Whether this is a sequel of pathogen persistence or a status of chronic auto-inflammation, auto-immunity or a form of fibromyalgia is highly debated. Since vaccination is not available, prevention of a tick bite or chemoprophylaxis is important. If the infection is manifest, then treatment strategies should target not only the pathogen by using antibiotics but also the chronic inflammation by using anti-inflammatory drugs. PMID:20067594

  17. [Veterinary dentistry (11). Feline gingivitis-stomatitis-pharyngitis complex. Chronic/recurrent stomatitis in cats].

    PubMed

    van Foreest, A

    1995-10-01

    This is the fourth article in a series on veterinary dentistry in cats. This article describes the clinical signs, possible investigations, and differential diagnosis of the gingivitis-stomatitis pharyngitis complex (GSP complex), a complex and frequently occurring disease. Strategies for the treatment of feline chronic stomatitis complex, which is frequently idiopathic, are presented.

  18. Pulling complexes out of complex diseases

    PubMed Central

    Mohan, Ryan D; Abmayr, Susan M; Workman, Jerry L

    2014-01-01

    Spinocerebellar ataxia 7 (SCA7) is an incurable disease caused by expansion of CAG trinucleotide sequences within the Ataxin-7 gene. This elongated CAG tract results in an Ataxin-7 protein bearing an expanded polyglutamine (PolyQ) repeat. SCA7 disease is characterized by progressive neural and retinal degeneration leading to ataxia and blindness. Evidence gathered from investigating SCA7 and other PolyQ diseases strongly suggest that misregulation of gene expression contributes to neurodegeneration. In fact, Ataxin-7 is a subunit of the essential Spt-Ada-Gcn5-Acetltransferase (SAGA) chromatin modifying complex that regulates expression of a large number of genes. Here we discuss recent insights into Ataxin-7 function and, considering these findings, propose a model for how polyglutamine expansion of Ataxin-7 may affect Ataxin-7 function to alter chromatin modifications and gene expression. PMID:25054097

  19. ICDF Complex Remedial Action Report

    SciTech Connect

    W. M. Heileson

    2007-09-26

    This Idaho CERCLA Disposal Facility (ICDF) Remedial Action Report has been prepared in accordance with the requirements of Section 6.2 of the INEEL CERCLA Disposal Facility Remedial Action Work Plan. The agency prefinal inspection of the ICDF Staging, Storage, Sizing, and Treatment Facility (SSSTF) was completed in June of 2005. Accordingly, this report has been developed to describe the construction activities completed at the ICDF along with a description of any modifications to the design originally approved for the facility. In addition, this report provides a summary of the major documents prepared for the design and construction of the ICDF, a discussion of relevant requirements and remedial action objectives, the total costs associated with the development and operation of the facility to date, and identification of necessary changes to the Agency-approved INEEL CERCLA Disposal Facility Remedial Action Work Plan and the ICDF Complex Operations and Maintenance Plan.

  20. Cell complexes through time

    NASA Astrophysics Data System (ADS)

    Klette, Reinhard

    2000-10-01

    The history of cell complexes is closely related to the birth and development of topology in general. Johann Benedict Listing (1802 - 1882) introduced the term 'topology' into mathematics in a paper published in 1847, and he also defined cell complexes for the first time in a paper published in 1862. Carl Friedrich Gauss (1777 - 1855) is often cited as the one who initiated these ideas, but he did not publish either on topology or on cell complexes. The pioneering work of Leonhard Euler (1707 - 1783) on graphs is also often cited as the birth of topology, and Euler's work was cited by Listing in 1862 as a stimulus for his research on cell complexes. There are different branches in topology which have little in common: point set topology, algebraic topology, differential topology etc. Confusion may arise if just 'topology' is specified, without clarifying the used concept. Topological subjects in mathematics are often related to continuous models, and therefore quite irrelevant to computer based solutions in image analysis. Compared to this, only a minority of topology publications in mathematics addresses discrete spaces which are appropriate for computer-based image analysis. In these cases, often the notion of a cell complex plays a crucial role. This paper briefly reports on a few of these publications. This paper is not intended to cover the very lively progress in cell complex studies within the context of image analysis during the last two decades. Basically it stops its historic review at the time when this subject in image analysis research gained speed in 1980 - 1990. As a general point of view, the paper indicates that image analysis contributes to a fusion of topological concepts, the geometric and the abstract cell structure approach and point set topology, which may lead towards new problems for the study of topologies defined on geometric or abstract cell complexes.

  1. Avascular necrosis of the lunate bone (Kienböck’s disease) secondary to scapholunate ligament tear as a consequence of trauma – a case study

    PubMed Central

    Kulhawik, Dorota; Szałaj, Tomasz; Grabowska, Monika

    2014-01-01

    Summary Background Avascular necrosis of the lunate bone (Kienböck’s disease), is a condition in which lunate bone, loses its blood supply, leading to necrosis of the bone. There is probably no single cause of Kienbock’s disease. Its origin may involve multiple factors, such as the blood supply (arteries), blood drainage (veins), and skeletal variations. Trauma, either isolated or repeated, may possibly be a factor in some cases. This case presented with multifactorial etiology. Case Report In the presented case, a patient with negative ulnar variant had injured her right wrist and presented at an orthopedic clinic due to nonspecific pain 6 months later. An arthro-MRI examination revealed necrosis of the lunate bone, scapholunate ligament tear and coexisting TFCC (triangular fibrocartilage complex) tear. Conclusions Early diagnosis and treatment can prevent progression of necrotic lesions and bone collapse. MRI examination seems to be the key diagnostic method in the early stage of the Kienböck’s disease with negative x-ray and CT images. Arthro-MRI examination also allows us to identify the underlying ligamentous injury. In cases of traumatic etiology, an additional CT test enables stating the final diagnosis. PMID:24523832

  2. Trauma-focused CBT for youth with complex trauma

    PubMed Central

    Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.

    2013-01-01

    Objectives Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth with complex trauma. Methods TF-CBT treatment phases are described and modifications of timing, proportionality and application are described for youth with complex trauma. Practical applications include a) dedicating proportionally more of the model to the TF-CBT coping skills phase; b) implementing the TF-CBT Safety component early and often as needed throughout treatment; c) titrating gradual exposure more slowly as needed by individual youth; d) incorporating unifying trauma themes throughout treatment; and e) when indicated, extending the TF-CBT treatment consolidation and closure phase to include traumatic grief components and to generalize ongoing safety and trust. Results Recent data from youth with complex trauma support the use of the above TF-CBT strategies to successfully treat these youth. Conclusions The above practical strategies can be incorporated into TF-CBT to effectively treat youth with complex trauma. Practice implications Practical strategies include providing a longer coping skills phase which incorporates safety and appropriate gradual exposure; including relevant unifying themes; and allowing for an adequate treatment closure phase to enhance ongoing trust and safety. Through these strategies therapists can successfully apply TF-CBT for youth with complex trauma. PMID:22749612

  3. Nipple areola complex sparing mastectomy

    PubMed Central

    Mingozzi, Matteo; Curcio, Annalisa; Buggi, Federico; Folli, Secondo

    2015-01-01

    Breast conservative therapy (BCT) is established as a safe option for most women with early breast cancer (BC). The best conservative mastectomy that can be performed, when mastectomy is unavoidable, is nipple-areola-complex sparing mastectomy (NSM), which allows the complete glandular dissection preserving the skin envelope and the nipple areola complex. In the treatment of BC, the cosmetic outcomes have become fundamental goals, as well as oncologic control. NSM is nowadays considered an alternative technique to improve the overall quality of life for women allowing excellent cosmetic results because it provides a natural appearing breast. The breast surgeon must pay attention to details and skin incision must be planned to minimize vascular impairment to the skin and the nipple. Preservation of the blood supply to the nipple is one of the most important concern during NSM because nipple or areolar necrosis is a well-described complication of this surgery. Another issue associated with the nipple preservation and the surgical technique is oncological safety related to nipple-areola-complex (NAC) involvement in patients with invasive BC. The authors present their experience on 252 NSM performed in the Breast Surgery Unit in Forlì. Careful selection of patients for this surgical procedure is imperative and many patients are not ideal candidates for this procedure because of concerns about nipple-areolar viability as women with significant large/ptotic breast, pre-existing breast scars and history of active cigarette smoking. To extend the benefits of nipple preservation to patients who are perceived to be at higher risk for nipple necrosis the authors describe technical modifications of NSM to allow nipple preservation and obtain good cosmetic outcomes. PMID:26645007

  4. Hydridomethyl iridium complex

    DOEpatents

    Bergman, Robert G.; Buchanan, J. Michael; Stryker, Jeffrey M.; Wax, Michael J.

    1989-01-01

    A process for functionalizing methane comprising: (a) reacting methane with a hydridoalkyl metal complex of the formula: CpIr[P(R.sub.1).sub.3 ]H(R.sub.2) wherein Cp represents a cyclopentadienyl or alkylcyclopentadienyl radical having from 1 to 5 carbon atoms; Ir represents an iridium atom; P represents a phosphorus atom; R.sub.1 represents an alkyl group; R.sub.2 represents an alkyl group having at least two carbon atoms; and H represents a hydrogen atom, in the presence of a liquid alkane R.sub.3 H having at least three carbon atoms to form a hydridomethyl complex of the formula: CpIr[P(R.sub.1).sub.3 ]HMe where Me represents a methyl radical. (b) reacting said hydridomethyl complex with an organic halogenating agent such as a tetrahalomethane or a haloform of the formulas: CX'X"X'"X"" or CHX'X"X'"; wherein X', X", X"', and X"" represent halogens selected from bromine, iodine and chlorine, to halomethyl complex of step (a) having the formula: CpIr[P(R.sub.1).sub.3 ]MeX: (c) reacting said halomethyl complex with a mercuric halide of the formula HgX.sub.2 to form a methyl mercuric halide of the formula HgMeX; and (d) reacting said methyl mercuric halide with a molecular halogen of the formula X.sub.2 to form methyl halide.

  5. Quantum Complexity in Graphene

    NASA Astrophysics Data System (ADS)

    Baskaran, G.

    Carbon has a unique position among elements in the periodic table. It produces an allotrope, graphene, a mechanically robust two dimensional semimetal. The multifarious properties that graphene exhibits has few parallels among elemental metals. From simplicity, namely carbon atoms connected by pure sp2 bonds, a wealth of novel quantum properties emerge. In classical complex systems such as a spin glass or a finance market, several competing agents or elements are responsible for unanticipated and difficult to predict emergent properties. The complex (sic) structure of quantum mechanics is responsbile for an unanticipated set of emergent properties in graphene. We call this quantum complexity. In fact, most quantum systems, phenomena and modern quantum field theory could be viewed as examples of quantum complexity. After giving a brief introduction to the quantum complexity we focus on our own work, which indicates the breadth in the type of quantum phenomena that graphene could support. We review our theoretical suggestions of, (i) spin-1 collective mode in netural graphene, (ii) relativistic type of phenomena in crossed electric and magnetic fields, (iii) room temperature superconductivity in doped graphene and (iv) composite Fermi sea in neutral graphene in uniform magnetic field and (v) two-channel Kondo effect. Except for the relativistic type of phenomena, the rest depend in a fundamental way on a weak electron correlation that exists in the broad two-dimensional band of graphene.

  6. Quantum Complexity in Graphene

    NASA Astrophysics Data System (ADS)

    Baskaran, G.

    Carbon has a unique position among elements in the periodic table. It produces an allotrope, graphene, a mechanically robust two dimensional semimetal. The multifarious properties that graphene exhibits has few parallels among elemental metals. From simplicity, namely carbon atoms connected by pure sp2 bonds, a wealth of novel quantum properties emerge. In classical complex systems such as a spin glass or a finance market, several competing agents or elements are responsible for unanticipated and difficult to predict emergent properties. The complex (sic) structure of quantum mechanics is responsbile for an unanticipated set of emergent properties in graphene. We call this quantum complexity. Infact, most quantum systems, phenomena and modern quantum field theory could be viewed as examples of quantum complexity. After giving a brief introduction to the quantum complexity we focus on our own work, which indicates the breadth in the type of quantum phenomena that graphene could support. We review our theoretical suggestions of, (i) spin-1 collective mode in netural graphene, (ii) relativistic type of phenomena in crossed electric and magnetic fields, (iii) room temperature superconductivity in doped graphene and (iv) composite Fermi sea in neutral graphene in uniform magnetic field and (v) 2-channel Kondo effect. Except for the relativistic type of phenomena and Kondo effect, the rest depend in a fundamental way on a weak electron correlations that exist in graphene.

  7. Transcatheter treatment of 'complex' malfunction of tricuspid valve prosthesis.

    PubMed

    Santoro, Giuseppe; Scognamiglio, Giancarlo; Palladino, Maria T; Mahmoud, Heba T; Russo, Maria G

    2017-01-23

    A 45-year-old man with Ebstein anomaly of the tricuspid valve, previously submitted for tricuspid valve replacement and plication of the atrialized part of the right ventricle, was referred because of signs of increased systemic venous pressure and low output symptoms. Clinical picture was due to severe prosthetic valve stenosis and significant paravalvular regurgitation across an aneurismal dilatation of the atrialized right ventricle. A combined transcatheter approach by Melody valve implantation and Amplatzer Vascular Plug occlusion of the paravalvular leak completely relieved the hemodynamic and clinical findings.

  8. [Parodontocid efficiency in complex treatment and prevention of gingivitis].

    PubMed

    Makeeva, I M; Turkina, A Iu; Poliakova, M A; Babina, K S

    2013-01-01

    Antiplaque/antigingivitis effect of an alcohol-free mouthrinse Parodontocid were evaluated by randomized parallel group clinical trial. Sixty patients with gingivitis were clinically examined to determine PHP, RMNPI and PMA indexes. After professional dental prophylaxis, subjects were randomly assigned in two groups to 10 days oral hygiene program. Group 1 patients used only toothbrush and prophylactic toothpaste while in group 2 persons used Parodontocid in conjunction with normal brushing and flossing.Parodontocid significantly reduced plaque and gingivitis compared to negative control.

  9. [Vacuum-therapy in complex treatment of epithelial coccygeal course].

    PubMed

    Cherkasov, M F; Galashokyan, K M; Startsev, Yu M; Cherkasov, D M; Melikova, S G

    2017-01-01

    Цель — анализ результатов лечения больных с эпителиальным копчиковым ходом (ЭКХ) с применением оригинального способа вакуум-терапии. Материал и методы. В исследование включен 61 пациент с ЭКХ. Больные разделены на три группы: 22 пациентам после иссечения ЭКХ выполнено первичное закрытие раны швами по Донати, у 19 больных после иссечения ЭКХ рана оставлена открытой, применялось лечение мазевыми повязками, у 20 пациентов проводилась вакуум-терапия открытой раны. Результаты. При первичном закрытии раны длительность госпитализации составила 11±1,9 дня (от 3 до 20 дней, Ме=11 дней), время полного заживления раны — 14,9±4,9 дня (от 8 до 49 дней, Ме=12,5 дня), осложнения в ближайшем послеоперационном периоде возникли у 5 (22,7%) пациентов, рецидив заболевания отмечен у 3 (13,6%). В группе лечения раны мазевыми повязками длительность госпитализации составила 13,7±2,6 дня (от 3 до 25 дней, Ме=15 дней), время полного заживления раны — 74±5,7 дня (от 35 до 112, Ме=57,0 дня), осложнения в послеоперационном периоде возникли у 2 (10,5%) пациентов, рецидив — у 1 (5,3%). При вакуум-терапии длительность госпитализации составила 13,9±2,3 дня (от 5 до 24 дней, Ме=15 дней), время полного заживления раны — 31,1±2,7 дня (от 15 до 39 дней, Ме=31,0 дня), осложнений и рецидивов заболевания отмечено не было. Вывод. Использование вакуум-терапии позволяет улучшить результаты хирургического лечения по сравнению с традиционными методами лечения.

  10. [Chondroprotectors in complex treatment of internal TMJ disorders].

    PubMed

    Sulimov, A F; Fel'ker, V V

    2015-01-01

    The article presents a detailed analysis of the clinical studies on the use of chondroprotector (Alflutop) in patients with persistent displacement of the articular disk of the temporomandibular joint in order to prevent the development of secondary osteoarthrosis. The study showed that the inclusion in the therapy chondroprotective action agents allows achieving short-term positive outcomes in most cases, relief of inflammation and pain, as well as improving joint function and stabilization of the thickness of the articular cartilage that provides cushioning function.

  11. Peripheral neuropathy: evidence-based treatment of a complex disorder.

    PubMed

    Hammersla, Margaret; Kapustin, Jane Faith

    2012-05-11

    Peripheral neuropathy (PN) is a common and often progressive condition frequently seen in primary care. The chronic pain associated with PN, or neuropathic pain, can significantly diminish patients' quality of life and be challenging to treat.

  12. Alanine water complexes.

    PubMed

    Vaquero, Vanesa; Sanz, M Eugenia; Peña, Isabel; Mata, Santiago; Cabezas, Carlos; López, Juan C; Alonso, José L

    2014-04-10

    Two complexes of alanine with water, alanine-(H2O)n (n = 1,2), have been generated by laser ablation of the amino acid in a supersonic jet containing water vapor and characterized using Fourier transform microwave spectroscopy. In the observed complexes, water molecules bind to the carboxylic group of alanine acting as both proton donors and acceptors. In alanine-H2O, the water molecule establishes two intermolecular hydrogen bonds forming a six-membered cycle, while in alanine-(H2O)2 the two water molecules establish three hydrogen bonds forming an eight-membered ring. In both complexes, the amino acid moiety is in its neutral form and shows the conformation observed to be the most stable for the bare molecule. The microsolvation study of alanine-(H2O)n (n = 1,2) can be taken as a first step toward understanding bulk properties at a microscopic level.

  13. The complex pendulum

    NASA Astrophysics Data System (ADS)

    Bender, Carl M.

    1998-12-01

    In this talk we propose to broaden the conventional notion of quantum mechanics. In conventional quantum mechanics one imposes the condition H†=H, where † represents complex conjugation and matrix transpose, to ensure that the Hamiltonian has a real spectrum. Replacing this mathematical condition by the weaker and more physical requirement H‡=H, where ‡=PT represents combined parity reflection and time reversal, one obtains new infinite classes of complex Hamiltonians whose spectra are also real and positive. These PT-symmetric theories may be viewed as analytic continuations of conventional theories from real to complex phase space. This talk describes the unusual classical and quantum properties of PT-symmetric quantum mechanical and quantum field theoretic models.

  14. The complex pendulum

    NASA Astrophysics Data System (ADS)

    Bender, Carl M.

    1999-07-01

    This talk proposes a generalization of conventional quantum mechanics. In conventional quantum mechanics one imposes the condition H †=H , where † represents complex conjugation and matrix transpose, to ensure that the Hamiltonian has a real spectrum. By replacing this mathematical condition with the weaker and more physical requirement H ‡=H , where ‡= PT represents combined parity reflection and time reversal, one obtains new infinite classes of complex Hamiltonians whose spectra are also real and positive. These PT-symmetric theories may be viewed as analytic continuations of conventional theories from real to complex-phase space. This talk describes the unusual classical and quantum properties of PT-symmetric quantum-mechanical and quantum-field-theoretic models.

  15. Nonergodic complexity management

    NASA Astrophysics Data System (ADS)

    Piccinini, Nicola; Lambert, David; West, Bruce J.; Bologna, Mauro; Grigolini, Paolo

    2016-06-01

    Linear response theory, the backbone of nonequilibrium statistical physics, has recently been extended to explain how and why nonergodic renewal processes are insensitive to simple perturbations, such as in habituation. It was established that a permanent correlation results between an external stimulus and the response of a complex system generating nonergodic renewal processes, when the stimulus is a similar nonergodic process. This is the principle of complexity management, whose proof relies on ensemble distribution functions. Herein we extend the proof to the nonergodic case using time averages and a single time series, hence making it usable in real life situations where ensemble averages cannot be performed because of the very nature of the complex systems being studied.

  16. Synchronization in complex networks

    SciTech Connect

    Arenas, A.; Diaz-Guilera, A.; Moreno, Y.; Zhou, C.; Kurths, J.

    2007-12-12

    Synchronization processes in populations of locally interacting elements are in the focus of intense research in physical, biological, chemical, technological and social systems. The many efforts devoted to understand synchronization phenomena in natural systems take now advantage of the recent theory of complex networks. In this review, we report the advances in the comprehension of synchronization phenomena when oscillating elements are constrained to interact in a complex network topology. We also overview the new emergent features coming out from the interplay between the structure and the function of the underlying pattern of connections. Extensive numerical work as well as analytical approaches to the problem are presented. Finally, we review several applications of synchronization in complex networks to different disciplines: biological systems and neuroscience, engineering and computer science, and economy and social sciences.

  17. Engineering complex tissues.

    PubMed

    Atala, Anthony; Kasper, F Kurtis; Mikos, Antonios G

    2012-11-14

    Tissue engineering has emerged at the intersection of numerous disciplines to meet a global clinical need for technologies to promote the regeneration of functional living tissues and organs. The complexity of many tissues and organs, coupled with confounding factors that may be associated with the injury or disease underlying the need for repair, is a challenge to traditional engineering approaches. Biomaterials, cells, and other factors are needed to design these constructs, but not all tissues are created equal. Flat tissues (skin); tubular structures (urethra); hollow, nontubular, viscus organs (vagina); and complex solid organs (liver) all present unique challenges in tissue engineering. This review highlights advances in tissue engineering technologies to enable regeneration of complex tissues and organs and to discuss how such innovative, engineered tissues can affect the clinic.

  18. Viral quasispecies complexity measures.

    PubMed

    Gregori, Josep; Perales, Celia; Rodriguez-Frias, Francisco; Esteban, Juan I; Quer, Josep; Domingo, Esteban

    2016-06-01

    Mutant spectrum dynamics (changes in the related mutants that compose viral populations) has a decisive impact on virus behavior. The several platforms of next generation sequencing (NGS) to study viral quasispecies offer a magnifying glass to study viral quasispecies complexity. Several parameters are available to quantify the complexity of mutant spectra, but they have limitations. Here we critically evaluate the information provided by several population diversity indices, and we propose the introduction of some new ones used in ecology. In particular we make a distinction between incidence, abundance and function measures of viral quasispecies composition. We suggest a multidimensional approach (complementary information contributed by adequately chosen indices), propose some guidelines, and illustrate the use of indices with a simple example. We apply the indices to three clinical samples of hepatitis C virus that display different population heterogeneity. Areas of virus biology in which population complexity plays a role are discussed.

  19. Planning Complex Projects Automatically

    NASA Technical Reports Server (NTRS)

    Henke, Andrea L.; Stottler, Richard H.; Maher, Timothy P.

    1995-01-01

    Automated Manifest Planner (AMP) computer program applies combination of artificial-intelligence techniques to assist both expert and novice planners, reducing planning time by orders of magnitude. Gives planners flexibility to modify plans and constraints easily, without need for programming expertise. Developed specifically for planning space shuttle missions 5 to 10 years ahead, with modifications, applicable in general to planning other complex projects requiring scheduling of activities depending on other activities and/or timely allocation of resources. Adaptable to variety of complex scheduling problems in manufacturing, transportation, business, architecture, and construction.

  20. Complexity and Animal Models

    DTIC Science & Technology

    2015-01-01

    SEP 2015 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Complexity and animal models 5a. CONTRACT NUMBER 5b. GRANT NUMBER...decrease W/Wmax, thereby maintaining the relationship between variability and W/Wmax. doi:10.1016/j.jcrc.2010.05.012 Complexity and animal models...may not be possible during mass casualty and natural disaster situations or may need to be postponed during combat to avoid danger to the medic’s life

  1. Universality classes of complexity

    NASA Astrophysics Data System (ADS)

    Saakian, David B.

    We give several criteria of complexity and define different universality classes. According to our classification, at the lowest class of complexity are random graph, Markov Models and Hidden Markov Models. At the next level is Sherrington-Kirkpatrick spin glass, connected with neuron-network models. On a higher level are critical theories, spin glass phase of Random Energy Model, percolation, self organized criticality (SOC). The top level class involves HOT design, error threshold in optimal coding, language, and, maybe, financial market. Alive systems are also related with the last class.

  2. The ESCRT Complexes

    PubMed Central

    Hurley, James H.

    2010-01-01

    The ESCRT machinery consists of the peripheral membrane protein complexes, ESCRT-0, -I, -II, -III, and Vps4-Vta1, and the ALIX homodimer. The ESCRT system is required for degradation of unneeded or dangerous plasma membrane proteins; biogenesis of the lysosome and the yeast vacuole; the budding of most membrane enveloped viruses; the membrane abscission step in cytokinesis; macroautophagy; and several other processes. From their initial discovery in 2001-2002, the literature on ESCRTs has grown exponentially. This review will describe the structure and function of the six complexes noted above and summarizes current knowledge of their mechanistic roles in cellular pathways and in disease. PMID:20653365

  3. Luminescent macrocyclic lanthanide complexes

    DOEpatents

    Raymond, Kenneth N [Berkeley, CA; Corneillie, Todd M [Campbell, CA; Xu, Jide [Berkeley, CA

    2012-05-08

    The present invention provides a novel class of macrocyclic compounds as well as complexes formed between a metal (e.g., lanthanide) ion and the compounds of the invention. Preferred complexes exhibit high stability as well as high quantum yields of lanthanide ion luminescence in aqueous media without the need for secondary activating agents. Preferred compounds incorporate hydroxy-isophthalamide moieties within their macrocyclic structure and are characterized by surprisingly low, non-specific binding to a variety of polypeptides such as antibodies and proteins as well as high kinetic stability. These characteristics distinguish them from known, open-structured ligands.

  4. The Corona Australis Complex.

    NASA Astrophysics Data System (ADS)

    Vaile, Roberta Anne

    What began as a HI study of the CrA star formation region has grown to incorporate the following: (1) a detailed investigation of the HI content of the CrA dark cloud; (2) an extensive molecular survey of the CrA dark cloud, from which the CrA molecular abundances were determined and compared to those of other Galactic environments; (3) an extensive HI survey of the CrA complex, which was compared to the established Galactic distributions in and near the region; (4) an examination of the extent and nature of the CrA IVCs, components of gas at intermediate, anomalous velocities; (5) an investigation of the correlations which may exist between the features of the CrA region; and (6) an evaluation of where the CrA complex fits within the framework of our understanding of the Galaxy. A review of our perceptions of the Galactic structure is contained in Chapter I. The established state of knowledge of the CrA dark cloud region--chiefly, that of a region of young and on-going star formation--is given in Chapter II. The observational studies of the CrA dark cloud region specifically are presented in Chapter III. The HI survey of the CrA complex is presented in Chapter IV, with the CrA IVCs results presented in Chapter V. A comparison of the CrA HI structure with nearby Galactic features suggests that the CrA complex--exemplified by the T_ {rm A} morphology given as a frontispiece and in Figure 4.1--is a coherently -moving HI structure falling subject to the Rayleigh-Taylor, Kelvin-Helmholtz, flute and Parker hydrodynamic and magnetohydrodynamic instabilities under the Galactic gravitational and differential rotation forces. As the distance to the CrA IVCs still remains speculative, no definitive identity for the CrA IVCs was established. Considering the whole, the CrA complex was interpreted as a feature triggered by the Sco-Cen association, possibly a late-comer to the Lindblad Ring and possibly a result of the Tau-Gem events. The similarities with the Oph northern

  5. Complexity and Fly Swarms

    NASA Astrophysics Data System (ADS)

    Cates, Grant; Murray, Joelle

    Complexity is the study of phenomena that emerge from a collection of interacting objects and arises in many systems throughout physics, biology, finance, economics and more. Certain kinds of complex systems can be described by self-organized criticality (SOC). An SOC system is one that is internally driven towards some critical state. Recent experimental work suggests scaling behavior of fly swarms-one of the hallmarks of an SOC system. Our goal is to look for SOC behavior in computational models of fly swarms.

  6. Luminescent macrocyclic lanthanide complexes

    DOEpatents

    Raymond, Kenneth N; Corneillie, Todd M; Xu, Jide

    2014-05-20

    The present invention provides a novel class of macrocyclic compounds as well as complexes formed between a metal (e.g., lanthanide) ion and the compounds of the invention. Preferred complexes exhibit high stability as well as high quantum yields of lanthanide ion luminescence in aqueous media without the need for secondary activating agents. Preferred compounds incorporate hydroxy-isophthalamide moieties within their macrocyclic structure and are characterized by surprisingly low, non-specific binding to a variety of polypeptides such as antibodies and proteins as well as high kinetic stability. These characteristics distinguish them from known, open-structured ligands.

  7. Tuberous Sclerosis Complex: Perioperative Considerations

    PubMed Central

    Rabito, Matthew J.; Kaye, Alan David

    2014-01-01

    Background Tuberous sclerosis complex (TSC), also known as Bourneville disease, is an inherited, progressive neurocutaneous disorder characterized by the potential for hamartoma formation throughout the body. TSC is an autosomal dominant genetic disorder, but more than two-thirds of cases are sporadic. Methods Clinical manifestations and treatment options are discussed. Both surgical and anesthetic perioperative considerations are described in this review. Results Routine monitoring is appropriate for minor surgical procedures for patients with TSC who have mild disease manifestations. More extensive monitoring is indicated for major procedures that have the potential for significant blood loss and for patients with more severe pathology. Postoperatively, TSC patients should be admitted for monitoring and treatment after more extensive procedures or if significant organ dysfunction occurs. Postoperative complications, which may be related to either the surgery or the TSC pathology itself, may have origins in many different organs and may include seizures, severe hypertension, and bradyarrhythmias. Conclusion TSC is a rare disease with a highly variable clinical presentation and provides a multitude of challenges for the patient, the family, and the healthcare team. PMID:24940133

  8. Salen complexes with dianionic counterions

    DOEpatents

    Job, Gabriel E.; Farmer, Jay J.; Cherian, Anna E.

    2016-08-02

    The present invention describes metal salen complexes having dianionic counterions. Such complexes can be readily precipitated and provide an economical method for the purification and isolation of the complexes, and are useful to prepare novel polymer compositions.

  9. Graphical Representation of Complex Functions.

    ERIC Educational Resources Information Center

    Renka, Robert J.

    1988-01-01

    Describes methods and software for graphing representation of a complex function of a complex variable. Includes an application of a graphical interpretation of the complex zeros of the cubic and their properties. (PK)

  10. Base-induced dehydrogenation of ruthenium hydrazine complexes.

    PubMed

    Field, Leslie D; Li, Hsiu L; Dalgarno, Scott J; McIntosh, Ruaraidh D

    2013-02-04

    Treatment of [RuCl(PP(3)(iPr))](+)Cl(-) (PP(3)(iPr) = P(CH(2)CH(2)P(i)Pr(2))(3)) with hydrazine, phenylhydrazine, and methylhydrazine afforded side-on bound hydrazine complexes [RuCl(η(2)-H(2)N-NH(2))(η(3)-PP(3)(iPr))](+), [RuCl(η(2)-H(2)N-NHPh)(η(3)-PP(3)(iPr))](+), and [RuCl(η(2)-H(2)N-NHMe)(η(3)-PP(3)(iPr))](+). The analogous reactions of [RuCl(2)(PP(3)(Ph))] (PP(3)(Ph) = P(CH(2)CH(2)PPh(2))(3)) with hydrazine, phenylhydrazine, and methylhydrazine afforded end-on bound hydrazine complexes [RuCl(η(1)-H(2)N-NH(2))(PP(3)(Ph))](+), [RuCl(η(1)-H(2)N-NHPh)(PP(3)(Ph))](+), and [RuCl(η(1)-H(2)N-NHMe)(PP(3)(Ph))](+). Treatment of parent hydrazine complex [RuCl(N(2)H(4))(PP(3)(iPr))](+) with strong base afforded the dinitrogen and dihydride complexes [Ru(N(2))(PP(3)(iPr))] and [RuH(2)(PP(3)(iPr))]. Treatment of phenylhydrazine complex [RuCl(NH(2)NHPh)(PP(3)(iPr))](+) with strong base afforded the hydrido ruthenaindazole complex [RuH(η(2)-NH═NC(6)H(4))(η(3)-PP(3)(iPr))] while similar treatment of methylhydrazine complex [RuCl(NH(2)NHMe)(PP(3)(iPr))](+) afforded the hydrido methylenehydrazide complex [RuH(NHN═CH(2))(PP(3)(iPr))]. Treatment of the hydrazine complexes [RuCl(NH(2)NHR)(PP(3)(Ph))](+) (R = H, Ph, Me) with strong base afforded the dinitrogen complex [Ru(N(2))(PP(3)(Ph))].

  11. Sewage Treatment

    NASA Technical Reports Server (NTRS)

    1976-01-01

    A million gallon-a-day sewage treatment plant in Huntington Beach, CA converts solid sewage to activated carbon which then treats incoming waste water. The plant is scaled up 100 times from a mobile unit NASA installed a year ago; another 100-fold scale-up will be required if technique is employed for widespread urban sewage treatment. This unique sewage-plant employed a serendipitous outgrowth of a need to manufacture activated carbon for rocket engine insulation. The process already exceeds new Environmental Protection Agency Standards Capital costs by 25% compared with conventional secondary treatment plants.

  12. Polymeric complexes of isonicotinic acid hydrazide with antituberculosis effects.

    PubMed

    Slivkin, A I; Lapenko, V L; Bychuk, A I; Suslina, S N; Slivkin, D A; Kornienko, S V; Belenova, A S

    2013-10-01

    We studied the effects of an analogue of isonicotinic acid hydrazide on the treatment course of experimental tuberculosis. Complex analysis has demonstrated the efficiency of isonicotinic acid hydrazide immobilized on a carrier that consisted of water-soluble cation-active analogue of chitosan (N-chlorohydroxypropyl chitosan) in a complex with cobalt ions in the therapy of experimental tuberculosis. Immunostimulating activity of the polymeric metal complex was revealed. The obtained data can be used for the development of highly effective methods for tuberculosis treatment.

  13. Surface complexation modeling

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Adsorption-desorption reactions are important processes that affect the transport of contaminants in the environment. Surface complexation models are chemical models that can account for the effects of variable chemical conditions, such as pH, on adsorption reactions. These models define specific ...

  14. Complexity in Cultural Identity

    ERIC Educational Resources Information Center

    Holliday, Adrian

    2010-01-01

    Despite their diverse national backgrounds, 28 interviewees speak similarly about the complexity of the cultural realities with which they live, and refuse to be pinned down to specific cultural types. While nation is of great importance, unless personally inspiring, it tends to be an external force which is in conflict with a wide variety of…

  15. Coordination Complexes of Cobalt.

    ERIC Educational Resources Information Center

    Williams, Gregory M.; And Others

    1989-01-01

    Described is an experiment involving the synthesis and spectral studies of cobalt complexes that not only give general chemistry students an introduction to inorganic synthesis but allows them to conduct a systematic study on the effect of different ligands on absorption spectra. Background information, procedures, and experimental results are…

  16. Complex Digital Visual Systems

    ERIC Educational Resources Information Center

    Sweeny, Robert W.

    2013-01-01

    This article identifies possibilities for data visualization as art educational research practice. The author presents an analysis of the relationship between works of art and digital visual culture, employing aspects of network analysis drawn from the work of Barabási, Newman, and Watts (2006) and Castells (1994). Describing complex network…

  17. Hydridomethyl iridium complex

    SciTech Connect

    Bergman, R.G; Buchanan, J.M.; Stryker, J.M.; Wax, M.J.

    1989-07-18

    This patent describes a hydridomethyl complex of the formula: CpIr(P(R{sub 1}){sub 3})HMe. Cp represents a cyclopentadienyl or alkyl cyclopentadienyl radical; Ir represents an iridium atom; P represents a phosphorus atom; R{sub 1} represents an alkyl group; and Me represents a methyl group.

  18. Complexity, Systems, and Software

    DTIC Science & Technology

    2014-08-14

    2014 Carnegie Mellon University Complexity, Systems, and Software Software Engineering Institute Carnegie Mellon University Pittsburgh, PA...NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Software Engineering Institute Carnegie Mellon University Pittsburgh, PA 15213 8...for the operation of the Software Engineering Institute, a federally funded research and development center sponsored by the United States

  19. Subelliptic Estimates for Complexes

    PubMed Central

    Guillemin, Victor; Sternberg, Shlomo

    1970-01-01

    New results are announced linking properties of the symbol module and characteristic variety of a differential complex with test estimates near the characteristic variety of the type considered by Hörmander (½-estimate). The first result is the invariance of the test estimates under pseudo-differential change of coordinates, and this leads to the introduction of a normal form for the complex in the neighborhood of a Cohen-MacCauley point of the symbol module. If the characteristic variety V is a manifold near the Cohen-MacCauley point (x0,ζ0) with parametrizing functions p1,...,pq, where q is the codimension of the characteristic variety in the complexified contangent bundle, the matrix [Formula: see text] of Poisson brackets defines invariantly a Hermitian form Q on the normal space to V at (x0,ζ0) when the dpζ(x0,ζ0) are used as basis, and the test estimates are satisfied at the ith stage of the complex if sig. Q (signature of Q) is ≥ n - i + 1 (n the dimension of the base manifold) or rank Q - sig. Q ≥ i + 1. Finally, conditions are given in order that, on a manifold with smooth boundary, the associated boundary complexes satisfy the ½-estimate. PMID:16591855

  20. Restricting Grammatical Complexity

    ERIC Educational Resources Information Center

    Frank, Robert

    2004-01-01

    Theories of natural language syntax often characterize grammatical knowledge as a form of abstract computation. This paper argues that such a characterization is correct, and that fundamental properties of grammar can and should be understood in terms of restrictions on the complexity of possible grammatical computation, when defined in terms of…